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Colorectal cancer (carcinoma of the colon and rectum) varies widely in frequency and in different parts of the world. In U.S.A., colorectal cancer is the second leading cause of cancer death among men and the third among women. By examining the following statistics we have on hand, one can derive without new extensive experimentation, the most likely causes of colorectal cancers.
- Colorectal cancers occur commonly in North America, Northwestern Europe and New Zealand. The risk is much less in South America, southwest Asia, equatorial Africa and India. The incidence varies from 3.5 per 100,000 in India to 32.3 per 100,000 in Connecticut. In U.S.A. colorectal cancer is the second leading cause of cancer death among males and third among females.
- Within the United States, colorectal cancers vary in rate in different regions. The highest incidence is in the Northeast. People in the United States with specific types of diets are remarkably cancer free. Utah with a high concentration of Mormons has the lowest incidence of cancer death rate. The Mormon Church doctrine does not condone the use of alcoholic beverages, tobacco, coffee and tea. Instead it promotes the use of grains, fruits, vegetables and wholesome herbs. Seven-Day Adventists, mainly vegetarians have low incidence of colorectal or other kinds of cancers.
- Migrants from part of the world with low incidence to regions with a higher risk, such as the United States and Canada, show a rapid increase in incidence.
- Puerto Ricans who have migrated to the mainland have a higher incidence compared to those in Puerto Rico.
- First and second generation Japanese and Chinese immigrants to Hawaii and the Mainland United States also show increase in incidence compared to Japanese in Japan and Chinese in the Peoples' Republic of China.
- The risk of colorectal cancer begins to increase from the age 50 and rises sharply at age 60; with each succeeding decade, the risk doubles, reaching a peak by age 75.
- Other risk factors for colorectal cancer. People with the following bowel diseases or conditions have higher risk for colorectal cancer:
- Associated disease: Ulcerative colitis, Crohn's colitis.
- Personal history: colorectal cancer, polyps, female genital or breast cancer.
- Family history of colorectal cancer.
Environmental factors, especially diet are the most likely culprit of colorectal cancer. In countries of high incidence of colorectal cancer, the majority of people are on a high meat and animal (saturated) fat diet with low consumption of whole grains, fruits and vegetables. Fat intake, not only the amount, but also the type of fat, has been correlated with the risk for colorectal cancer in many studies. Consumption of saturated fat (with a high content of animal fat) has been reported to be related to a higher incidence of colon cancer. In countries with higher incidence of colon cancer, the average of fat content in the diet is about 40% of total calories, in contrast to the dietary fat content of 15 to 20% or less of total calories in countries with low cancer incidence.
In countries with low cancer incidence, people usually consume more fibers from grains, nuts, fruits and vegetables. Fiber is not a single chemical substance. Certain components in fiber may be helpful in reducing the risk of cancer by diluting and binding carcinogens in the lumen, by modifying colonic bacterial flora and by acidifying the colonic lumen by short-chain fatty acids. In addition, fiber decreases the transit time of food in the gastrointestinal tract and speeds up the removal of waste stored in the colon. This allows less time for the body to absorb chemical waste or toxins produced by bacteria through the process of putrefaction.
Among people on a high meat and animal (saturated) fat diet, chronic constipation is usually accepted as a norm. It is not unusual for this group of people to have a bowel movement only every two to three days or once a week. When protein decays in a lazy colon, a highly carcinogenic hydrocarbon, called 3-methylcholanthrene, and other substances are formed with the evolution of ammonia or its derivatives and hydrogen sulfide; characterized usually by the presence of toxic or malodorous products. One can imagine what the damages this toxic buildup can do to the tissues of the colon. To use a common sense analogy, kitchen garbage left in the house can fill up your whole house with foul odor after one or two days.
One of the main reasons that the risk of colorectal cancer increase with age is that most people are ignorant about intestinal cleansing and they allow the accumulation of putrefied food residue in their colon for decades. Other factors that have been postulated to play a role in colorectal cancer are excess caloric intake, obesity and inadequate intake of calcium and vitamin D. People who suffer other bowel diseases are more prone to colorectal cancer. Polyps can slowly develop into cancer. We often hear that cancer is hereditary. However, if you examine the above statistics carefully, it is easy to realize that the hereditary factor is in reality mostly an inheritance of unhealthy eating habits and the ignorance of intestinal cleansing.
Current medical practices do not put enough emphasis on preventive therapies for colon cancers or other kinds of cancers. Most medical doctors do not give nutrition consult to patients due to the fact that they received very little education in nutrition and secondly, they have little time, if any, to talk to their patients about preventive therapies. In addition, physicians are in the disease business. They are educated in how to cure diseases using drugs, surgeries and radiation after the diseases have already occurred. Many physicians and pharmaceutical companies look at preventive therapies as a conflict of interest to their practices and industries.
Among the recommendations from the National Cancer Institute, routine intestinal cleansing and body detox measures are obviously missing. After I became a nutritionally oriented pharmacist, it frustrates me to see patients with chronic metabolic diseases being subjected to multiple drugs therapies without much effort to investigate the real causes of the diseases. During my 20 years of practice in hospital pharmacy, physicians prescribing 15 to 20 drugs, especially for older patients are quite common. There are no easy ways to understand all the drug interactions that can possibly happen when these many drugs are being taken concurrently. Those physicians and pharmacists who pretend they know all the drug interactions are fooling their patients and themselves. Often times, some of the drugs are being prescribed to counteract the side effects of other drugs. Our body must detoxify all drugs. Our liver is the most hard-working detoxifying organ. We have the detoxifying enzyme system in our liver called the "P450" system for short. However, it can be overwhelmed easily by too many drugs or other toxic substances. Simply put, you are doing your liver, your kidney and your body a big favor if you can maintain your health without drugs. Human beings are not meant to live on drugs.
We are still at the beginning stage of understanding the significance of nutrition in relation to diseases. We must investigate the wisdom of legends in the medical fields from years past. Shin-huang-ti, the Ch'in era physician who compiled the "Fundamentals of Chinese Medicine", said: It is diet, which maintains true health and becomes the best drug. Hippocrates, the father of Medicine said: A disease is to be cured naturally, by man's own powers; physicians merely help. Let your food be your medicine.
The following are the recommendations from Nutrigenesis Approach as preventive measures for colorectal cancer or other cancers in addition to the preventive measures presented by National Cancer Institute:
- Intestinal cleansing and body detox to hasten the removal of toxic buildup in our body on a regular basis using safe and non-habituating methods. Please see the section on NUTRIGENESIS APPROACH TO INTESTINAL CLEANSING/BODY DETOX for more details. Follow Nutrigenesis Approach Intestinal Cleansing Program initially. After the program, take Lean-N-Clean 1-2 times a day. Repeat Stage II of this program every 6-12 months.
- Avoid intake of all known toxins, which include chemicals approved by FDA to be added to our foods including but not limited to preservatives and artificial sweeteners.
- Reduce fat intake to < 15% of calories.
- Flexible sigmoidoscopy is of limited benefit since it only reviews the condition in the sigmoid colon. People who eat a high fat diet consisting of abundance of meat, cheese and dairy products should schedule for a colonoscopy much earlier in life (probably as early as age 35) to monitor their colon health. If you wait until you already have visible symptoms, you might have already acquired colon cancer. The current recommendation by medical field for colonoscopy every 5 years after age 50 is too long and too late in life. It is best to be done as part of annual physical checkup. This procedure is expensive; however, it is hardly as expensive or as painful as "chemo" therapy, radiation therapy or surgery, which can poison and burn the normal tissues of the body and spread the cancer, leading to earlier death.
Enough money and time have been spent in finding cures for cancers without great success. It is time to concentrate on prevention, not just early detection.
Preventive measures presented by National Cancer Institute:
- PRIMARY PREVENTION: Identifying factors, either environmental or genetic responsible for colorectal cancer.
- Reduce fat intake to < 30% of calories.
- Increase dietary fiber to 20 to 30 grams per day.
- Include a variety of vegetables and fruits in the diet.
- Avoid obesity.
- Consume alcohol in moderation if at all.
- Avoid cigarettes and tobacco.
- Exercise regularly.
- SECONDARY PREVENTION: Identifying and eradicating pre-cancerous lesions while still curable.
- Annual digital rectal examination after age 40.
- Testing for fecal occult blood annually after age 50.
- Flexible sigmoidoscopy every 3 to 5 years after age 50. Patients with abnormal findings require more careful diagnostic evaluation, including colonoscopy.
What is flexible sigmoidoscopy? Flexible fiberoptic sigmoidoscopy (FFS) is the photographic examination of the sigmoid colon, which is the lower part of the descending colon with a flexible instrument about 60 cm or 2 feet long. FFS preparation uses only 2 enemas. It is not usually done unless there are symptoms such as rectal bleeding, or suspicions of some types of colon diseases.
What is colonoscopy? Colonoscopy is the photographic examination of the entire colon with a flexible instrument about 180 cm or 6 feet long. This instrument also has the capability of removing polyps or adenoma (benign tumor of glandular structure) if found during the procedure. Colonoscopy requires a two-day liquid diet preparation and the bowel must be totally cleansed with large volume of isotonic solution. Colonoscopy is currently recommended every 5 years for people over age 50 or when polyps or cancers are suspected in other parts of the colon other than the sigmoid. This procedure is very expensive and is usually not reimbursed by many insurance companies as part of a routine checkup unless your gastro-enterologist suspect the presence of certain colon diseases.
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