Preventing colorectal cancer

Colorectal cancer, otherwise known as bowel cancer, is the third most common cancer. In 40% of cases, it occurs in the colon, also known as the large intestine, and in 60% of cases in the rectum, located in the latter end of the large intestine. This type of cancer generally affects people over the age of fifty. Disregarding age, the main sources for the emergence of bowel cancer are:

• lifestyle,
• the presence of a benign colorectal tumor (polyp or adenoma),
• genetic predisposition,
• if you are a carrier of inflammatory bowel disease.

Colorectal cancer develops slowly.
It originates in the emergence of polyps in the lining of the colon. Polyps may be benign, but after a few years they become enlarged and develop into a malignant tumor. This can often result in imperceptible bleeding. When the cancer is at an advanced stage, it may spread to lymph nodes, then the liver, ultimately spreading
throughout the body in the form of metastases.

In addition to genetic predisposition and the factors stated above, daily habits may contribute to the development of colorectal cancer, in particular:

• smoking or a high level of alcohol consumption,
• obesity,
• excessive consumption of red meat and cold meats,
• a lack of physical activity.

Some signs may be indicative of the emergence of colorectal cancer:

• long-term changes to bowel movements (constipation or diarrhea),
• blood in stools,
• intestinal problems (cramps, pain, gas),
• a constant need to defecate,
• prolonged tiredness,
• unexplained weight loss.

Colorectal cancer can be treated more effectively if detected early.
If you are aged between 50 and 75, it is recommended that you conduct a screening test.
This test is a means of looking for traces of blood in the stools. Several types of tests exist. The most recent test is simple and accurate, you do it at home by following the instructions that come with the kit. It is called a fecal immunochemical test in english. If the test comes back positive (in 4-5% of cases), your doctor will recommend that you undergo a colonoscopy.

In addition, if you find out that any family members (ascendants or descendants) have polyps or bowel cancer, you must ask your doctor to refer you to a gastroenterologist, who will conduct a screening colonoscopy.

What is a colonoscopy?
A colonoscopy is an examination which is uncomfortable but not painful, which explores the entire internal lining of the colon. This test requires a preparation which must be followed to the letter in the days preceding it, based on a specific diet and, the day before, the ingestion of several liters of bowel preparation (4 liters), which will flush out all fecal matter.
Any polyps or adenomas found will be removed during the colonoscopy.

Different types of treatment can be recommended to limit the development of colorectal cancer.

Surgery
At an early stage of the disease, surgery is limited to removing polyps during the colonoscopy, but if cancer is diagnosed when there is a tumor, surgery will involve removing a section of the colon.
Following surgery, you will be advised to adopt a specific diet.

Radiotherapy and chemotherapy
Further treatment will depend on the stage of the cancer and any local extensions.
If the tumor does not go beyond the last layers of the colon, surgery is generally considered to be sufficient. If, on the other hand, the disease has spread, for example affecting the lymph nodes, radiotherapy or chemotherapy treatment would be deemed necessary.

Some preventive measures can help to prevent colorectal cancer:

• eat fruit and vegetables: 5 portions spread across the meals of the day,
• limit how much red and cold meat you eat,
• do not smoke and limit your alcohol consumption,
• engage in regular physical activity,
• keep your BmI (Body mass Index) within the normal range.

If colorectal cancer is detected early through screening, it can be cured in nine out of ten cases. screening is recommended for men and women aged between 50 and 74.

If you have questions upon receiving colonoscopy results, MSH International provides a medical second opinion network which acts to confirm or negate a diagnosis which may be worrying. Your contact in the network will also advise you on the most appropriate course of treatment.

MSH International will also help you to find the best specialist in the region where you have opted to undergo treatment.