Tips on Preventing and Controlling Colorectal Cancer

Xue Manzi (a.k.a. Charles Xue), a famous Chinese business angel* was diagnosed on May 20, 2011, with colorectal cancer (CRC). Since his diagnosis, he has actively used Sina.com’s Weibo microblog to update his “fans” about his condition. His optimism has set an example for other cancer patients and has raised awareness for CRC, a disease that is affecting increasing numbers of people in China. Mr. Xue generated a lot of publicity for the prevention of CRC. This article further discusses the important but often-ignored issue of CRC prevention, and follows up on another article by Dr. Ji Kaiyu, BJU’s Internal Medicine Department Chair. (You can find Dr. Ji’s article entitled “Caring for Your Colon” in the June 2011 issue of Health-Line.)

CRC encompasses all cancers of the colon and rectum. The cancer commonly manifests as a malignant tumor in the gastrointestinal tract. CRC has distinct characteristics in China compared with those in western countries. One characteristic is the early age of onset in China. There are increasing numbers of CRC patients 30 to 40 years of age, as well as rare cases of CRC patients in their 20s. Another characteristic is that doctors in China see a remarkably high percentage of patients with late-stage CRC and high degrees of malignancy. The third characteristic is the high incidence of rectal cancer, which accounts for up 60% to 70% of CRC cases here. As living standards continue to improve and diets continue to change in China, experts estimate that the incidence of CRC will keep rising.

The following are some tips for reducing your risk for CRC.

Tip #1: Watch what you eat

All diseases can be traced to a variety of causes; CRC is no different. The causes of CRC include genetic factors, lifestyle factors and environmental factors related to where you live. For example, there are high rates of CRC in North America, Europe and Australia, but low rates in Japan. Lifestyle factors – especially diet and exercise – also play a huge role.

In medical textbooks, there is a classic case study about Japanese Americans in the U.S. The first generation of Japanese immigrants had the lowest incidence of CRC in their area. However, CRC incidence rose with each subsequent generation. In the third generation, CRC incidence within their population had caught up with that of the populations around them. This data suggests that a western diet may have a lot to do with the incidence of CRC. Data for China seems to corroborate this conclusion as dietary changes correlate strongly with the rise of CRC incidence. In the 1950s, Chinese people ate mainly vegetables and whole grains. During this time, CRC patients were very rare. Today, people in higher socio-economic brackets tend to consume more high-calorie foods. Not coincidentally, CRC incidence has also experienced a significant increase.

Tip #2: Pay attention to early symptoms

In its early stages, CRC exhibits mild symptoms. Bowel mucosa is stimulated by the tumor; a small amount of mucus is passed before the stool itself or is attached to the outside of the stool. As the tumor grows, ulcers or necrosis occur together with the infection. This leads to an increase in stool frequency, usually two to three times a day, and the stool is mucous, loose or even bloody.

When the tumor is confined in the mucosa, blood in the stool is present in 85% of early-stage cases and is often the only warning of possible CRC. Unfortunately, people often ignore this symptom. We recommend that people consult a doctor as soon as possible when they habitually see irregularities in their bowel movement or bloody stools. Before the diagnosis is clear, don’t assume that a bloody stool is a symptom of a less serious disease (e.g., enteritis or dysentery).

Tip #3: Get regular health checkups

To prevent CRC, regular checkups should be a top priority. Gastrointestinal experts point out that early detection of CRC can greatly improve survival rates. We recommend that people older than 40 should get a CRC screening every three to five years. Screening methods include digital rectal examination, occult blood test, colonoscopy, and serum tumor markers.

CRC risk guidelines differ between countries and even areas within the same country. United Family Healthcare (UFH) has a cancer screening program that takes patients’ ages and life situations into consideration. Doctors discuss and evaluate CRC risk for each patient and then design “individualized” screening plans.

We strongly recommend that everyone make lifestyle changes step by step to preserve good health and stave off CRC and other cancers. If you haven’t already, share this information with your family, friends and colleagues, and help us raise awareness about CRC.

*Business angels are wealthy, entrepreneurial individuals who provide capital in return for a portion of a company’s equity. They are often called “Angel Investors” in the west. (See http://tutor2u.net/business/finance/business_angels.htm)