World Cancer Day 2022: How a fibre-rich diet can help prevent colon cancer

The day is marked to encourage its prevention, detection, and treatment.

Cancer develops when the body's normal control mechanism stops working and old cells do not die, instead, they grow uncontrollably to form new, abnormal cells. 

These extra cells, which spread to other parts of the body may form a mass of tissue called a tumour. This can happen almost anywhere in the human body, which is made up of trillions of cells.

Hence, in layman's terms when this out-of-control cell growth happens in the colon or rectum, it's called Colorectal or colon cancer.

The colon is the large intestine or large bowel, while the rectum is the passageway that connects the colon to the anus. Sometimes abnormal growths, called polyps, form in the colon or rectum. Over time, some polyps may turn cancerous. 

Screening tests can find polyps so they can be removed before turning into cancer. Screening also helps in finding cancer at an early stage, when treatment works best. 

Shedding light on some early signs of colon cancer, Dr Shalabh Arora, Consultant- Medical and Hemato- Oncologist at Ujala Cygnus Central Hospital, Haldwani, shared, "Blood in stools or black coloured stools, sustained change in bowel habits (increased or decreased frequency, sense of incomplete evacuation, pain while passing stools), iron deficiency, anaemia due to frequent blood loss from the large intestine, and abdominal pain, are of the early symptoms of the condition. 

If you notice any of the mentioned signs, do consult your physician and discuss the need for evaluation." However, as the saying goes, prevention is always better than cure, hence, the protective effect of dietary fibre on colon cancer was described over 50 years ago by Dr Dennis Burkitt while working in Africa. 

Dietary fibre is usually not digested or absorbed from the intestines. It is fermented by bacteria that are normally present in the colon of healthy individuals. 

Dr Arora spoke on the subject and said, "Fibre in the diet makes the stool bulky, binds other chemicals that may cause cancer, and ensures rapid clearance of stools from the intestine. Fibre also helps with the generation of short-chain fatty acids, which has anti-cancer properties."

She also suggested some foods that contain high fibre, "The Indian Council of Medical Research (ICMR) recommends a daily intake of 40 grams fibre for adults. Fruits, green leafy vegetables, oats, barley, wheat, jowar, bajra, ragi, maize, and legumes (pulses/dal) or beans are rich sources of fibre. 

Try to consume whole fruits for maximum benefit, for example, one apple (with skin) or one orange includes 3-4 grams of fibre, whereas one cup of apple juice or orange juice contains only 0.5-0.7 grams of fibre.

"Vegetables like radish, carrots, cauliflower, spinach, broccoli, banana, apples, pears, oranges, cereals, are all rich in fibres. Also seeds like chia seeds, flax seeds are a rich source of fibres. 

The integral factor is fruits and vegetables should be consumed as a whole because when their juice is strained, they carry negligible amounts of fibre. Apart from helping with colon cancer, "Dietary fibre also prevents against stomach cancer and breast cancer. 

A high-fibre diet has also been shown to significantly reduce the risk for diabetes, high blood pressure, high cholesterol, heart disease, and stroke. 

For patients already diagnosed with diabetes, high fibre foods can help in better control of blood sugar and possibly reduction of medicines," said Dr Arora. 

She continued, "Even in patients with previous coronary heart disease, a high fibre diet reduces the subsequent risk for heart attack and death. Fibre softens the stools and makes it easy to pass - hence, it is also a natural and effective way for the treatment of digestive problems including constipation, chronic diarrhoea, and haemorrhoids (piles).

"Today, over-the-counter dietary supplements are also a big business and older adults make up a big part of its sales. 

However, supplements are never a substitute for a balanced, healthful diet. Although fibre supplements like wheat bran, psyllium etc. can be used to make up for the deficiency of fibre in the diet, their direct protective effect on colon cancer has only been reported in a couple of studies. 

Sharing her opinion on supplements, Dr Aditi Aggarwal, Senior Consultant- Radiation Oncology, Paras Hospitals, Gurugram, said, "Fibre supplements are recommended only for people who are unable to take natural sources of fibre due to some disease or nutrition-related issues.

These supplements do help in preventing constipation, but should not be recommended as a rule as they are artificially created products and their long-term effects are not known, and they cannot equate the properties of natural food contents.

"She suggested an ideal way to ensure daily intake of fibre and added, "An ideal way is to ensure that every meal has some source of good quantity fibre which is the fruits, vegetables, seeds along with good intake of water throughout the day.

This means taking salads and fruits before meals in good portions on a daily basis." Further, Colon cancer is curable with surgery alone in 50-70 per cent of cases if detected early. On the other hand, advanced colon cancer may require a combination of surgery and chemotherapy, yet remains incurable in most cases. "Colon cancer is curable if it can be picked up early. 

This can be detected by simply testing the stool for presence of blood, which may not be always seen, and a test called colonoscopy. 

This is not recommended for the general population, but for people with a family history of colorectal cancers, or for people over 60 years if they are anaemic. Any abnormal symptoms as mentioned should be investigated," suggested Dr Aggarwal. 

Most professional societies in the West recommend that all individuals between 50 and 75 years of age undergo a colonoscopy test every 10 years to screen for early colon cancer. 

Alternatively, stool testing for occult blood may be done every year, combined with a sigmoidoscopy every five years. 

With modernization people have become dependent on machines for most of their work, limiting physical activity, which leads to a sedentary lifestyle. 

They consume more juices in their diet, equating them to healthy food. Hence, they themselves are playing a role in the development of these cancers. Yes, fruit juices are healthy, but fruits consumed whole are the best source of all vitamins, minerals and fibre as well. Also, physical activity should be a very important part of our lifestyles. 

In the current era, where going to the gym has become more of a fad, more emphasis is laid on proteins which are required for wear and tear of our body, but every component of the diet is equally important.

All in all, a balanced diet that includes all components in required proportions, having adequate water, and physical activity, prevents diseases and for sure cancers, especially of the gastrointestinal tract.