March is Colon Cancer Awareness month. In addition to raising awareness, I would like to address the issue of colon cancer prevention. It’s one thing to raise awareness but what’s really important is what can one do to prevent this dreaded disease. I would like to address those ‘things’ that you can do to help prevent colon cancer. It is worth mentioning the scope of colon cancer in the U.S. One in 20 people in the U.S. or 5% will develop colorectal cancer. (By the way, for the purpose of discussion, consider colon cancer to mean the same thing as colorectal cancer; the differences in colon and colorectal cancer for the purposes of this blog are not important.) There are presently more than 1 million colon cancer survivors. Colon cancer is the leading cause of cancer-related deaths among non-smokers. Let that sobering fact sink in. But there is good news: the death rate for colon cancer has been decreasing for the past 20 years due to improvements in early detection and treatment. A key role in the decreasing death rate from colon cancer is due to colonoscopy screening which leads to the early detection of colon cancer and precancerous polyps.
I will now discuss what measures you can do to help prevent colon cancer in addition to getting a screening colonoscopy. It is important to stress that the single most important thing you can do to prevent colon cancer is to get a screening colonoscopy at age 50 or younger if you have risk factors.
Tobacco, Diabetes, and Diet
If you smoke tobacco, you should quit. Smoking is a risk factor for so many diseases including colon cancer. If you are obese, you should lose weight which will not only decrease your risk for colon cancer but help to prevent diabetes and lessen the likelihood of arthritic problems. I previously blogged about exercise and its positive influence on preventing colon cancer. Eating a healthy diet that includes daily vegetable intake can help to prevent colon cancer. See my prior blog on this topic.
There is very good evidence that a daily aspirin can help prevent the development of precancerous colon polyps and colon cancer. However, only about a third of colon cancers are prevented by regular aspirin use. Chronic aspirin use is not without its side effects which include gastrointestinal upset including stomach and intestinal ulcers and increased bleeding risk related to trauma. A related group of medications known as COX-2 inhibitors (example celecoxib also known as Celebrex) also have shown benefit in preventing the formation of precancerous colon polyps and colon cancer. COX-2 inhibitors are also associated with side effects including gastrointestinal ulcers and heart disease. Aspirin and COX-2 inhibitors should only be taken under the supervision of a healthcare provider.
Statins are a class of medications that lower cholesterol and prevent heart disease. Statins show promise in preventing colon cancer. Bisphosphonates which are used to treat osteoporosis have shown benefit in preventing colon cancer. Lastly, hormonal replacement therapy for postmenopausal women either in the form of estrogen or estrogen plus progestin have shown promise in lowering the risk of colon cancer.
Vitamins, Antioxidants, and Micronutrients
There is ample evidence for the preventative effects of vitamins, antioxidants, and micronutrients on colon polyps and colon cancer. The strongest evidence is for the use of calcium and vitamin D. There is also strong evidence for the benefit of folate, selenium, vitamin B2, vitamin B6, and beta-carotene. The evidence is weaker for vitamin C, vitamin E, and magnesium. Of the world of herbal remedies, only curcumin has shown benefit. The evidence for green tea extract is weak and you can dismiss essentially all other herbal remedies when it comes to the prevention of colon cancer. I have researched this topic of vitamins, antioxidants, and micronutrients because I want to offer my patients the best advice when it comes to helping them to prevent colon cancer. I decided to combine the vitamins, antioxidants, and micronutrients that have shown benefit and created ‘The Colon Vitamin.’ I am pleased to offer my patients and customers everywhere ‘The Colon Vitamin’ to help promote colon health.
Here’s to your colon health!
Frank Farrell, MD, MPH, AGAF