The colon is part of a section of the digestive tract called the large intestine. The large intestine is a tube that is 5 to 6 feet in length. The first 5 feet make up the colon, which connects to about 6 inches of rectum, and ends with the anus. Colon cancer is the third most common type of cancer, in both males and females, in the western world with close to 150,000 new cases each year in the United States. Despite recent advances in screening and treatment for colon cancer, the number of people dying from the disease has remained steady since the late 1980s.
Cancer supplements, herbs and vitamins
People who consume relatively high levels of calcium and take vitamin D supplements seem to be protected to some degree against colon cancer. Colon cancer is one of the most commonly diagnosed cancers worldwide, and dietary factors are considered to be important in its risk. Consider the following supplements:
Curcumin is an extract from turmeric that may be of benefit. This supplement is not absorbed too well into the bloodstream so most of it stays in the gut and it can have its anti-inflammatory and anti-tumor activity in the GI system. Perhaps curcumin may be of benefit in those who have Familial Adenosis Polyposis, especially when combined with quercetin.
Fish oil supplements may be of benefit. People who eat plenty of fish oil and other omega-3 fatty acids could cut their risk of colon cancer. American Journal of Epidemiology, 2010.
Ginger appears to lower some indicators of inflammation in the colon.
Folic Acid and B vitamins may be helpful
Calcium -- A daily calcium supplement protects against colon polyps, particularly the advanced type that go on to become cancer. Vitamin D supplementation is also a good idea.
Citrus Bioflavonoids may be helpful
Magnesium is a mineral
Reishi mushroom extract
Anthocyanins found in bilberry fruit
IP-6 could be of benefit
Medications, prevention or survival
Use of a baby aspirin a few times a week may be of benefit in some whose tumors had mutations in the PIK3CA gene.
Diet and colon cancer
Long-term high consumption of red and processed meat increases the risk of rectal and colon cancer. People with this condition who continue to eat a lot of red and processed meats have increased odds of dying from the disease. Higher calcium consumption is linked with reduced odds of developing colon cancer. Eating lots of preserved meats such as salami, bacon, cured ham and hot dogs could increase the risk of bowel cancer by 50 percent. Fiber found in vegetables, fruits, and whole grain cereals and legumes may reduce colon cancer risk. Health experts estimate that about 70 percent of colorectal cancers could be prevented by changes in diet and nutrition.
Eating foods rich in omega-3 polyunsaturated fatty acids (PUFAs) -- the healthy fatty acid found in foods such as fish and nuts -- may reduce a person's risk of developing colon cancer.
Children who consume high levels of diary products may have a greater risk of developing colon cancer in adulthood.
Soy food consumption is associated with a lower risk.
A high consumption of fruits and vegetables is associated with a reduced risk of colon cancer. Cooked Green Vegetables, dried fruit, legumes, and brown rice are associated with fewer colon polyps
Obesity is accompanied by inflammation in the colorectal mucosa and diet-induced weight loss reduces this inflammatory state and may thereby lower risk.
Prospective cohort study of soy food intake and
colorectal cancer risk in women
Soy and some of its constituents, such as isoflavones, have been shown to have cancer-inhibitory activities in experimental studies. Our objective was to investigate whether soy food intake is associated with colorectal cancer risk. We prospectively examined 68,412 women aged 40–70 y and free of cancer and diabetes at enrollment. During a mean follow-up of 6 years, 321 incident colorectal cancer cases were identified. Total soy food intake was inversely associated with colorectal cancer risk. Each 5-gram per day increment in intake of soy foods as assessed by dry weight [equivalent to 1 oz tofu/d] was associated with an 8% reduction in risk. Women in the highest tertile of intake had a multivariate relative risk of 0.67compared with those in the lowest tertile. This inverse association was primarily confined to postmenopausal women. Similar results were also found for intakes of soy protein and isoflavones. This prospective study suggests that consumption of soy foods may reduce the risk of colorectal cancer in postmenopausal women. American Journal of Clinical Nutrition, 2009.
People who eat a lot of processed meats may have a higher risk of developing pre-cancerous growths -- polyps -- in the colon, while the opposite may be true for fans of chicken. Researchers found that among adults with a history of colon polyps, those who ate a diet heavy in processed meats had a higher risk of polyp recurrence than those with the lowest intake. On the other hand, patients who favored chicken had a lesser risk of new polyps than those who ate the least. Colon polyps are growths that, while usually benign, can become cancerous. Patients in the current study had all had polyps removed and were then followed for 4 years to detect any recurrences. Overall, the one-quarter of patients with the highest intake of processed meat were 75 percent more likely to develop an advanced polyp compared with the one-quarter of patients who ate the least processed meat, the researchers found. In contrast, those with the highest chicken intake were 39 percent less likely than those who ate the least to develop an advanced polyp. Type 2 or non-insulin dependent diabetes is associated with increased risk of developing colon polyps and colon cancer.
Patients found to have elevated insulin or blood sugar levels at the time of colonoscopy to remove polyps face an increased risk of developing recurrent polyps, including advanced polyps -- the type with a high likelihood of progressing to colon cancer.
Red Meat and Colon Cancer
Red meat and processed meat raise levels of compounds in the large bowel, which can alter DNA and increase the likelihood of cancer. The chance of developing colorectal cancer is a third higher in people who regularly eat more than two portions of red or processed meat a day compared to someone who ate less than one portion a week.Red meat consumption is linked to increased levels of substances called N-nitrosocompounds, which are formed in the large bowel. The compounds may stick to DNA, making it more likely to undergo mutations that increase the odds of cancer. The DNA damage may be repaired naturally in the body, and fiber in the diet may help the process.
Curry and Onions
Chemicals in turmeric and onions reduce both the size and number of precancerous lesions in the human intestinal tract. Johns Hopkins researchers say a pill containing chemicals found in turmeric, a spice used in curries, and quercetin, an antioxidant found in onions could be helpful for colon cancer. The study, published in the journal Clinical Gastroenterology and Hepatology, found the average number of polyps dropped 60 percent, and the average size dropped by 50 percent. A research team was led by Dr. Francis M. Giardiello of The Johns Hopkins University School of Medicine and Dr. Marcia Cruz-Correa of Johns Hopkins and the University of Puerto Rico School of Medicine. Familial adenomatous polyposis is a disorder that runs in families and is characterized by the development of hundreds of polyps and eventual colon cancer.
Curcumin and Quercetin - Patients with pre-cancerous polyps in the colon who took a pill containing a combination of curcumin, which is found in the curry spice turmeric, and quercetin, an antioxidant found in onions, experienced a marked reduction in both the size and number of polyps. "We believe this is the first proof of principle that these substances have significant effects in patients with FAP (familial adenomatous polyposis)," Dr. Francis M. Giardiello of The Johns Hopkins School of Medicine in Baltimore said in a statement. The potential of curcumin to prevent and/or treat cancer in the lower intestines surfaced in studies in lab rats fed curry, as well as in observational studies of Asian populations that consume a lot of curry. Quercetin has also been shown to have anti-cancer potential. In their study, Giardiello and colleagues gave five FAP patients who had five or more polyps in their lower intestinal tract with 480 milligrams of curcumin and 20 milligrams of quercetin three times daily. "All five patients had a decreased polyp number and size from baseline after a mean of 6 months," the team reports in the medical journal Clinical Gastroenterology and Hepatology. The average number of polyps dropped by 60 percent, and the average size dropped by 51 percent. Side effects were minimal. One colon cancer patient experienced nausea and sour taste within a couple of hours of taking the pill, which subsided after three days and did not recur, and another patient reported mild diarrhea. Of the two compounds, the researchers believe curcumin is the key cancer-fighting agent. The amount of quercetin we administered was similar to what many people consume daily; however, the amount of curcumin is many times what a person might ingest in a typical diet. Clinical Gastroenterology and Hepatology, 2006.
Dr. Donald Maxwell Parkin of the Cancer Research UK Centre for Epidemiology in London looked at how lifestyle changes now being promoted in the UK might impact rates of the disease in the future. These include eating less red meat and drinking less alcohol, eating more fruits and vegetables, exercising more, and maintaining a healthy weight. If men reduced their daily intake of red meat to just under 3 ounces, for example, Dr. Donald Maxwell Parkin found the incidence of colorectal cancer would fall by 13% by 2024. Eating five servings of fruits and vegetables daily would cut colorectal cancer incidence by 6%. Upping average activity levels to 30 minutes five times a week would cut risk by 2%, while limiting alcohol intake to two to three drinks a day would reduce men's risk by 5% and women's by 1%. Overall, the researchers found, if the UK population's average for all these lifestyle habits met these targets, and its weight profile returned to 1986-1987 levels, 31% of colorectal cancers in men and 18% of cases in women could be prevented. European Journal of Cancer Prevention, 2009.
Aspirin and colon cancer
Long-term use of aspirin may be a cheap way of warding off colon cancer for people who are at high risk, but bleeding risks make it a bad idea for the average patient.
Taking aspirin not only can help keep colon cancer
from coming back, but it also can lower the risk of dying from the disease.
Aspirin likely works by blocking the enzyme cyclooxygenase2, or COX-2, which
promotes inflammation and cell division. Many tumors make an abundance of COX-2.
Moderate exercise reduces risk of colon cancer recurrence. Whether is it jogging around the park, pumping iron or swimming, an hour of vigorous exercise a day can lower the risk of bowel cancer. Even cleaning the house, or two hours of less strenuous activity can make a difference.
Causes of colon cancer
This condition has many causes, including a genetic predisposition, diet, and lifestyle habits. Cigarette smoking promotes the development of polyps in the colon, especially those that are more likely to progress to colon cancer.
Radiation for prostate
cancer increases risk for colon cancer
There is an increased long-term risk of colon cancer in men who have undergone external radiation therapy for prostate cancer. International Journal of Cancer, September 1, 2008.
An infection from a common type of mouth bacteria can contribute to colorectal cance. The bacteria, called Fusobacterium nucleatum, can attach to colon cells and trigger a sequence of changes. Levels of F. nucleatum are much higher in people with gum disease.
Colon Cancer Screening and Sigmoidoscopy, colonoscopy
The U.S. Preventive Services Task Force recommends traditional colonoscopy -- in which a doctor uses a 3-foot-long flexible camera to examine the colon -- as a screening test for colon cancer beginning at the age of 50 years and continuing until the age of 75 years.
2009 - The American College of Gastroenterology (ACG) released new guidelines for colorectal cancer screening. One key change is that screening tests are now divided into those designed to prevent colon cancer and those designed to detect the cancer. Prevention screening is preferred over early detection. The best colorectal cancer prevention test is still colonoscopy. The prior recommendation that screening colonoscopy be performed every 10 years starting at age 50 years still stands with one modification: screening should begin at age 45 for African American men. Virtual colonoscopy, also known as CT colonography, is not as effective as traditional colonoscopy in detecting small lesions and carries an unclear radiation risk. It should only be considered in subjects who refuse standard colonoscopy. If selected, CT colonography should be performed every 5 years. An alternative for patients refusing colonoscopy include flexible sigmoidoscopy, a less invasive version of colonoscopy, performed every 5 to 10 years, and annual fecal immunochemical blood test, the preferred detection test. American Journal of Gastroenterology, March 2009.
Although swallowing a pill camera can give doctors a good picture of the colon, it is not as good as traditional colonoscopy at detecting precancerous growths and cancer.
Sigmoidoscopy is recommended every 5 years
starting at age 50. Virtual" colonoscopy is similar to conventional colonoscopy
in its ability to spot large colon polyps in patients at high risk for
colorectal cancer, researchers report. However, the non-invasive technique can
miss flat polyps, while falsely detecting non-polyp artifacts. Conventional
screening with a colonoscope inserted into the colon via the anus is the
preferred test for patients with personal or family history of colorectal polyps
Doctors may be overdoing it a bit on colonoscopies, even though they can save lives. Patients who have a low-risk polyp removed in a first colonoscopy do not need to have repeat colonoscopies as often as many doctors are prescribing them. Colonoscopies involve threading a flexible fiber-optic tube through the rectum into the colon and are the most accurate way to screen for colon cancer. People over 50 are advised to undergo the procedure every 10 years. The American Cancer Society estimates that 147,000 Americans will be diagnosed with colorectal cancer this year and 57,000 will die from the disease. Many gastroenterologists and general surgeons surveyed recommended surveillance colonoscopy every three to five years for a small, hyperplastic polyp, when in fact, every 10 years is sufficient. "Overuse of colonoscopy taxes the health care system and may compromise the quality of care," the researchers wrote. A colonoscopy costs between $1,500 to $1,700 in the United States. In a second report, the American Society of Clinical Oncology issued new recommendations saying patients who have been successfully operated on for stage II colon cancer do not need any chemotherapy. Writing in the Journal of Clinical Oncology, they said patients who get chemotherapy after surgery have only about a 4 percent to 5 percent greater chance of survival five years after surgery, compared with patients who had surgery alone.
Colonoscopy is not perfect. There can be human errors in visualizing, stool blocking vision, inability to guide the scope too deep or lack of experience or determination of the examiner. Although colonoscopy is the accepted gold standard for detecting colonic polyps, its performance is much better with polyps of 10 mm or more than it is with those of smaller size.
Three out of four Americans aged 50 to 70 aren't getting regular colon cancer screening. The American Cancer Society recommends that everyone get a colonoscopy to test for colon cancer at age 50. But a quarter of people surveyed say their doctor had never discussed colon cancer screening with them, and another quarter said they didn't get screened because they had no symptoms of the disease. Twenty-eight percent said they didn't want to have a colonoscopy. Colon cancer screening isn't something most people are comfortable chatting about around the water cooler, despite efforts by Katie Couric and others to raise awareness of the need for colon cancer screening. If a person with no family history of the disease has a colonoscopy at 50, the doctor performing the test is able to review the entire colon, and no problems are found, he or she doesn't need to have the test again for 10 years. The risks of colorectal cancer screening may outweigh the benefits for some patients aged 70 years and older.
People who have a colonoscopy in the morning rather than afternoon may be more likely to have potentially cancerous growths detected. American Journal of Gastroenterology, 2009.
To prevent colon cancer or
to diagnose it early
Get a sigmoidoscopy or colonoscopy every five years to check for polyps or tumors, especially if you're over 55 or if a family member has had colon cancer.
Eat a diet rich in fruits and vegetables and low in saturated fat. People who regularly eat red meat and processed meat have an increased of developing colorectal cancer
Get at least 30 minutes of exercise at least five days a week.
Consumer more fiber and spices such as curcumin and consider supplementing with one or two times the RDA in folic acid and other B vitamins.
Erbitux ( cetuximab ) is used to treat patients with advanced colorectal cancer that has spread to other parts of the body. Cetuximab is the first monoclonal antibody approved to treat this type of cancer and is indicated as a combination treatment to be given intravenously with irinotecan, another drug approved to fight colorectal cancer, or alone if patients cannot tolerate irinotecan.
The Food and Drug Administration and Genentech have warned doctors that Avastin, used to treat colorectal cancer, increases patients’ risk of suffering heart ailments — including chest pain, strokes, mini-strokes and heart attacks.
Radiation induced colitis
Cancer treatment regimens that include radiation therapy to the abdominal region for cervical, ovarian, prostate, sigmoid, or colorectal cancer potentially disturb the colonization resistance of the indigenous gut flora, causing radiation therapy-induced diarrhea, enteritis, and colitis in more than 80% of patients with cancer. One approach for the prevention of RT-induced diarrhea is the use of probiotics.
Colon Cancer Research
Consumption of the putative chemopreventive agent curcumin by cancer patients: assessment of curcumin levels in the colorectum and their pharmacodynamic consequences.
Cancer Epidemiol Biomarkers Prev. 2005.
Curcumin, a constituent of the spice turmeric, has been shown to reduce the adenoma burden in rodent models of colorectal cancer. We tested the hypothesis that pharmacologically active levels of curcumin can be achieved in the colorectum of humans. Patients with colorectal cancer ingested curcumin capsules (3,600, 1,800, or 450 mg daily) for 7 days. Biopsy samples of normal and malignant colorectal tissue, respectively, were obtained at diagnosis and at 6 to 7 hours after the last dose of curcumin. Blood was taken 1 hour after the last dose of curcumin. Curcumin and its metabolites were detected and quantitated by high-performance liquid chromatography with detection by UV spectrophotometry or mass spectrometry. The concentrations of curcumin in normal and malignant colorectal tissue of patients receiving 3,600 mg of curcumin were 12.7 +/- 5.7 and 7.7 +/- 1.8 nmol/g, respectively. Curcumin sulfate and curcumin glucuronide were identified in the tissue of these patients. Trace levels of curcumin were found in the peripheral circulation. The results suggest that a daily dose of 3.6 g curcumin achieves pharmacologically efficacious levels in the colorectum with negligible distribution of curcumin outside the gut.
New research hints that a suboptimal intake of folic acid may play a role in the development of colon cancer, which points to a possible role for folic acid supplementation in colon cancer prevention. In individuals with colonl adenomas -- polyps that can be precursors to bowel cancer -- folic acid supplementation reverses so-called DNA hypomethylation.
Myricetin inhibits matrix metalloproteinase 2 protein
expression and enzyme activity in colorectal carcinoma cells.
Mol Cancer Ther. 2005.
Colon cancer is a leading cause of human mortality due to its high metastatic ability. Because the activation of matrix metalloproteinases (MMP) is a key factor in the metastatic process, agents with the ability to inhibit MMP activity have potential in the treatment of colon cancer. In the present study, among 36 flavonoids examined, myricetin was found to be the most potent inhibitor of MMP-2 enzyme activity in COLO 205 cells.
Effects of commercial anthocyanin-rich extracts on
colonic cancer and nontumorigenic colonic cell growth.
J Agric Food Chem. 2004. Department of Nutrition and Food Science, University of Maryland, College Park, MD
Commercially prepared grape (Vitis vinifera), bilberry (Vaccinium myrtillus), and chokeberry (Aronia meloncarpa) anthocyanin-rich extracts (AREs) were investigated for their potential chemopreventive activity against colon cancer. The growth of colon cancer-derived HT-29 and nontumorigenic colonic NCM460 cells exposed to semipurified AREs (10-75 microg of monomeric anthocyanin/mL) was monitored for up to 72 h using a sulforhodamine B assay. All extracts inhibited the growth of HT-29 cells, with chokeberry ARE being the most potent inhibitor. HT-29 cell growth was inhibited approximately 50% after 48 h of exposure to 25 microg/mL chokeberry ARE. Most importantly, the growth of NCM460 cells was not inhibited at lower concentrations of all three AREs, illustrating greater growth inhibition of colon cancer, as compared to nontumorigenic colon cells. Extracts were semipurified and characterized by high-pressure liquid chromatography, spectrophotometry, and colorimetry. Grape anthocyanins were the glucosylated derivatives of five different anthocyanidin molecules, with or without p-coumaric acid acylation. Bilberry contained five different anthocyanidins glycosylated with galactose, glucose, and arabinose. Chokeberry anthocyanins were cyanidin derivatives, monoglycosylated mostly with galactose and arabinose. The varying compositions and degrees of growth inhibition suggest that the anthocyanin chemical structure may play an important role in the growth inhibitory activity of commercially available AREs.
The variable effect on proliferation of a colon cancer cell line by the
citrus fruit bioflavonoid Naringenin.
Colorectal Dis. 2003.
Naringenin, a naturally occurring flavonoid found in citrus fruits, is known to have anticarcinogenic properties. We have examined the effect of Naringenin on cell proliferation of an HT-29 colon cancer cell line. HT-29 colon cancer cells were cultured in 96-well tissue culture plates. Naringenin concentrations ranging from 0.02 to 2.85 mmol were added to the wells of the Test group. The Control group contained all the elements present in the Test group with the exception of Naringenin. Cell proliferation was measured by colourimetric assay using the 2% WST-1 cell proliferation kit. RESULTS: Significant inhibition of cell proliferation was observed in HT29 colon cancer cells exposed to Naringenin at doses greater than 0.71 mmol. These results suggest a potential role for citrus fruits as a source of chemoprotective agents for colon cancer.
What's the difference between colon cancer and colorectal cancer?
Basically, they are the same. Colon cancer, colorectal cancer and rectal cancer are all the same disease. Rectal cancer is more specific to the rectum, the last part of the colon as it ends in the anus.
Do you have information on colon cleanses?
See colon cleansing information.