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Healthy Lifestyle
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How can I prevent colon cancer?
Taking a pill to prevent colorectal cancer, the second most common malignancy, is an attractive proposition and while unrealistic, there are measure you can take to prevent colon cancer and colon polyps. Remember, apart from dietary restrictions such as avoidance of animal fats and alcohol and adequate exercise in addition to periodic colonoscopy to exam the colon and remove colorectal polyps and tumors, there are no proven measures that reduce the risk of colorectal neoplasia. However, various dietary supplements have been purported to be protective.
Diet high in fresh fruits and vegetables, low in calories, alcohol and animal fat is cancer protective although the presumed protective effects of fiber per se is doubted by recent trials. Calcium, folate, and selenium may help in colon cancer prevention. Intracellular folate deficiency alters gene-specific DNA methylation and affect DNA stability by production of DNA strand breaks or misincorporation of uracil. Folate supplementation slows cryptal colocyte proliferation in patients at high risk for colon cancer. Low dietary folate and methionine and high alcohol consumption increase risk of colon cancer, possibly by modulating methylation. The inverse association of folic acid consumption with colon cancer risk was greater in women with a family history. More practically, Folate seems to abolish the undesirable influence of family history of colon cancer, which increases the risk of colorectal carcinogenesis.
A deficiency of micronutrients such as folic acid, Vitamin B12, Vitamin B6, niacin, Vitamin C, and Vitamin E damages DNA by causing single- and double-strand breaks, oxidative lesions. This damage is similar to radiation induced DNA damage. This may explain high colon cancer risk associated with low folate intake. Vitamin B12 and B6 deficiencies, common in elderly population also lead to high uracil and chromosome breaks. Micronutrient deficiency may explain why the quarter of the population that eats the fewest fruits and vegetables has about double the cancer rate for most types of cancer when compared to the quarter with the highest fruit consumption. Correcting the micronutrient deficiency by dietary supplementation can have noticeable cancer-preventive benefits.
Epidemiologically, dietary calcium and vitamin D intake is inversely related to incidence of colon cancer. Dietary calcium supplements lower epithelial cell proliferation indexes from a higher- to a lower-risk pattern, indicating oncoprotective benefit.
Yogurt and Lactobacilli suppress carcinogen-induced preneoplastic and neoplastic lesions in animal models Yogurt and the lactic acid producing bacteria (probiotics) may decrease the ability of the other colonic microflora to produce carcinogens. Prebiotics such as non-digestible oligosaccharides alter colonic microflora by selectively augmenting the growth of Lactobacilli in the colon. Evidence for cancer-preventing properties of pro- and prebiotics is also based on fecal enzyme activities in humans, in vivo and in vitro inhibition of genotoxicity of carcinogens. The combinations of pro and prebiotics (synbiotics) are more effective than either of the categories.
Cox-2 inhibitors may also be candidates in chemoprevention of colon cancer. Carcinoigenesis is a complex process associated with overexpression of prostaglandins. Incidence of colon cancer inversely correlates with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), which inhibit prostaglandin synthesis. The NSAIDs inhibit cyclooxygenases (COX), which are active in prostaglandin production. Cyclooxygenase-2 (COX-2) is usually not expressed in normal tissue but over expressed in premalignant lesions and neoplasms. Early clinical data suggest that COX-2 inhibitors may protect against colon cancer. Prostaglandin E2 acts by binding to the membrane receptor EP1. EP1 receptor is believed to be important in colon carcinogenesis and selective EP1 receptor antagonists may prove to be oncoprotective.
There is no one prescription that you can suggest to your patients when they ask you about colon cancer prevention. Secondary prevention by identification and removal of premaligant colorectal adenomas by periodic colonoscopy is currently the best measure of prevention of colorectal neoplasia.
- Mason JB, Nutritional chemoprevention of colon cancer. : Semin Gastrointest Dis 2002 Jul; 13(3): 143-53)
- Khosraviani K. et al Effect of folate supplementation on mucosal cell proliferation in high-risk patients for colon cancer. Gut 2002 Aug; 51(2): 195-9).
- Fuchs CS. Et al The influence of folate and multivitamin use on the familial risk of colon cancer in women. Cancer Epidemiol Biomarkers Prev 2002 Mar; 11(3): 227-34).
- (Dang CT et al Potential role of selective COX-2 inhibitors in cancer management. Oncology (Huntingt) 2002 May; 16(5 Suppl 4): 30-6
- Kawamori T, Wakabayashi K, COX-2 and prostanoid receptors: good targets for chemoprevention. J Environ Pathol Toxicol Oncol 2002; 21(2): 149-53).
- Holt PR, Wolper C, Moss SF, Yang K, Lipkin M, Comparison of calcium supplementation or low-fat dairy foods on epithelial cell proliferation and differentiation. Nutr Cancer 2001; 41(1-2): 150-5);
- Wu K et al, Calcium intake and risk of colon cancer in women and men. J Natl Cancer Inst 2002 Mar 20; 94(6): 437-46).
- Ames BN. DNA damage from micronutrient deficiencies is likely to be a major cause of cancer. Mutat Res 2001 Apr 18; 475(1-2): 7-20).
- Burns AJ, Rowland IR. Anti-carcinogenicity of probiotics and prebiotics. Curr Issues Intest Microbiol 2000 Mar; 1(1): 13-24)
Got milk? Current studies suggest that calcium supplementation of 1200 mg/day or more decreases the risk of adenomatous polyps. Scientists are unsure about why calcium helps protect the colon from cancer. Current evidence suggests that calcium may protect the colon from the damaging effects of lipids. How much calcium per day is 1200 mg? Each glass of milk has about 330 mg of calcium. So a healthy, well balanced diet should allow you to achieve the cancer preventative dose of 1200 mg without difficulty. Calcium not only creates strong bones, but it also helps prevent colon cancer.
Weingarten MA,
Zalmanovici A, Yaphe J. Dietary
calcium supplementation for preventing colorectal
cancer and adenomatous polyps. Cochrane Database Syst
Rev. 2004(1):CD003548.
Alternatives to Conventional Medical Therapy
If I
am diagnosed with an illness or begin to suffer new symptoms, should I
consider seeking alternative medical therapy such as herbs, vitamins, or
acupuncture?
This is a very important question. Much of the public has the impression
that physicians and members of groups offering alternative medical
therapies disagree on all topics and one must choose to be treated by one
or the other. This is a myth. The reality is that there are many sources
of people and organizations whose purpose is to help patients with all
sorts of ailments. The problem lies in the legitimacy of what these groups
and individuals have to offer. In the United States, the medical system
has worked hard to establish mechanisms, such as American Board
certification, to weed out physicians failing to demonstrate adequate
judgment in treating patients. Also, there is great emphasis placed on
“evidence based medicine”. This refers to practice parameters and
protocols established based upon appropriately analyzed data accumulated
on various subjects. The quality of that data is carefully sorted to
determine the degree of legitimacy to proposed conclusions. This provides
the foundation on which the physician bases their recommendations for
patients.
Unfortunately, this same level of commitment to accuracy, experience, and quality of results is not found as uniformly in some of the alternative medicine options that are offered to patients. This is not at all to say this is the case for all alternative medicines. One just needs to be extremely careful in accepting claims that seem overly optimistic, especially in comparison to those options listed by your physician. For example, advertisements that offer a “cure for cancer” that is not offered by your medical doctor is exceedingly unlikely to truly “cure” you of cancer. In fact, it may cause an unnecessary delay in the best treatment for you and may even harm you. It is paramount that you ask pointed questions regarding studies with real patients that have been done to show outcomes that support their claims. It is also important to verify that those patients actually had cancer that was proven and not just suggested by symptoms.
The Federal Trade Commission is targeting false and unsubstantiated health claims on the internet through Operation Cure All. And there are other attempts to protect patients, but there is no way the government can do it all.
Every year we see many patients who have ongoing symptoms such as rectal pain, bleeding, unexpected weight loss, or an abnormal growth that is not going away. Often these symptoms have an explainable cause and cancer is not the diagnosis. But sometimes it is. If you have these kinds of symptoms, seek medical attention from a fully qualified medical physician. Establish a reliable diagnosis. If you would like, get a second opinion. A good doctor will welcome the input from another physician. He or she should be able to defend their recommendations to their colleagues and should not be offended by your request for a second opinion. When the diagnosis is established, listen to the physician’s recommendations. Then do your internet search and pursue any and all alternative options that you think may help you. The resources available to patients today over the internet is remarkable. We encourage you to take advantage of that.
When you have completed your search, see your doctor again. Present your findings and ask him or her how well they think that option would work in your case. Remember that every patient is different. What may work well for some patients advertised on a website, may not work well for you. You may not agree with your doctor and you may not even follow their advice, but at least listen to it. It may give you some insight that has an important effect on your decision.
Above all, try not to be the patient who has disturbing symptoms for a prolonged period of time and seeks alternative therapy that has not been adequately proven effective. We emphasize the importance of establishing the right diagnosis. And do it early, when you first develop symptoms that something might be wrong. Every year, we see a number of patients who either delay their diagnosis, or make a treatment decision based on inadequate information. Frequently and unfortunately, these patients end up doing much worse and some even die unnecessarily. Make sure you have all the facts before you make the important decision of how you choose to have your ailment treated.
For more information on alternative medicine therapy, you might try this National Institute of Health website, Http://nccam.nih.gov/health/decisions. This site is available in Spanish as well.
The "Oat" Fashion Way
Oat bran and high-fiber breakfast cereals have taken the super market aisle's by storm. In fact, it's difficult to find a cereal manufacturer that hasn't jumped on the "oat bran wagon." With all the recent publicity, many Americans are finally realizing the importance of not only oat bran, but fiber in maintaining good health.
Scientists discovered four decades ago that fiber has important benefits, especially for the digestive system. Recent research has shown that high fiber intake may not only prevent colonic problems but also lower blood cholesterol and the risk of coronary heart disease.
Over 50% of the adults in the United States have blood cholesterol levels over 200 - high enough to put them at risk for heart disease. In fact, many Americans have levels that exceed 250 or 300, putting them at very high risk.
Coronary heart disease is responsible for one-third of all the deaths in the United States. It is a disease of the heart. While heredity and gender will always be uncontrollable risk factors elevated blood cholesterol, can be lowered by eating soluble fiber found in oat bran, and fruits and vegetables.
How does the soluble fiber in oat bran lower cholesterol?
Dietary fiber cleans the coronary arteries of cholesterol deposits. Fiber actually decreases the absorption of cholesterol and saturated fats from the digestive system and increases their excretion from the body. Our bodies use cholesterol to make the digestive fluid, bile.
Oat bran and other soluble fibers increase the output of bile in the stool. This leaves less cholesterol to circulate in the blood and gum up arteries.
Although soluble fiber such as oat bran can lower cholesterol levels it takes quite a bit to do so. To experience its cholesterol lowering benefits you must eat at least 35 grams of soluble fiber every day. The average American only consumes 11 grams of fiber a day, according to the National Cancer Institute (NCI). But don't be discouraged by these figures. All Americans should eat 25-30 grams of fiber a day, not just those trying to lower their cholesterol, according to the NCI. With a gradual increase in fiber intake you too can see the benefits for not only your heart, but your overall health.
However, one kind of fiber alone is not sufficient for a healthy, high-fiber diet. Over doing oat bran will cheat you of needed vitamins and minerals.
There are many other foods you should include in your diet on a daily basis. Dietary fiber is not a single substance, but a group of substances with similar characteristics.
Fiber is found in plant foods such as whole grains, fruits, vegetables, beans, and nuts. It's the part of plants that supports and holds them together. Fiber resists digestion and reaches the colon basically unchanged. As fiber moves through the colon, it absorbs water, lowering the concentration of cancer-causing agents to reduce the risk of colon cancer. Fiber speeds up the movement of waste material, exposing the colon to harmful substances for a shorter length of time. There are two types of fiber. insoluble and soluble.
Insoluble
Insoluble fiber does not dissolve in water and remains essentially unchanged during digestion. Wheat bran, whole grains, vegetables and some fruits contain this fiber. Insoluble fiber draws water from the system and increases the bulk and softness of the stool. This decreases the time it takes to travel through your system, making elimination easier.
Soluble
Soluble fiber dissolves in water to form gel-like substances that are fermented by colonic bacteria. It is found in beans, oats, barley, lentils and some fruits and vegetables such as apples, bananas, carrots, pears, and citrus fruits. Besides lowering cholesterol, soluble fiber also helps to delay the stomach's emptying into the small intestines, making you feel full longer.
How to get more fiber
| You can increase your fiber intake by making a few simple changes in your diet. |
| Choose fresh fruits and vegetables rather than juices. |
| Eat the entire fruit or vegetable, skin and all. |
| Choose bran and whole grain breads, muffins, and cereals. Cracked wheat bread, brown rice and whole grain pastas can add variety as well as fiber to your diet. |
| An increase in fiber should be done gradually, along with increased water intake. |
Fabulous Fiber
Grandma called it roughage. We call it fiber and today nutritionists agree with what grandma always assumed: Fiber is necessary for good health. Its' role in digestion has been linked with preventing diseases such as colon cancer, heart diseases such as colon cancer, heart disease, diabetes and in weight control.
At Colon & Rectal Care, we recommend a high fiber diet to correct many of your colon problems. Some of your current dietary habits may be the cause of your physical problems. Adjusting your diet could decrease or even eliminate your discomfort.
Millions of Americans know the importance of including fiber in their diet. Yet, dietary surveys indicate that the average daily intake of fiber among adults is only 11 grams. this amount is well below the National Cancer Institute's daily recommendation of 20 to 30 grams.
Fiber is not a mystery ingredient. It's readily available in a variety of delectable edibles that might surprise you. Test your fiber fact knowledge by rating the following foods for fiber content. Guess the highest one in each grouping by placing your pointer over the food. The highest will appear in green when the pointer is placed over it.
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Link to the Complete USDA National Nutrient Database
The Benefits of Exercise
Current studies suggest that regular physical exercise will dramatically reduce your risk of contracting colon cancer. How does exercise help? The studies indicate that exercise speeds up the digestive process and thus shortens the bowel’s exposure to the carcinogens in our food. How much exercise is recommended? The American Society of Colon and Rectal Surgeons recommends exercise that lasts for at least 20 minutes three to four days per week. Moderate exercise such as walking, swimming, cycling, gardening, or climbing steps may help to accomplish your exercise goal.
The Effects of Alcohol / Tobacco
The studies have been conducted and the evidence is clear. The use of alcohol and tobacco increases your risk of getting colon cancer. Regarding smoking, several recent studies provide strong evidence that smoking is linked to colon cancer. In addition, the studies found that unlike with heart and lung cancer in which quitting can reverse or lower the risk, smoking, especially smoking that begins in the twenties, increases your risk for colon cancer throughout your lifetime. It is important to remember that the longer you smoke the greater the risk. It is also important to remember that it is never too late to stop this deadly habit.
Regarding the use of alcohol, the American Society of Colon and Rectal Surgeons recommends that if you use alcohol, drink only in moderation. The Society highlights that alcohol and tobacco are a deadly combination and are linked to colorectal cancer and other gastrointestinal cancers.
If you would like to read more about colon and rectal health care try these links.
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