March is Colorectal Cancer Awareness Month, a time set aside to highlight the importance of screening for colorectal cancer and to emphasize the promotion of healthy lifestyle habits that can greatly decrease your chances of getting this disease. The month is almost over, but you need to be aware of your health habits every day of the year, and this is what this article aims to help you do.
What is colorectal cancer?
The Centers for Disease Control and Prevention (CDC) gives this definition for colorectal cancer (called colon cancer for short): Colorectal cancer is a disease in which cells in the colon or rectum grow out of control. The colon is the large intestine or large bowel. The rectum is the passageway that connects the colon to the anus. Sometimes polyps may develop in your colon and your doctor may find these when you have a colonoscopy or cancer screening. These polyps can become cancerous. This is why early screening works best to spot and get rid of any growths that may lead to colorectal cancer (CRC).
Stats about type 2 diabetes and CRC
Since this is a blog about type 2 diabetes, you may be wondering what is the relevance of this topic. According to the Library of Medicine (NIH), the risk of colorectal cancer (CRC) was estimated to be 27% higher in people with type 2 diabetes than in people who do not have diabetes. In the United States, CRC is the second leading cause of cancer death among men and women combined.
Risk factors for CRC
The CDC states that inflammatory bowel disease such as Crohn’s disease or ulcerative colitis is a risk factor for colorectal cancer, however, colorectal cancer and type 2 diabetes mellitus (DM) share some of the same risk factors, such as
- Age – Your chances of getting CRC increase as you get older. People over age 50 are especially at risk.
- Lifestyle factors – diet and regular physical activity play an important role in both type 2 DM and colorectal cancer. A diet high in fiber and low in fat and processed foods can help to reduce the risk of getting these illnesses. The Mediterranean diet has been known to decrease both DM and CRC.
- Genetic – like diabetes, some people may have a family history of colorectal cancer or colorectal polyps. People with the classic type of familial adenomatous polyposis may begin to develop multiple noncancerous (benign) growths (polyps) in the colon as early as their teenage years, but, the CDC says, these polyps will become malignant if the colon is not removed.
- Obesity – another factor contributing to both type 2 DM and CRC
- Alcohol consumption and smoking can also contribute to DM and CRC.
Symptoms of CRC
According to the CDC, you can have polyps or colorectal cancer and not know it, this is why early screening, starting at age 45 is recommended. The CDC lists the following symptoms:
A change in bowel habits
Blood in or on your stool
Diarrhea, constipation or feeling that the bowel does not empty all the way.
Abdominal aches, pain, or cramps that don’t go away
Unexplained weight loss
Tests for CRC
The earlier cancer is detected the easier it is to be treated. A colonoscopy is the most accurate test for colon cancer. Before your colonoscopy, your doctor will give you thorough instructions to prepare for your examination. During the procedure, your doctor uses a thin, flexible tube, called a colonoscope or endoscope, with a camera attached to the end so he can see the inside of your colon. You are given sedation to avoid pain. If polyps are found, the doctor removes them with a wire loop attached to the endoscope.
A sigmoidoscopy is a less invasive version of a colonoscopy, as it only examines the lower part of the colon, known as the descending or sigmoid colon, and the rectum. Preparation is similar to that done for a colonoscopy.
A CT colonography or scan of the large intestine. This is less invasive than the two tests mentioned above but is done when the person is unable to undergo a colonoscopy. Preparation is the same, but if after the colonography, cancer is suspected, then the person will have to undergo a colonoscopy so that the doctor can perform a biopsy in order to make a firm diagnosis.
Stool tests – Your doctor may give you a test kit that you use to collect a small sample of stool (feces) to detect if there is blood in it. If a significant amount of blood shows up then you will need a colonoscopy.
Treatment for CRC
Treatment for CRC depends on what stage the cancer is at when it is detected. In the early stages, the cancer may be curable, but not in every case. Treatment for stages 1, 2, and 3 — before the cancer has spread to other parts of the body — will all involve surgery. Either a part or the whole colon will be removed depending on the type of cancer. This can result in you having to use a colostomy.
Chemotherapy and radiation are used when the cancer is no longer operable, or if the cancer is only located in the rectum.
One study found that Metformin use has been associated with a decreased risk of colon cancer and increased survival but states that further studies are needed.
A diagnosis of colorectal cancer can be as frightening as a diagnosis of type 2 diabetes, but the good news is both illnesses can be managed or even cured if detected early and if proper lifestyle changes are made. According to the American Diabetes Association (ADA), the survival rate for those diagnosed with CRC in the early stages is very high, yet over a third of US adults aged 50 to 75 have never been screened. If you have type 2 diabetes, you are at a greater risk for developing CRC. This March, if you are in the group of people who should have been screened and have not, please make it your duty to do so.
A diagnosis of type 2 diabetes can send your life into a tailspin. It can leave you feeling alone and overwhelmed, but it doesn’t have to. Join my type 2 diabetes network group and get the help and support you need.