COLON CANCER

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

Colorectal cancer, or colon cancer for short, is the third most common cancer in the world – and the second leading cause of cancer-related death. Most cases occur in people over the age of 50.

Colorectal cancer affects the colon (large intestine) or rectum. It usually begins as small clumps of cells called polyps that form inside the colon. Polyps generally aren’t cancerous, but some can become cancerous over time, which is why screening for polyps is so important. Finding and removing polyps helps prevent colon cancer.

While colon cancer can be linked to your genetic inheritance, it is largely a disease of lifestyle and is most likely to affect people who are inactive, obese, and who consume lots of red meat, processed food, alcohol and tobacco products.

COLON CANCER IN SOUTH AFRICA

Colon cancer is one of the top three cancers affecting both men and women in South Africa. While it affects mostly older individuals, we have evidence of many younger people also being diagnosed in South Africa. Our rapidly increasing levels of colon cancer are largely due to our unhealthy diets and lack of exercise. Smoking, alcohol consumption, and obesity are also risk factors and South Africa has high levels of all of these.

A predisposition to colon cancer can be inherited, and studies have shown that the prevalence of inherited colon cancer in South Africa is 3-5 times higher than in high-income countries.

Our under-resourced healthcare services, exacerbated by a lack of access to these services for the majority of our population, means there is a desperate lack of preventative screening in South Africa. Our limited access to effective cancer treatment options, particularly in public healthcare settings, further contributes to our high colon cancer mortality rates.

RISK FACTORS FOR COLON CANCER

Genes
Age

Age is a significant risk factor for colon cancer. Around 87% of people who receive a diagnosis of colon cancer are over 50 years of age, with around 20% of all diagnoses occurring in patients younger than 55. However, it is becoming more common in people under 50.
Diet
Lifestyle
Other health conditions
Some conditions have links to an increased risk of colon cancer. These include:

a medical history of polyps

inflammatory bowel diseases, such as ulcerative colitis or Crohn’s disease

other cancers, such as breast, ovarian, or endometrial cancer

being obese or overweight

HOW DO I KNOW IF I HAVE COLON CANCER?

Unfortunately, colon cancer often has no symptoms in the early stages. Regular screenings from the age of 45 are essential to catch the disease early and have the best chance of effective treatment.

Symptoms to look out for:

A change in bowel habits, like diarrhoea, constipation, or a narrowing of your stool
Blood in your stool or rectal bleeding, either bright red or dark and tar-like
Abdominal cramps, pain or bloating that won’t go away
A feeling that your bowel doesn’t empty completely
Sudden, unexplained weight loss
Feeling constantly tired and weak, even with enough rest
Anaemia, an iron deficiency that can be caused by chronic bleeding

HOW CAN I PREVENT COLON CANCER?

The lifestyle decisions you make can go a long way to protecting you from colon cancer:

Healthcare screening

Annual screening for colon cancer from the age of 45 is highly recommended as early detection and treatment is important. Bonitas covers a faecal occult blood test every year for members aged 45-75. This test detects if there is hidden blood in your stools, which can be an early sign of polyps or colon cancer.

If blood is detected in your stool, your doctor will likely recommend a colonoscopy to examine your colon and identify the source of the bleeding. During a colonoscopy, a flexible, thin tube with a camera is inserted into your rectum so that your doctor can identify any abnormalities or areas of bleeding.
Diet
Eat a healthy, balanced diet rich in fruits and vegetables

Eat whole grains and other sources of fibre – 25g a day is recommended

Limit your consumption of red meat, and processed meat in particular

Eating more fish high in Omega-3 lowers the risk of colon cancer
Exercise
Maintain a healthy weight

Obesity is linked to increased risk for cancer, including colon cancer, as it leads to chronic inflammation, insulin resistance, and altered hormone levels, all of which can promote cell growth and potentially lead to cancer development. Visceral abdominal fat, which is the fat around your internal organs, is a strongly linked to an increased risk of colon cancer.
Avoid exposure to toxins
Limit alcohol consumption: women should have no more than one alcoholic drink a day

Avoid tobacco: all tobacco products, from smoking to chewing tobacco to e-cigarettes, increase your risk of developing colon cancer

TREATMENTS FOR COLON CANCER

Treatments for colon cancer are based on how far your cancer has progressed, as well as your medical history. As with most diseases, early detection can lead to better treatments and outcomes.

The main treatments for colon cancer that has not spread to other parts of your body are surgery and chemotherapy.

Treatments for advanced cases of colon cancer include radiotherapy, targeted therapy, immunotherapy, and palliative care.

Surgery

In the early stages, surgery can remove the cancerous polyps. In more advanced stages, part of your colon may also be removed. Surgery to remove part or all of the colon is called a colectomy. During this procedure, a surgeon will remove the part of the colon that contains cancer, as well as some of the surrounding area.

If your surgeon is unable to connect the healthy portions of your colon, you will require a colostomy. This is when a surgeon makes an opening in the wall of the abdomen, called a stoma. Faeces then pass through this opening into a bag, called a stoma bag, bypassing your lower colon. Stoma bags need to be changed regularly; usually between one and three times a day depending on the amount of faeces.
Chemotherapy
Radiotherapy
Targeted therapy
Immunotherapy
Palliative care

If your cancer is so far advanced that treatment doesn’t have much chance of success, you will be offered palliative care. This focuses on relieving your pain and other symptoms, improving your quality of life as much as possible, and helping you and your family come to terms with your serious illness.

COLON CANCER

COLON CANCER

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

COLON CANCER IN SOUTH AFRICA

RISK FACTORS FOR COLON CANCER

HOW DO I KNOW IF I HAVE COLON CANCER?

HOW CAN I PREVENT COLON CANCER?

TREATMENTS FOR COLON CANCER

FURTHER READING