Every year, about 1.8 million new cases of colorectal (colon) cancer are diagnosed worldwide. Being diagnosed with colorectal cancer, as with any cancer, is a terrifying ordeal. It also might be a little embarrassing, since it involves a part of the body that's hidden from view and not openly discussed. At present, the local statistics are high: in Malta, on average, two people a week die of colorectal cancer. Despite it being one of Malta's most prevalent cancers, awareness remains low, and yet with regular screening, and if diagnosed early enough, it is often curable.
Colorectal cancer develops in the colon (the longest part of the large intestine) and/or the rectum (the last several inches of the large intestine before the anus) and often falls under the umbrella term 'bowel cancer.'
Anthony Rossi says: "If you're diagnosed with colorectal cancer, don't be shy about getting the information you need to cope with the diagnosis and the journey it's going to set you on and, equally important, if you get a letter inviting you to have a screening - then go!" He himself very nearly missed the diagnosis of colorectal cancer by throwing the screening request letter away. "It was a pure chance meeting with an old friend in Valletta, who told me he was working at the National Health Screening Centre. I mentioned that I had received a letter but had dismissed it and he stressed the importance of screening to me, and issued me with another screening request."
This was a chance meeting that very much changed the course of Mr Rossi's life. Not long after the screening, he received a call: the unthinkable had happened, his screening showed abnormal results warranting a follow-up colonoscopy. Fortunately, his cancer had been caught at a sufficiently early stage for it to be removed entirely without the need for chemotherapy. "After the colonoscopy, when the doctor came to tell me they had found cancer, I was actually very calm. It was my wife and daughters who were more upset than me," he recalls. Having lost family and friends to cancer, he admits: "I always used to wonder how I would cope if I was told I had cancer. Of course, nobody would wish for cancer but being negative about it only makes it worse: either you wallow in self-pity or you carry on. I decided to follow the latter route and be as proactive as possible."
Some weeks later, after an extensive operation to remove the cancer, Mr Rossi was recovering in Mater Dei when he decided to start Malta's only colorectal cancer awareness group (MCRCAG). "Mentally, I had to keep myself busy. I prepared an entire plan for the group and for me, I guess, it was almost a form of therapy. Apart from my family, I found there was very little advice and guidance available, so it seemed a natural step to take." So it was there, in a hospital bed, that the formation of a group with now over 450 Facebook members began.
Mr Rossi has worked relentlessly alongside his job to improve awareness and develop his group, with the backing of various key medical professionals in the field. "People call me at all hours for advice, but I don't mind one bit!" he says. The group is now a member of the National Cancer Platform and Europacolon and holds regular events. Mr Rossi is also an integral member of the Patient Advisory Committee (PAC) within the Europacolon organisation across Europe, and gives keynote speeches at conferences.
Although, it is very reassuring to know that such a support group now exists in Malta, what can be done to identify colorectal cancer or prevent it? Anyone can get colorectal cancer, but it usually strikes people over the age of 50. The risk rises quickly with age and people with a family history of colorectal cancer have a higher chance of getting the disease, so we asked Anthony what precautions can be taken.
How can you prevent colorectal cancer?
- Get regular screening tests from the age of 50
- Eat less red or processed meat
- Eat plenty of vegetables, fruit and whole-grain foods
- Be physically active for at least 30 minutes every day
- Maintain a healthy weight
- Limit the amount of alcohol you drink
- Do not smoke
Who should get regular screening tests for colorectal cancer?
All women and men aged 50 or over should be regularly screened for colon cancer. The need for screening before the age of 50 depends if there is a family history of the disease. Regular screening is the single best way of reducing the risk of colorectal cancer because it can detect polyps - small, non-cancerous tumours in the colon or rectum that sometimes turn into cancer - which can then be removed.
What are the symptoms of colorectal?
There may have no symptoms in the early stages but as the cancer grows, symptoms may include:
- A change in bowel habits
- A change in the appearance of your stools
- Diarrhoea or constipation
- Rectal bleeding or blood in your stool
- Persistent abdominal discomfort, such as cramps, gas or pain
- An unexplained loss of weight
- Fatigue
These symptoms can also be caused by something less serious, such as an ulcer, the swelling of the colon or haemorrhoids, but if you have any of these symptoms for the first time, talk to a doctor.
Risk factors
Most medical professionals agree that these affect the risk of colorectal cancer: some may apply to you, but others may not.
- Being over 50 years old
- A strongfamily historyof bowel cancer
- A history of non-cancerous growths (polyps) in your bowel
- Long-standing inflammatory bowel disease such as Crohn's disease or ulcerative colitis
- Type 2 diabetes
- An unhealthy lifestyle
Anthony's aim for the Malta Colorectal Cancer Awareness Group is for the Maltese Islands to be free of colorectal cancer, with education, prevention, early detection and treatment leading to an increased survival rate for everyone.
You can join the Malta Colorectal Cancer Awareness Group on Facebook and follow local events during the European Colorectal Cancer Awareness Month in March, including a conference entitled The Effectiveness of Screening in 2019 and beyond on 27 March at San Anton Palace.
For more information contact [email protected] or call 9943 8446