Oncologist Encourages Jamaicans to Screen for Colorectal Cancer

Jamaicans are being encouraged to screen for colorectal cancer, as it continues to be an increasing cause of death on the island.

The call comes from Radiation Oncologist and Head of the Radiotherapy Department for the National Cancer Treatment Centre at the St. James-based Cornwall Regional Hospital, Dr. Praveen Sharma.

Colorectal cancer starts in the colon or the rectum. It can also be called colon cancer or rectal cancer, depending on where it starts. Colon cancer and rectal cancer are often grouped together because they have many features in common.

While some persons may be asymptomatic, symptoms of colorectal cancer may include a change in bowel habits, blood in or on your stool, diarrhoea, constipation, or feeling that the bowel does not empty all the way. Other symptoms may include abdominal pain, aches or cramps that do not go away, and weight loss.

“Colorectal cancer is one of the third most common cancers in Jamaica, in terms of incidence, if we take [into account] both males and females, and it is also the third leading cause of mortality. So, after prostate, after breast, it is colorectal cancer that is killing most patients,” Dr. Sharma told JIS News.

He noted that based on recent data, there are 800 to 900 new cases of colorectal cancer detected yearly.

“Earlier, it was very rare to see rectal cancers in my clinic, but now it is almost one or two cases every week… my radiation department receives almost one patient for colorectal cancer per week. So, you can understand the enormity of the situation,” Dr. Sharma said.

He pointed out that the illness has become one of the “priority cancers” and the Health and Wellness Ministry has outlined screening guidelines among six other priority illnesses, namely hypertension, diabetes, depression, prostate, breast and cervical cancers.

Dr. Sharma also informed that colorectal cancer is now included in the National Health Fund (NHF) subsidy.

The oncologist noted that persons from age 45 to 74 are typically at risk of getting the disease. Persons that have a family history of the illness, regardless of their age, are encouraged to screen for the illness, as they may be genetically predisposed to develop colorectal cancer.

“The median age group [of persons who get the illness] is about 63 in Jamaica, but more and more now we are seeing that the trend is shifting to younger patients. In fact, there is data which says 20 per cent of our cases are less than 50 years of age,” Dr. Sharma noted.

“If you have a family history, then screening can start as young as 12 years of age. Now you do the screening test and based on the results you then decide what next has to be done,” he added.

Other risk factors for colorectal cancer include obesity, smoking, drinking alcohol and a diet which consists of less fibre and more fats.

Dr. Sharma pointed out that there are a few screening tests that are done to detect the illness.

“One is what we call a stool-based test, that is the easiest and most commonly available. There are three types of stool-based test, but we use only two. One is called FOBT, which is faecal occult blood testing, which just means that you test the sample of stools for the presence of blood, basically the haemoglobin that is present in the blood,” he informed.

“So, the haemoglobin component is tested by using certain chemicals on the stool sample, and we can detect if there is any bleeding happening or not. If it comes positive, then the patient is referred for further evaluation to rule out colorectal cancer,” Dr. Sharma told JIS News.

The faecal immunochemical testing (FIT) is also used to detect colorectal cancer as well as the FIT deoxyribonucleic acid (DNA) test.

For her part, Nurse in the Cornwall Regional oncology department, Sherice Allen, told JIS News that when patients come to the hospital, they usually come when the disease is at an advanced stage.

“With our very capable professionals here, we aim to quickly get them speaking to a consultant and then on their way to beginning a treatment regimen. Now, usually when our patients begin a treatment regimen, we try to help and support them to continue the journey, continue the treatment,” she said.

“If any complications should arise while they’re getting their cancer treatment, we all come together as a multidisciplinary team to ensure that we try to mitigate anything. Our aim is always to improve the patient’s lives and help them to lead a quality life, even though they have a cancer diagnosis,” Nurse Allen said.

She pointed out that the “gold standard” for screening would a be colonoscopy, which should be done every eight to 10 years.

Nurse Allen also cautioned persons not to self-diagnose if they are having symptoms of the disease.

“Do not go on Google and get yourself all anxious. Go to the doctor, speak to a professional, get an accurate diagnosis, and then go from there,” she advised.

Beres* (not his real name) who was diagnosed with colorectal cancer in February of last year, spoke about his experience with the illness.

He told JIS News that he saw a specialist when he saw blood in his stool.

“[ I saw blood] three or four times straight, so I knew it was something strange. So, I went and checked it out,” he said.

After getting diagnosed with colorectal cancer, he did surgery to extract the polyps in April of last year, then completed eight sessions of chemotherapy as well as radiation.

Beres* is now cancer-free and is getting ready for bowel reconstruction surgery.