An estimate by the National Cancer Institute (Inca) indicates the emergence of 44,000 new cases per year of bowel cancer, or colorectal cancer, in Brazil, with 70% concentrated in the Southeast and South regions. “It is a very prevalent disease. It’s the third. she will lose to [câncer de] mom, you will lose to [câncer de] prostate. In third place comes colorectal cancer,” said oncological surgeon Rubens Kesley, coordinator of the Colorectal Cancer Group at INCA.
According to the specialist, developed countries, such as the United States, tend to have a greater number of new cases of this type of cancer each year. Among North Americans, who have a population of around 300 million inhabitants, it is estimated that 150,000 new cases appear annually. As Brazil is progressively improving its socioeconomic condition, the perspective is of expanding cases. “There is a vertiginous increase. It’s a sharp curve.”
Rubens Kesley recalled that five years ago, Brazil had 25 thousand new cases/year of colorectal cancer, and the expectation for the next five years is to reach 80 thousand cases/year. “In a simpler way: today, there are 44,000 and counting. And the incidence will go up a lot.”
Factors
A Diet low in fiber is related to the increase in the number of cases of colorectal cancer, confirmed the oncological surgeon. This is explained because, as the socioeconomic conditions of a country improve, people start to eat more industrialized and ultra-processed foods and stop eating foods with fiber. “The fiber is like a sweeper. Imagine a broom that cleans the colon, the large intestine. When you stop using the broom, the garbage builds up. So, the lack of fiber-rich foods increases the incidence a lot”.
Another factor that can lead to colorectal cancer is red meat, especially that used in barbecues, burnt, with a lot of fat. “Because it is rich in hydrocarbons, which are very carcinogenic”. Boiled meat is best. Other things that favor the appearance of bowel cancer are smoking, sedentary lifestyle, alcoholism, obesity, especially in the belly.. Among these, Kesley highlighted as main factors for the development of colorectal cancer the obesity, lack of physical activity and industrialized and fiber-poor foods. “These are really the flagship of the most aggressive risk factors.”
Another precaution that must be taken is the oral health, because there is a bacteria in the mouth that favors the development of the disease. “This bacterium is associated with a very high incidence of colorectal cancer.” A recent study by researchers at the Columbia School of Dentistry, in New York, showed how the Fusobacterium nucleatum, one of the bacteria in the mouth, can accelerate the growth of this type of cancer. Hence the importance of oral prophylaxis, recommended the doctor.
Colonoscopy
All over the world, the Colonoscopy was considered the most efficient method for the prevention of colorectal cancerKesley said. This explains why bowel cancer doesn’t start out big. “He’s discovered big. But it was once a polyp, it was tiny”. At this stage, colonoscopy removes these small polyps. “Colonoscopy is a weapon, comparable to a nuclear bomb, against colorectal cancer, because it manages to prevent it, identify it early, see it even at the polyp stage, and manages to treat it, because it removes the polyp, without the need for surgery, saving millions.
In the diagnosis, the doctor identifies that there is a tumor, and in the treatment, if there is a small tumor, you cure the patient. The cancer is removed by colonoscopy in some selected situations.
The deadline for redoing the colonoscopy will depend on whether there is polyp. If the patient undergoes the colonoscopy and everything is normal, he can repeat the exam every five years. If you have a polyp of a specific type (adenoma), which is a precursor to colorectal cancer, the patient should have a repeat colonoscopy in the following year. The term for renewing the exam therefore extends from one to five years.
right age
For the vast majority of the population, who have no history of cancer in their family, they are healthy living patientswith very low risk, who do not smoke or drink, have normal daily bowel movements, the ideal is Colonoscopy at age 55. “But this has to be seen by the coloproctologist. This is a medical decision because, depending on the risk, you may need it sooner,” warned the specialist.
In the case, for example, of people who have a history of cancer in the family, as happened with the actress Angelina Jolie, they cannot wait. You have to look for a good professional who will tell you the best time to do a colonoscopy.
This exam can be done, however, before the age of 55, in the presence of symptoms. Patients with anemia or recurrent pain (intestinal cramps) should see a doctor to rule out the risk of colorectal cancer. In this case, they are patients with changes in bowel habits, that is, the frequency with which they evacuate, which include diarrhea or constipation with colic.
advanced stage
According to Rubens Kesley, the lack of colonoscopists, mainly in the interior of the country, causes most patients to be diagnosed with bowel cancer in an advanced stage, as happened with soccer players Pelé and Roberto Dinamite. “Usually, this advanced stage is a determining factor in the severity of the cancer.” That is, the stage of the disease determines the prognosis.
The surgeon at Inca highlighted, on the other hand, that the evolution of the treatment has been so great in recent years that even if the stage is very advanced, there is a possibility of survival. Of all patients with colorectal cancer, 20% survive, 80% die.
“It’s worth the patient to run after because, even if the stage is very advanced, it can be cured”. The chance of healing is less. Out of every five patients with advanced cancer, one will survive. “But there is a chance. If we manage to save one in five, that’s a big step forward,” said Kesley.
He admitted, however, that cancer is still a challenge for science. THE disease is a DNA mutation, which is protected by two membranes. Unfortunately, there are currently no drugs capable of rearranging DNA. So when a patient already has a disease that is resistant to chemotherapy and radiotherapy and has already spread, cancer treatment becomes ineffective. In the case of Pelé and Roberto Dinamite, the tumor had already become resistant to chemotherapy and radiotherapy, and surgery was futile. That is, when the cancer cells have already spread, the possibility of cure is greatly reduced.
