There's an old adage, What you eat today, you feel tomorrow. The state of our large bowels - comprising the colon and the rectum - can easily determine the quality of our day-to-day lives. But more importantly, as Wendy Champagne discovered, for the one in every twenty-two Australians who will develop bowel cancer by the age of seventy-five, taking care of their "gut" could save their lives.
Professor Terry Bolin, director of the Gut Foundation in Sydney has spent the last seventeen years trying to educate both the public and doctors about bowel cancer. "Few people realize it is the commonest cancer outside of lung cancer," he says. "We have a particularly high death rate in Australia, about 4000 people a year, and yet we have no national screening program."
The primary purpose of the colon (large intestine)is to lubricate waste products, absorb the fluids and salts remaining after they have travelled through the small intestine, and store these waste products until they are ready to be passed from the body at controlled intervals. Healthy mucous and bacteria are all-important to this process - if chemical imbalance or irritation occurs, adenomas (polyps) can form on the colon walls.
It's these polyps that are potentially life threatening. Many benign polyps sit on the wall of the colon for five to ten years, increasing in size, before undergoing the transformation to cancer. Not every polyp becomes cancerous but, according to Professor Bolin, in 90 percent of cases polyps are the precursor to bowel cancer, and the bigger the polyp, the greater risk of its becoming cancerous.
Although genetic factors are important in bowel cancer, they only account for about fifteen percent of the 4000 deaths a year in this country. The other eighty-five percent of bowel cancers occur sporadically in people without any risk factors. And for the majority of these people, diet may be a predominant factor.
While bowel cancer is very common in countries like Australia and the United States; in Japan, South America and the Mediterranean its incidence is low. There is also strong evidence showing that families who migrate from those countries with a low rate of the cancer will assume the risk of the local population within two generations.
Although Australian's enjoy some of the leanest meat available in the world; the high saturated fat content of our diet - meat, butter, cream and milk - puts us in the high-risk group for bowel cancer, unlike Greeks or Italians who consume most of their fat in the form of olive oil.
A diet rich in fruit, vegetables and plenty of fibre does help to protect against bowel cancer. Eating regularly, in moderation, and steering clear of fast food is good advice for those wanting to keep their gut healthy.
Bowel cancer is slow growing but it's also one of the most insidious internal cancers. "If you hear of someone dying of liver cancer," says Professor Bolin, "you can bet that bowel cancer was the primary." Bowel cancer mestastaises to the liver and the lungs, and the only available treatment involves major surgery, chemotherapy and radiation therapy.
Professor Bolin believes this drastic course of action can be avoided. "Apart from cervix cancer, bowel cancer is the only cancer that is preventable," he says. "Statistics prove that you can lower the risk of bowel cancer by thirty-three percent through regular Faecal Occult Blood testing (FOBT). And we believe we can reduce deaths by eighty percent by removing all the adenomas."
You are in a High-Risk Group if:
You have one or more close relatives who have had bowel cancer There is a member of your family who has polyps You have had ulcerative colitis or Crohn's disease for more than eight years.
Prevention is the cure
Regularly check your stool for blood If you are in a high-risk group have a regular Faecal Occult Blood test Have a colonoscopy every five to ten to ten years to remove any intestinal polyps.
References: Professor Terry Bolin, Gastro-Enterologist, Director Gut Foundation and Associate Professor of Medicine, UNSW
NSW Health Department Cancer Council of NSW 93341900
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