This infographic focuses on the benefits of catching colon cancer early, identifying the people at greatest risk for developing colon cancer, and the steps you can take to detect colon cancer early or even prevent it altogether.
Despite substantial decreases in colon cancer death rates over the past two decades, it remains the third-deadliest cancer in the United States among men and women. If it’s found and treated early, however, the 5-year survival rate is 90%. Many more lives could be saved by understanding colon cancer risks, increasing screening rates, and making lifestyle changes.
The 5-year, survival rate is 90%, if colon cancer is found early, but only 39% of colon cancer cases are diagnosed at an early stage, partly due to low screening rate.
Anyone can get colon cancer, but some groups are at increased risk.
Gender: Overall, colorectal cancer incidence and mortality rates are about 35% to 40% higher in men than in women.
Age: Incidence and death rates for colorectal cancer increase with age. Overall, 90% of new cases and 94% of deaths occur in individuals 50 and older. The incidence rate of colorectal cancer is more than 15 times higher in adults 50 years and older than in those 20 to 49 years.
Race/Ethnicity: Colorectal cancer incidence and mortality rates are highest in African American men and women; incidence rates are 20% higher and mortality rates are about 45% higher than those in whites. Incidence and mortality rates among other major racial/ethnic groups are lower than those among whites.
Reduce risk by managing your diet, weight and physical activity.
Diet
Body Mass Index (BMI)
Physical Activity
Lifestyle
If you're 50 or older, talk to your doctor about getting tested.For average-risk individuals with no symptoms, screening should begin at age 50. If you are at increased risk or are experiencing symptoms, speak to your doctor right away.
Symptoms can include: Rectal bleeding, blood in the stool, dark- or black-colored stools, change in the shape of stool, lower stomach cramping, unnecessary urge to have a bowel movement, prolonged constipation or diarrhea, and unintentional weight loss.
Flexible Sigmoidoscopy: Slender tube is inserted through the rectum into the colon. Provides visual exam of the rectum and lower 1/3 of the colon.
Pros:
Cons:
Colonscopy: Direct exam of the colon and rectum. Polyps removed if present. Required for abnormal results from other tests
Pros:
Cons:
Double-Contrast Barium Enema: Radiological exam of the colon. Barium sulfate is introduced through the rectum and spreads throughout the colon.
Pros:
Cons:
CT Colonography: Detailed, cross-sectional, 2D or 3D views of the colon and rectum with a x-ray machine linked to a computer
Pros:
Cons
Fecal Occult Blood Test/Fecal Immunochemical Test: Can detect blood in stool caused by tumors or polyps. A kit is obtained from a health care provider.
Pros:
Cons:
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]]>Cancer affects different populations differently, and minority groups in the United States continue to bear a greater cancer burden than whites. Much of this difference is due to factors like poverty and lack of access to prevention/detection services and high-quality treatment, according to a report in Cancer Facts & Figures 2013, a yearly American Cancer Society publication. For instance, African Americans and Hispanics in the US have higher poverty rates than whites and are less likely to have health insurance, making it harder for them to get the care they need.
So far this year the American Cancer Society has awarded 18 national research grants totaling more than $17.4 million to help improve access to cancer screening and treatment as well as quit-smoking programs. In addition, the Society is striving to enroll people from diverse ethnic and racial backgrounds in its landmark Cancer Prevention Study 3, a long-term study that will shed light on how lifestyle factors affect cancer risk and help us understand what to do to help prevent cancer.
Earlier studies like this one have helped us learn about some of the things everyone can do to help reduce their cancer risk or improve their chances of beating the disease if they do get it.
Regular screening tests can catch some cancers early, when they’re more treatable. With a few cancers, these tests can even prevent cancer from developing in the first place. Talk with your doctor about the tests for colon, lung, prostate, breast, and cervical cancers.
Being overweight or obese is a risk factor for many cancers, including breast, colon, uterine, esophageal, and kidney cancer. You can control your weight by exercising regularly and eating more healthfully.
Even if you’re already at a healthy weight, getting regular exercise is important. Physical activity has been shown to lower the risk of several types of cancer, including breast, colon, and advanced prostate cancer. It also reduces the risk of other serious diseases like diabetes and heart disease. The Society recommends adults get at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week, preferably spread throughout the week.
Eat at least 2 ½ cups of vegetables (including legumes) and fruits each day. Choose whole-grain breads, pasta, and cereals over those made from refined grains. Eat less processed meat such as bacon, sausage, luncheon meats, and hot dogs. Substitute fish, poultry, or beans for red meat (beef, pork, and lamb). Bake, broil, or poach meats rather than frying or charbroiling.
Smoking damages nearly every organ in the human body, is linked to at least 15 different cancers, and accounts for some 30 percent of all cancer deaths. Quitting smoking is one of the best things you can do for yourself and your loved ones.
]]>Researchers have long linked exercise with lower breast cancer risk for women past menopause, believing it works partly by lowering their estrogen levels. Higher estrogen levels can raise breast cancer risk.
The new study provides more clues as to how the exercise may be protective, said Cher Dallal, a cancer prevention fellow at the U.S. National Cancer Institute. She is scheduled to present the findings Tuesday at the American Association for Cancer Research's annual meeting in Washington, D.C.
Because this study is presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.
"Our aim was to try to better understand how physical activity may affect levels of estrogen," Dallal said. She evaluated 540 Polish women, aged 40 to 74, who were enrolled as healthy control patients in the NCI Polish Breast Cancer Study. None of the patients was on hormone therapy.
The women engaged in a range of physical activity. For seven days, they wore a device called an accelerometer on their waist while awake, which measured overall activity. The women also collected 12-hour urine samples.
Dallal measured the hormones estradiol and estrone, along with different estrogen breakdown products, or metabolites, in the urine. "Physical activity was associated with lower levels of the main estrogens," she said. Activity also was associated with increased metabolism of some of the breakdown products, she found.
"Increased overall activity appears to increase the metabolism of estrogen," she said. "This is the first time we have been able to assess these 15 metabolites."
Using the accelerometers gives a much more accurate picture of activity during the day than other methods, such as having women recall their exercise activity, said Leslie Bernstein, a professor and director of cancer etiology at the City of Hope Comprehensive Cancer Center, in Duarte, Calif.
Bernstein was not involved in this study, but was one of the first to study exercise as a way to reduce estrogen exposure and breast cancer risk. The new study, she said, "just adds evidence to say that this is one mechanism by which physical activity reduces your risk of breast cancer. You have less excretion [of the hormones] so it means you are producing less. [However], it's still not proven."
But, she said, "we know for breast cancer [risk], hormones are important. This is the first time we have strong evidence that measured physical activity reduces hormone levels. It helps us understand what's going on and how it's working."
It doesn't mean, however, that physical activity doesn't also reduce risk in other ways, such as improving insulin metabolism, she said. Higher insulin levels have been linked with some cancers, including breast cancers.
Exercise also helps with weight control. Most estrogen comes from fat tissue after menopause, and having more fat tissue raises estrogen levels and, in turn, breast cancer risk.
Some researchers are also looking at whether physical activity can improve your ability to repair DNA, which would perhaps explains the reduced cancer risk, Bernstein said.
The take-home message for women from the new research is to exercise, Bernstein said. Women who haven't been active should check in first with their doctor, and then, after getting the go-ahead from their doctor, engage in exercise that "puts some stress on the body," such as brisk walking, she suggested.
]]>Though estimates vary, the rate of thyroid disease -- either under- or overactive thyroid -- may be as high as 30 percent in people with type 1 diabetes, according to Dr. Betul Hatipoglu, an endocrinologist with the Cleveland Clinic in Ohio. And the odds are especially high for women, whether they have diabetes or not, she said, noting that women are eight times more likely than men to develop thyroid disease.
"I tell my patients thyroid disease and type 1 diabetes are sister diseases, like branches of a tree," she said. "Each is different, but the root is the same. And, that root is autoimmunity, where the immune system is attacking your own healthy endocrine parts."
Hatipoglu also noted that autoimmune diseases often run in families. A grandparent may have had thyroid problems, while an offspring may develop type 1 diabetes.
"People who have one autoimmune disease are at risk for another," explained Dr. Lowell Schmeltz, an endocrinologist and assistant professor at the Oakland University-William Beaumont School of Medicine in Royal Oak, Mich.
"There's some genetic risk that links these autoimmune conditions, but we don't know what environmental triggers make them activate," he explained, adding that the antibodies from the immune system that destroy the healthy tissue are different in type 1 diabetes than in autoimmune thyroid disease.
Hatipoglu said that people with type 1 diabetes are also more prone to celiac disease, another autoimmune condition.
Type 1 diabetes occurs when the immune system mistakenly attacks the insulin-producing cells in the pancreas, destroying them. Insulin is a hormone that's necessary for the metabolism of carbohydrates in foods. Without enough insulin, blood sugar levels can skyrocket, leading to serious complications or death. People who have type 1 diabetes have to replace the lost insulin, using shots of insulin or an insulin pump with a tube inserted under the skin. Too much insulin, however, can also cause a dangerous condition called hypoglycemia, which occurs when blood sugar levels drop too low.
The thyroid is a small gland that produces thyroid hormone, which is essential for many aspects of the body's metabolism.
Most of the time, people with type 1 diabetes will develop an underactive thyroid, a condition called Hashimoto's disease. About 10 percent of the time, Schmeltz said, the thyroid issue is an overactive thyroid, called Graves' disease.
In general, people develop type 1 diabetes and then develop thyroid problems at some point in the future, said Hatipoglu. However, with more people being diagnosed with type 1 diabetes in their 30s, 40s and 50s, Schmeltz said, it's quite possible that thyroid disease can come first.
Thyroid problems are often diagnosed through routine annual blood tests, according to both experts.
Untreated thyroid problems can affect blood sugar levels in people with type 1 diabetes. "If I see someone having a lot of trouble controlling their blood sugars, it could be the thyroid," noted Hatipoglu.
"People who are diagnosed with type 1 diabetes often work very hard to control their blood sugar, but if they're not aware of an underactive thyroid, they may have a lot of unexplained low blood sugars," she said. "If someone is hyperthyroid, they may have unexplained high blood sugars."
Sometimes people with type 1 diabetes gain weight from taking insulin, but unexplained weight gain can also be due to an underactive thyroid.
"People really need to be aware that if you have one of these conditions, you're at risk of the other," Schmeltz said. "And, symptoms aren't always so obvious. Someone might be tired a lot and think it's because of diabetes, and they end up ignoring thyroid symptoms."
He said the classic symptoms of an underactive thyroid are decreased energy, hair loss, inappropriate weight gain, feeling cold, constipation, dry skin, heavy periods and difficulty concentrating. Some of the symptoms also overlap with a diagnosis of depression.
Symptoms of an overactive thyroid, which are often mistaken for other conditions, include trouble concentrating, heat intolerance, frequent bowel movements, excessive sweating, increased appetite, unexpected weight loss, restlessness, a visible lump in the throat (goiter), nervousness and irregular menstrual periods, according to the U.S. National Library of Medicine.
Autoimmune thyroid disease is usually managed with a daily pill, according to Schmeltz. Hatipoglu said it's important to try to take this pill at the same time every day and to not eat for about 45 minutes after taking it. She said she tells her patients to take the pill before breakfast, or at night before bed if they have to get out the door quickly in the morning. "Take it when you know you can take it in the same way every day," she said.
Hatipoglu also pointed out that autoimmune thyroid disease can be episodic in the beginning.
"It's like a volcano erupting," she said. "It can happen on and off as the thyroid is being damaged by the immune system. One day it will be totally destroyed, but until you come to that point, it may come and go — for how long depends on the individual. For some it's months. For some it can be decades."
SOURCES: Betul Hatipoglu, M.D., endocrinologist, Cleveland Clinic, Cleveland, Ohio; Lowell Schmeltz, M.D., endocrinologist and assistant professor, Oakland University-William Beaumont School of Medicine, Royal Oak, Mich.
]]>A low-residue diet, aka low-fiber diet, is usually recommended during the flare-up periods of diverticulitis to decrease bowel volume so that the infection can heal. An intake of less than 10 grams of fiber per day is generally considered a low-residue diverticulitis diet. If you have been on a low-residue diet for an extended period of time, your doctor may recommend a daily multivitamin supplement.
You may be asked to start with a clear fluid diet at the onset of diverticulitis. After a few days, you may incorporate the following low fiber foods (less than 10 g per serving) that are mild enough to be eaten during a diverticulitis flare-up.
Grain Products:
Fruits:
Vegetables:
Meat and Protein Choice:
Dairy:
Drinks:
When symptoms of diverticulitis improve, you may ease off of the low-residue diet and gradually add more fiber back into your diet. A high-fiber diet is very important in preventing future diverticulitis attacks. As you increase your fiber intake, don't forget to increase your fluid intake as well. If you have challenges eating a diet with higher fiber content, your doctor may suggest a fiber supplement like Metamucil. In addition, you may also heard from others that nuts should be permanently avoided. In the past, the medical community indeed recommended patients to avoid hard foods like nuts and seeds, fearing that these foods get stuck in between the pockets and become inflamed. However, modern studies really didn't find such recommendation to be clinically valid.
]]>Be sure to check the entire breast area—going down until you feel only ribs and up to the neck or collar bone (clavicle).
There is some evidence to suggest that the up-anddown pattern (sometimes called the vertical pattern)
is the most effective pattern for covering the entire breast without missing any breast tissue.
• Repeat the exam on your left breast, using the finger pads of your right hand.
• Stand in front of a mirror. Press your hands firmly down on your hips. Look at your breasts for any changes of size, shape, contour, dimpling, pulling, or redness or scaliness of the nipple or breast skin.
(The pressing down on the hips position contracts the chest wall muscles and enhances any breast changes.)
Continue to look for changes with your arms down at your sides. Then look for changes with your arms raised up over your head with your palms pressed together.
• Examine each underarm while sitting up or standing. Raise your arm only slightly so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it difficult to examine.
Note From American Cancer Society:
This procedure for doing breast self-exam is different from previous procedure recommendations. These changes represent an extensive review of the medical literature and input from an expert advisory group. There is evidence that the woman’s position (lying down), area felt, pattern of coverage of the breast, and use of different amounts of pressure increase the sensitivity of breast self-exam, as measured with silicone models, and of clinical breast exam, using patient models with known small, noncancerous lumps in their breasts.
Provided as an educational resource by Merck
]]>Your breasts, like all parts of your body, are made up of cells that are too small to see. These cells can form a mass called a “growth” or a “tumor” (TOO-mer). Most tumors do not contain cancer, but sometimes they do. When this happens in your breast, it is called breast cancer.
Early breast cancer may have no symptoms at all— there will be no pain and nothing will look or feel wrong. That is why it is so important to be screened (screening is when you or your doctor look for cancer even if you don’t have any symptoms).
Breast cancer is one of the most common cancers in women. Most doctors feel that finding breast cancer early through screening saves thousands of lives.
These are changes in the breasts that may be warning signs of cancer:
• A lump in or near your breasts or under your arms
• A change in size or shape of one of your breasts
• A discharge from nipples or nipple pain
• One of your nipples turns inward
• The skin in your breast area has ridges or pitting, like the skin of an orange
• Changes in the skin of your breast, your nipples, or the area around your nipples—for example, if an area is red or the skin is scaly
These symptoms most often are not a sign of cancer. They are usually a sign of another less serious health problem. But it is important to get them checked by a doctor as soon as you can.
The earlier breast cancer can be found, the more likely treatment will work. If cancer is found in your breasts, your doctor will talk to you about what type of treatment is right for you.
Who Gets Breast Cancer?
As you get older, your chances of getting breast cancer increase—about 80% of breast cancer is in women who are 50 or older. You also have more chance of getting breast cancer (you are at higher risk) if:
• Your sister, mother, or daughter has had breast cancer. A family history nearly doubles your risk.
• You have had breast cancer before.
• You have gained weight after the change of life (menopause) or after turning 60.
• You have been on combined hormone replacement therapy (estrogen and progesterone) for several years. Talk to your doctor about the risks and benefits of your current hormone replacement therapy.
• You have had radiation treatment to your chest area in the past.
There are some things you can do to lower your risk:
• Get a mammogram every year if you are 40 or older (the American Cancer Society recommends this). Speak to your doctor if you have had a family history of breast cancer to see if you should have a mammogram done at a younger age.
• Have a breast exam done by your doctor every year.
• Learn how to do a breast self-exam and do it monthly. Have your doctor or nurse show you how to do this.
• Add healthy habits to your routine: Cut down on the red meat you eat and eat more fruits and vegetables. Cut down on how much alcohol you drink. Be more active—do more walking and try to exercise more. Lose extra weight.
• See your doctor regularly.
Provided as an educational resource by Merck
]]>What Is Cancer?
There are many kinds of cancer. Cancer means the growth and spread of cells that are not normal. Each of us has trillions of cells that allow our body to carry on normal functions like breathing, digesting, and thinking. When cells stop behaving normally, they can become cancer cells.
What Can I Do to Prevent Colorectal Cancer?
Screening can save lives—colorectal cancer is one of the most preventable and curable cancers if found early. Start getting screened at age 50, or earlier if there is colorectal cancer in your family or if you have had colorectal cancer before. Other ways to prevent cancer include eating a healthy diet, being more active, and losing extra weight.
Colorectal cancer is when a tumor grows in the large
intestine. The large intestine is a long tube (4 to 5 feet
long). The longest part of this tube is called the colon;
the last few inches of the tube is the rectum.
Who Gets Colorectal Cancer?
Age is the number-one risk factor for colorectal cancer (it increases your chances of getting cancer). You should be screened (tested) at age 50.
You also have a greater chance of getting colorectal cancer if:
• Your parents, brothers, sisters, or children have had colorectal cancer. Your doctor may recommend screening or testing at a younger age if this is the case.
• You have polyps (PAH-lips), which are small balloon-shaped pouches in the colon or rectum that may contain cancer cells. Polyps usually don’t cause symptoms (a symptom is a change in the body due to illness) but can be felt or seen if your doctor tests for them. If polyps are found, your doctor can remove them. Polyps are not always cancerous.
• You have had colorectal cancer or polyps that are cancerous before.
• Have ulcerative colitis (UHL-ser-uh-TIV koh-LI-tiss) or Crohn’s (Kronze) disease, which cause inflammation in the colon or small intestine.
• You are African American.
There are over 1 million survivors of colorectal cancer in the United States. The most powerful weapon against colon cancer is screening or testing.
Some Signs of Colorectal Cancer
These are some of the symptoms of colorectal cancer:
• A change in bowel habits, such as diarrhea or constipation
• You feel like you still have to go after you’ve had a bowel movement
• Blood in your stool (bowel movement)
• Stomach cramping or bloating
• Unexplained weight loss
• Feeling tired or fatigued all the time
Keep in mind that there are many other conditions that may cause these symptoms. Make sure you see your doctor.
Provided as an educational resource by Merck
]]>Mammograms: Providing a Closer Look
Mammograms are one of the best screening tools to detect cancer before it has grown and spread. This makes it more likely that cancer treatment will be a success.
Women who are 40 and older should have a mammogram once a year. If you are a woman who is at high risk of getting breast cancer, talk to your doctor about whether you should start getting mammograms before age 40. Remember, a mammogram may find cancer before you or your doctor can see or feel anything wrong in your breast.
Breast cancer is the second most common cancer in women. A mammography (mam-AH-gruh-fee), a special breast X-ray, lowers the number of deaths from breast cancer.
When you go in for a mammogram, you will undress above the waist and wear a hospital gown. You will stand in front of an X-ray machine. The mammogram technician will help get your breasts into the right position on the X-ray plates. Then pictures of your breasts will be taken.
What else can you do to help prevent breast cancer?
• Improve your health by eating healthy and exercising.
• Get screened regularly.
Know Your Risk Factors
What increases a woman’s chance of getting breast cancer?
• Age. About 8 out of 10 breast cancers occur in women older than 50.
• Genetics. About 10% of breast cancer can be linked to certain changes in genes.
• Family history. The risk increases for a woman with close blood relatives who have had breast cancer.
• Personal history. Cancer in one breast can increase the likelihood of cancer in the other.
• Race. White women are at a slightly higher risk of getting breast cancer. African American women have a higher death rate from breast cancer.
• Menstrual periods. The risk increases if a woman started menstruating before the age of 12 or menopause occurred after the age of 55.
• Alcohol. 2 to 5 alcoholic drinks per day increase the risk 1.5 times compared with women who do not drink.
• Weight. Overweight women have a greater risk of breast cancer, especially women who have gained weight after the change of life (menopause) or after turning 60.
Do all you can to help detect breast cancer early. Besides getting regular mammograms:
• Do regular breast self-exams.
• Have your breasts examined by your doctor regularly.
If my mammogram results are abnormal, does this mean I have cancer?
No. Many times results from mammograms are not normal. If this happens, you will be called to come in for more testing. Most of the time, the results of these further tests show that there is no cancer.
Provided as an educational resource by Merck
]]>Your colon and rectum make up what is called your large intestine (in-TES-tin). This is a long tube that absorbs water and cleans your body of waste. The large intestine is the final place where food is processed after you eat. It is also where stools are formed. If you find colorectal cancer early, your chances of surviving are high. The best way to catch it early is to get screened or tested.
Did you know?
• Most people have no symptoms in the early stages of colorectal cancer. It can grow for years without your feeling any pain or discomfort.
• About 1 in 15 people get colorectal cancer.
• If colorectal cancer is caught in its early stage, it is up to 90% curable.
Who Should Get Screened for Colorectal Cancer?
You should get screened for colorectal cancer if you:
• Are over 50 years old.
• Have had polyps (PAH-lips), which are small balloon-shaped pouches in the colon or rectum that may contain cancer cells.
• Have had colorectal cancer before.
• Have parents, brothers, sisters, or children who have had colorectal cancer.
• Have ulcerative colitis (UHL-ser-uh-TIV koh-LI-tiss) or Crohn’s (Kronze) disease, which cause inflammation in the colon or small intestine.
• Are African American.
Provided as an educational resource by Merck
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