HEALTH C olorectal cancer can start in the lining of the large intestine (colon) or rectum, i.e. the lower parts of the gastrointestinal tract. The colon absorbs water and nutrients from food, and stores waste until you pass it. If you neglect your general health or have inherited genetic gut problems, polyps can form in these areas and become cancerous. ON THE RISE “The incidence of colorectal cancer has increased considerably, particularly among adults aged 50 and older, but the incidence of early-onset colorectal cancer (in those under 50) has also been rising globally,” says Professor Michael Herbst, health specialist at the Cancer Association of South Africa (CANSA). “In this country, it is the second most common cancer in men (after prostate) and the third most common in women (after breast and cervical).” It begins when the normal replacement of cells lining the intestinal walls goes awry, for reasons still poorly understood, leading to fleshy growths called polyps, he explains. “Some polyps can become cancerous in a slow process, taking around eight to 10 years to develop to full- blown cancer.” SPOT THE SIGNS There are no signs in the early stages, which is why check-ups are vital, especially if you are at high risk (see "Know Your Risk"). As the disease progresses, you may notice a change in bowel habits (constipation or diarrhoea) or stool consistency, a feeling that your bowel does not empty completely, rectal bleeding or blood in your stools (streaks of red or a tarry black consistency), persistent abdominal discomfort (gas, cramps or pain not related to diet), fatigue, weakness and unexplained weight loss. “Check with your health provider if you have these signs, but also take advantage of the opportunity to screen for colorectal cancer before you experience any,” Professor Herbst urges. CANSA advises having a colonoscopy every 10 years from age 50 (and more often if you are at high risk). Polyps can be removed during the procedure before they become cancerous. CANSA also provides a faecal occult stool test 60 that you can do at home to detect blood in your stool and if it is positive, they will provide a referral letter to your health provider, says Lorraine Govender, CANSA National Manager: Health Programmes. GET DIAGNOSED AND TREATED Your health provider will take your history and do a physical exam and a digital rectal exam. If colon cancer is suspected, you will be referred for a sigmoidoscopy (where a device with a small camera and light is inserted for an internal examination of the lower part of your colon), or a more extensive colonoscopy (where a similar device with a longer tube examines your entire colon). If cancer is detected, most people with early colorectal cancer will have surgery, says Professor Herbst. “If it is caught early, it can be removed without the need for further
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