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Colon Polyps and Cancer
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 Colon cancer is very common and is a leading cause of cancer deaths. In almost every case, colon cancer starts out as a colon polyp. Therefore, removing polyps prevents colon cancer. If someone in your immediate family,parents, brother, sister, children - has had colon polyps, and, especially colon cancer, then you are at increased risk. African Americans have an increased death rate from the disease. The bottom line is that almost anyone can develop colon cancer and that it is preventable by removing polyps.
- anyone can get colon cancer.
- if someone in your family has it, you are at increased risk.
- colon cancer is preventable by removing colon polyps.
What is a Polyp?
A polyp is a growth. These fleshy tumors can be shaped like a mushroom or dome-like, growing on the inside of the colon wall, button-shaped. They may be as small as a pea or larger than a plum. They start out benign but then some of them become malignant as they get larger. The larger the polyp, the more likely it will have cancer within it.
- polyps are benign growths that become cancerous.
What Causes Colon Polyps and Cancer?
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 The science on this question is slowly becoming clear. In some people it is determined by your genes. Some of these genes cause a huge number of colon polyps at a very early age. Colon cancer develops in all these individuals and the only cure is to remove the colon. Other cancer causing genes are not so devastating but they are still important to respect. However, we physicians still see so many people with colon cancer with no family history of polyps or cancer at all. It is frustrating. Of course, you cannot change your genes, at least not yet.
However, the other major contributing factor is dietary and this can be changed. What we eat and what we don't eat makes a difference. I refer you to the section below on prevention, but in a word, those who consume large amounts of red meats, saturated and trans fats and who eat low quantities of fruits, vegetables and fiber are at increased risk. Your calcium intake may also be a factor. You can do lots about your diet.
- cancerous genes can cause colon polyps and cancer.
- excessive red meats, saturated fats and inadequate vegetables, fruits, fiber, and perhaps calcium, are key risk factors.
What Are the Signs and Symptoms With These Tumors?
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With polyps, the answer is nothing. They occur painlessly and can only be detected by screening colonoscopy. With cancer, the following symptoms and signs may occur. Unfortunately, when they do, the tumor may be fairly large and advanced. If you have any of the following, see your physician immediately.
- rectal bleeding
- maroon, dark or even black, bowel movements.
- recurrent, frequent abdominal cramps or "gas"
- unexplained weight loss or fatigue.
How Do You Make the Diagnosis?
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 The first thing that is done by the physician is to take a careful medical history and do a digital rectal exam. Colonoscopy is almost always the preferred exam as this is the only way to see the entire colon, remove polyps and do biopsies. Colonoscopy uses a lighted, flexible tube and is done under light sedation. Virtual colonoscopy uses an advanced form of x-ray. It is fairly good at detecting polyps and tumors, but of course, these can not be removed or biopsied. An older exam called a barium enema, at times, is helpful but not often done anymore.
- medical history
- digital rectal exam
- colonoscopy
Prevention
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The diet of North Americans and Europeans has dramatically changed over the past several hundred years. As we live day to day and year to year, we just don't see it. We assume this is the way people have always eaten. However, in the distant past, plant food - fruits, vegetables, seeds, fiber - was the mainstay of the diet. For the ordinary person meat was not readily available and not often eaten. My, how things have changed! For detailed dietary recommendations, go to /Colon Cancer/Polyp Prevention Diet
Red Meats and Saturated Fats
There are substances in red meat and saturated fats that, when broken down by bile salts, enzymes and colon bacteria, are not nice to the cells that line the colon. In fact, experimentally in animals, certain cancerous materials - carcinogens - may appear. The exact role of these factors is uncertain in humans, but it is an observed fact that people who eat lots of red meat and saturated fat have an increased incidence of colon cancer.
Fruits, Vegetables, Grains
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The same thing applies here in reverse. Those who consume the recommended 5 servings per day of fruits and vegetables have fewer colon cancers develop. What is the reason? Well, the anti-oxidants in colorful vegetables may be one answer as these are known to fight cancer. Another is the fact that cruciforous vegetables, cauliflower, broccoli, brussel sprouts and cabbage contain large amounts of a known anti-cancer chemical called sulforaphane. Whatever the reason, these plant foods are associated with lower rates of colon cancer.
Fiber
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 Rural Africans eat over 50 grams of fiber a day and have little colon cancer. Indeed, they have few, if any, ills that affect the colon in the Western World such as chronic colitis and diverticulosis. Yet, when this ethnic group comes to North America, they have a high incidence of all these diseases. This may be a coincidence, but I doubt it. Fiber in plant food is now known to have many health benefits. A more recently uncovered form of fiber is prebiotics. These fibers fuel the good bacteria in the colon producing substances which have been clearly shown to be healthy. In some animal studies, they reduce the occurrence of experimental colon cancer. We still don't know the full cancer prevention benefits in humans but they are likely to be found to be important. Prebiotics are a more recently discovered form of soluble plant fibers.
Calcium
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Calcium regulates the rate of growth of cells that line the colon. There is now considerable experimental and epidemiological evidence that adequate calcium helps to control the rate of growth of colon cells. In addition, certain prebiotic plant fibers enhance the absorption of calcium and magnesium. Calcium intake should be high, over 1500 mg per day. Furthermore, the current recommendation for vitamin D, which helps increase calcium absorption and bone strength, should be 800 to 1200 units a day.
Aspirin
There is evidence that aspirin may aid in colon cancer prevention. Check with your physician on the use of aspirin.
Summary
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Colon cancer and polyps are very common. If detected early, cancer can be prevented by removing polyps. Eating the proper diet is a major preventative step everyone can take. You can't change your genes but you can change what goes into your mouth and reaches the colon. In summary:
- decrease red meat and saturated fat intake
- increase fruits, vegetables, grains and fibers - including prebiotic fiber
- increase calcium and vitamin D to recommended levels.
- maybe an aspirin each day.
Medical References
Colorectal cancer (CRC) is the third most common form of cancer. Current treatments including chemotherapy, radiotherapy and surgery are all associated with a high risk of complications and are not always successful, highlighting the need to develop new treatment strategies. The ingestion of probiotics, prebiotics or combinations of both (synbiotics) represents a novel new therapeutic option. Probiotics and prebiotics act to alter the intestinal microflora by increasing concentrations of beneficial bacteria such as lactobacillus and bifidobacteria, and reducing the levels of pathogenic micro-organisms. This strategy has the potential to inhibit the development and progression of neoplasia via mechanisms including; decreased intestinal inflammation, enhanced immune function and anti-tumorigenic activity, binding to potential food carcinogens including toxins found in meat products, and a reduction in bacterial enzymes which hydrolyse precarcinogenic compounds, such as beta-glucuronidase. There is substantial experimental evidence to suggest that probiotics and prebiotics may be beneficial in the prevention and treatment of colon cancer, however to date there have been few conclusive human trials. Probiotics and prebiotics have the potential to impact significantly on the development, progression and treatment of colorectal cancer and may have a valuable role in cancer prevention.
Colon cancer remains a significant global health concern. The impact of specific dietary components on colon tissue likely depends on a host of genomic processes that influence the growth, development, and differentiation of the epithelial cells at the colon crypt surface, where the balance between proliferation and differentiation is maintained possibly through the Wnt (beta-catenin/T-cell factor) signaling pathway. A loss of balance caused by either genetic mutations or environmental factors such as dietary habits can modulate the risk for the formation of aberrant crypt foci and ultimately the development of colon cancer. Evidence exists that butyrate reduces the number and the size of aberrant crypt foci in the colon. Butyrate is a natural histone deacetylase inhibitor as well as a molecule involved with enhanced TGF-beta-induced SMAD3 phosphorylation, increased IFN-gamma-mediated apoptosis, and altered expression of the intestinal muc2 gene that is responsibl e for mucin synthesis. Other dietary components, such as vitamin D and (n-3) fatty acids, may regulate proliferative properties of colon progenitor cells as well as the differentiation of subcellular lineages. Although these findings are intriguing, there are uncertainties that remain to be resolved including the optimal exposure needed to bring about an effect, the appropriate timing of administration, and if nutrient-nutrient and nutrient-gene interactions determine the overall response. The expanded use of high-throughput technologies, knowledge about the expression of genes and protein fingerprints, and metabolomic profiling will assist in addressing these issues and ultimately in determining the physiological significance of bioactive food components as cancer protectants.
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