Walk away from colorectal cancer: Exercise can lower risk

In January 2017, researchers reported that exercise is associated with a lower risk of death from metastatic colorectal cancer. Metastatic colorectal cancer is cancer of the colon or rectum that has spread to other areas of the body. This study found people who were physically active for four or more hours per week reduced their risk by 20 percent. People who exercised for at least five hours per week lowered their risk by 25 percent.  

These results reinforce other data researchers have collected on how exercise affects the risk of colorectal cancer. Though we don’t fully understand why, exercise plays a role in the development of colorectal cancer—for people who may be at risk for the disease, people who already have it and people who have been treated for it.

Who’s at risk for colorectal cancer?

Several lifestyle factors can increase the risk for colorectal cancer, including:

  • Diets high in red meat, such as beef and pork
  • Diets high in processed meats, such as hot dogs and bologna
  • Heavy alcohol use
  • Obesity, particularly excess belly fat
  • Smoking

Other factors can also increase the risk of developing colorectal cancer. These include:  

  • A history of inflammatory bowel disease, including Crohn’s disease and ulcerative colitis
  • Family history of colorectal cancer or colon polyps (growths in the colon)
  • Being African-American
  • Having type 2 diabetes

Colorectal cancer tends to affect people in older age groups. That’s why we recommend people over 50 get a colonoscopy on a regular basis to lower their risk for colorectal cancer. Your doctor may recommend starting earlier if you have one or more of the above risk factors. For instance, we recommend African-Americans start getting regular colonoscopies at age 45. Though there are other tests available to screen for colorectal cancer, colonoscopy is still the best option for finding and treating the disease as early as possible. 

Getting active to stay healthy

As we age, we tend to be less active and at higher risk for conditions like heart disease and diabetes, which can further limit our activity levels. But even a little exercise every week can lower your risk of colorectal cancer. Studies cited by the National Cancer Institute have found adults who increase their physical activity can reduce their risk of developing colorectal cancer by 30 to 40 percent compared to people who don’t exercise. That’s on top of the benefit researchers have found exercise has in people whose cancer has spread.  

Modest amounts of moderate exercise can help. I tell patients that if they’re breaking a sweat for about 20 minutes at a time two to three times a week, that seems to be enough. Walking is a great way to do this. Some other examples of moderate exercise, according to the Centers for Disease Control and Prevention (CDC), include:

  • Aerobics
  • Biking
  • Climbing stairs or using a stair climber
  • Dancing
  • Playing basketball
  • Swimming
  • Yoga 

Research shows that people don’t have to do intense exercises to get these survival benefits. When it comes to lowering your risk of colorectal cancer, just getting up and doing something is important. If you can do more, that’s great! If you can’t, do what you can. Just make sure you’re doing something. And talk to your doctor about starting any new exercise plan, especially if you have conditions like heart disease, lung disease, diabetes or other serious conditions.

Exercise even helps after a patient has had surgery to treat colorectal cancer. The American Cancer Society notes that people who exercise regularly after being treated for colorectal cancer have a lower chance of the disease coming back, as well as a lower chance of dying from the disease. In addition, exercise has been linked to an improved quality of life and less fatigue after colorectal surgery. If you’re starting or resuming an exercise routine after colorectal surgery, be sure to talk to your doctor beforehand about the types of exercise you can do safely. 

Controlling your colon cancer risk

I realize that getting active is easier for some people than others. By the time people are in their 60s and 70s, if they haven’t exercised regularly before, making that sort of lifestyle change can be tough. But I encourage my patients to do what they can to lower their risk for colorectal cancer. I let them know that even little changes in their activities or walking just a little bit can benefit them in the long term.  

Older adults who have never exercised before may not know where to start. It can be intimidating to walk into the local gym and get started on a fitness plan. The National Institute on Aging has examples of sample exercises for older adults based on four key fitness areas: endurance, strength, balance and flexibility. Your doctor can also provide guidance on the types and amount of exercise you should do.  

And exercise isn’t the only thing I advise people do to lower their risk. Other ways you may be able to reduce the risk of colorectal cancer include:

Take the first step

We need more research in this area of medicine to find out exactly why exercise lowers the risk of death from colorectal cancer and the risk of developing it in the first place. For now, though, the data show a clear link between the disease and activity levels.

 You don’t have to live at the gym or train for marathons to reduce your risk for colorectal cancer. Take a brisk walk around the block once a day, or watch your favorite TV show while you walk on the treadmill. Every step is one you’re taking to live a healthier, more active life—and one free from colorectal cancer. 

A Patient with a Purpose: Battle Colon Cancer

My Battle with Colon Cancer

Timing is everything. It’s a lesson Johnette and Jeffrey Powell learned the very hard way —and one they are anxious to pass on to others.

In 2010, the Powells packed up their lives and moved to Washington, D.C. It was a busy year and the-then 50-year-old Johnette was preoccupied with all the details of starting a new life in a new city. “I knew I needed to begin screening for colon cancer at 50—but in the transition from one place to the next, I delayed,” she explains. “It was a year later that I finally found a primary care doctor who sent me to Dr. Mitesh Patel at MedStar Washington Hospital Center for a colonoscopy. I was shocked to hear the results. More than one of the polyps he had removed was malignant. I had colon cancer.”

Surgery to resect a small section of her colon and remove nearby lymph nodes was quickly scheduled. “The cancer had spread beyond my colon,” Johnette explains. “So I spent the next six months receiving chemotherapy every other Friday.”
Today, nearly five years since her diagnosis, Johnette is a very proud and grateful colon cancer survivor. But she understands that any further delay in screening may have resulted in a far worse outcome—and with earlier screening, she may have been spared months of difficult treatment. Now the Powells are talking to everyone they know and telling them to “get checked,” says Jeffrey. It’s their battle cry and people are listening. “We both know all too well that screening saves lives,” he adds.

Screening for Prevention, Early Detection

In fact, screening colonoscopy can not only detect colon cancer early when it is more easily treated, it can prevent colon cancer by finding and removing polyps before they become malignant. Because risk increase with age, it’s recommended that men and women begin regular screening at age 50. However, for African-American men and women, the recommended age is 45. Some people may need to be screened earlier and more often because they have a higher risk for the disease.

You might be at an increased risk for colon cancer if you:
• Are African-American
• Smoke or use tobacco
• Are overweight or obese
• Are not physically active
• Drink alcohol in excess
• Eat a lot of red meat or processed meat
• Have a personal or family history of colorectal cancer or colorectal polyps
• Have a personal or family history of inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease

Reduce Your Colon Cancer Risks

In addition to regular screening, making some lifestyle changes can reduce risk of colon cancer—and other cancers as well.
• Maintain a healthy weight and waist size throughout life.
• Be physically active for at least 30 minutes, five days a week.
• Eat a diet rich in vegetables, fruits and whole grains.
• Limit the amount of red meat and processed meat you eat, including pork.
• If you drink alcohol, limit the amount to one drink per day for women, two per day for men.
• Don’t smoke. If you do smoke, quit.

While you’re learning to live a healthier life, take time to learn all you can about your family’s medical history. It wasn’t until after she was diagnosed that Johnette discovered her great aunt had had colon cancer. While a single relative may not be meaningful, it’s important to do your homework to determine your own level of risk for the disease. Then talk to your physician about what you’ve discovered and about when you should begin screening.

Learn more about Johnette's story below. 

Have any questions?

We are here to help! Contact us to find a gastroenterologist and to schedule your screening test today. Call us at 202-877-3627.

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Colon Cancer: A Preventable and Treatable Disease

Colon cancer is the third most commonly diagnosed cancer in the U.S., and it’s also a cancer that’s highly preventable through screening.

If you are aged 50 or older, get screened for colon cancer. But for African-American men and women, the recommended age is 45. Why? Research proves that African Americans risk forming polyps (grape-like growths) sooner than other populations and this group is more likely to be diagnosed after the cancer has spread to other organs.

“Most screenings for colon cancer are normal, but in 20 percent of cases there may be polyps which are usually benign,” says Dr. Thomas Stahl, regional director for the MedStar Colorectal Surgery Program. “All polyps are sent to the lab for a biopsy (test) to determine if there are any cancerous cells.”

Colonoscopy- An Effective Screening Test

Colon cancer usually has no symptoms in its early stage and that’s why the screening is vital. The most effective screening tool is colonoscopy, but people avoid the test because of fear. The traditional bowel prep consists of drinking a four-liter bottle of solution and a liquid diet the day before the test. Adhering to the strict diet is critical to ensure the colon is entirely cleaned out.

“The prep has improved over the years,” says Dr. Mitesh Patel, a gastroenterologist with MedStar Washington Hospital Center. “You don’t have to drink as much liquid as before and we have incorporated Gatorade, which has electrolytes that help decrease nausea.”

Colorectal cancer almost always starts with a polyp - a small growth on the lining of the colon or rectum – that doctors can remove during a colonoscopy procedure.

“When a polyp is removed from the body, it no longer has the opportunity to grow and potentially spread,” says Dr. Patel. “Once we discover a polyp, the patient is put on a surveillance program, depending on the number of polyps discovered during the colonoscopy and the size.”

Clinical guidelines say that if a patient has two or fewer polyps, they don’t need another screening for five years. If an individual has three or more polyps, they need to get screened every 3 years.

In addition to the age guidelines, African- Americans and people with a family history of the disease are at a higher risk, so talk to your primary care provider about getting screened early. Don’t put the test off another day, be proactive and get screened!

Have More Questions?

We are here to help! Contact us to find a gastroenterologist and to schedule your screening test today. Call us at 202-877-3627.

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