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Friday, July 26, 2013

The Ugly Truth of Colon Cancer

Githaiga was in a state of mental anguish – he had never had any major health problems in his life yet there he was, seated on his hospital bed passing stool through a hole in his abdomen.

Nothing made sense anymore. His doctor had told him that he had colon cancer (cancer of the large intestine) and that he needed surgery, but nothing prepared him for his new life.

Prior to his cancer diagnosis, Githaiga was your average middle-aged Kenyan man. He was a successful, mid-level manager of a local bank. He worked hard and often found himself eating snacks at his desk and leaving work late.

He was a little overweight – thanks to his love for roasted goat meat and beer, but he took pride in his chubby form.

In his opinion and that of those around him, it was a sign that he was happy and content. Between work and family commitments, he rarely went to the gym - he just couldn’t find the time. So when he first noticed that he was losing weight, he put it down to the stresses of work and ignored it.

He didn’t consider going to hospital for check-ups because he believed that ‘you don’t go to hospital when your are well unless you are looking for trouble!’ He, therefore, first visited his doctor when he was alarmed at finding blood in his stool. That was one month ago. Now he had had surgery and was facing months ahead of chemotherapy.

The colon is also known as the large intestine. The lower part of this intestine is known as the rectum - which opens into the anus.

You can, therefore, have cancer of the colon, rectum or anus. Under normal circumstances, the cells lining the intestines are constantly being shed and replenished to allow for normal body function.

Colon cancer happens when the body produces cells in a disorganised and abnormal manner. Usually, this takes place over many months or even years and that is why cancer screening is an important way of catching this disease before it fully develops and spreads.

Interestingly, colorectal cancer was rare among black Africans a few decades ago. But it has shown a rapid increase in incidence over the past few years. This is thought to be as a result of dietary changes.

We used to have a diet almost exclusively of unprocessed foods, high in fibre and generally low in fat but this has slowly been replaced over the years as we have adopted new eating habits.

There is still a lot of research going into the role of diet in colon cancer development.

How does it present?

In the initial stages, there are no symptoms. Like all cancers, it is a silent predator. Most people notice a change in their bowel habits first. Either you find yourself getting constipation or diarrhoea without any change in your eating habits.

You may also notice some blood in your stool. There can also be abdominal pain or discomfort. Some people get excessive gas and tend to bloat. You may also feel as though you have not fully voided each time you go to the toilet. As it progresses, you will notice weight loss.

What can you do?

Unfortunately, the risk factors listed above almost all describe most urban people in Kenya. Even though you cannot 100 per cent prevent colorectal cancer, certain things have been found to be useful.


This should start at the age of 50 for most people or at 40 for people with a family history of colorectal cancer. Screening involves doing a general physical examination, a stool test and a special examination known as a colonoscopy, which is a test in which a special probe (pipe) with a video recorder attached to it is put into your rectum and up your intestines.

It is done under anaesthesia (sedation). This is a short procedure and does not require admission to a hospital. It is usually done once every 10 years as a screening tool. Some doctors also do special radiographs (x-rays) known as barium enemas as part of their screening.

Lifestyle changes

Eat a diet rich in fibre and low in fat. Try and maintain a healthy weight. Stop smoking and keep alcohol intake to a minimum.

General health

Make sure any polyps or intestinal conditions are adequately taken care of. Most polyps need removal.

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