A: Screening for colorectal cancer is in its early stages. Not all doctors screen for colorectal cancer, or some patients may be reluctant to go for testing. This is unfortunate because widespread screening could save up to 30,000 lives each year. Colorectal cancer is the second leading cause of cancer death in the

Q: Do most people who develop colon cancer have risk factors for the disease?

A: Any person is at risk for colorectal cancer. Most people are in their 60’s and 70’s when diagnosed. Therefore age is a risk factor for this disease. Only one in five have other risk factors for the disease, such as family history of colorectal cancer.

Q: How can you tell whether stomach distress comes from colon cancer or a less serious disease?

A: Less serious diseases such as irritable bowel syndrome, ulcerative colitis or even the flu may cause digestive symptoms and bowel changes that are similar to those of colorectal cancer. If you are concerned about bowel or digestive symptoms, seek medical advice as soon as possible. The only way to know if the condition is caused by cancer is to undergo testing.

Q: Don’t hemorrhoids, not colon cancer, cause rectal bleeding usually?

A: True, hemorrhoids are a common cause of rectal bleeding. But a symptom of colorectal cancer is bright red blood in the stool. So rectal bleeding should not be dismissed as unimportant and should be investigated as to the specific cause.

Q: How does a person’s digestive system function if a large part of the intestine is removed during surgery?

A: The digestive system of most people functions very well after surgery. The small intestine is about 20 feet; the large intestine is about five feet long. People are able to live quite normally without a portion of the small intestine and all of the large intestine. Most digestion takes place before food reaches the colon; therefore, most people function as well as they did before the surgery. The most common change after removal of a portion of the colon is an increased frequency of bowel evacuations.

Q: Do most people who undergo colon cancer surgery have to wear a colostomy bag?

A: No. Recent improvements in surgical techniques have reduced the chances of needing a colostomy bag. And if a colostomy is needed, it is usually not permanent. The procedure may be reversed after the intestines have had the opportunity to recovery from the surgery. In a small number of cases a colostomy may be permanent. But, even in these cases, people become accustomed to a colostomy bag worn inside their clothing for the collection and elimination of waste.

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A team at the University of california, san diego found that the hormone leptin triggered increased growth in human colon cancer cells.

Obese people are up to three times more likely to develop colorectal cancer.

Other researchers have already found that some colon cancer cells appear to be set up to respond to leptin, with “receptors” for the chemical on their surfaces.

The more fat cells a person has, the more leptin will be in their bloodstream.

The san diego team wanted to find further evidence of the link by watching what happened to human cancer cells exposed to the hormone.

In a laboratory, they added the hormone to different varieties of cancer cell.

Growth was stimulated in all the cell lines - and in two out of three tested, the hormone also hampered the usual process of programmed death that allows the body to replace normal cells, but which often malfunctions in cancers.

Dr Kim Barrett, who led the research, said: “These results may explain why obesity increases a person’s risk of colonic cancer.

“The fact we have shown how leptin stimulates these cells means that drug companies may be in a better position to develop new treatments against the disease.”

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Scott M. Stanzel, a White House spokesman, said the polyps were not deemed worrisome on visual inspection by a team of doctors from the National naval medical center, who performed the procedure in

Mr. Stanzel said there would be a 48- to 72-hour wait for the results. He described the polyps as less than a centimeter in diameter each.The use of a sedative during the colonoscopy necessitated the transfer of power to Mr. Cheney. President Bush’s physician, Dr. Richard Tubb, oversaw the exam.It was the second cancer screening of Mr. Bush’s presidency. During the first, in 2002, Mr. Bush also transferred his presidential powers to Mr. Cheney.

That year, doctors found no polyps. But doctors did find and remove benign polyps from Mr. Bush’s colon during exams in 1998 and 1999, when he was the governor of  Texas.

The polyps were of a type called adenomatous, which arise out of glandular tissue. In such cases, doctors recommend follow-up examinations every few years to search for new polyps and to check for smaller polyps that may have escaped notice in earlier colonoscopies.Mr. Stanzel said the temporary transfer of Mr. Bush’s powers to Mr. Cheney began at 7:16 a.m. The procedure began shortly thereafter and concluded at 7:44 a.m. The president resumed power at 9:21 a.m.

Before the screening, Mr. Bush sent a letter to the House speaker, Nancy Pelosi, Democrat of California, and the president pro tem of the Senate, Senator Robert C. Byrd, Democrat of West Virginia, in which he invoked Section 3 of the 25th Amendment of the Constitution in transferring power to Mr. Cheney. Afterward, he sent another letter declaring, “I am presently able to resume the discharge of the constitutional powers and duties of the office of the president of the United States.” Mr. Stanzel said Mr. Bush was in “good humor” and planned to take a bicycle ride later in the day.

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“This study underscores the need to include more berries in the diet, especially blueberries,” said study leader Bandaru Reddy, Ph.D., a professor in the chemical biology department at Rutgers. Although the blueberry compound won’t cure colon cancer, it represents a strategy for preventing the disease naturally, said Reddy, who specializes in studying the relationship between nutrition and colon cancer.

The researchers studied 18 rats in which colon cancer had been induced in a manner similar to human colon cancer development. All of the animals were placed on a balanced diet, with half of the animals’ diets supplemented with pterostilbene. After eight weeks, the rats fed pterostilbene had 57 percent fewer pre-cancerous colon lesions compared to the control group. The researchers also noted that pterostilbene inhibited certain genes involved in inflammation, considered a colon cancer risk factor. 
 

Colon cancer is the second leading cause of cancer death in the U.S. It has been linked to a high intake of saturated fats and calories common in Western diets. Pterostilbene may be able to reverse this process, possibly by lowering lipids, Reddy said.

Reddy cited a recent study by co-author Agnes Rimando of the Department of Agriculture. Rimando demonstrated that blueberries, particularly their skins, can lower cholesterol when fed to animals.

Some thirty different species of blueberries are native to North America. The berries are rich in anthocyanins, widely recognized for their antioxidant qualities. Blueberries are also a good source of ellagic acid, which blocks metabolic pathways that can lead to cancer.

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A study in the Aug. 1 issue of the journal Gastroenterology finds that GCC, a protein receptor on the surface of intestinal epithelial cells for two hormones, guanylin and uroguanylin, can suppress tumour formation. These hormones regulate the growth of the intestinal cells. Early in colon cancer development, these growth-controlling hormones are deactivated, disrupting GCC’s activity and contributing to tumour formation, Scott Waldman, chair of pharmacology and experimental therapeutics at Jefferson Medical College, said in a release. The finding “converts colon cancer from a genetic disease, which is the way we’ve all thought about it, to a disease of hormone insufficiency,” said Waldman. “It’s a completely different way of thinking about the disease. Using two separate mouse models that mimic the development of colon cancer in people, researchers showed that GCC signaling blocks cancerous tumours from forming in the colon. When GCC was removed from the mice and a carcinogen introduced, researchers found tumours larger and in greater number in both the colon and intestines. The same scenario occurred in mice that carried a mutation of the APC gene, which causes the growth of colon polyps that lead to colon cancer.  Taken together, exposure to a carcinogen or mutations in APC, along with the loss of GCC signaling is “a recipe for colon cancer,” Waldman said. Researchers would like to extend this study to show that by treating patients with hormone replacement therapy, intestinal cancer formation can either be prevented or treated.

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Eat More Fruits & Vegetables 

Eat five to nine servings every day.  Although five sounds like a lot, the serving sizes are small, making this easy!

·         One serving of fruit equals 1cup fresh fruit, 1 tennis ball sized fruit, ¼ cup dried fruit, ½ cup canned fruit or 4 ounces of 100% juice.

·         One serving of vegetables equals ½ cup cooked, 1 cup raw or 6 ounces of 100% vegetable juice.

·         Fruits and vegetables contain fiber along with many anti-cancer nutrients, so fill up!

 Limit Fast Food 

If you can’t avoid fast food, make healthy choices when you go. 

·         Order a baked potato and salad, or vegetable soup with salad. 

·         Sub shops offer vegetarian sandwiches, so load up on the veggie toppings and low-fat condiments and enjoy!

·         Pack your own lunch using one fruit, one vegetable, a whole grain and a low-fat protein to avoid grabbing something quick and unhealthy.

·         Review online nutrition information for fast food chains, so you can make healthier choices.  Aim to create a meal with no more than 500-600 calories, including your drink.

Use Meat Substitutes

·         Replace meat at meals three or more times per week with another protein, such as dried, cooked beans or a soy food, such as tofu.

·         Eat less beef, pork, and smoked, cured and processed meats such as luncheon/deli meats, jerky, sausage, bacon, ham, canned meat, Spamâ, pepperoni, and hot dogs.

 Limit Alcohol

·         Women should limit alcohol to one drink per day.  Men should limit intake to no more than two drinks per day.

·         One drink equals 12 ounces of beer, 1.5 ounces of liquor or 5 ounces of wine.

 Invest in Community Health

·         Work with your employer and community to advocate for healthy food in the workplace and access to recreation, parks and trails.

·         Support development of parks, sidewalks, bike paths, and rails to trails programs in your community to maintain a healthy lifestyle.

 ‘Weight’ No More to Shed Some Pounds

·         Increase your activity every day.  Wear a pedometer to help you track the number of steps you walk daily.  Record your steps and set goals to walk further each week.

Choose Healthy Fats

·         Eat more foods high in Omega-3 fatty acids such as salmon, trout, tuna, swordfish, flaxseed, canola and soybean oils, walnuts, and wheat germ.

·         Limit shortening, margarine and “partially hydrogenated oils” in many processed foods.  Read the ingredients on food labels to look for these bad fats.

·         Bake, steam, broil or grill foods instead of frying.

Exercise

 ·         Once you have made the decision to exercise, choose an activity that suits your personality – if you like the company of other people, choose an activity like a dance class or a team sport. If you prefer solitary activity, then walking or using equipment in a gym may be better for you.

 ·         Remember that even moderate exercise has health benefits. Moderate exercise is defined as activity that burns 150 calories of energy a day or 1000 a week. Try walking, yard work or recreational games like tennis or basketball.

·         Always check with a physician when you begin a new exercise program, especially if you have been sedentary.

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For patients with hepatic metastasis considered to be resectable (based on limited number of lesions, intrahepatic locations of lesions, lack of major vascular involvement, absent or limited extrahepatic disease, and sufficient functional hepatic reserve), a negative margin resection has resulted in 5-year survival rates of 25% to 40% in mostly nonrandomized studies.

For patients with hepatic metastases deemed unresectable, radiofrequency ablation has emerged as a safe technique (2% major morbidity and <1% mortality rate) that may provide for long-term tumor control.

Other local ablative techniques that have been used to manage liver metastases include embolization and interstitial radiation therapy. Patients with limited pulmonary metastases, and patients with both pulmonary and hepatic metastases, may also be considered for surgical resection, with 5-year survival possible in highly-selected patients.

The role of adjuvant chemotherapy after potentially curative resection of liver metastases is uncertain. A trial of hepatic arterial floxuridine plus systemic fluorouracil (5-FU) plus leucovorin was shown to result in improved 2-year disease-free and overall survival (OS) (86% vs. 72%, P = .03), but did not show a significant statistical difference in median survival, compared with systemic 5-FU therapy alone. [Level of evidence: 1iiA] A second trial preoperatively randomized 109 patients who had one to three potentially resectable colorectal hepatic metastases to either no further therapy or postoperative hepatic arterial floxuridine plus systemic 5-FU. Of those randomized, 27% were deemed ineligible at the time of surgery, leaving only 75 patients evaluable for recurrence and survival. While liver recurrence was decreased, median or 4-year survival was not significantly different. Further studies are required to evaluate this treatment approach and to determine if more effective systemic combination chemotherapy alone may provide similar results compared with hepatic intra-arterial therapy plus systemic treatment.

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That’s the indication of a new study, presented at the American Society for Gastrointestinal Endoscopy’s national meeting, which shows that patients who listened to music during their routine colonoscopy required less sedation for the procedure.

“Offering music makes sense,” said Dr. Benjamin Krevsky, lead author of the study and professor of medicine at Temple University School of Medicine. “It has no downside, it may prove beneficial and patients appear to be satisfied with the procedure.”

For the study, Krevsky and colleagues invited 73 men and women to bring music from home or choose from a selection of CDs with the understanding they may be played during their colonoscopy.

Ear buds were taped to the participants’ ears before each procedure and the volume was adjusted so the music was only audible to the patient. Then, after the initial dose of a sedative commonly used during a colonoscopy, it was randomly determined if the music would be played during the procedure itself. Further doses of the sedative were given if necessary.

After the procedure, each patient was asked about their discomfort and pain levels during the procedure and if they had any anxiety.

From their data, the researchers determined that those who listened to music during the colonoscopy needed approximately one less dose of the sedative mediation, while still reporting about the same levels of comfort as those who did not listen to music.

If music does indeed reduce the amount of sedation a patient needs for a colonoscopy, it could lead to reduced healthcare costs and greater satisfaction with the overall procedure.

“Over all, colonoscopies are very, very safe.” Krevsky said. “And while the risks of sedatives are relatively small, in general, less medication is better.”

The type of music the patients selected didn’t seem to matter. Krevsky even suggests toting along your mp3 player to your next colonoscopy. Your favorite tunes may make the procedure a little easier to bear.

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§                 Inflammatory intestinal conditions. Long-standing inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease, can increase your risk.

§                 Family history. You’re more likely to develop colorectal cancer if you have a parent, sibling or child with the disease. If many family members have colon cancer or rectal cancer, your risk is even greater. Familial adenomatous polyposis (FAP) is a rare hereditary disorder that causes you to develop hundreds of polyps in the lining of your colon and rectum. If these go untreated, you’ll likely develop colon cancer by age 40. Hereditary nonpolyposis colorectal cancer (HNPCC) is another hereditary disorder that can put you at high risk of developing colon cancer or rectal cancer at an early age. Unlike FAP, however, you may have relatively few polyps.

§                 Diet.

§                 A sedentary lifestyle. If you’re inactive, you’re more likely to develop colorectal cancer. This may be because when you’re inactive, waste stays in your colon longer. Getting regular physical activity may reduce your risk.

§                 Diabetes. People with diabetes have up to a 40 percent increased risk of developing colorectal cancer.

§                 Smoking. More than one in 10 fatal colon cancers may be caused by smoking. Once diagnosed with colorectal cancer, smokers face a 30 percent to 40 percent increased risk of dying of the disease.

§                 Alcohol. Heavy use of alcohol may increase your odds of colorectal cancer.

§                 A personal history of colorectal cancer or polyps. If you’ve already had colorectal cancer or adenomatous polyps, you have a greater risk of colorectal cancer in the future.

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