KATHMANDU, March 14: Doctors are urging the government to implement regular and mandatory colon screenings for citizens over the age of 45 to curb the rising cases of colon cancer in Nepal.
They attribute the delay in diagnosis to the common practice of treating stomach issues as gastritis, which often leads to patients seeking treatment only after the disease has progressed to its later stages. With an increase in unhealthy lifestyles and dietary habits, experts emphasize the importance of early detection and prevention in tackling this growing health concern.
"Many patients only get diagnosed after months of treating the condition as gastritis," said Dr Ganga Sapkota, a cancer surgeon at Bharatpur Cancer Hospital. He explained that 70 percent of patients arrive at the hospital with third- or fourth-stage cancer. Among those seeking treatment, 60 percent have third-stage cancer, 20 percent have second-stage, and 20 percent have fourth-stage cancer.
Dr Punya Kharbuja explains that the lack of awareness about colon cancer and the absence of mandatory screening in the health system lead to delayed diagnoses. Since the risk of developing this cancer increases after the age of 45, regular colon screenings become essential, but Nepali society lacks this practice.
In developed countries, health systems require annual colon screenings after the age of 45 and offer them for free. However, doctors say that Nepal lacks such provisions. "People do not seek treatment until a serious issue arises, and by the time they do, the disease is often in its advanced stages," Dr. Kharbuja added.
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Doctors attribute the rise in colon cancer to poor eating habits, increased consumption of red meat, pesticide-laden and chemically processed foods, and a sedentary lifestyle, all of which have contributed to growing obesity levels.
Dr Sapkota, a cancer surgeon at Bharatpur Hospital, reports an increase in cancer cases linked to unhealthy lifestyles. Furthermore, cases in younger individuals are also on the rise. "We are seeing this cancer in people under 20, which is concerning," Dr. Kharbuja stated.
If a family member has polyps (small growths in the colon), children may develop them later. If not treated in time, polyps can lead to colon cancer. "In Nepal, the trend of consuming burgers and fried chicken is increasing," he added.
Additionally, the practice of preparing red meat as pickles, roasting, grilling, or drying it for long-term storage has contributed to the increase in colon cancer. "Meats prepared this way contain toxins and carcinogenic elements, which we consume daily," he said. He also pointed out that even the food available in the market is often chemically treated and not fresh, further contributing to the rise in this cancer.
Preventable through regular testing
Doctors emphasize that early detection of colon cancer can lead to a complete cure through surgery. However, if detected late, the cancer may spread to other parts of the body, making early identification and prompt treatment crucial.
For patients with colon cancer in the second or third stage, 70 percent survive only for five years after treatment. Even if the cancer spreads, surgery, chemotherapy, and radiotherapy can still help them survive. Recently, surgeons in Nepal have started performing colon cancer surgeries using laparoscopic methods, eliminating the need for large incisions. Doctors state that while a cancer surgeon performs the surgery, the results are generally favorable.
Regular screenings detect this disease at an early stage. Maintaining a healthy lifestyle and undergoing timely surgery to remove hereditary polyps (small growths in the colon) can help prevent it. Symptoms such as changes in bowel movements, infrequent stools (every two to three days), alternating between hard and loose stools, feeling of incomplete bowel evacuation, blood in stool, vomiting, bloating, and unexplained weight loss may indicate colon cancer. When these symptoms appear, many patients often self-medicate with piles or gastric medications.
Doctors recommend that patients take medication only after confirming the diagnosis. Additionally, even in the absence of symptoms, individuals over 45 should regularly check their stool. If blood appears in the stool, doctors may perform a colonoscopy to detect colon cancer at an early stage.
To prevent cancer, doctors advise adopting a healthy lifestyle, which includes regular health check-ups, eating a fresh and balanced diet, maintaining a healthy weight, avoiding alcohol, and engaging in regular exercise. They also suggest that the government implement a system to provide free or insurance-covered mandatory colon screenings for citizens over 45 to enable early detection and prevent colon cancer.