- In Mexico alone, 14,500 new cases of this tumor are diagnosed each year.
- Due to its incidence, it is classified as the fourth most frequent at the national level.
- Due to the lack of clear symptoms in its early stages it is considered to be a “silent killer”.
Tumors are as old as humanity and to date remain a serious public health problem. In fact, to date they are responsible for almost 10 million deaths annually. One of its characteristics is that they can develop anywhere in the body, although some are more dangerous than others. Among those with a higher mortality rate is the Colorectal cancer.
To take into account, the National Institute of Public Health (INSP) affirms that this neoplasia is the fourth most frequent in Mexico. While like the rest, one of the biggest drawbacks is that most cases are identified in advanced stages.
To delve deeper into the subject, we share an interview with the Dr Antonio Ucarwho is an oncologist and hematologist at BHM Cancer Institute. He told us from the first warning signs to the treatments that exist for patients.
Can you tell us about the main risk factors for colorectal cancer?
Important risk factors that people may not pay much attention to are age. People over the age of 50 are at higher risk. Also family history; inflammatory bowel disease; ulcerative colitis; and Crohn’s disease.
Other lesser known factors include racial or ethnic factors. African-Americans are about 20 percent more likely to develop colon cancer during their lifetimes, and people of Skenacit Jewish descent also tend to have a higher frequency of colorectal cancer.
Are there any symptoms that most people would not necessarily associate with this tumor?
There are symptoms that are not specific and therefore may not be associated with colorectal cancer in the first place. Something as simple as feeling fatigued. For example, one of my patients who is a runner, came to me to express his extreme tiredness after exercising. ‘Doc, I used to run five miles a day and now after one mile I’m exhausted and I think I can’t run anymore.’ That could be an indication that the patient developed anemia, which may be related to blood loss from a malignant lesion such as colon cancer.
Also, when patients have constipation or when they notice that the stool is smaller or thinner. This may indicate that there is a blockage in the path of stool. More specific symptoms related to the gastrointestinal tract include abdominal distension, or a palpable mass.
Can you explain the guidelines or measures for colorectal cancer screening tests?
Patients who are ‘average risk’ are those who have no predisposing factors. Have not had prior cancer or polyps, family history, inflammatory bowel disease, hereditary syndrome of colorectal cancer, or prior radiation therapy to the abdomen/pelvis.
For these average-risk patients, the recommendation of the American Cancer Society (ACS) today is to start doing screening colonoscopies at age 45, instead of 50 as was proposed for many years. The frequency of colorectal cancer in the 40-49 age group has been increasing, and that has been the catalyst for earlier colonoscopies being recommended.
Can you tell us in more detail about the many tests for colorectal cancer that are available in addition to colonoscopy?
There are other tests that are simpler and non-invasive that can be done once a year, such as a fecal immunochemical test (PIF in Spanish or FIT for its acronym in English) and the guaiac occult blood test (gFOBT).
These tests are not as specific as a colonoscopy, but they can still be very effective. There are other tests such as the stool DNA test (FIT-DNA) that detects not only blood in the stool, but also tumor or polyp DNA that could alert the presence of complex polyps or cancer in the colon.
There are other tests that are non-invasive that may also be helpful such as CT colonography (virtual colonoscopy). Flexible sigmoidoscopy is simpler than a colonoscopy because it requires less bowel preparation, but the limitation is that it only examines the left side of the colon.
Is it true that if a person already has symptoms, they could have advanced cancer?
Not necessarily. Sometimes patients have obstructive symptoms and the cancer is still localized and therefore curable. However, we want to find the tumors when they are very small or when the patient does not have cancer yet – when the patient has a premalignant polyp – that is the best way to intervene and cure the patient, or prevent the cancer from developing altogether.
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INCan offers a free test to detect colorectal cancer and so you can participate