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Ailmemts & Remedies

Colorectal cancer(Bowel cancer)

Alternative Names:Bowel cancer,large bowel cancer,colon cancer or “CRC” includes cancerous growths in the colon, rectum and appendix.

What is Cancer?
Cancer is a group of more than 100 different diseases. They affect the body’s basic unit, the cell. Cancer occurs when cells become abnormal and divide without control or order. Like all other organs of the body, the colon and rectum are made up of many types of cells. Normally, cells divide to produce more cells only when the body needs them. This orderly process helps keep us healthy….

If cells keep dividing when new cells are not needed, a mass of tissue forms. This mass of extra tissue, called a growth or tumor, can be benign or malignant.

Benign tumors are not cancer. They can usually be removed and, in most cases, they do not come back. Most important, cells from benign tumors do not spread to other parts of the body. Benign tumors are rarely a threat to life.

Malignant tumors are cancer. Cancer cells can invade and damage tissues and organs near the tumor. Also, cancer cells can break away from a malignant tumor and enter the bloodstream or lymphatic system. This is how cancer spreads from the original (primary) tumor to form new tumors in other parts of the body. The spread of cancer is called metastasis.

When cancer spreads to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if colon cancer spreads to the liver, the cancer cells in the liver are colon cancer cells. The disease is metastatic colon cancer (it is not liver cancer

Definition :

It is an   Invasive cancers that are confined within the wall of the colon (TNM stages I and II) are curable with surgery. If untreated, they spread to regional lymph nodes (stage III), where up to 73% are curable by surgery and chemotherapy. Cancer that metastasizes to distant sites (stage IV) is usually not curable, although chemotherapy can extend survival, and in rare cases, surgery and chemotherapy together have seen patients through to a cure.[3] Radiation is used with rectal cancer.

..click to see the pictures

On the cellular and molecular level, colorectal cancer starts with a mutation to the Wnt signaling pathway. When Wnt binds to a receptor on the cell, that sets in motion a chain of molecular events that ends with ß-catenin moving into the nucleus and activating a gene on DNA. In colorectal cancer, genes along this chain are damaged. Usually, a gene called APC, which is a “brake” on the Wnt pathway, is damaged. Without a working APC brake, the Wnt pathway is stuck in the “on” position
Invasive cancers that are confined within the wall of the colon (TNM stages I and II) are curable with surgery. If untreated, they spread to regional lymph nodes (stage III), where up to 73% are curable by surgery and chemotherapy. Cancer that metastasizes to distant sites (stage IV) is usually not curable, although chemotherapy can extend survival, and in rare cases, surgery and chemotherapy together have seen patients through to a cure. Radiation is used with rectal cancer.

On the cellular and molecular level, colorectal cancer starts with a mutation to the Wnt signaling pathway. When Wnt binds to a receptor on the cell, that sets in motion a chain of molecular events that ends with ß-catenin moving into the nucleus and activating a gene on DNA. In colorectal cancer, genes along this chain are damaged. Usually, a gene called APC, which is a “brake” on the Wnt pathway, is damaged. Without a working APC brake, the Wnt pathway is stuck in the “on” position.

Most cases of colon cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Over time some of these polyps become colon cancers.

Symptoms:
*A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool for more than a couple of weeks
*Rectal bleeding or blood in your stool
*Persistent abdominal discomfort, such as cramps, gas or pain
*A feeling that your bowel doesn’t empty completely
*Weakness or fatigue
*Unexplained weight loss

Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they’ll likely vary, depending on the cancer’s size and location in your large intestine.

Causes:
It’s not very clear what causes colon cancer in most cases. Doctors know that colon cancer occurs when healthy cells in the colon become altered. Healthy cells grow and divide in an orderly way to keep your body functioning normally. But sometimes this growth gets out of control — cells continue dividing even when new cells aren’t needed. In the colon and rectum, this exaggerated growth may cause precancerous cells to form in the lining of your intestine. Over a long period of time — spanning up to several years — some of these areas of abnormal cells may become cancerous.

But doctors are certain that colorectal cancer is not contagious (a person cannot catch the disease from a cancer patient). Some people are more likely to develop colorectal cancer than others. Factors that increase a person’s risk of colorectal cancer include high fat intake, a family history of colorectal cancer and polyps, the presence of polyps in the large intestine, and chronic ulcerative colitis.

Polyps may be small and produce few, if any, symptoms. For this reason, doctors recommend regular screening tests to help prevent colorectal cancer by identifying polyps before they become colorectal cancer.

Risk Factors:
The lifetime risk of developing colon cancer in the United States is about 7%. Certain factors increase a person’s risk of developing the disease. These include:

*Age: The risk of developing colorectal cancer increases with age. Most cases occur in the 60s and 70s, while cases before age 50 are uncommon unless a family history of early colon cancer is present.

*Polyps of the colon, particularly adenomatous polyps, are a risk factor for colon cancer. The removal of colon polyps at the time of colonoscopy reduces the subsequent risk of colon cancer.

*History of cancer. Individuals who have previously been diagnosed and treated for colon cancer are at risk for developing colon cancer in the future. Women who have had cancer of the ovary, uterus, or breast are at higher risk of developing colorectal cancer.

Heredity:
*Family history of colon cancer, especially in a close relative before the age of 55 or multiple relatives.
*Familial adenomatous polyposis (FAP) carries a near 100% risk of developing colorectal cancer by the age of 40 if untreated
*Hereditary nonpolyposis colorectal cancer (HNPCC) or Lynch syndrome
*Gardner syndrome

*Smoking: Smokers are more likely to die of colorectal cancer than nonsmokers. An American Cancer Society study found “Women who smoked were more than 40% more likely to die from colorectal cancer than women who never had smoked. Male smokers had more than a 30% increase in risk of dying from the disease compared to men who never had smoked.”

*Diet: Studies show that a diet high in red meat and low in fresh fruit, vegetables, poultry and fish increases the risk of colorectal cancer. In June 2005, a study by the European Prospective Investigation into Cancer and Nutrition suggested that diets high in red and processed meat, as well as those low in fiber, are associated with an increased risk of colorectal cancer. Individuals who frequently eat fish showed a decreased risk. However, other studies have cast doubt on the claim that diets high in fiber decrease the risk of colorectal cancer; rather, low-fiber diet was associated with other risk factors, leading to confounding. The nature of the relationship between dietary fiber and risk of colorectal cancer remains controversial.

*Lithocholic acid: Lithocholic acid is a bile acid that acts as a detergent to solubilize fats for absorption. It is made from chenodeoxycholic acid by bacterial action in the colon. It has been implicated in human and experimental animal carcinogenesis. Carbonic acid type surfactants easily combine with calcium ion and become detoxication products.

*Physical inactivity: People who are physically active are at lower risk of developing colorectal cancer.
Viruses: Exposure to some viruses (such as particular strains of human papilloma virus) may be associated with colorectal cancer.[citation needed]
Primary sclerosing cholangitis offers a risk independent to ulcerative colitis.
Low levels of selenium.

*Inflammatory bowel disease: About one percent of colorectal cancer patients have a history of chronic ulcerative colitis. The risk of developing colorectal cancer varies inversely with the age of onset of the colitis and directly with the extent of colonic involvement and the duration of active disease. Patients with colorectal Crohn’s disease have a more than average risk of colorectal cancer, but less than that of patients with ulcerative colitis.

*Environmental factors. Industrialized countries are at a relatively increased risk compared to less developed countries that traditionally had high-fiber/low-fat diets. Studies of migrant populations have revealed a role for environmental factors, particularly dietary, in the etiology of colorectal cancers.

*Exogenous hormones. The differences in the time trends in colorectal cancer in males and females could be explained by cohort effects in exposure to some gender-specific risk factor; one possibility that has been suggested is exposure to estrogens. There is, however, little evidence of an influence of endogenous hormones on the risk of colorectal cancer. In contrast, there is evidence that exogenous estrogens such as hormone replacement therapy (HRT), tamoxifen, or oral contraceptives might be associated with colorectal tumors.

*Alcohol: Drinking, especially heavily, may be a risk factor.

*Vitamin B6 intake is inversely associated with the risk of colorectal cancer.

Diagnosis:
If your signs and symptoms indicate that you could have colon cancer, your doctor may recommend one of more tests and procedures, including:

*Blood tests. Your doctor may order blood tests to better understand what may be causing your signs and symptoms, but there are no blood tests that can detect colon cancer. Blood tests may include a complete blood count and organ-function tests.

*Using a scope to examine the inside of your colon. Colonoscopy uses a long, flexible and slender tube attached to a video camera and monitor to view your entire colon and rectum. If any suspicious areas are found, your doctor can pass surgical tools through the tube to take tissue samples (biopsies) for analysis.

*Using dye and X-rays to make a picture of your colon. A barium enema allows your doctor to evaluate your entire colon with an X-ray. Barium, a contrast dye, is placed into your bowel in an enema form. During a double-contrast barium enema, air also is added. The barium fills and coats the lining of the bowel, creating a clear silhouette of your rectum, colon and sometimes a small portion of your small intestine.

*Using multiple CT images to create a picture of your colon. Virtual colonoscopy combines multiple computerized tomography (CT) images to create a detailed picture of the inside of your colon. If you’re unable to undergo colonoscopy, your doctor may recommend virtual colonoscopy.

Staging colon cancer.
Once you’ve been diagnosed with colon cancer, your doctor will then order tests to determine the extent, or stage, of your cancer. Staging helps determine what treatments are most appropriate for you. Staging tests may include imaging procedures such as abdominal and chest CT scans. In many cases, the stage of your cancer may not be determined until after colon cancer surgery.

The stages of colon cancer are:

*Stage 0. Your cancer is in the earliest stage. It hasn’t grown beyond the inner layer (mucosa) of your colon or rectum. This stage of cancer may also be called carcinoma in situ.
*Stage I. Your cancer has grown through the mucosa but hasn’t spread beyond the colon wall or rectum.
*Stage II. Your cancer has grown into or through the wall of the colon or rectum but hasn’t spread to nearby lymph nodes.
*Stage III. Your cancer has invaded nearby lymph nodes but isn’t affecting other parts of your body yet.
*Stage IV. Your cancer has spread to distant sites, such as other organs — for instance to your liver or lung.
*Recurrent. This means your cancer has come back after treatment. It may recur in your colon, rectum or other part of your body.
Treatment:
The main treatment option for Colorectal cancer  is surgery – if the disease can be caught before it breaks through the bowel wall, chances of success are much higher.

Usually, the piece of bowel that contains the cancer is removed and the two open ends are joined back together. This operation is called a bowel resection.

If the two sections can’t be joined back together, often because the tumour is too low, the bowel can be brought out through the abdominal wall. This is called a stoma, which is connected to a colostomy bag. Although this procedure is more likely after removal of a tumour in the rectum, it isn’t always necessary and may only be temporary. In these cases, further treatment may not be necessary.

Chemotherapy and radiotherapy are increasingly being used to treat bowel cancer in addition to surgery, especially in more advanced tumours. For example, a combination of radiotherapy and chemotherapy may be given before surgery for rectal cancer. This is known as neo-adjuvant therapy and may reduce the risk of recurrence and improve survival rates.

How well patients do after treatment depends on the stage the cancer has reached. Survival rates have improved in the past 30 years, but overall survival is still only about 50 per cent at five years. However, when bowel cancer is caught early – before it has spread to other organs such as the liver or the lungs – the chances of recovery are more than 80 per cent.

Alternative Medication:
No complementary or alternative treatments have been found to cure colon cancer.

Alternative treatments may help you cope with a diagnosis of colon cancer. Nearly all people with cancer experience some distress. Common signs and symptoms of distress after your diagnosis might include sadness, anger, difficulty concentrating, difficulty sleeping and loss of appetite. Alternative treatments may help redirect your thoughts away from your fears, at least temporarily, to give you some relief.

Alternative treatments that may help relieve distress include:

*Art therapy
*Dance or movement therapy
*Exercise
*Meditation
*Music therapy
*Relaxation exercises

Your doctor can refer you to professionals who can help you learn about and try these alternative treatments. Tell your doctor if you’re experiencing distress.

Prognosis:
Survival is directly related to detection and the type of cancer involved, but overall is poor for symptomatic cancers, as they are typically quite advanced. Survival rates for early stage detection is about 5 times that of late stage cancers. For example, patients with a tumor that has not breached the muscularis mucosa (TNM stage T1-2, N0, M0) have an average 5-year survival of approximately 90%. Those with a more invasive tumor, yet without node involvement (T3-4, N0, M0) have an average 5-year survival of approximately 70%. Patients with positive regional lymph nodes (any T, N1-3, M0) have an average 5-year survival of approximately 40%, while those with distant metastases (any T, any N, M1) have an average 5-year survival of approximately 5%.

CEA level is also directly related to the prognosis of disease, since its level correlates with the bulk of tumor tissue.

Follow Up:
The aims of follow-up are to diagnose, in the earliest possible stage, any metastasis or tumors that develop later, but did not originate from the original cancer (metachronous lesions).

The U.S. National Comprehensive Cancer Network and American Society of Clinical Oncology provide guidelines for the follow-up of colon cancer.[93][94] A medical history and physical examination are recommended every 3 to 6 months for 2 years, then every 6 months for 5 years. Carcinoembryonic antigen blood level measurements follow the same timing, but are only advised for patients with T2 or greater lesions who are candidates for intervention. A CT-scan of the chest, abdomen and pelvis can be considered annually for the first 3 years for patients who are at high risk of recurrence (for example, patients who had poorly differentiated tumors or venous or lymphatic invasion) and are candidates for curative surgery (with the aim to cure). A colonoscopy can be done after 1 year, except if it could not be done during the initial staging because of an obstructing mass, in which case it should be performed after 3 to 6 months. If a villous polyp, a polyp >1 centimeter or high grade dysplasia is found, it can be repeated after 3 years, then every 5 years. For other abnormalities, the colonoscopy can be repeated after 1 year.

Routine PET or ultrasound scanning, chest X-rays, complete blood count or liver function tests are not recommended. These guidelines are based on recent meta-analyses showing intensive surveillance and close follow-up can reduce the 5-year mortality rate from 37% to 30%.

Prevention:
People are encouraged to eat plenty of fresh fruit and vegetables, as this appears to reduce the risk. A high-fibre diet with plenty of fruit, vegetables and carbohydrates (pasta, bread, rice) is believed to reduce the risk of colorectal cancer. Moderate amounts of exercise may also protect against bowel cancer.

Eating a diet high in saturated fat and red meat, and low in fibre, smoking and being overweight, increases your risk as does drinking excessive amounts of alcohol.

Eating at least five portions of fruit and vegetables every day is thought to protect against this and many different cancers through the benefits of the antioxidant vitamins and minerals they contain.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.medicinenet.com/colon_cancer/article.htm
http://en.wikipedia.org/wiki/Colorectal_cancer
http://search.myway.com/search/GGmain.jhtml?pg=AJmain&action=click&searchfor=colorectal+cancer&ss=sub&st=site&ct=TG
http://www.bbc.co.uk/health/physical_health/conditions/in_depth/cancer/typescancer_bowel.shtml
http://www.mayoclinic.com/health/colon-cancer/DS00035

http://www.bbc.co.uk/health/physical_health/conditions/in_depth/cancer/typescancer_bowel.shtml

http://www.khg2.net/colon-cancer/

http://www.metrohealth.org/body.cfm?id=1628&oTopID=1616

Categories
Ailmemts & Remedies

Colon Polyps

Endoscopic image of colon cancer identified in...
Image via Wikipedia

Definition
Colon polyps are fleshy growths that occur on the inside (the lining) of the large intestine, also known as the colon. Polyps in the colon are extremely common, and their incidence increases as individuals get older. As many as 30 percent of middle-aged and older adults have one or more colon polyps — a small clump of cells that forms on the colon lining. Although the great majority of colon polyps are harmless, some may become cancerous over time. Anyone can develop colon polyps, but you’re at higher risk if you are 50 or older, are overweight or a smoker, eat a high-fat, low-fiber diet, or have a personal or family history of colon polyps or colon cancer.

..You may click to see pictures of Colon Polyps

Sometimes colon polyps can cause signs and symptoms such as rectal bleeding, a change in bowel habits and abdominal pain. But most small colon polyps don’t cause problems, which is why experts generally recommend regular screening. Colon polyps that are found in the early stages usually can be removed safely and completely.

Types of polyps become cancerous:
The polyps that become cancerous are called adenomatous polyps or adenomas. Adenomas account for approximately 75% of all colon polyps. There are several subtypes of adenoma that differ primarily in the way the cells of the polyp are assembled when they are examined under the microscope. Thus, there are tubular, villous, or tubulo-villous adenomas. Villous adenomas are the most likely to become cancerous, and tubular adenomas are the least likely.

Other Factors that may determine a polyp’s chance of becoming cancerous
Another factor that contributes to a polyp’s likelihood of becoming cancerous is its size. The larger a polyp grows, the more likely it is to become cancerous. Once a polyp reaches two centimeters or approximately one inch in size, the risk of cancer is in excess of 20 percent. Therefore, it is advisable to remove polyps of any size, preferably when they are of a small size, to prevent their growth and progression to cancer.

Although adenomas are by far the most common type of colon polyps, there are several other types of polyps. Among the other types of polyps that have no malignant potential are the hyperplastic, inflammatory, and hamartomatous polyps

Symptoms
Colon polyps range from smaller than a pea to golf ball sized. Small polyps, especially, aren’t likely to cause problems, and you may not know you have one until your doctor finds it during an examination of your bowel. Sometimes, however, you may have signs and symptoms such as:

Rectal bleeding. You might notice bright red blood on toilet paper after you’ve had a bowel movement. Although this may be a sign of colon polyps or colon cancer, rectal bleeding can indicate other conditions, such as hemorrhoids or minor tears (fissures) in your anus. Hemorrhoids don’t usually bleed consistently over a period of weeks, however, so if your bleeding is prolonged, be sure to tell your doctor.

Blood in your stool. Blood can show up as red streaks in your stool or make bowel movements appear black. Still, a change in color doesn’t always indicate a problem — iron supplements and some anti-diarrhea medications can make stools black, whereas beets and red licorice can turn stools red.

Constipation or diarrhea. Although a change in bowel habits that lasts longer than a week may indicate the presence of a large colon polyp, it can also result from a number of other conditions.
Pain or obstruction. Sometimes a large colon polyp may partially obstruct your bowel, leading to crampy abdominal pain, nausea, vomiting and severe constipation.

Causes:
Your digestive tract stretches from your mouth to your anus. As food travels along this 30-foot passageway, nutrients are broken down and absorbed by your body to build cells and produce energy.

The last part of your digestive tract is a long muscular tube called the large intestine. The colon is the upper 4 to 6 feet of the large intestine; the rectum makes up the lower 8 to 10 inches. The colon’s main function is to absorb water, salt and other minerals from colon contents. Your rectum stores waste until it’s eliminated from your body.

Why polyps form
The majority of polyps aren’t cancerous (malignant), yet like most cancers, they result from abnormal cell growth. Healthy cells grow and divide in an orderly way — a process that’s controlled by two broad groups of genes. Mutations in any of these genes can cause cells to continue dividing even when new cells aren’t needed. In the colon and rectum, this unregulated growth can cause polyps to form, and over a long period of time, some of these polyps may become malignant.

Polyps can develop anywhere in your large intestine. They can be small or large and flat (sessile) or mushroom shaped and attached to a stalk (pedunculated). Small and mushroom-shaped polyps are much less likely to become malignant than flat or large ones are. In general, the larger a polyp, the greater the likelihood of cancer.

There are three main types of colon polyps:

Adenomatous. Once adenomatous polyps grow beyond the size of a pencil eraser — about 5 millimeters (mm), or 1/4 inch — there’s a small but increasing chance that they’ll become cancerous. This is especially true when their diameter exceeds 10 mm. For that reason, doctors normally take a tissue sample (biopsy) from polyps during a sigmoidoscopy and either biopsy or remove large polyps during a colonoscopy.
Hyperplastic. These polyps occur most often in your left (descending) colon and rectum. Usually less than 5 mm in size, they’re rarely malignant.
Inflammatory. These polyps may follow a bout of ulcerative colitis or Crohn’s disease of the colon. Although the polyps themselves are not a significant threat, having ulcerative colitis or Crohn’s disease of the colon increases your overall risk of colon cancer.

Risk Factors:

Anyone can get polyps, but certain people are more likely than others. You may have a greater chance of getting polyps if you

*Are over age 50
*Have had polyps before
*Have a family member with polyps
*Have a family history of colon cancer
*Most colon polyps do not cause symptoms. If you have symptoms, they may include blood on your underwear or on toilet paper after a bowel movement, blood in your stool, or constipation or diarrhea lasting more than a week.

A number of factors may contribute to the formation of colon polyps and colon cancer. They include:

*Age. The great majority of people with colon cancer are 50 or older. Your risk generally starts increasing around age 40.


*Your sex.
More men than women develop colon polyps and colon cancer.
Inflammatory intestinal conditions. Long-standing inflammatory diseases of the colon such as ulcerative colitis and Crohn’s disease can increase your risk.

In an autosomal dominant disorder, the mutated gene is dominant, which means you only need one mutated gene to have the disorder. A person with an autosomal dominant disorder — in this case, the father — has a 50 percent chance of having an affected child with one mutated gene (dominant gene) and a 50 percent chance of having an unaffected child with two normal genes (recessive genes). These chances are the same in each pregnancy. .

*Family history. You’re more likely to develop colon polyps or cancer if you have a parent, sibling or child with them. If many family members have them, your risk is even greater. In some cases this connection isn’t hereditary or genetic. For example, cancers within the same family may result from shared exposure to an environmental carcinogen or from similar diet or lifestyle factors.

*Diet. Eating a high-fiber diet — one plentiful in fruits, vegetables and whole grains — can reduce your risk of colon polyps and colon cancer. Fiber seems protective against colon cancer because it provides bulk that moves your stool more quickly through your bowel. This means that cancer-causing substances (carcinogens) in the foods you eat aren’t in contact with your bowel wall as long as they might be if you ate a low-fiber diet. Fruits and vegetables are also rich in antioxidants — substances that protect cells from damage caused by unstable molecules (free radicals) that may lead to cancer.

*Smoking and alcohol. Smoking significantly increases your risk of colon polyps and colon cancer. Smokers are 30 percent to 40 percent more likely to die of colon cancer than are nonsmokers. Drinking alcohol in excess also makes it more likely that you’ll develop colon polyps. If you smoke and drink, your risk increases even more.

*A sedentary lifestyle. If you’re inactive, you’re more likely to develop colon cancer. This may be because when you’re inactive, waste stays in your colon longer.

*Obesity. Being significantly overweight — 30 pounds or more — has been linked to an increased risk of several types of cancer, including colon cancer.

*Race. If you are black, you are at higher risk of developing colon cancer than if you are white.

Inherited gene mutations
Another risk factor for colon polyps is genetic mutations. A small percentage of colon cancers result from gene mutations. These cancers are autosomal dominant, meaning you need to inherit only one defective gene from either of your parents. If one parent has the mutated gene, you have a 50 percent chance of inheriting the mutation. Although inheriting a defective gene greatly increases your risk, not everyone with a mutated gene develops cancer.

One genetic defect that plays a key role in colon cancer occurs in the adenomatous polyposis coli (APC) gene. When the APC gene is normal, it helps control cell growth. But if it’s defective, cell growth accelerates, leading to the formation of multiple adenomatous polyps in your intestinal lining. Conditions related to APC gene defects include:

*Familial adenomatous polyposis (FAP). This is a rare, hereditary disorder that results from an APC gene defect. FAP causes you to develop hundreds, even thousands, of polyps in the lining of your colon beginning in your teenage years. If these go untreated, your risk of developing colon cancer is nearly 100 percent. The encouraging news about FAP is that in some cases, genetic testing can help determine whether you’re at risk of the disease.

*Gardner’s syndrome. This syndrome is a variant of FAP. This condition causes polyps to develop throughout your colon and small intestine. You may also develop noncancerous tumors in other parts of your body, including your skin (sebaceous cysts and lipomas), bone (osteomas) and abdomen (desmoids).

*Hereditary nonpolyposis colorectal cancer (HNPCC). This is the most common form of inherited colon cancer. It, too, results from a defect in the APC gene, but unlike people with FAP or Gardner’s syndrome, people with hereditary nonpolyposis colorectal cancer tend to develop relatively few colon polyps. They do, however, often have tumors in other organs. Hereditary nonpolyposis colorectal cancer includes Lynch I and Lynch II syndromes. People with Lynch I syndrome usually develop a small number of polyps that quickly become malignant. Those with Lynch II syndrome tend to develop tumors in the breast, stomach, small intestine, urinary tract and ovaries as well as in the colon.

Tests and diagnosis:
Nearly all colon cancers develop from polyps, but the polyps grow slowly, usually over a period of years. Screening tests play a key role in detecting polyps before they become cancerous. These tests can also help find colorectal cancer in its early stages, when you have a good chance of recovery. When early-stage cancers are found and removed during routine screening, the five-year survival rate may be as high as 90 percent.

Several screening methods exist — each with its own benefits and risks. Be sure to discuss these with your doctor:

*Digital rectal exam. In this office exam, your doctor uses a gloved finger to check the first few inches of your rectum for polyps. Although safe and relatively painless, the exam is limited to your lower rectum and can’t detect problems with your upper rectum and colon. In addition, it’s difficult for your doctor to feel small polyps. This test should not be used alone as a screening method.

*Fecal occult (hidden) blood test. This noninvasive test checks a sample of your stool for blood. It can be performed in your doctor’s office, but you’re usually given a kit that explains how to take the test at home. Be sure to follow the instructions carefully, because your diet and other factors can affect the results. You then return the test to a lab or your doctor’s office to be checked. The problem is that most polyps don’t bleed, nor do all cancers. This can result in a negative test result, even though you may have a polyp or cancer. On the other hand, if blood shows up in your stool, it may be the result of hemorrhoids or an intestinal condition other than cancer. For these reasons, many doctors recommend other screening methods instead of, or in addition to, fecal occult blood tests.

*Flexible sigmoidoscopy. In this test, your doctor uses a slender, lighted tube to examine your rectum and sigmoid — approximately the last 2 feet of your colon. Nearly half of all colon cancers are found in this area. Yet a sigmoidoscopy only looks at the last third of your colon, and doesn’t detect polyps elsewhere in the large intestine. It’s often combined with a barium enema to better visualize the entire colon, or your doctor may recommend performing a colonoscopy instead. A sigmoidoscopy can be somewhat uncomfortable, and though there’s a slight risk of perforating the colon, the risks are less than they are for colonoscopy.

*Barium enema. This diagnostic test allows your doctor to evaluate your entire large intestine with an X-ray. Barium, a contrast dye, is placed into your bowel in an enema form. The barium fills and coats the lining of the bowel, creating a clear silhouette of your rectum, colon and sometimes a small portion of your small intestine. Air may also be added to provide better contrast on the X-ray. The test typically takes about 20 minutes and can be somewhat uncomfortable because the barium and air distend your bowel. There’s also a slight risk of perforating the colon wall. Because barium enema has a higher miss rate for colon polyps, it’s not nearly as reliable as other screening tests. It also doesn’t allow your doctor to take a biopsy during the procedure to determine whether a polyp is cancerous.

*Colonoscopy. This procedure is the most sensitive test for colorectal polyps and colorectal cancer. It’s better at detecting polyps than is a barium enema X-ray alone. Colonoscopy is similar to flexible sigmoidoscopy, but the instrument used — a colonoscope, which is a long, slender tube attached to a video camera and monitor — allows your doctor to view your entire colon and rectum. If any polyps are found during the exam, your doctor may remove them immediately or take tissue samples (biopsies) for analysis. A colonoscopy takes about a half-hour. You’re likely to receive a mild sedative to make you more comfortable. The risks of diagnostic colonoscopy include hemorrhage and perforation of the colon wall. Complications are more likely to occur when polyps are removed.

*Genetic testing. If you have a family history of colorectal cancer, you may be a candidate for genetic testing. This blood test may help determine if you’re at increased risk of colon or rectal cancer, but it’s not without drawbacks. The results can be ambiguous, and the presence of a defective gene doesn’t necessarily mean you’ll develop cancer. Knowing you have a genetic predisposition can alert you to the need for regular screening.

*Pill camera. Colonoscopy is effective at detecting polyps in the colon, but the colonoscope can’t reach the small intestine. Until recently, a barium X-ray was the only way to screen the small intestine, but the test is often inaccurate. Now doctors have found that a tiny camera fitted inside a capsule that you swallow can identify polyps in the small intestine with a high degree of accuracy. But because small intestine polyps are rare, the test isn’t routinely performed.

*New technologies. New technologies such as virtual colonoscopy (CT colonography) may make colon screening safer, more comfortable and less invasive. In virtual colonoscopy, you have a two-minute computerized tomography scan, a highly sensitive X-ray of your colon. Then, using computer imaging, your doctor rotates this X-ray in order to view every part of your colon and rectum without actually going inside your body. Before the scan, your large intestine is cleared of any stool, but researchers are looking into whether the scan can be done successfully without the usual bowel preparation. Although virtual colonoscopy potentially is a tremendous step forward, it may not be as accurate as regular colonoscopy, it is highly dependent on the skill of the doctor reading the test, and it doesn’t allow your doctor to remove polyps or take tissue samples during the procedure.

Another new test checks a stool sample for DNA from abnormal cells. In preliminary studies, the test proved highly accurate, but results in the first large trial of the test were disappointing. In that trial, the DNA test found more colon and rectal cancers than did the fecal occult blood test, but fewer than did colonoscopy.

Treatments and drugs:
Although some types of colon polyps are far more likely to become malignant than are others, a pathologist usually must examine a polyp under a microscope to determine whether it’s potentially cancerous. For that reason, your doctor is likely to remove all polyps discovered during a bowel examination.

The great majority of polyps can be removed during colonoscopy or sigmoidoscopy by snaring them with a wire loop that simultaneously cuts the stalk of the polyp and cauterizes it to prevent bleeding. Some small polyps may be cauterized or burned with an electrical current. Risks of polyp removal (polypectomy) include bleeding and perforation of the colon.

Polyps that are too large to snare or that can’t be reached safely are usually surgically removed — often using laparoscopic techniques. This means your surgeon performs the operation through several small incisions in your abdominal wall, using instruments with attached cameras that display your colon on a video monitor. Laparoscopic surgery may result in a faster and less painful recovery than does traditional surgery using a single large incision. Once the section of your colon that contains the polyp is removed, the polyp can’t recur, but you have a moderate chance of developing new polyps in other areas of your colon in the future. For that reason, follow-up care is extremely important.

In cases of rare, inherited syndromes, such as FAP, your surgeon may perform an operation to remove your entire colon and rectum (total proctocolectomy). Then, in a procedure known as ileal pouch-anal anastomosis, a pouch is constructed from the end of your small intestine (ileum) that attaches directly to your anus. This allows you to expel waste normally, although you may have several watery bowel movements a day.

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Daily calcium supplements can help prevent colon polyps, study suggests

Recognizing Colon Cancer Symptoms & Detoxification

Lower Your Colon Cancer Risk with Calcium

Prevention:
You can greatly reduce your risk of colon polyps and colorectal cancer by having regular screenings and by making certain changes in your diet and lifestyle. The following suggestions may help lower your risk of colon polyps and colon cancer:

*Pay attention to calcium. Calcium can significantly protect against colon polyps and cancers, even if you’ve had them before. For example, studies have shown a 19 percent to 34 percent reduction in recurrence of polyps in those who take daily calcium supplements. Good food sources of calcium include skim or low-fat milk and other dairy products, broccoli, kale and canned salmon with the bones. Vitamin D, which aids in the absorption of calcium, also appears to help reduce the risk of colorectal cancer. You get vitamin D from foods such as vitamin-D fortified milk products, liver, egg yolks and fish. Sunlight also converts a chemical in your skin into a usable form of the vitamin. If you don’t drink milk or you avoid the sun, you may want to consider taking both a vitamin D and a calcium supplement.

*Include plenty of fruits, vegetables and whole grains in your diet. These foods are high in fiber, which can cut your risk of developing colon polyps. Fruits and vegetables also contain antioxidants, which may help prevent cancer. The American Cancer Society recommends eating five or more servings of fruits and vegetables every day. Look for deep green and dark yellow or orange fruits and vegetables such as Swiss chard, bok choy, spinach, cantaloupe, mango, acorn or butternut squash, and sweet potatoes, as well as vegetables from the cabbage family, including broccoli, brussels sprouts and cauliflower. Lycopene, a nutrient found in tomatoes and other red fruits and vegetables, such as strawberries and red bell peppers, may be a particularly powerful anti-cancer chemical.

*Limit fat. People who eat high-fat diets have a higher rate of colorectal cancer than do people who consume less dietary fat. Be especially careful to limit saturated fats from animal sources such as red meat. Other foods that contain saturated fat include whole milk, cheese, ice cream, and coconut and palm oils. Restrict your total fat intake to less than 35 percent of your daily calories, with no more than 8 percent to 10 percent coming from saturated fats.

*Limit alcohol consumption. Consuming moderate to heavy amounts of alcohol — more than one drink a day for women and two for men — may increase your risk of colon polyps and cancer. A drink is considered to be a 4- to 5-ounce glass of wine, a 12-ounce can of beer, or a 1.5-ounce shot of 80-proof liquor. Curbing alcohol consumption can reduce your risk, even if colon cancer runs in your family.

*Stop smoking. Smoking can increase your risk of colon cancer and a wide range of other diseases. Talk to your doctor about ways to quit that might work for you.

*Stay physically active and maintain a healthy body weight. Controlling your weight alone can reduce your risk of colorectal cancer. And staying physically active may significantly cut your colon cancer risk. Exercise stimulates movement through your bowel and reduces the time your colon is exposed to harmful substances that may cause cancer. The American Cancer Society recommends at least 30 minutes of physical activity five or more days a week. Forty-five minutes of moderate or vigorous activity can lower your risk of breast and colon cancer even more. If you’re overweight, lose weight until you are at a healthy level and maintain it.

*Talk to your doctor about aspirin. Studies on the role of aspirin in colorectal polyp and cancer prevention are mixed. Some show a 13 percent to 28 percent reduction in relative risk of these conditions with aspirin use. Others show no risk reduction. Aspirin appears to decrease the risk of these conditions primarily when taken at a high dose, such as 325 milligrams or more a day, and for more than 10 years. But aspirin use can increase your risk of gastrointestinal bleeding, and in high enough doses, stroke. So check with your doctor before starting any aspirin regimen.

*Talk to your doctor about hormone therapy (HT). If you’re a woman past menopause, hormone therapy may reduce your risk of colorectal cancer. Women who use HT have a somewhat lower risk of colorectal cancer than do women who don’t use HT. But not all effects of HT are positive. Taking HT as a combination therapy — estrogen plus progestin — can increase your risk of breast cancer, dementia, heart disease, stroke and blood clots. Discuss your options with your doctor. Together you can decide what’s best for you.

*If you’re at high risk, consider your options. If you’re at risk of FAP because of a family history of the disease, consider having genetic counseling. And if you’ve been diagnosed with FAP, start having regular colonoscopy tests in your early teens and discuss your options with your doctor. To prevent cancer from developing, most experts recommend having surgery to remove your entire colon when you’re in your 20s. The risk for people with hereditary nonpolyposis colorectal cancer isn’t quite as great as it is for those with FAP. Doctors recommend that people at risk of HNPCC begin having regular colonoscopies around age 20, but less often recommend removing the colon.

In the past, researchers believed that folate could help prevent colon polyps, but subsequent research indicates that it has no protective effect and should not be taken for that purpose.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.mayoclinic.com/health/colon-polyps/DS00511
http://www.medicinenet.com/colon_polyps/article.htm
http://www.nlm.nih.gov/medlineplus/colonicpolyps.html

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