Colon cancer cases rising

BY JANICE BUDD Associate Editor – Sunday buddj@jamaicaobserver.com

Sunday, March 06, 2011

MORE Jamaicans are being afflicted with colon cancer, new medical data have shown, and a doctor who specialises in treatment of the disease is urging men and women to have regular tests in order to reduce health risks.

According to university lecturer and consultant physician and Gastroenterologist Dr Mike Mills, the most recent data available suggest that the number of cases of colon cancer has increased over the past decade.

This, he said, may be due to increased reporting as well as increased incidences.

“We are picking up more cancers because more and more people are becoming aware of it and the more aware you are, the more likely that you will turn up at the doctor’s for minor health issues,” said Dr Mills. “And if you show up with these minor things, we are more likely to investigate you and find more serious things.”

The most recent publication of Gibson Medical Journal points to an increasing incidence of colorectal cancers among Jamaicans living in Kingston and St Andrew between 2003 and 2007.

Among men aged 25 to 59 years there were 59 cases. Among women in the same age group over the same period, there were 67 recorded cases.

The number of cases increased within an older demographic.

Among Kingston and St Andrew males aged 60 to 74, there were 108 colorectal cancer diagnoses between 2003 and 2007. There were 77 cases among women in the same demographic over the same period.

Female colon cancer victims surpass their male counterparts once they hit the 75-years-and-over age bracket. In the period under study, there were 84 cases among women in Kingston and St Andrew compared to 62 cases among males.

Mills also disclosed that during the four years spanning 2003-2007, occurrence among males was 17 per 100,000. This is up from a ratio of 13 per 100,000 males recorded four years earlier, between 1998 and 2002.

Colorectal cancer showed up in 13 women per 100,000 in this earlier period and has remained constant over the four-year period up to 2007.

Colon cancer begins in the colon or large intestine, where waste material is stored. Most patients will show no symptoms until it has reached an advanced stage, which makes it a silent killer.

A telltale sign of the dreaded disease is the presence of bright red or dark blood in the stool. Other symptoms include continuous or cramping abdominal pain; a change in bowel habits (diarrhoea or constipation which lasts for more than a few days); weakness and tiredness; nausea and vomiting; unexplained weight loss; loss of appetite; pelvic pain; and anaemia.

In previous years when cancer was spoken of in hushed tones, victims suffered in silence, which meant by the time medical help was sought, it was too late.

“People used to stay home with blood in their stool and not come to the doctor until a few years on. And by the time they present with symptoms, they are pretty far along,” said Mills, who is also one of the consulting physicians for the Jamaica Cancer Society (JCS).

He told the Sunday Observer that there are certain factors that help determine the level of risk for any Jamaican.

Research shows that obesity and, by extension, diet, play a major role, especially diets high in processed foods, rice, flour and fats. Smoking and drinking also increase risk. While 80 per cent of colon cancer patients have no readily identifiable risk factors, about 20 per cent have polyps — growths, usually on a stem, that emerge from the intestinal wall and sometimes develop into cancer.

“On an average day, if we see 10 people just from off the street for a colonoscopy, we expect to see at least two people with polyps. Not cancer, polyps. This is what we call our polyp detection rate. If we did four colonoscopies and we didn’t find polyps in even one person, we might have missed it,” said Mills as he illustrated how common these potentially pre-cancerous growths are.

Persons who have close family members who have other bowel-related problems also fall in the high-risk category.

Ulcerative colitis, a chronic inflammatory condition of the digestive tract, may also be another risk factor for colon cancer.

But according to Dr Mills, nobody is risk-free, and at a certain age everyone should undergo screening as opposed to waiting for symptoms to show.

“Everybody is at average risk for colon cancer — everybody. So everybody needs to get some kind of screening. We recommend between [age] 45 and 50,” said Mills. “At that age we would recommend a colonoscopy, a barium enema, or, at the very least, an annual test for blood in the stool.”

A colonoscopy is a medical test in which a thin, flexible instrument with a light and camera at the end is used to view the inside of the large intestine. It is inserted into the anus while the patient is under anaesthesia and threaded through the bowels where the surgeon can spot any abnormalities of the inner lining such as colitis, colon polyps or cancer.

Polyps found could become cancer at some point in the future and are often cauterised or burned off right there and then.

A barium enema is a procedure in which a liquid containing barium is inserted into the rectum and colon by way of the anus and the patient is then given an X-ray.

While colon cancer is easily the most preventable cancer, because this screening can find and treat pre-cancerous growths, Dr Mills said people continue to come in for treatment too late.

“When you do breast cancer screening you only detect it when the cancer is already there. With prostate you do the screening, when it becomes abnormal the cancer is already there. Colon now, you do the screening, you find a polyp and remove it and that’s it,” he explained.

Still, cultural beliefs and fears continue to keep men especially away from screening.

Dr Mills said women tend to be more conscientious about their health and more willing to subject themselves to testing. Men in Jamaica fear any invasive medical procedure such as the standard digital-rectal examination, in which the doctor inserts a finger into the anus to feel for abnormalities.

“Men don’t want anyone to go into their rectum, they feel it’s going to turn them gay, etc, etc. So in a way it’s bad and that’s why the more common cancers are prostate and colorectal cancer, the ones that need a digital test to detect,” he said.

“If you don’t want the finger in the rectum, at the very least do the faecal blood test, and you have to have one every year. If not that, then at least do the barium enema,” Mills urged.

Cost is also a factor, with private medical facilities charging patients between $30,000 and as much as $100,000 for a colonoscopy. In the public health system, it could cost around $19,000. However, only two facilities, Dr Mills advised — Kingston Public and Spanish Town hospitals — have the proper equipment. The University Hospital is also an option.

The JCS, having designated March Colon Cancer Awareness Month, will tonight host ‘Doctors on Stage for Cancer’, an annual fund-raiser showcasing various doctors’ talents and in which Dr Mills will participate.

The money will help subsidise the JCS’s clinics and diagnostic screening services which the non-profit offers below cost to persons who would not be able to afford them otherwise. The organisation also intends to boost its colon cancer public awareness campaign and spread the message of prevention.

“Screening, screening, screening!” Mills emphasised. “We are trying to get away from people coming in when the cancer is already present. The earlier you present with some symptoms, the sooner and better the medical intervention. If you have an obstruction in the bowel, when the tumour is so big they can’t pass anything and have to have emergency surgery, it’s bad. But if you present early enough so we can take out just a small part of the colon and plan the surgery; it is much better.”

He cautioned that the horrific alternative is to remove the tumour/s and a sizeable portion of the bowels, leaving the patient to wear the dreaded colostomy bag for the rest of their lives.

Colon cancer tips

* More than 90% of colon cancer cases are diagnosed in men and women older than 50.

* Survival rate is 90% when colon cancer is found in its early stages.

* Colon cancer usually has no symptoms in its early stages.

* Colon cancer tests are as important as annual Pap tests, mammograms and prostate exams.

* If you have bleeding from your rectum or blood in your stool, see a doctor.

* You can help prevent colon cancer by getting tested.

Colon cancer cases rising – News – JamaicaObserver.com

Tags: Female colon cancer, st andrew, common cancers

2,826 Responses to “Colon cancer cases rising – News – JamaicaObserver.com”