Is Stomach Bacteria Correlated with Colorectal Cancer?

Colorectal Cancer

New research suggests that colorectal cancer may not only originate in the the colon itself, but from bacteria in the stomach.

In a study published in the Journal of the National Cancer Institute, New York University researchers analyzed the intestinal flora in stool samples of 94 healthy individuals and 47 people diagnosed with colon cancer, finding those with the disease to generally have higher degrees of Fusobacteria and Porphyromanas—or “bad” bacteria. Conversely, those not affected by the disease were found to have higher levels of Clostridia—or “good” bacteria—as well as butyrate acid, which has been shown to reduce inflammation of the colon.

According to Jiyoung Ahn, PhD, assistant professor at NYU Langone Medical Center and a member of the NYU Cancer Institute, ““Our next step is to study how diet and lifestyle factors modulate these gut bacteria associated with colorectal cancer. This may lead to ways to prevent this disease.”

Of course, these findings represent correlations, not causations, and are therefore only speculative in terms of what actually causes colorectal cancer.

University of Florida’s Glenn Morris Jr. and Volker Mai commented by saying the study provided potential insight into preventing and treating colon cancer, but warned that “given the complexity of these biologic systems, caution must be exercised (and a lot more research done) before proceeding too far in promoting changes in microbiota as a prevention strategy for [colorectal cancer].”

As well as the possibility that stomach bacteria contributes to higher rates of colorectal cancer, poor dietary habits, lack of exercise, and genetic predisposition, are other known factors.

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Colorectal Polyps and their Link to Cancer

Colorectal Polyps

As the third-leading cause of U.S. cancer deaths, colorectal cancer results from carcinogenic formations in the inner lining of the colon — one of the most important parts of the digestive system. So what does colon cancer have to do with colorectal polyps?

Colon cancer is particularly insidious in that it can present itself asymptomatically in its early stages. However, regular screenings and a knowledge of one’s family medical history can help prevent and effectively treat the disease if detected early enough.

In the majority of cases, colorectal cancer develops from rectum tissue growths known as polyps. Although polyps are not always cancerous, they have the potential to develop into tumors. Adenomatous polyps, for instance, are considered precancerous, but often lead to colon cancer if left untreated. Inflammatory and hyperplastic polyps, on the other hand, carry less of a risk of developing into colon cancer. Large hyperplastic polyps, however, often require surgical removal.

Cell abnormalities, such as dysplasia, constitute another precancerous phase of the diseaseoften seen in those affected by Crohn’s disease, for instance.

Roughly 90% of those with colon cancer are over 50 years-old. Poor dietary habits, lack of regular exercise, genetic predisposition, obesity, unhealthy habits like smoking cigarettes and excessive alcohol consumption, as well as pre-existing inflammatory bowel diseases, all elevate one’s risk of developing colorectal cancer. Early detection of the disease is sometimes made difficult by the fact that symptoms are either non-existent or easily attributable to other relatively minor digestive problems. That is why regular screenings and doctor consultations are vital.

Early symptoms include abdominal pain, unexplained weight and appetite loss, blood in the stool, and irregular bowel activity.

Colonoscopies, one of the most common forms of screening, involves examining the colon and rectum and removing polyps if found. Special X-ray tests are done using a computed tomography scanner, and generally, represent a less invasive form of screening. Sigmoidoscopies examine the rectum and last part of the colon specifically, with any polyps found sent for a biopsy.

The detection of colorectal polyps usually requires their removal, followed by laboratory analysis to determine their type. Most colorectal polyps can be removed during colonoscopies, however, particularly large adenomas require surgery. In their early stages, surgical removal can effectively eliminate the cancer. However, more aggressive tactics are required at later stages, including radiation therapy, chemotherapy, and more advanced surgery.  

Those over 50 are encouraged to undergo a colonoscopy every 10 years, or if symptoms develop. Flexible sigmoidoscopies are recommended every 5 years, and stool tests on an annual basis. Stool tests represent an easy method of examination as there are kits available that can be performed at home, testing for fecal occult (hidden) blood in the stool that may indicate the presence, or the risk of developing, carcinogenic tissue.

Knowing one’s family history is an effective way to help prevent the development of the disease. A genetic predisposition for polyps means regular screenings are vital, and should possibly be commenced even younger than 50.

Eating low-fat, high-fiber foods, like fruits and vegetables, as well as regular exercise, are other preventative measures. Additionally, research shows a correlation between nonsteroidal anti-inflammatories, such as Aspirin, and a reduced risk of developing colorectal cancer.

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How Screening for Colorectal Cancer can Save your Life

Colorectal Cancer

Regular screening for precancerous polyps in the colon can often lead to the prevention or effective treatment of colorectal cancer. In particular, colonoscopies have saved the lives of many diagnosed with early-stage colon cancer

The asymptomatic nature of early-stage colon cancer, or its relatively minor symptoms misattributed to otherwise benign digestive problems, mean that often not enough patients are going to the doctor early enough. It is very important to get regularly screened by your doctor, particularly after the age of 50. If detected early on, treatment is often highly effective in eradicating the disease. Small cancerous growths in the colorectal tissue are often successfully removed during a colonoscopic investigation if detected early enough.

“Compliance to screening colonoscopy guidelines can play an important role in prolonging longevity, improving quality of life, and reducing healthcare costs through early detection of colon cancer,” authors wrote in JAMA Surgery (a publication endorsed by the American Medical Association). Further, researchers publishing in the New England Journal of Medicine reported “an estimated 53 percent reduction in mortality from colorectal cancer” in patients receiving colonoscopies and subsequent removals of cancerous tissues, particularly polyps (which constitute 95% of colorectal cancer types).

Although colon cancer is still the second-leading cause of cancer deaths in the U.S., research towards its prevention and treatment have made significant strides over recent years. Contributing factors to the decreasing numbers of colorectal cancer deaths include more effective screening procedures, increased public education campaigns urging regular screening, and better cancer treatment techniques overall.   

Experts recommend getting screened for colon cancer beginning at age 50, particularly through colonoscopies. A colonoscopy is recommended every subsequent ten years — or whenever symptoms appear, such as abdominal pain, blood in stool, severe appetite changes, or unexpected weight loss.

Others screening tests include flexible sigmoidoscopies, which test the lower part of the colon and interior of the rectum and are recommended every five years. Fecal blood tests are recommended every three years. Screening sometimes involves checking for blood hidden in stools, which is indicative of carcinoma and other abnormalities.

The high cost of healthcare in the U.S. is sometimes blamed for a lower frequency of screening, particularly among those with lower incomes. Health advocacy groups work to educate the public about the need for regular screening, particularly among the elderly, in hopes of reducing a large number of colon cancer deaths that could have otherwise been effectively treated.

According to the American Cancer Society, just over 50,000 deaths are expected this year, attributed to colorectal cancer.

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Symptoms of Colon Cancer

Symptoms of Colon Cancer

Affecting mainly people over the age of 50, colon cancer is the second-leading cause of cancer deaths in the U.S. Also known as colorectal cancer, it is particularly insidious as early stages of the disease can be asymptomatic, or accompanied by symptoms patients wrongly attribute to more benign digestive irregularities. However, by watching out for certain symptoms and consulting with your doctor on a regular basis, colon cancer may be treated more effectively if caught early on. So what are the symptoms of colon cancer?

Unexplained weight loss and sudden changes in appetite are both symptoms. If you are losing weight more quickly than usual without an abnormal amount of dieting or exercising, or you experience an inexplicable lack of desire for once-favorite foods, it may mean it’s time to visit the doctor.

Rectal bleeding is a common symptom of colon cancer and can be easily misattributed to a rectal tear or hemorrhoids without first going to see the doctor.  

Atypical fatigue is common to most types of cancer. If you feel uncharacteristically tired or weak along with experiencing digestive difficulties, it is recommended that you consult with your doctor.

Irregularities in bowel movements, such as darkened stool, pencil-shaped stools, rectal cramping, inability to empty bowels entirely, are all major warning signs.

Feeling bloated, or experiencing abdominal pain, are also attributable to colon cancer; but again, false self-diagnosis or minimization of those symptoms without doctor consultation can prove ultimately fatal.

To see whether your symptoms correlate with colon cancer, it’s wise to get regularly screened, especially after the age of 50.  Doctors perform fecal blood tests, colonoscopies, x-rays, and sigmoidoscopies to check for adenocarcinoma polyps and other cancerous growths in colorectal tissues.

In addition to regular doctor consultations, the best preventatives include knowing your family medical history, eating high-fiber, low-fat foods like fruits and vegetables, as well as incorporating physical activity into your daily routine.

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What is Colon Cancer?

Colon Cancer

Colon cancer is essentially a malignant tissue growth occurring in the colon. Affecting one of the most vital elements of the digestive system, colon cancer is considered a particularly serious form of cancer. Caused primarily by poor dietary habits, with research showing also that patients are often predisposed genetically, both eating high-fiber foods such as fruits and vegetables, as well as knowing your family medical history, are key preventatives. The majority of those affected are 50 or older, with symptoms often going ignored or wrongly self-diagnosed as some other irregularity.

Common symptoms include diarrhea, irregular bowel activity, blood in stool, abdominal pain, and constipation. Although many in early stages perceive these as the result of typical digestive difficulties, they cause enough to consult with a doctor immediately — especially if they are recurring and you are 50 or older. A doctor may quickly determine if those symptoms represent the disease and offer the most suitable and effective treatment if such is the case. Diagnosis is the first step to treatment.

Tests can include an x-ray and a colonoscopy, both of which require an empty bowel prior to an examination. Pain and discomfort are often experienced given the invasive nature of the examination. A biopsy ultimately confirms whether the patient has colon cancer.

The most effective way to treat the cancer is by catching it in its early stages. There are a vast number of different colon cancer treatments, each depending on whether the colon cancer is early-, mid-, or late-stage. Early-stage colon cancer is often treated with anastomosis (a surgical connection made between two parts of the colon). Late-stage colon cancer usually involves no other option than more invasive surgery. Although the search for better means of treating the disease is ongoing, the most effective treatment currently involves the surgical removal of cancerous tissues.

Other treatments include chemotherapy and radiotherapy.

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How is Colon Cancer Treated?

Colon Cancer

The single most important treatment for Colon cancer is pre-screening, where patients have the opportunity to prevent and delay the diagnosis. Specifically, these initial screenings include colonoscopies and sigmoidoscopies that detect pre-cancerous tumors. This article will break treatment at each of its 4 stages.

Stage 0: colon cancer is discovered in the innermost lining of the colon. The removal of a tumour requires polypectomy to remove a small amount of the surrounding tissue. In other cases, removal of larger cancer requires a process called anastomosis that tackles the diseased part of the colon and re-attaches health tissue to ensure bowel function.

Stage I: colon cancer has expanded beyond the inner lining of the colon to the second, third, and inside walls of the colon. Standard treatment requires a surgical removal of the tissue around the tumour. Large-scale surgery to remove all the cancer is also an option and offers a high potential for sure.

Stage II: colon cancer has expanded through the muscular wall of the colon, but not yet to lymph nodes. These nodes are found throughout the body that provides cells for the immune system. Once the cancer has spread to the nodes, it can infiltrate and spread through other areas of the body at a fast pace. Treatment for this stage entails a standard surgical removal, as well as chemotherapy to prevent further recurrence. However, chemotherapy is only recommended to those with high-risk disease.

Stage III: colon cancer has spread beyond the colon to one or more lymph nodes. The tumour has expanded through the colon wall to the surrounding tissue. Treatment for this stage entails surgery to remove the tumour, with follow-up chemotherapy. Radiation may also be required if the tumour is too invasive and large in size.

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What Causes Colon Cancer?

What Causes Colon Cancer

The multiplication of mutating cells found in the colon, expanding towards the large intestine is otherwise referred to as Colon cancer. In the United States, Colon cancer is categorized as one of the most relevant cancers in both men and women. In the world, with a heavy demographic attributed to developing countries, Colon cancer is the third most diagnosed cancer. Those who do not undergo regular screening procedures are a lot more likely to experience high risks, despite Colon cancer is very treatable. So what causes colon cancer?

While most cancers develop from mutation of healthy cells, the general cause of Colon cancer is not academically known. As a natural life cycle of cells, old cells die and are replaced by healthy new ones. When this multiplication process is altered, the old cells take over healthy cells and form polyps that lead to colon cancer.

The statistic for men and women developing colon cancer is high: with each being 20%. Factors that drastically increase these chances include aging,  especially beginning at the age of 50, those of African-American descent, and those who suffer genetic diseases that cause inflammation of intestines such as Crohn’s or development of ulcer-like sores on the colon. In prevention, it is recommended that those over 50 undergo colonoscopies every 10 years and sigmoidoscopies every 5 years.

Another predisposed high risk for developing colon cancer is personal or family histories. In prevention, individuals can undergo genetic testing to verify syndromes and anatomy makeup to determine risks for developing colon cancer. Further, individuals who possess two or more cases of immediate relatives who have had Colon cancer also experience high risk. Additionally, previous colon cancer survivors are considered to be a high risk of re-development in the future.

Perhaps the most important factor in affecting the chances of colon cancer development is personal and lifestyle choices. Individuals who smoke, drink, or do not exercise regularly experience higher chances of developing colon cancer. Other factors attributing to high risk may also include obesity, and high-fat/ low fiber, and high red meat diet.

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The Stages of Colorectal Cancer

Stages of Colorectal Cancer

Colorectal cancer, or colon cancer, entails the growth of a singular or multiple tumours in the large intestine and rectum. While colorectal cancer is preventable and treatable, it is important to be aware of its symptoms that occur during the stages of colorectal cancer:

  • Inconsistent bowel movements
  • Bloody stool
  • Dry stool
  • Constipation, Diarrhea
  • Constant bloating, cramps, gas
  • Unusual weight loss
  • Fatigue

Stages

The National Cancer Institute identifies 5 stages of colorectal cancer:

Stage 0 Carcinoma in Situ: within the mucosal lining of the lining, unregular pre-cancerous cells are found and could possibly spread and develop into true cancer

Stage 1:

The irregular cells have spread into both the mucosa and sub-mucosa layers, forming cancer, possibly beginning to spread into the muscle tissue

Stage 2 (Stage 1+ the following) 3 sub-stages:

  • Stage 2A: the expansion of cancer through the muscle tissue into the serosa, the outermost layer of the colon wall
  • Stage 2B: the expansion of cancer through the serosa, without metastasizing to other organs
  • Stage 2C: cancer has expanded into other organs

Stage 3 (Stage 2+ the following) 3 sub-stages:

  • Stage 3A: the expansion of cancer into minimum of one and maximum of three lymph nodes, or cancer cells have developed near the lymph nodes
  • Stage 3B: the expansion of cancer to minimum four and maximum six lymph nodes, or cancer has expanded through the serosa and to a maximum of seven nearby lymph nodes
  • Stage 3C: the expansion of cancer to minimum of seven or more nearby lymph nodes, or discovered in tissue near the lymph nodes

Stage 4 (Stage 3+ the following) 2 sub-stages:

  • Stage 4A: the expansion of cancer to either nearby organs or lymph nodes adjacent to the colon, and to minimum of one organ or lymph nodes at a distance from the colon
  • Stage 4B: the expansion of cancer to lymph nodes or organs near the colon, to minimum one organ not adjacent to the colon, or has perforated the abdominal wall lining

Prognosis

The earlier the discovery of colorectal cancer, the higher the survival rates for treatment. As cited by the Colon Cancer Alliance:

  • Colon cancer found at the local stage is 90% for the five-year survival rate
  • Colon cancer found at the regional stage is 70% for the five-year survival rate
  • Colon cancer found at the distant stage is 12% for the five-year survival rate

Despite its high treatability, colorectal cancer risk increases with age. In prevention, routine colonoscopy is recommended as the most proactive methods in discovering colorectal cancer.

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