Image credit: Gordon Johnson from Pixabay

 

There have been moments where we have experienced a symptom and attributed it to a completely different disease or condition than it ended up being. There are infographics to help acknowledge the similarities and simultaneously clarify distinct differences across the common cold, flu strains, and COVID-19. Since there is much overlap and potentially confusion that can arise regarding symptoms of Crohn’s disease, ulcerative colitis, and colorectal cancer, we have created infographics to help visualize commonalities as well as distinguish their disparate characteristics. 

We hope that these graphics will provide a clearer picture of symptoms that are unique to specific conditions and diseases and where and how they manifest in our body.

 

 

Sources:

  1. Colon cancer vs. ulcerative colitis (UC) symptoms & signs. eMedicineHealth. April 2, 2020. Accessed November 8, 2023. https://www.emedicinehealth.com/colon_cancer_symptoms_vs_ulcerative_colitis/article_em.htm.
  2. Crohn’s disease and colon cancer: What you need to know. HealthMatch. October 15, 2021. https://healthmatch.io/colon-cancer/crohns-disease-and-colon-cancer#overview.
  3. Colon cancer. Mayo Clinic. July 27, 2023. https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669.
  4. Colorectal cancer – symptoms and signs. Cancer.Net. June 1, 2022. https://www.cancer.net/cancer-types/colorectal-cancer/symptoms-and-signs.
  5. Colorectal cancer signs and symptoms: Signs of colorectal cancer. Signs of Colorectal Cancer | American Cancer Society. June 29, 2020. https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/signs-and-symptoms.html.
  6. Colorectal cancer: Symptoms and diagnosis. Colon Cancer Foundation. December 1, 2022. https://coloncancerfoundation.org/colorectal-cancer-symptoms-diagnosis-and-treatment/.

 

Vanessa Seidner is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

The Network for Excellence in Health Innovation (NEHI) conducted research to shine a spotlight on disparities in colorectal cancer (CRC) screening and has proposed short-term and long-term recommendations to address these disparities. The report, Addressing Persistent Disparities in Colorectal Cancer Screening Among Racially and Ethnically Diverse Populations, proposes solutions that would help close existing gaps and legislative involvement for long-term resolutions.

By Parker Lynch

We all know that exercise is healthy. However, the extent to which a patient with colon cancer could improve their prognosis through exercising is something that was previously unknown, and is still being researched. Authors of one such research study published their findings after analyzing how physical activity impacted individuals with Stage III colon cancer.

Does Exercise Improve Colon Cancer Outcomes?

In collaboration with the National Cancer Institute, two groups of patients with Stage III colon cancer (one of them being a placebo or control group) were randomly assigned to various community and academic centers throughout the U.S. and Canada to be evaluated during the duration of their treatment. Patients were then instructed to report the average weekly time that they spent exercising.                                                                                                                                                                                                                                                                       

Each physical activity was assigned a specific metabolic equivalent (MET). The MET values were then multiplied by the hours that each patient reported spending each week, which were then categorized as:

  • <6 METs (light- to moderate-intensity physical activities) 
  • ≥6 METs (vigorous-intensity activities) 

Patients’ METs were evaluated throughout their chemotherapy treatments as well as six months after treatment completion. 

Here’s What They Found

During a median follow-up of 5.9 years, the study found the following relation between the status of a patient’s health and their corresponding physical activity levels: 

  • For light-intensity to moderate-intensity activities, the 3-year disease-free survival (DFS) was 65.7% with 0.0 hour/wk
  • For vigorous-intensity activity, the 3-year DFS was 76.0% with 0.0 h/wk and 86.0% with ≥ 1.0 h/wk

These results strongly indicate that more frequent, high-intensity recreational activities can improve DFS.

Implications for Patients 

Nothing is ever directly causational, and there are never guarantees that one specific lifestyle change will influence treatment outcome. However, studies like this are vital because they provide information that could change one’s quality of life while going through cancer treatment. If a patient with colorectal cancer picks up running as a new hobby because of this study and it makes them feel better in their day-to-day life, then that is a real-world influence of research studies. 

 

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

By Vanessa Seidner

The Colon Cancer Foundation and the 2024 Early-Age Onset Colorectal Cancer (EAO-CRC) Chair, Dr. Cathy Eng of the Young Adult Cancer Program at Vanderbilt-Ingram Cancer Center, will be hosting the 8th Annual EAO-CRC Summit in Nashville, Tennessee, which will provide the grounds for discussions about the latest technological and medical advances, how to build community, and about what actions can be taken at various levels to address the rise in EAO-CRC. 

Colorectal cancer (CRC) is the third most common cancer among men and women. This cancer occurs more often in the older population, yet there has been a rapid rise in CRC incidence among young people. Early-Age Onset (EAO) CRC refers to cases of colon or rectal cancer that occur in people under the age of 50 years. There has been an annual increase in these cases of approximately 2% since 2011.

Some of the best ways to prevent CRC or avoid unfavorable outcomes include on-time screening (starting at age 45 years – earlier if there are symptoms or family history), knowing the risk factors and family history, and consulting medical professionals when potential symptoms arise. One of the most effective ways to increase awareness of these solutions is through health education.

How Can We Encourage Health Education on EAO-CRC for College Students?

There are several opportunities to host educational events. The implementation of peer educators in colleges and universities is a cost-effective approach that allows students to impart valuable knowledge to their peers about meaningful and healthy lifestyle changes. While health outlooks differ, health education can be tailored to specific audiences to increase the likelihood that someone can reach and maintain their concept of optimal health. 

Health education events can appear as presentations, panels, tabling, and expositions. 

  • Presentations
      • Longer, more information-dense messaging
        • Can incorporate interactive questions and activities and pre/post surveys that allow participants to think critically about what they have learned and about how they will apply it to their lives moving forward. Information pamphlets and giveaways can also bolster interactivity. 
      • Key takeaways: Elaborate and in-depth, allows for active participation, and allows for future action to be taken.
  • Panels
      • Question and answer sessions. These can allow for an increased sense of closeness.
        • Panelists can provide a variety of perspectives germane to their topic
        • They can share anecdotes and experiences – personal, occupational, or both 
        • Specific contact information can be provided in case an audience member wishes to reach out to a panelist.
      • Key takeaways: Allows sharing of diverse viewpoints, opportunity for an open dialogue 
  • Tabling Events 
    • Drop-by event; can give quick overviews
    • Opportunity to share information pamphlets and giveaways
    • Can host activities to engage visitors in discussion and have giveaways
    • Key takeaways: Cost- and time-effective, succinct, and engaging – tabling events are a popular health education method                                                                                                   

Colleges and universities can host one or more of these events to increase awareness on risk factors, symptoms, the need to consult a medical professional if symptoms occur, and the importance of regular screening. As for timing, it is best to do so on days where there are not as many classes, in populous areas, and during a time of day when there is a higher influx of people, such as around a mealtime or when a certain timeblock for classes commonly ends. 

March is Colorectal Cancer Awareness Month. Consider a tabling event with information about the disease and with some free merchandise. Students can also be encouraged to wear dark blue to increase awareness of CRC.

Reach out to us at info@coloncancerfoundation.org if you would like to partner on an information event in March or any other time!

 

Vanessa Seidner is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Photo Source: Naassom Azevedo on Unsplash

By Emmanuel Olaniyan

Colorectal cancer (CRC) is one of the more common types of cancer and is the third largest cause of cancer-related deaths worldwide. According to the American Cancer Society, 153,020 new cases of CRC are expected to be detected throughout the U.S. in 2023, out of which 52,550 people will die from the disease. Considering these figures, it is important to raise public awareness about CRC in order to decrease the number of CRC-related deaths and new cases.

Several studies have researched the causes of CRC, and age, diet, genetics, and the gut microbiota have all been identified as risk factors in various ways. The gut microbiome, in particular, has been shown to play an important role in a number of diseases, and research has begun to focus heavily on its role in CRC. 

What is the Gut Microbiome?

The human gut microbiota refers to the trillions of microbes, such as bacteria, viruses, fungi, and others present in the human digestive tract. The microbiome is the environment they live in. Most microbes in the body are beneficial, but they may become harmful when out of balance.

The gut microbiota is crucial for the overall functioning of a healthy digestive system because it supports the absorption of energy from digested food, guards against pathogens, controls immunological response, and fortifies biochemical barriers of the intestine. However, when harmful bacteria enter the gastrointestinal tract through eating contaminated food or drinking contaminated water and cause infection, all of these advantageous activities could be disrupted.

Jaeho Kim and Heung Kyu Lee published a study in 2022 that found a strong association between gut microbiota and CRC. They came to the conclusion that the patients with CRC experienced dysbiosis (an imbalance in bacterial composition, changes in bacterial metabolic activities, or changes in bacteria distribution within the gut) more frequently than healthy individuals. Opportunistic infections were discovered to be more prevalent, and intestinal inflammation has been shown to be reduced along with the percentage of bacteria that produce butyrate, which is an essential component of our digestive system that reduces inflammation in the digestive tract, protects the brain and prevents cancer.

How Can We Maintain a Healthy Gut Microbiome?

Maintaining good hygiene and being mindful of the foods we eat can help keep our gut microbiota healthy. Studies have shown that eating more processed foods and a low intake of dietary fiber increase the risk of CRC. For this reason, it is recommended to consume fermented foods like cheese, soy sauce, vinegar, and yogurt as well as meals high in fiber like whole grains. It has been established that the bacteria present in these fermented foods are similar to those linked to gastrointestinal health. 

Finally, a decrease in processed food consumption and antibiotic use lowers the risk of developing CRC caused by gut microbes. 

 

Emmanuel Olaniyan is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Image source: OpenClipart-Vectors from Pixabay

By Parker Lynch

The COVID-19 pandemic has had a lot of repercussions within the healthcare realm. The inability of patients to visit their providers in-person (out of fear of COVID-19 exposure) led to the expansion and adoption of telehealth services all across the world. While we have a better handle on the pandemic in America, telehealth services are still being utilized by physicians from a vast assortment of specialties. Telehealth increased access and was beneficial to patients as well as doctors, there are some caveats.

A recent article shares how patients are now really comfortable emailing their doctor to provide health updates or ask medical questions. Patients may live several hours away from a specialist’s clinic or might be too sick, which may make it inherently difficult for them to schedule in-person appointments. Justifiably so, they might prefer to reach out to their doctors via the clinic’s or hospital’s patient portal. As a result, doctors are flooded with email messages, many of which are received after hours. Doctors feel obligated to answer all of these questions/comments, 24/7.

Patient Portal Communication Causing Physician Burnout 

Due to the burnout that physicians are experiencing from this constant and overwhelming communication, hospitals including Johns Hopkins, Houston Methodist, and the Cleveland Clinic have begun charging patients for the clinical advice that they are receiving through messages. The goal of these charges is to reimburse physicians for their time, but has discouraged patients from contacting their providers. 

Many doctors believe that open communication between them and their patients is vital to an accessible healthcare system and do not want their patients to ever refrain from reaching out. At the same time, these doctors also recognize that open communication can’t feasibly mean “open” 24/7. Moving forward, it is important to keep in mind that this issue is hardly black-or-white. Should patients continue to be charged for messaging their providers, there will be accessibility barriers for those that cannot afford these charges. On the other hand, constant communication between patients and their doctors has proven to be detrimental to the doctors themselves. Eve Rittenberg, a physician and professor at Harvard Medical School, believes that this line of communication should remain, with boundaries in place.

Implications for Cancer Patients

For patients in the cancer realm, specifically, there are some implications of this limited/“controversial” communication. Dr. Jyoti Patel, suggests several different ways in which patients can effectively use their patient portal messaging features. Most importantly, one should never send a message regarding chemo-induced fever or sudden symptom changes, rather they should immediately call the doctor’s office. Chat features with physicians should never be used to discuss complex questions that revolve around one’s diagnosis, prognosis, goals of treatment, etc. It can be very difficult for physicians to properly convey their thoughts on these matters. Instead, patients should only be asking questions that yield a straight-forward and easy response (like prescription refills, appointments, etc.). 

Boundaries can be really hard to establish between patients and their doctors. However, the fundamental goal of wishing the absolute best quality of care for a patient remains consistent. Hopefully, a happy medium can be met: allowing the patients to communicate with their providers without the providers feeling overwhelmed. 

 

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Image credit: National Institutes of Health

Cancer incidence has been growing among younger adults—not just in the U.S., but globally. According to a recent analysis, the three decades between 1990 and 2019 saw almost an 80% increase in incidence of early-onset cancer. Following breast cancer, cancers of the digestive tract (stomach and colorectal) have seen a rise among young adults—in 2019, 37% of early-onset cancers diagnosed across the world were in the colon and rectum.

These trends are also reflected in the U.S. population. Here’s a startling prediction: by the year 2040, colorectal cancer (CRC) is estimated to be the second-leading cancer in the 20-49 age group and the top cause of cancer-related death in that age group.

The Need to Raise Awareness Among Providers

What is frustrating for the early-age onset CRC (EAO-CRC) community is that young individuals are not your typical candidate for developing colon cancer, which means their symptoms are either dismissed or attributed to some other gastrointestinal issue. According to cancer epidemiologist Yin Cao, 50% of EAO-CRC cases are among those under 45 years of age. Current guidelines recommend that someone with an average risk for CRC should start screening at age 45, so anyone younger may not get screened despite their symptoms.

An average-risk person is someone who does not have a known family history of CRC or a known genetic condition that’d increase their risk for developing CRC.

As a result, diagnosis is delayed, which raises the risk of an advanced-stage disease that may be harder to treat. One such study among nearly 1,200 EAO-CRC patients found that 71% were diagnosed at an advanced stage (stage III or IV).

*Information on the various stages of CRC can be found here.

What’s Leading to the Rise in EAO-CRC?

While there are a lot of guesses, researchers and clinicians are not quite sure. There are talks about a birth cohort effect, which is a term that describes the unique experiences or exposures faced by a group of individuals based on their year of birth. For example, Americans born prior to 1945 have been found to have a lower risk of being obese.

Going back to CRC, medical oncologist Christopher Lieu told ScienceNews that those in their 40s today are at a greater risk of developing CRC than those who turned 40 a decade ago (so now in their 50s). Several different risk factors are being investigated in those who develop EAO-CRC:

  • Obesity
  • Antibiotic exposure
  • Changes in the gut microbiome (meaning the microbes that live in our gastrointestinal tract)
  • Dietary habits
  • Environmental exposures

However, there’s no definitive answer for the cause. The best preventive efforts include being physically active, managing your body weight, reducing the intake of processed food and integrating fresh fruits and vegetables in your diet.

What Do We Know?

What is definitely known are the telltale symptoms: pain in your abdomen, abnormal bowel movements (unexplained diarrhea or constipation), blood in your stools/rectal bleeding, unexplained weight loss, weakness. It is important to pay attention to these symptoms, which are often misdiagnosed as inflammatory bowel disease or hemorrhoids, especially in young adults. Any two of these signs could indicate a serious problem with your gastrointestinal tract—potentially, cancer.

By Parker Lynch

According to a study published in Cancer Biology & Medicine, the role of intestinal bacteria in the development of colorectal cancer (CRC) has been receiving a lot of attention in recent years. Various bacteria such as Fusobacterium nucleatum, Escherichia coli, Bacteroides fragilis, Enterococcus faecalis, and Salmonella sp., have been known to cause DNA damage. Additionally, these bacteria also help tumor cells evade the body’s immune response, creating a pro-inflammatory environment. The DNA damage and other hindrances upon one’s immune system and bodily function have been associated with the development and progression of CRC.

These bacteria can be useful biomarkers for CRC. Additionally, progress is being made in developing effective antibacterial therapies, which could prove useful in the treatment of CRC.

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Nutrition & Colorectal Cancer Prevention Series: Blog 3

In the previous installments of this blog series, we explored both the molecular pathways behind dietary prevention of colorectal cancer (CRC) as well as the barriers within the built environment that prevent individuals from properly accessing those preventative nutrients. This post will further explore strategies and resources that can aid communities in achieving a balanced diet.

With rising costs of living and barriers in the built environment such as food deserts, reducing CRC through dietary prevention can feel like a daunting task, but there are many resources available that can provide support in this process. 

So how can individuals identify resources that are available to them? This can be done through a multi-pronged approach from accessing fresh food from local organizations to engaging in nutritional education classes. 

Where can you find these resources? Findhelp.org is a database that provides direct links to resources in your zip code. Individuals can input their location and find resources from direct food access, to community gardens, to education. 

Our infographic below provides a snapshot of how integrating dietary pathways can help CRC prevention.

 

Emma Edwards is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Photo credit: Nathan Dumlao on Unsplash

By Parker Lynch

In a recent study conducted in Canada, 5,026 patients with colorectal cancer (CRC, all younger than 50) were evaluated between 2007 and 2018. This study evaluated the time between a patient’s first presentation with CRC and their treatment initiation. The overall objective of this study was to determine if a longer time from presentation to treatment start would result in worse survival rates for CRC patients, particularly those under 50.

Relation Between Treatment Start and Disease Outcome

The median age of the participants was 44 years, with about an equal number of males and females:

  • 25.2% overall had metastatic disease
  • 31.2% had rectal cancer

The lower-urgency subset consisted of 2,548 patients. Patients with metastatic CRC had shorter median (IQR) overall intervals (83 days) compared with those with less advanced disease. Five-year overall survival was 69.8%. Overall intervals longer than 18 weeks were not associated with significantly worse overall survival (OS) or cancer specific survival (CSS) compared with those waiting 12 to 18 weeks. Additional analysis by the researcher where patients were stratified by stage of disease  did not show significantly worse OS or CSS with increasing overall interval lengths.

One would expect the findings to support that a later treatment start would result in worse outcomes for the patient. In other words, starting treatment as soon as possible would yield the best prognosis for patients. However, this study found something quite different: time from presentation to treatment was not associated with advanced disease or poor survival. This finding insinuates that a patient has a little bit of “leeway” in terms of the time it takes for them to begin their actual treatment, without having to worry that this delay will correspond to decreased survival.

Another Study With a Different Perspective

In another study, the administrative time of adjuvant chemotherapy following a curative surgical procedure for stage 3 CRC was evaluated. Specifically, researchers wanted to determine if there was a so-called “sweet spot” for when a patient should begin chemotherapy to maximize their chances of survival. 

In this study, 159 patients with stage III CRC, who had undergone a curative resection, were enrolled. Patients were categorized into 3 groups representing different timings to initiate chemotherapy treatments:

  • less than 2 weeks (group 1)
  • 3 to 4 weeks (group 2)
  • more than 5 weeks (group 3)

The OS and relapse-free survival rate (RFS) were analyzed to evaluate the effectiveness of adjuvant chemotherapy. The 5-year OS was:

  • 73.7% in group 1
  • 67.0% in group 2
  • 55.2% in group 3

The 5-year RFS was:

  • 48.8% in group 1
  • 64.7% in group 2
  • 57.1% in group 3

When specifically considering CRC patients who have undergone resection procedures, it was loosely determined that chemotherapy should be administered 6-8 weeks after one undergoes an operation. However, the administration prior to the 6-week mark didn’t result in a statistical difference in outcomes.

This, however, should not encourage patients to “wait out” their cancer; rather, that time should still be spent on interactions with providers to come up with a treatment plan. CRC, on average, takes around two years before it metastasizes to other organs such as the lungs, liver, lymph nodes, peritoneum, etc. Though this sounds like a lot of time, it is always best to be aware of one’s condition as soon as possible. 

The Dangers of Misdiagnosis 

When CRC is discovered at an advanced stage, it can be one of the deadliest and most difficult cancers to tackle. This is why misdiagnosis is such a prominent fear and active issue within the CRC community, particularly among younger CRC patients, who often struggle with getting the right diagnosis in the first place. 

When a younger person experiences CRC symptoms, it is often easy for them to be excused as hemorrhoids, irritable bowel syndrome, inflammatory bowel disease, or other gastrointestinal conditions. When properly diagnosed after the initial misdiagnosis, patients would have typically already progressed to a more intense and worrisome stage of CRC, therefore making their treatment plans and overall survival rates more complicated. 

Every CRC patient is different–they may vary in age, sex, predisposing health, stages of CRC, etc. Therefore, it is impossible for researchers to determine the perfect time in which every single patient should start treatment while keeping their survival rates in mind. However, the dangers of waiting too long are known. Though beginning chemotherapy treatments early (less than six weeks after resection procedures) don’t typically have a significant impact on one’s survival rate, significant delays in initiating treatment may result in negative outcomes. 

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.