Chemoprevention and colorectal cancer

While medicine has come a long way in its ability to treat colorectal cancer, it remains one of the most common cancers and is expected to cause almost 51,000 deaths this year.

Early detection is a key to ensuring patients can be successfully treated, but wouldn’t it be better if you could do something to prevent colorectal cancer from developing in the first place?

Chemoprevention – using drugs or natural compounds to prevent tumor development – is one option for those at higher-than-average risk of developing colorectal cancer. It doesn’t guarantee cancer won’t develop and it comes with its own risks, so it’s definitely not indicated for everyone.

A number of studies have shown that taking aspirin and other non-steroidal anti-inflammatory drugs such as ibuprofen, Aleve and Celebrex may decrease the risk of developing polyps and colorectal cancer. Regular use of these medications is associated with a 20 to 40 percent reduction in the risk of polyps and colorectal cancer in people at average risk.

Before you run to the drugstore to stock up, you need to meet with your physician to discuss whether chemoprevention is appropriate for you. Any protective benefit needs to be balanced against the potential side effects of the longterm ingestion of these agents, including gastric ulcers, increased risk of bleeding and increased cardiovascular risk with non-aspirin, non-steroidal anti-inflammatory drugs.

Chemoprevention isn’t recommended for patients who are at an average risk of developing colorectal cancer, but it may be an option for some people deemed to be high risk, after carefully weighing the risks and benefits. You should also watch what your diet – limiting red meat and adding plenty of fiber – and maintain the screening regimen suggested by your doctor.

Since most colorectal cancers arise from polyps and the progression from polyps to actual cancer can take up to 10 years on average, being screened on a regular basis is the best way to ensure your long-term colorectal health it’s been shown to decrease mortality from colorectal cancer. For average-risk patients, screening should start at age 50 and continue until life expectancy is estimated to be less than 10 years. Screening recommendations are different for individuals with hereditary colon cancer syndromes, personal or family history of colorectal cancer or polyps, and inflammatory bowel disease.

There’s no “magic pill” that can prevent colorectal cancer, and that includes the chemoprevention methods noted above. You may also read that folic acid, calcium, Vitamin D and antioxidants such as Vitamin A, Vitamin C, Vitamin E and beta-carotene have been found to decrease your chances of developing colorectal cancer. However, the strength of these associations is uncertain and you should never act on information that hasn’t been vetted by your doctor as being appropriate for your specific situation.

Studies are ongoing regarding the value of chemoprevention, especially when compared against the risk of medicating over long periods of time as a preventive therapy. Your doctor can keep you up to date on any developments that may be relevant to you.

Dr. Kanwaldeep Rasila is a board-certified hematologist and medical oncologist affiliated with Sutter Medical Foundation – Sutter Medical Group, Solano and Sutter Solano Medical Center. She is also a member of Solano Coalition for Better Health.