Colon cancer on the rise, but preventable

No matter your age, don’t ignore problem signs, like blood in the stool or a change in your bowel output. In this report by Sade Oguntola, experts, say this could be the first sign of a colon cancer.

SEPTEMBER 27, 2015, is a day that is forever ingrained in the memory of relatives of Bamke Haruna. Months before, she had noticed symptoms such as constipation and bloody stool. She didn’t think much of them at first, but as they grew worse, she knew something was wrong.

At age 72, Bamke Haruna was diagnosed with stage 3 colorectal cancer after she was referred to a teaching hospital where a colonoscopy revealed a tumour in her large intestine or colon.

Colorectal cancer, a cancer affecting the colon and rectum, is the second most common cancer worldwide. In Nigeria, incidence of colon cancer unfortunately is on the rise.

“About 30 years ago, we saw about 12 to 15 cases per year at the University Teaching Hospital (UCH), Ibadan. But now we are seeing about 70 to 100 cases per year,” said Dr David Irabor, a colon cancer expert at the hospital.

The situation is not restricted to UCH, Ibadan. Other federal medical tertiary institutions are also recording an increase in the number of colon and rectal cancer cases.

Ironically, colon and rectal cancer thought to be a white man’s disease is having a foot hold in Africa. “Since, we are also now imbibing a lot of the vices and virtues of the white people, it stands to reason that we are also developing their diseases,” said Dr Irabor.

Colon cancer is one of those things that occur inside the large intestine, where end products of digestion and other things from the small intestine becomes solidified, and then gets passed out as stool.

The large intestine has a large capacity and many times when this colon cancer starts; it may not give any symptom. Howbeit, one of its earliest symptoms of colon cancer is bloody stool.

“No doubt, individuals that pass fresh blood in their stool will wonder what could have caused it. But it is overlooked oftentimes by many people in Nigeria because it is termed jedijedi,” Dr Irabor said.

“Some people also start to lose weight, but that occurs for all forms of cancer because cancer cells will compete with your normal cells for body nutrients.

“So, if you keeps seeing blood in the stool, not feeling too well, a packed cell volume (PCV) that is a bit low and within the 40 to 50 years age range, or with a change in the bowel output, what is happening in the large intestine needs to be checked.”


Westernised diet increases chances of colon cancer

When it comes to colon cancer in Nigeria, its incidence starts between ages of 40 and 50 years. That is the productive age group. Of course, the chance of a colon cancer is higher in this age group, being a group that is more likely to be affluent and take westernised diets and lifestyle.

Moreover, Dr Irabor, declared that the proliferation of fast food joints; increased intake of sugar, carbohydrate and red meat have all been shown to increase chances of developing colon cancer. But white meat and fish are safer.

It has been shown that countries like USA, UK and Argentina that consume a lot of meat have a high incidence of colon cancer. But consuming boiled meat is far safer than fried or roasted meat.

“Although fried meat tastes far better than boiled meat, but when you fry meat, the high temperature denatures the meat and gives rise to some chemicals which can cause cancer.

“Again when you roast meat over an open fire, some chemicals which can cause cancer are also produced; whether the roast is over an open fire, a griller or anything that shots the temperature higher and causes charring of meat,” he added.

In addition, colon cancer could run in some families as well as arises from exposure to environmental pollution.


Diet is the major cause of most colon cancer

Unlike traditional African foods that contain high fibre that is protective against colon cancer, westernised diets like hamburgers, ice creams, noodles and so on contribute to a change in the internal environment of the colon.

“It has been shown that our diet is protective. Do you know that pepper has anti-colon cancer properties because of its capciasin content? It has been shown that communities that eat pepper have a lower incidence of colon cancer,” said Dr Irabor.


Surviving colon cancer

But most popular strategy for colon cancer detection is the colonoscopy, which offers the most comprehensive look at the entire colon. If the doctor sees polyps during the test, he or she can recommend biopsy or remove them on the spot.

Detecting and removing polyps, a growth that may or may not develop into cancer, must logically lower incidence, and therefore death, from the disease.

Paradoxically, more Nigerians with colon polyps are being seen, something that was rare before now, and buttressing Nigerian’s changing diet.

But colonoscopy is not cheap either. “Colonoscopy costs about N44, 000, which is far above the minimum wage in Nigeria,” he said.

In addition, where colon cancer is detected, he said “surgery to remove the cancer is about N120, 000. So, on the average the cost of its treatment, including tests, cannot be less than N800, 000.”

Howbeit, if the cancer is detected early and treatment commenced promptly, 85 out of 100 of such people will live for more than five years; at stage two, it is getting to about 60 per cent. And stage 3, that is now about 30 per cent; and stage 4, may between five and 10 per cent.


Any chance of the cancer recurring after treatment

“There is a chance of its reoccurrence, and as such after treatment, such patients every year will be coming for colonoscopy to check their colon so that if anything is happening again, such can be quickly removed.”