March is Colon Cancer Awareness Month in the Philippines. The Globocan lists cancer (neoplasms) as the 3rd cause of illness in the country. For 2024, the PSA (2025) listed neoplasm as 2nd cause of death following ischemic heart disease.
Some parts of the foods we eat, say fiber, are indigestible or cannot be broken down during the process of digestion. These will collect in the large intestine particularly in the colon where the water and some minerals like sodium are absorbed. The food residue dries out to a certain extent and forms the feces. Normally, the feces are not dry and its passage to the anus is easy because of the mucus that lubricates the fecal material. Now, imagine if the feces are there for days? The longer retention time, the drier it becomes. The more difficult to pass, that is, constipation occurs.
Next to the colon is the rectum where feces (or poop) is temporarily collected before released thru the anus. The two parts – colon and rectum are usually the sites where cancer begins, thus we hear colorectal cancer. Usually, such cancer starts as a non-cancerous polyp/s that grows in the inner lining of either the colon or the rectum. Polyps are of different types, with certain types being most likely to become cancer. The size, number and appearance of the polyps may also increase the possibility of becoming a cancer.
The American Cancer Society noted that often, colorectal cancers are not felt until it has grown or spread. Signs and symptoms include change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days; feeling that you need to have a bowel movement yet not relieved by defecting; blood in the stool that maybe bright red (if rectum is affected) or look dark brown or black; cramping or abdominal (belly) pain or bloating; weakness and feeling tired always; and unexplained weight loss. Consult a physician if any of these is bothering you. The doctor may do physical examination, and digital rectal exam (DRE) and may prescribe colonoscopy, biopsy, CT scan or ultrasound.
Cancer is a complicated disease with several risk factors (note that we don’t say causes). Risk factors include personal or family history of colorectal cancer, polyps in the rectum or colon and inflammatory bowel disease, as well as lifestyle factors such as physical inactivity and unhealthy diet (PCHRD, 2025). In particular, alcohol consumption, a high fat diet and a diet deficient in whole grains, fruits and vegetables are risk factors. If you have the risk factor, your chance of developing cancer will be higher compared to one who do not have the risk factor. Experts say, we can overcome genes with a healthy environment and lifestyle to include food and physical activity. Nonetheless, prevention includes a high fiber diet, that is, more fruits and vegetables in their natural state, foods that are minimally processed. Processed meat like tocino, longganisa should be avoided. White meat is preferred over red meat. Prefer a plant-based diet.
Right after surgery, the patient may have to be on a clear liquid diet for up to 3 days progressing to general liquid, soft and then regular diet. A high calorie, high protein diet to replace nutrients as well as facilitate recovery will be prescribed. A colostomy bag to collect feces while awaiting healing of the operated part, will necessitate a low residue diet to minimize fecal formation. Chemotherapy and radiation may have several side effects like loss of appetite, mouth dryness and sores, nausea and vomiting, each of which will have to be dealt with individually. With pain and mouth sores, cold to room temperature, soft, soothing foods are recommended. With dry mouth, plenty of fluids, soft foods should be taken. Puree if you may.
A healthy diet that observes the principles of adequacy, variety, balance, moderation is still recommended either for prevention and management of cancer. While foods that are minimally processed are recommended, there may be patients needing oral nutrition solutions or enteral formulas.
