Four steps to cancer prevention

By Todd Crocenzi, M.D., oncologist, Providence Oncology and Hematology Care, and medical director, Providence Gastrointestinal Cancer Program.

Most of us would do just about anything to avoid getting cancer, right? Well, maybe not. Colorectal cancer is one of the most preventable of all cancers, yet, for whatever reason – be it lack of information, fear of screenings, or just procrastination due to busy lives – most people don’t take the steps that we know can prevent it. Thus, this very preventable cancer remains the third most prevalent form of cancer and the second leading cause of cancer deaths in the United States.

It doesn’t have to be that way. The scientific evidence points to four actions you can take that will greatly reduce your risk of developing this deadly cancer. These actions may not be as simple as taking a pill, but they are definitely within your power, and can have powerful protective benefits.

  1. Take 30 minutes a day to exercise.

    Besides getting regular screenings (see step 4), exercise is the most important thing you can do to prevent colon cancer. A recent analysis of 52 studies revealed that regular activity could cut the risk of developing colon cancer by 24 percent. To learn more about this analysis, listen to my radio interview. Exercise is so powerful that it also was found to cut the risk of recurrence in people who have been treated for colon cancer.

    The recommendations aren’t complicated: just get up and move. Earlier studies have suggested that walking a few hours a week can make a difference. Even 15 to 20 minutes a day will help. If you’re not into walking, choose whatever activity you enjoy, start with 15 minutes, and increase your time gradually until you’re up to 30 minutes or more.

    Colorectal cancer is most common among people who are overweight and have inactive lifestyles. Get active for 30 minutes a day, and take yourself out of this category.

  2. Take a closer look at what you eat.

    Accumulating evidence suggests that controlling body weight can reduce the risk of developing colon cancer. This is true for breast cancer risk, as well. Adopting step 1 can help you move toward your ideal weight. Taking a closer look at the foods you eat – and how much you eat – can get you the rest of the way there.

    In addition to their contributions to weight loss, certain foods may have protective benefits in and of themselves. It’s generally accepted that a diet that is rich in fruits and vegetables, and that depends less on meat (particularly red meat), will reduce the risk of colorectal cancer.

    For cancer protection, try to incorporate these changes into your diet:
    • Eat smaller portions, and less overall.
    • Eat five to six servings of vegetables and fruits every day.
    • Eat less red meat.
    • Incorporate more whole grains into your diet.
    For more ways to incorporate healthy changes into your diet, read this overview of the 2010 Dietary Guidelines for Americans by Providence’s Regional Clinical Nutrition Manager. Providence Integrative Medicine has compiled additional information on eating to fight cancer.

  3. Take another shot at quitting smoking.

    It’s not just lung cancer that smokers have to worry about. Tobacco use is now firmly established as a cause of colon cancer – as well as dozens of other cancers and diseases – increasing the risk by 25 percent. According to an American Cancer Society study published in 2009, “The incidence of colorectal cancer was significantly higher in current and former smokers compared with lifelong nonsmokers.”

    But there was good news in the study, too: when smokers quit, their risk declined steadily over time. Take this information to heart. If you’ve tried to quit before, try again, and ask your doctor for help – your chances of finally quitting for good are substantially higher when you take advantage of medications and support programs.

  4. Take your doctor’s advice about screenings.

    If the idea of colon cancer screening makes you uncomfortable, be aware that there are several ways to get screened, some of which are completely noninvasive, and all of which are much better than avoiding screenings altogether. Read more about how to get past your fear of screenings.

    Colonoscopy – the scope that views the inside of your colon – is the test that most people have heard about. This procedure offers the only opportunity to find polyps – small growths in the colon that sometimes turn into cancer – and to remove them before they become cancerous. Since all colon cancers start as polyps, colonoscopy gives you the chance to stop cancer before it even starts. A new study finds that colonoscopy screening is associated with a 77 percent reduction in colorectal cancer risk.

    If the idea of this test makes you nervous, I suggest talking to someone who has already had a colonoscopy; most people will tell you that it’s a piece of cake. If you’re still strongly averse to the test, ask your doctor about other effective screening options. Stool testing, for example, has a long history of use, and involves no bowel prep, sedation or scoping. It can’t detect pre-cancerous polyps, but it can help find cancer in its earliest, most treatable stages, and is proven to reduce colorectal cancer deaths.

    Regardless of the method chosen, most people should start getting screened at age 50, but certain at-risk populations should start sooner. African Americans and people with a family history of colon cancer, for example, may be at risk for developing polyps earlier in life, and their polyps may transform into cancer at a faster rate. People with Crohn’s disease or ulcerative colitis may be advised to start earlier, as well. Your doctor can advise you about when and how often to get screened, based on your medical history.

One of the things that makes cancer so frightening is that its causes are so often unknown or out of our control. With colorectal cancer, though, much is within our control. By some estimates, this form of cancer is 90 percent preventable – and the steps taken to prevent it may very well reduce your risk of other cancers, as well. So get your screenings, keep moving, eat better, and if you smoke, keep trying to quit until you succeed.

For more information, visit the Providence Health & Services Colon and Rectal Cancer Prevention and Resource Center.