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December 14, 2019
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March is colorectal cancer awareness month

By: George Malkemus
March 22, 2019

Colorectal cancer is one of the most easily prevented cancers if discovered early through a colonoscopy. 

I can speak personally to the importance of being tested for colorectal cancer.  It has been fourteen years since I was found to have colorectal cancer. In 2005, the cancer was detected during a colonoscopy.   I am doing great with no reoccurrence after undergoing chemotherapy, radiation and surgery in 2005 and 2006.  I am very lucky and happy to be alive. 

Living a healthy life reduces the statistical chance of getting colon cancer, but it can still occur.  I did not have any cancer risk factors, and yet I got colorectal cancer.  I don’t smoke, I am not obese, I eat healthy, I drink in moderation and I exercise daily.  So early detection is necessary for everyone.  And a screening colonoscopy should be done right away, if you have any changes in bowel habits, such as stomach discomfort, excess gas, bloody stools, and/or unexplained weight loss.

Colorectal cancer in the U.S.

Colorectal cancer is the third leading cause of cancer deaths in the United States. Each year, there are about 50,000 deaths from colorectal cancer and about 150,000 new cases detected. The lifetime risk of developing colorectal cancer is about 5 percent, 1 in 20. The risk is slightly higher in men than women. 

Younger adults can develop colorectal cancer, but the chances increase dramatically after age 55: about seven out of 10 people diagnosed with colorectal cancer are over 55 years old. However, a recent study has showed a sharp increase in rate on colon and rectal cancer in younger age groups.  Over the last 20 years the colon cancer rates have increased between 1 and 2 percent per year for Americans in their 20s and 30s.  Rectal cancer rates have increased 3 percent per year in the 20-30-year age group and 2 percent annually for those ages 40 to 54. This is a dramatic increase in younger patients.  Three in ten cases of rectal cancer are now diagnosed in patients younger than 55, which is double the proportion from 1990.  Meanwhile, rectal cancer rates in Americans ages 55 and older have continually dropped over the last 40 years, due to an increase in preventive colonoscopies in adults over 50. 

The increased rate of colorectal cancer in younger individuals is thought to be due to a combination of more sedentary life, less exercise, poorer diet with less fiber and more sugar with an increase in obesity and more toxins in the environment.  Age 50 has been the recommended age for having one’s first colonoscopy by the medical community, but younger is probably better, especially if there is a family history of colorectal cancer or risk factors involved. 

Colonoscopy

The colorectal cancer develops from polyps that can be easily removed at the pre-cancerous stage if they are detected early with a colonoscopy. Colon polyps are fleshy growths or bumps that occur on the inside lining of the colon.  Polyps in the colon are extremely common.  Polyps are found in over 50 percent of the people undergoing a colonoscopy.  Polyps are slow growing and are easily removed during the colonoscopy procedure.   

I could have avoided my stressful, involved treatment if I had been tested earlier.  Since the original diagnosis, I have had eight weeks of radiation and chemotherapy, two colorectal surgeries, 11 colonoscopies, and eight PET scans.  I should have been checked at age 50, but I put it off to age 55, since I figured that I was in such good health and that it couldn’t happen to me.

In the last few years, death rates from colorectal cancer are down, partly due to improved treatments, but mostly from early detection in patients over 50. The crusade to increase awareness of the importance of testing has had a major impact in reducing colorectal cancer through early detection.   There is over a 90 percent cure rate when colorectal cancer is detected early.    

However, sadly, only a small percentage of the people who would benefit from a colorectal screening proceed with the testing. There are several weak reasons that people don’t get the colorectal screenings. People say they are inconvenient, that the preparation prior to the test can be unpleasant and many simply don’t understand the importance of regular colon screenings. The fact remains: regular colorectal screening for both men and women is the best way to monitor colon health and to catch any problems early.

After initially being reluctant to do the procedure, I have not found the colonoscopy uncomfortable and I have had the procedure eleven times. A colonoscopy entails taking a video of the rectum and colon in order to look for abnormalities and polyps. Any polyps found are removed and then biopsied to determine whether the polyps are cancerous.  

The video exploration of the colon is interesting to me, actually looking at my insides on screen.  The video is somewhat similar to the video camera that I use for dental examinations in my office, letting the patient look at their mouth on the big screen and being involved in treatment decisions.  The worst part for me is the drinking of the preparation to clean oneself out, but that is a small price to pay for avoiding colon cancer.

Two-thirds of the people who get colon cancer have no family history of the disease.  In my case, no one in my family history had colon cancer.  If you have a parent, brother, sister, or child who has had colon cancer, then early testing is even more important for you.  I encourage everyone to get a colonoscopy by age 50, and much earlier if there is a family history of colorectal cancer.

Colon cancer is a silent killer; it can be growing for many years with no symptoms. At age 55, just a few months after minor symptoms began, my cancer was detected at an advanced stage, stage three; it had already begun to spread, detected in two lymph nodes. When I was diagnosed, I was in great health, I had no risk factors and I had no family history of colon problems; it was quite a shock. My cancer had been there for at least two years.  If detected early, colon cancer is easy to successfully treat.  If you wait like I did, treatment becomes much more involved, the results are much less predictable and the survival rates are much reduced.  However, I am one of the lucky ones to have survived.

Prevention of cancer

Obesity, lack of exercise, heavy alcohol use and smoking are associated with colorectal cancer.  Diet that is high in red meat is also associated with polyp formation and colorectal cancer. Lifestyle modifications  include reducing red meat and dietary fat, increasing fiber, ensuring adequate vitamin intake, losing weight and regular exercise can reduce the risk of cancer.  Fiber plays a protective role in the colon by adding bulk and easing the passage of the stool.  This keeps the waste moving through the colon and passes toxins through the body.  A diet with at least 10 grams of fiber per day is recommended with an ideal goal of 25 to 35 grams per day.  

If you haven’t had a colon screening or feel you are due to have one, talk to your doctor and get yours scheduled today. It may save your life.  I know it saved mine!

ENJOY LIFE AND KEEP SMILING!

George Malkemus has a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@ malkemusdds.com.  Visit Dr. Malkemus’ Web site at http://www.malkemusdds.com