(Dr. Rajeev Premnath, General, Laparoscopic Surgeon and Endoscopist, Hitech Hernia Centre, Ramakrishna Hospital Jayanagar, Bengaluru)

A lively young adult would never have suspected that persistent stomach aches and unexplained fatigue were anything more than stress from a hectic job or busy schedule. Cancer was the last thing on their mind. However, a shocking diagnosis of colon cancer turned their world upside down.

Changing Demographics of Colon Cancer

In the past, adults over 50 were typically diagnosed with colon cancer. Yet, troubling statistics indicate that people in their 20s, 30s, and 40s are becoming more and more affected. Disturbingly frequent neglect of screening tests and symptoms including abdominal pain, altered bowel habits and unexplained weight loss sometimes result in young individuals receiving advanced-stage diagnoses. With more understanding there is potential to fight this alarming trend and guarantee that young people can enjoy healthy, cancer-free lives.

What is Colon Cancer?

Colon cancer, also known as colorectal cancer, impacts the large intestine or rectum. It is highly treatable and often curable when detected early and localized to the bowel. The disease begins when cells in the colon undergo changes in their DNA, which causes them to multiply rapidly and avoid natural cell death. This results in an overgrowth of cells, forming a mass called a tumor. These cancerous cells can invade and destroy healthy tissue and, over time, may spread to other parts of the body, a process known as metastasis.

Symptoms of Colon Cancer

Colon cancer typically manifests with symptoms like rectal bleeding, alterations in bowel habits, and abdominal discomfort. If left untreated, it can metastasize to other organs. Initially, individuals with colon cancer may not show any symptoms. However, as the disease progresses, symptoms usually correlate with the tumor’s size and its specific location within the large intestine.

Additional signs include persistent changes in bowel habits (like diarrhea or constipation), prolonged abdominal pain or cramping, rectal bleeding, abdominal discomfort (such as cramps or gas), a sensation of incomplete bowel movements, unexplained fatigue, and noticeable weight loss. Detecting these indicators promptly can significantly improve the chances of successful recovery and treatment.

Risk Factors and Contributing Elements

Obesity, smoking, inactivity, an unhealthy diet high in processed meats and fats, as well as poor fruit and vegetable consumption, can all raise the chance of developing colorectal cancer at a younger age. Although inherited factors enhance risk due to illnesses such as Lynch syndrome and familial adenomatous polyposis, they account for only a small proportion of early-onset cases (10-20%).

The composition of gut bacteria is strongly influenced by dietary choices and habits. Research has shown that diet, obesity, and certain medications can significantly alter the gut microbiome. These changes can lead to inflammation, which is a known factor that contributes to the growth of cancerous cells. In addition to these dietary and medication-related factors, inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis are associated with an increased risk of colorectal cancer. Other lifestyle factors like alcohol consumption, diabetes, and exposure to environmental toxins or pollution also play significant roles in the development of this disease.

The Impact of Lifestyle Choices

Unhealthy dietary habits, such as low fiber intake, frequent consumption of processed foods high in unhealthy fats and sugars, and regular intake of red and processed meats, significantly elevate the risk of colon cancer. These behaviors contribute to inflammation, obesity, and exposure to carcinogens, thereby increasing susceptibility to the disease. Insufficient consumption of fruits and vegetables, which are rich in protective antioxidants, further compounds this risk. Additionally, studies suggest that carrying excess body fat, particularly around the abdominal area, promotes inflammation and insulin resistance, which can create conditions favorable for the proliferation of cancer cells.

Treatment Options for Colon Cancer

Treatment options for colon cancer are personalized based on factors like cancer stage, location, and overall health to achieve optimal results. Surgery, such as colectomy or rectal resection, is often the first choice to remove tumors and surrounding tissue.

Chemotherapy shrinks tumors before surgery (neoadjuvant therapy), eliminates remaining cancer cells after surgery (adjuvant therapy), or treats advanced stages. Radiation therapy, using high-energy rays or particles, complements surgery or chemotherapy to shrink tumors and lower recurrence risk, especially in rectal cancer.

Targeted therapy addresses specific cancer cell abnormalities, while immunotherapy boosts the immune system to potentially control advanced colon cancer long-term. Palliative care prioritizes symptom management and enhances quality of life, particularly when curing the cancer is not possible.

Regular monitoring and follow-up are critical to manage treatment effects and detect early signs of recurrence.