Colon Cancer: Early Detection Can Save Your Life

Newswise, June 6, 2017 — Colorectal cancer is the second leading cause of cancer death for men and women in the United States according to the American Cancer Society (ACS).

 In fact, the ACS estimates that 134,490 people in the United States were diagnosed with colorectal cancer in 2016, including 70,820 men and 63,670 women. In addition, the ACS estimates that 49,190 people, 26,020 men and 23,170 women, died from colorectal cancer in 2016.

According to Mitchell Rubinoff, M.D., Chair, Gastroenterology, Valley Medical Group, “In order to reduce the mortality rate of this disease, it is crucial for individuals to be aware of the signs of colon cancer—and not hesitate to have any cause for concern checked out as soon as possible. Early detection saves lives!”

What is Colon Cancer?

Often referred to together as colorectal cancer, colon cancer is cancer of the large intestine (colon), and rectal cancer is cancer of the last few inches of the colon. It most often begins as precancerous polyps on the inside lining of the colon. Colon polyps, as defined by the National Institutes of Health, are growths on the lining of your colon or rectum.

Who is At Risk?

Both men and women are at risk for developing colorectal cancer, even if they do not have any of the identifiable risk factors such as:• A family history of colorectal cancer• Being over age 50• Colorectal polyps• Genetic changes

Early Detection Through Screening Tests

“It is best to catch colorectal cancer before you become symptomatic. Doctors can actually prevent cancers from ever developing by removing polyps and they can cure more patients by diagnosing cancer at an early stage,” explains Dr. Rubinoff.

Possible screening tests for colorectal cancer include stool tests, colonoscopy, or virtual colonoscopy. A colonoscopy is an outpatient procedure that is used to try to detect colon polyps and remove them before they can become cancerous. Your doctor will work with you to decide which test is appropriate for your individual history and symptoms.

It is also important for individuals who are not showing any symptoms of colorectal cancer to go for routine screenings. The CDC states that “The U.S. Preventive Services Task Force recommends that adults age 50 to 75 be screened for colorectal cancer.

“The decision to be screened after age 75 should be made on an individual basis. If you are older than 75, ask your doctor if you should be screened. People at higher risk of developing colorectal cancer should begin screening at a younger age, and may need to be tested more frequently.”

Signs and Symptoms

There are many potential symptoms of colon cancer and it is important to note that there is a great deal of overlap between colon cancer’s symptoms and symptoms of other illnesses. And, while it is possible that your symptoms may be caused by something else, you should still be aware of what to look out for and make sure to see your doctor right away if you experience any of the following symptoms:

• A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days• A feeling that you need to have a bowel movement that is not relieved by doing so• Rectal bleeding• Dark stools, or blood in the stool (often, though, the stool will look normal)• Cramping or abdominal (belly) pain• Weakness and fatigue• Unintended weight loss

Recognizing these symptoms, which are outlined by the American Cancer Society, is the first step to early detection. Once you alert your doctor to these symptoms, you may be sent for screening tests to confirm a diagnosis.

Prevention

You can help to prevent cancer by exercising, eating fresh fruits and vegetables, and maintaining a healthy weight. Be proactive and take charge of your health!

The New Face of Colon Cancer

WASHINGTON, May 18, 2017 - Matt Wixon is not the typical colon cancer patient. He has none of the risk factors sometimes associated with the cancer — he is active and fit, eats healthy and smoked only for a very short time. But, most unusual of all, Wixon is young  — he was 39 when he was diagnosed with stage 4 colon cancer last December.

However, Wixon and patients like him are the new faces of colon cancer. A study published February 28 in the Journal of the National Cancer Institute found that colorectal cancer rates are rising in people under age 50, who will make up one in ten of the 135,500 new cases of colorectal cancer expected to be diagnosed in 2017.

That means that people born in 1990 have double the risk of colon cancer and quadruple the risk of rectal cancer compared to people born in 1950.

Of the 1,000 GI cancer patients seen at his clinic last year, nearly half were under age 50, says John L. Marshall, MD, director of the Ruesch Center for the Cure of Gastrointestinal Cancers at Georgetown Lombardi Comprehensive Cancer Center and chief of hematology and oncology at MedStar Georgetown University Hospital. Many are in their 20s and 30s; one was just 17.

“This has been a trend that has become an alarming issue in the last decade,” he says. “Treatment of colorectal cancer in patients over 50 has improved — there is less cancer and lower mortality — but we seem to be trading that good news for this really disturbing trend that people in the prime of life are getting a diagnosis no one was expecting.”

FINDING THE SILVER LINING

That was certainly true for Wixon, a patient at the Ruesch Center, who owns a moving company. When he received his news, he and his wife were anticipating the birth of their first child.

“This is a grave diagnosis that came as a shock, an existential threat,” says Wixon. “This was two weeks before Christmas and my wife was seven months pregnant with a boy. All the plans I had for our son— the books I would read to him, the vacations we would take, the joy we would have — just vanished.”

Wixon had noticed some changes in his bowel habits, but they weren’t severe and hadn’t been going on for long. Still, when he met with his gastroenterologist, who suggested he might have hemorrhoids, Wixon insisted on a colonoscopy. Knowing that the test would not be covered by insurance, he was concerned enough that he was ready to pay for the test out of pocket.

Now he is on three different drugs, several of which require infusions every two weeks. Wixon makes the most of these events. “I bring friends, read books, joke around a lot with the really extraordinary nurses and staff at Georgetown.”

Wixon tries to find the silver lining in the cloud hanging over his head. He knows his youth is a benefit and sometimes he finds it hard to believe he is as sick as he is. He is active on “Colontown,” a Facebook group that Marshall told him about, where he has found “hope and solace.”  He is planning for the day when he is healthy enough to have surgery that can remove the tumors that have metastasized in his liver.

LOTS OF THEORIES

Marshall doesn’t know why this trend is happening, nor do other colorectal experts.  “I did not sign up to be a cancer doctor for young people,” he says. “Most of my young patients are marathon running, cardboard eating people.”

But he suspects one player may be an altered microbiome, the galaxy of symbiotic bacteria that live in the human gut to aid digestion. “There is a beautiful coral reef of bacteria in the colon, but the reef may be dying or altered in some people due to modern habits — too much use of antibiotics and antibacterial hand wash, for example, that could reduce the known effectiveness of bacteria in protecting against cancer,” he says. But Marshall is the first to say there are many theories.

Mohamed Salem, MD, a gastrointestinal oncologist and researcher at Georgetown Lombardi, is among a team of investigators studying the foundations of young onset colon cancer. He is exploring whether colon cancer in these patients is more aggressive, and, if so, why, and where it occurs, whether on the left side or right, which matters in terms of outcome and drug treatment.

Then there is the question of diagnosis. No one imagines giving every person younger than 50 a colonoscopy, Marshall says. And for those with some symptoms, there are less invasive and cheaper screening tools than a colonoscopy. But it is important that frontline health care providers, such as primary care doctors, know about the real risk of colon cancer in young people, and “that they take it seriously,” he says.

“All I can say is that people really need to pay attention to their bodies, and if there is something real going on, they should not hesitate to be assertive with their doctors,” Wixon says. “So many people are afraid of bad news. But it will only get worse if you wait.”

Aspirin Slows Growth of Colon, Pancreatic Tumor Cells

Newswise, December 19, 2016--Researchers from Oregon Health and Science University and Oregon State University have found that aspirin may slow the spread of some types of colon and pancreatic cancer cells. The paper is published in the American Journal of Physiology—Cell Physiology.

Platelets are blood cells involved with clotting. They promote the growth of cancerous cells by releasing growth factors and increasing the response of certain proteins that regulate tumor cell development (oncoproteins).

Low doses of aspirin, an anti-platelet drug, have been shown to reduce the risk of some types of gastrointestinal cancers, but the process by which aspirin hampers tumor growth has been unclear.

“The current study was designed to determine the effect of inhibition of platelet activation and function by aspirin therapy on colon and pancreatic cancer cell proliferation,” the researchers wrote.

The research team combined activated platelets primed for the clotting process with three groups of cancer cells:
• metastatic colon cancer (cells that have spread outside the colon),
• nonmetastatic colon cancer (cells that grow only within the colon) and
• nonmetastatic pancreatic cancer cells.

When they added aspirin to the mixture, they found that the platelets were no longer able to stimulate growth and replication in the pancreatic and nonmetastatic colon cancer cells.

The metastatic colon cancer cells continued to multiply when treated with aspirin.

In pancreatic cancer cells, low doses of aspirin stopped the platelets from releasing growth factor and hampered the signaling of the oncoproteins that cause cancer to survive and spread.

Only very high doses—larger than are possible to take orally—were effective in stopping growth in the metastatic colon cells, explained the researchers.

The findings detail the interaction among platelets, aspirin and tumor cells and are promising for the future treatment of nonmetastatic cancer, according to the researchers.

 “Our study reveals important differences and specificities in the mechanism of action of high- and low-dose aspirin in metastatic and nonmetastatic cancer cells with different tumor origins and suggests that the ability of aspirin to prevent platelet-induced c-MYC [an oncoprotein] expression might be selective for a nonmetastatic phenotype.”

Physiology is the study of how molecules, cells, tissues and organs function in health and disease. Established in 1887, the American Physiological Society (APS) was the first U.S. society in the biomedical sciences field. The Society represents more than 11,000 members and publishes 14 peer-reviewed journals with a worldwide readership.