Colon Cancer in Young Patients a Growing Concern

Getting a colon exam isn’t exactly top of anyone’s favourite medical checkups, but, colonoscopies are lifesaving tools. Most colorectal cancers begin as polyps, which can turn cancerous if not removed.

Dr. Luvuyo Dyasi is a General Surgeon at St Philip's Private Hospital in Accra.

He says the colon exam has become so refined that patients are typically less anxious getting this procedure done over other procedures because so much of the experience is within their control. “Bowel prep can be done at home, a patient does not need to stay overnight in hospital and the entire procedure is over in approximately 20 minutes,” he says.

Another factor to consider is that if a biopsy reveals cancerous growths, cancer treatment is a multi-disciplinary approach. Patients feel less anxious knowing that a whole team of professionals are behind their treatment.

Dr. Dyasi says that more screening and genetic testing is encouraged as generally you find that a lot of cancers are still sporadic. Sometimes they are genetic and the sooner a genetic cancer is picked up through screening the better it is for the patient.

So, where does colon cancer start and how can it be detected in the early stages?

Dr. Dyasi explains that the ‘colon’ is actually the large intestine. He says it is important for surgeons to differentiate between the areas of the colon, as the percentage of cancers differs in each part of the colon.

Generally, the most common part of the colon where cancer is detected is on the left side where the rectum and descending colon are located.

Dr. Dyasi says cancer in each part of the colon will present related warning signs. For example, if a patient presents with bowel obstruction it commonly occurs from the left side of the intestine. An early warning sign would therefore be pain in the abdomen and the abdomen may start to distend or swell.

Cancers appearing in the distal colon – which includes the descending colon, the sigmoid colon (that ‘S-shaped’ section) or the rectum where waste is excreted might find blood in their stool. This would be an early warning sign commonly associated with cancers. Patients might think that they have piles or an anal fissure, but, any rectal bleeds or discomfort should be discussed with your doctor.

Dr. Dyasi says a digital exam, or a finger examination, may help rule out any suspicious growths.

For cancers that are present on the right side of the large intestine, a patient would typically display warning signs such as anemia and fatigue for unknown reasons.

An early warning sign from this region of the intestine would be unexplained weight loss, and paleness.

Dr. Dyasi says these symptoms are typical signs for sporadic cancers.

“The factor about colonoscopy examinations is that we can visually see if there are abnormalities, and this is what should reduce a patient’s anxiety. A colon examination will reveal a patient’s results fairly quickly.”

Genetic cancers usually present in patients at a younger age.

Dr. Dyasi says getting a family history is a vital step in information gathering to pick up if there is a family history of gastrointestinal cancer.

These patients would be screened to determine if they have polyps. If they do, it could indicate that they are at risk of developing cancer in the future.

“We are seeing younger patients with colon cancer these days,” Dr. Dyasi says, adding that ‘younger’ ranges between the ages of 30 and 50 years old.

“Previously, patients with colon cancers were largely in the 55+ age group, but with today’s lifestyle it’s becoming more common to see these types of cancers in younger patients.”

There are a multitude of reasons why colon cancer features so prevalently in younger patients.

Lifestyle tops the list. Dr. Dyasi says the public would do itself a service if it paid closer attention to making better dietary choices.

“Obesity is a problem in Ghana. Westernised diets, with a heavy carbohydrate and fat load, contribute to obesity. There are several case studies which show the link between obesity and cancer,” he says.

Dr. Dyasi adds that weight loss can reduce the likelihood of developing gastric cancers and other malignancies.

“Start adding more fibre and less carbohydrates to your diet,” is his advice.

Finally, Dr. Dyasi says that an educated patient that is aware of their symptoms makes treatment more effective. He therefore encourages patients to research their symptoms to get an idea of their condition.

Patients should however still engage and consult with a health care professional to ensure that the correct diagnosis is obtained.

“An educated patient is more compliant with therapy, and this makes for a collaborative approach that serves the patient’s best intent – which is to get better.”