The title is misleading because this post is about the bowel and very rarely is there any pain associated with colo-rectal cancer. Since there is information in the news lately, especially surrounding younger people, I thought we would explore a bit. You may brush this blog aside as not pertinent to you. But data says otherwise and you may want to gain knowledge as to encourage your adult children to not miss the signs. This is the number one cancer in men and women combined (prostate number one for men, breast number one for women, but together it is colo-rectal, and second leading cause of death after lung cancer).

March is colo-rectal awareness month so pay attention, there may be a test at the end of this. Good news about cancer is that overall it is on the decline. Bad news is that colo-rectal cancer seems to be increasing in the younger population with a 1 to 3% increase in people in their 40s. The fact that we have screening recommendations for those over the age of 50 (and then finally we moved it to age 45) still will not catch all of those at the earliest stages. Because there is rarely pain involved, it will take real attention to find these cases early and curable.

Since the bowel has the capacity to expand, people can get large tumors before they know they have a problem. It is not unusual to find very elderly people, often in nursing homes, with large bowel cancer and requiring surgery. For younger people, especially those who are fit, they often believe that they’re change in bowel habits could be related to lack of hydration from exercise, nervousness around events, lack of fiber, etc. For James Van der Beek, it was a change in habits that he did not realize was related to an actual obstruction in the bowel. I am not a fan of the kits used to detect colo-rectal cancer and here is why: a colonoscopy can go in and actually remove polyps. If those polyps continue to grow they could form cancers so it is actually a diagnostic and therapeutic test. Researchers are also investigating possible vaccines.

Finally (Oh thank God Joanne! ) Awareness is key, especially in these cancers found at early stages by screening. Family history of colon cancer? Get checked early before 40 by GI. There are genetic testings available to see if you have Lynch and other syndromes that make you susceptible to disease.

Everyone will not have their diagnosis found early. Everyone will not have curable disease. What patients often regret, as witnessed by several folks giving interviews now, is lack of attention and awareness earlier. You have insurance. Go to the doctor and bring your list of concern. They are not mind readers and the 9 pages of symptoms you fill out in the waiting room, can still miss the “money shot”. No one regrets paying attention, only dismissing until a multitude of symptoms can no longer be ignored- true for every disease.

The early age onset is contributed to unhealthy diet and microbiome, obesity, chemicals in environment, alcohol, antibiotic use and sedentary lifestyle. To reduce risk, cut down on red meat, a processed and bbq meats, increase fruits and vegetables, whole grains, fish. Don’t ignore rectal bleeding it is the early sign and not always hemorrhoids, so get checked out. Change in stool, chronic constipation, even loose stools, rectal pressure (tenesmus) need attention.

So, please be your own attentive advocate. You know you best, so always be responsible for yourself. Your body will thank you.

Resources: American Institute for cancer research is a good online place to find diet information. ACS (American cancer society has recommendations for screening and for each specific cancer. AACR.org for updates on research for detection and treatment.