March is International Colon Cancer Awareness Month. This month, the Stomach Liver Intestine Foundation wants to make people more aware of the alarm signals of colon cancer. This serious illness plays a major role in the life of Natascha van Kuilenburg (49); both her parents got colon cancer. As a result, she is constantly alert to symptoms of colon cancer.
Natascha van Kuilenburg-Umans (49) is eleven years old when her father becomes seriously ill. “He had been eating and drinking poorly for some time and had blood in his stools,” she says. “When he went to the doctor with these complaints, he was immediately referred to the hospital.” After examination it becomes clear that her father has colon cancer, with metastases to his liver. “My father was told he had about six months to live.”
I get myself checked regularly
Eight months after her father is diagnosed with colon cancer, he dies. “He had never been sick before he got colon cancer. It really came as a bolt from the blue for us. When I look back at the photos, I see that he had lost a lot of weight and looked sick, but at the time we were less aware of that.” His death has had a major impact on Natascha’s life. “It was so surreal. I wanted to pretend nothing was wrong and went straight back to school the day after he died. That went well for a long time, but after a few years the irrevocable blow came and I still had to come to terms with his death.”
Common shape
In 2022, 12,000 people will be diagnosed with colon cancer. In the Netherlands, twelve people die of this every day, it says Comprehensive Cancer Center Netherlands. “Colon cancer is a very common form of cancer and is the fifth most common type of cancer after skin cancer, breast cancer, lung cancer and prostate cancer – for both men and women,” says Dr. Arnold Baars, who works as an internist at the hospital Gelderse Valley in Ede.
In 2021, almost 4,500 people died from this disease. This puts colon cancer in second place of cancers from which people die in the Netherlands. In the oncology department where Dr. Baars works, between 150 and 200 people with colorectal cancer are treated every year. “Colon cancer is a disease that mainly affects the elderly; 56% of all patients with colorectal cancer are 70 years or older. On average, men are diagnosed with colorectal cancer slightly more often than women (53% versus 47%).”
Heredity
“Why one person gets colon cancer and another does not, is not yet well known,” says Dr. Baars. Colon cancer is more common in some families than in others. In addition, environmental factors play a major role in the development of all forms of cancer. “Unfortunately, there is little you can do yourself to reduce the risk of colon cancer. However, it is likely that our diet and lifestyle play a role in the development of cancer. Unhealthy eating and little exercise increase the risk of colon cancer.” Being overweight, drinking a lot of alcohol and often eating processed or red meat are risk factors of colon cancer.
Because Natascha was afraid that her father had a hereditary variant of colon cancer, she had a hereditary test done. Dr. Fortunately, Baars says that colon cancer is not hereditary in most cases. “About 5% of people with colorectal cancer have a hereditary form,” he says. Blood tests have shown that Natascha is indeed not a carrier of the hereditary gene. “So I have the same chance of getting colon cancer as anyone else,” she says.
So I have the same chance of getting colon cancer as anyone else
Still, she is not reassured and she regularly checks for colon cancer. “Coincidentally, another colonoscopy is scheduled for next week,” she says. This is an endoscopic examination of the colon. “I’ve been struggling with this for weeks, because I don’t like that kind of research. But if I catch it in time – if I do turn out to have cancer – then I would be happy to do so.” She realizes that it is an illusion to be able to completely exclude the risks with this. “It may be good now, but it may not be in a few months. It will then take another 4.5 years before I am examined again.” She is therefore constantly alert to possible symptoms of colon cancer and checks daily whether there is no blood in her stools.
Population survey
Since the introduction of the Bowel Cancer Population Screening in 2014, many cases of bowel cancer have been detected. In 2021, more than 1.5 million people participated in this study. In total, 2,790 colon cancers were detected that year and polyps were found in 16,878 people; a precancerous stage of colon cancer.
In this way, intestinal cancer also comes to light in Natascha’s mother. “How much chance is there that both your father and your mother will get colon cancer? It was so incredibly unreal that colon cancer was also discovered in her. Fortunately, thanks to the population screening, she was there in time and was able to undergo successful surgery,” says Natascha. “My mother has now been cancer-free for five years and we dare to breathe a sigh of relief again. I was so afraid that she, like my father, had metastases and would die.”
The earlier colon cancer is detected, the greater the chances of survival
The survival rate of colon cancer is highly dependent on the stage at diagnosis. “In patients with colon cancer, the 5-year survival ranges from 96% at stage I to 12% at stage IV. “Partly because a lot of research is being done into this nasty disease, the treatment options have fortunately increased in recent years. This does not alter the fact that it remains very important to detect the disease at the earliest possible stage. That is why participation in the population screening is so important,” emphasizes Dr Baars.
He advocates being alert to the alarm signals associated with colon cancer, but at the same time warns that colon cancer is not always easy to recognize at an early stage. “Many symptoms are non-specific. It is always good to go to the doctor if there is repeated blood and / or mucus in the stool; a change in stool does not pass; there is an empty urge; weight loss with no apparent cause and fatigue that persists (due to anemia). The earlier colon cancer is detected, the greater the chances of survival are.”