Colorectal cancer one of the leading cause of cancer death among people under 50 in the western world. India is not lagging behind.
Genetics contribute to 5% of the overall colorectal cancer
Colorectal cancer one of the leading cause of cancer death among people under 50 in the western world. India is not lagging behind. Mr. Mithul 22 years, Ms. Farida 23 years, Mrs. Uma 30 years, Mrs. Neethi 31years and Mr. Ameer 32 years are just a few from the recent past. All of them have had colo-rectal cancers. They ignored the early symptoms …I am young, nothing can be wrong, I think it is piles…Delay in diagnosis led to disease and in some early death. (names changed)
Causes of Colorectal Cancer in Young Adults:
Environmental factors: Environmental factors contribute to 95% of all the colorectal cancers seen. Sedentary lifestyle (more time sitting and less time being active), Physiological stress, Obesity, lack of exercise, smoking, Alcohol, fast food, excess red meat, lack of fibre all are playing a role. Food, water and Air pollution play a role. Even the so called organic diet – the source of which is questionable.
Chemicals in the Environment: Fertilisers, chemicals and pesticides used to augment the productivity of food produce may be playing a silent role. The above damage DNA, potentially leading to harmful mutations in cells causing cancer. Chemical mixtures can disrupt the body’s metabolism, leading to obesity. Water and air pollution are compounding the problem.
Toileting: Toileting habits and positions have a role to play is our belief. The longer the stools stay in the gut, more the damage to the lining of the Gut and carcinogenesis.
Tumour Biology: The biology of the Tumour is the King. Tumour biology is varied amongst the older age (sporadic cancers) and younger age early onset cancers. We see more mucinous with signet cell morphology in these young patients. They also tend to be more aggressive.
Diet, Gut Bacteria, and Inflammation
The possible causes of early-onset disease is related to the triad of diet, bacteria in the gut (gut microbiome) and inflammation.
- Diet: An unhealthy diet high in processed meat and fat, red meat and foods low in fruits, fibre and vegetables can lead to early-onset colorectal cancer.
- Gut Microbiome: Intestines are called gut. Within the Gut is a micro-biological environment. Organisms live in it in symbiosis. Disruption of the balance here is known to cause gut problems and also cancers.
- Inflammation: Unhealthy diets and gut bacteria can both lead to inflammation—the body’s reaction to injury, disease, or irritation. This can trigger gut inflammation and fasten the growth of tumours. Chronic diseases, inflammatory bowel disease such as Crohn’s Disease, ulcerative colitis and diabetes, can cause inflammation in the gut.
Genetic factors: Contribute to 5% of the overall colorectal cancers. Family history of cancer or polyps, Genetic conditions like Lynch Syndrome and familial adenomatous polyposis (FAP) increase the risk of colorectal cancer at a young age.
Symptoms of Colorectal Cancer in Young Adults:
Symptoms are those manifestations, which are not normal to oneself, cannot be explained by a reason and have persisted for more than 6 weeks.
The symptoms of colorectal cancers would include one or more of the below:
- Rectal bleeding
- Change in Bowel Habit (Diarrhoea or Constipation)
- Unexplained weight loss
- Excessive Mucous
- Mass in the rectum
- Palpable fullness in the abdomen
- Lump over the area of Colon or Liver.
Prevention and Treatment: Prevention is always better than cure. While CRC is not entirely preventable, you can bring down your risk with Awareness, a healthy lifestyle, regular exercise, and balanced diet with fruit, vegetables, whole grains and foods containing fibre. Colonoscopy as a screening tool has a role to play in the above 40 age group.
(Prof. (Dr.) Narasimhaiah Srinivasaiah, Associate Professor of Surgery, Apollo Hospitals, Head of colorectal services, Karnataka region)
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