Oncologist: people should care more about themselves!

8. February 2016

When detected early, bowel cancer is one of the most highly treatable forms of cancerous tumours, but despite the availability of excellent diagnostic tools, it is often discovered too late in Estonia. Why? Because people do not care enough about their health.

Vivian Esko, oncologist of the East-Tallinn Central Hospital, admits that late detection is the problem not only with bowel cancer. “As a rule, all sites of cancer in the digestive tract and internal organs do not exhibit highly specific changes or characteristic symptoms at first. The younger a person, the less attention is paid to a pricking or stabbing sensation or pain. Only when things have got so bad that the person is unable to cope with symptoms, he or she ends up in a doctor’s office,” she says. However, by then, cancer has had more than enough time to develop undetected and insidiously.

Cancer screenings – hopefully to be started in Estonia in the second half of the coming year – may contribute to the early detection of bowel cancer. It is planned to use the immunochemical faecal occult blood test and follow up positive test results with endoscopy. Dr. Esko admits that launching a screening programme is a very complicated process, but it needs to be done. “Sadly, trends show that bowel cancer rates are increasing at an unpleasantly fast pace,” he adds.

A dreaded procedure

Gastrointestinal endoscopy is considered a highly unpleasant procedure and that is why those who harbour certain concerns hesitate to make an appointment for it. Dr. Esko has seen in her medical practice that irrespective of the severity of gastrointestinal bleeding, people can be unbelievably resourceful and creative when it comes to making up reasons for it, without considering other, more serious options.

“It must be said that in this regard, oncologists are somewhat paranoid – they tend to imagine the worst and are please when their suspicions are not confirmed,” she says, smiling. “People should be more attentive about themselves. The only physiological reason for bleeding is menstruation in women – any other type of haemorrhage is abnormal. Bleeding is not always caused by cancer, but the patient needs to agree to an examination to establish its reason,” she adds.

The doctor agrees that no procedure is a pleasant one, but holds that in the case of suspicions it is preferable to undergo one. The 1.5-2-metre-long large intestine is not a straight channel and air needs to be pumped into the collapsed bowel to enhance visibility. This procedure may cause discomfort and pain, the doctor admits. “In the worst case scenario we discontinue the procedure and tell the patient that next time it will be performed under anaesthesia. Also, it is possible to resort to various analgesic and relaxation techniques to be able to complete the procedure,” she says.

What is bowel cancer?

Bowel cancer (or colorectal cancer) is a cancer of the large intestine and rectum. The large intestine and rectum form the lower section of the gastrointestinal tract.

In Estonia, the number of bowel cancer incidents shows a steady rise over the past 30 years. Almost 800 cancer cases are diagnosed annually and more than 400 people die of it each year.

People with a disease causal mutation running in their family have the highest risk of developing bowel cancer as well as those who suffer from inflammatory bowel disease. Additionally, people over the age of 50 have an increased risk for the disease.

Other symptoms potentially indicating bowel cancer are irregularities in bowel function (bowel movement problems), blood in stool, bouts of stomach ache, anaemia and a strange, painless abdominal lump. When people have certain health-related concerns or complaints, they should seriously consider consulting their family doctor.

Eating meat is not the culprit

Recently, the meat-eaters among us were shocked by a rather grim WHO report on the link between eating meat and colorectal cancer. Later it was explained that the truth is not as harsh as initially communicated.

“It is clear that a connection exists between the two. On the one hand, research data demonstrates that colorectal cancer is more common among people who consume red meat,” confirms Dr. Vivian Esko. On the other hand, eating meat every day does not necessarily give you cancer. “Cancer does not have a definitive cause,” she underlines. According to her, a number of factors play a role in its onset.

Moderation and balanced diet – these are two keywords that the meat-eaters among us should keep in mind. And when a cut of grilled meat gets partly burned, better avoid eating the scorched bits.

Avoid constipation

A properly functioning digestive tract is essential to good health and helps ward off a number of diseases. Dr. Esko underlines that in addition to a healthy diet, good gastrointestinal function requires drinking enough water and a certain level of physical activity.

“We should drink an average of one and a half litres of liquid a day. According to rule of thumb, half of this amount should come from water and the other half from soups, milk, juices and juice puddings. Coffee and strong tea do not count as liquid because they over-stimulate kidney function. In the human body, liquid is passed to the large intestine and then absorbed from there by the system. When the body does not get enough water, it does not leave any of it in the large intestine,” she explains.

Also, a sedentary lifestyle slows down gastrointestinal function, which in turn contributes to constipation. “Digestive tract function reflects an individual’s activity level. When someone is not active enough, intestinal matter in the tract moves slowly. The result is constipation. But constipation does not automatically translate into cancer – the former condition is merely one of many factors that may contribute to its development,” she adds.

Source: Linnaleht