Arjun Luthra

Period 6
"Colon Cancer Center." John Hopkins Medicine: The Sidney Kimmel Comprehensive Cancer
Center. John Hopkins Medicine, n.d. Web. 05 Nov. 2015.
<http://www.hopkinsmedicine.org/kimmel_cancer_center/centers/colon_cancer>.

Current diagnosis include Digital rectal examination, fecal occult, sigmoidoscopy,

colonoscopy and Lower GI series
o Lower GI series are also considered as barium enema, which helps doctors
detect tumor growth
The most common treatment currently for colon cancer is surgery
Approximately two thirds of colon cancer patients have localized cancer(Colon
Cancer Center, John Hopkins Medicine)
This substantiates reason why physicians advise patients to go through surgery to
locally excise cancerous tissue
Treatment plans combine chemotherapy and surgery to treat colon cancer
Researchers are studying colon cancer in more detail to find more effective
treatment options and a cure to colon cancer
Currently researchers are testing for mutations in the Kras gene, which is involved
in cell growth and cell signaling pathways
o By analyzing the mutations, researchers are trying to see how the cancer
will respond to certain drugs
A team at John Hopkins is testing to see whether Clostridium Novyi-NT can
potentially kills off colon cancerous tissue
Along with developing new drugs, new approaches to treat colon cancer include a
new colon cancer vaccine, monoclonal antibody therapy, radio-immunotherapy,
imaging guided and robot-assisted surgery and molecular-targeted therapies
Current research is being conducted to see how demethylating agents can treat
colon cancer
Another option is cytoreductive (debulking) surgery and hyperthermic
intraperitoneal chemotherapy (HIPEC)(Colon Cancer Center, John Hopkins
Medicine), which seems to be effective in treating other gastrointestinal cancers
Dr. Vogelstein from John Hopkins Kimmel Cancer Center helped identify a
mutation in a gene called p53
o Mutation in p53 will lead to cancerous cells resistant to apoptosis
Genetic disorder called hereditary nonpolyposis colon cancer which is believed to
be about 50 percent of inherited colon cancers
Studies using stool samples in 2009 have found that alteration in the gene
expression for four potential biomarkers

I found this resource to beneficial because it discusses the cutting edge research this
professional institution is conducting or had conducted which has led to the development
of new mechanisms in treating and preventing colon cancer.

Arjun Luthra
Period 6
Ketwaroo, Gyanprakash A., and Mandeep S. Sawhney. "Quality Measures and Quality
Improvements in Colonoscopy." Current Opinion in Gastroenterology 31.1 (2015): 5661. US National Library of Medicine. Web. 05 Nov. 2015.
<http://www.ncbi.nlm.nih.gov/pubmed/25402548>.

Approximately 14 million colonoscopies are performed annually in the United

States making this the most common gastrointestinal endoscopic procedure
(Gyanprakash 56)
Studies have shown that patients are recommended to undergo a colonoscopy
about every 10 years without signs of polyps
There has been a larger prevalence of inappropriate or overuse of colonoscopy
A recent analysis confirms that this type of screening is cost-effective to age of 83
Reasons for a potential inadequate bowel preparation include failure to follow
preparation instructions, constipation and diabetes
Bowel prep includes splits and intervals of having laxative dose for the day
before and the day of the colonoscopy
Bowel prep includes dose of magnesium citrate and leads patients to have
diarrhea
Studies have been conducted to see incidence of perforation caused by
colonoscopy
A potential complication resulting from a colonoscopy is bleeding at the site
where a polyp is removed
Quality measures also include whether informed consent has been received from
the patient.
Adenoma Detection Rate
o Helps physicians understand risk of cancer after screening
technologies are advancing to increase the effectiveness of a colonoscopy as a
tool for polyp and cancer detection
o One such improvement is the Full Spectrum Endoscopy, which gives a
wider field view to examine the insides of the colon
o Narrow Band Imaging is now incorporated in a colonoscope which helps
detect flat lesions in the colon that are otherwise difficult to identify
Improvements in fecal DNA technology are now more dominant
o An alternative to a recommended colonoscopy

This resource is beneficial because it helps me understand the concerns with colon cancer
screening including bowel prep, how it is becoming advanced and what are alternatives to
a colonoscopy.

Arjun Luthra
Period 6

Marshall, James R. "Nutrition and Colon Cancer Prevention." Current Opinion in Clinical Nutrition
and Metabolic Care 12.5 (2009): 539-43. US National Library of Medicine. Web. 05 Nov. 2015.
<http://www.ncbi.nlm.nih.gov/pubmed/19512917>.

Mandel found that a fecal blood test could reduce chances of developing colon cancer by
50 percent
Another individual named Winawer found that a colonoscopic screening and
polypectomy could decrease colon cancer risk by as much as 80%(Marshall 539)
Nutritional modification and diet plays a crucial role in preventing colon cancer
Cigarette consumption and smoking have an adverse effect on colon health
Diet directly affects the intestinal lumen as well as bowel movement
Initial analysis of diet on colon health used population-based research
o Looked at differences in diet between Americans, American vegetarians and etc.
Many original studies failed to confirm that high vegetable and fruit intake would be
beneficial in reducing chance of polyp formation
On contrary, many meat products have been linked to an increase in risk of colon
cancer(specifically red meat)
Red meat has a significant amount of protein and iron
Sunlight expose giving Vitamin D helps in the fight against colon cancer
Scientific literature have not found overwhelming results that vegetables can prevent the
development of colon cancer
Aspirin has been studied and been linked to a reduction in cancer risk
o However can cause gastric bleeding
Aspirin help decrease adenoma formation by about 70 percent
Folate found much in greens is critical to cellular repair and cell replication
It is under dispute whether folate reduces or increases chances of colon cancer
o Some sources say that folate can be a cause of adenomatous polyps recurrence
o While some sources validate claim that deficiency may increase chance of
mutation in DNA and further carcinogenesis
Food residue that gives nutrients to colon come mostly from dietary fiber that is not
digested in
Investigative studies were conducted to see whether Beta-carotene can serve as a
chemopreventive agent
Sources validated that Beta-carotene increases the risks of other cancers
High resistant starch diet contributes to a reduction in colon cancer risk
Lack of convergence of nutritional epidemiologic results(Marshall 542) has led to
increased research looking into correlations between nutrient and genetics

Arjun Luthra
Period 6
I found this resource beneficial to me because it will support and help me explain in my final
presentation how important diet and lifestyle is to the prevention and the reduction in risk of
colon cancer.