There were none of the telltale signs. Amy Elmaleh's mother, Maureen, felt overtired, but who doesn't when raising three teenage girls? It was in 1996, during a family funeral, that a doctor friend told the 46-year-old mom she didn't look well. The friend suggested she come see him at his office. As it turned out, his intuition was right. Via a series of tests, Amy's mother found out she had a tumour the size of a grapefruit in her colon—and worse, that it was malignant. Maureen underwent chemotherapy and surgery, only to lose her battle with cancer 15 months later at the age of 47.

"She really hadn't had any symptoms," says Amy. "The problem with colon cancer is that weight loss or changes in bowel habits can be attributed to so many other things, like stress." Shortly after her mother passed away, Amy's 39-year-old uncle (not a blood relation) was also diagnosed with colon cancer. It was then that Amy and her aunt, Bunnie Schwartz, decided to form Colon Cancer Canada, a nonprofit dedicated to helping spread awareness of the disease.

"There's quite a bit of stigma and embarrassment around the issue, which makes people not want to talk about it," says Amy. But colorectal cancer is the third most common cancer in Canada (affecting an estimated 23,000 people) and the second leading cause of cancer-related death for both Canadian men and women.

Know your risk level
Family history is one of the biggest risk factors for colon cancer. According to Dr. Manoj Raval, MD, a specialist in colorectal surgery and a clinical assistant professor of surgery at the University of British Columbia, if there is someone in your immediate family (a sibling, parent or child) who has had colorectal cancer, your own risk is two times higher than average. (Amy's mother had an aunt who had colon cancer, but Maureen didn't find out until after her own diagnosis.) Other high-risk factors: having a relative under the age of 60 with colon cancer, or having more than one non-immediate family member with colon cancer.

You should also be concerned if you have an inflammatory bowel disease (IBD) such as Crohn's or ulcerative colitis, says Dr. Raval. Even if your IBD is under control, you should undergo frequent colonoscopies to look for small growths—called polyps—along the lining of your colon.  

Colon cancer doesn't discriminate based on age, either: While those over 50 are at highest risk (making up more than 90 percent of all cases), Dr. Raval sees patients as young as 20 years old.

Signs and symptoms
If you have bloody bowel movements or very dark, tar-colour stool, go see your doctor. Other symptoms include changes in bowel habits, vomiting, nausea that won't go away and unintentional weight loss. Because symptoms are often subtle, they can be easy to ignore.

Many benign problems like hemorrhoids can mimic colon cancer symptoms, and people are often surprised to learn that pain is not a reliable indicator. "Usually when someone has pain in their colon I am relieved, because it does not mean colon cancer," says Dr. Raval.

Get tested
If you have an immediate relation who has had colon cancer, start getting screened a minimum of 10 years before the age that they were diagnosed, and make sure to have a colonoscopy every five years. (A colonoscopy examines the inner lining of the colon, and involves having a thin scope inserted into the rectum.) If you have other high-risk factors, such as IBD, you should speak to your doctor about being screened more frequently. If you're not high-risk, the first screening step is a Fecal Immunochemical Test (FIT), a noninvasive stool-sample test that detects the presence of blood. If you're over the age of 50, you should get a FIT every two years. If the FIT comes back abnormal, your doctor will likely prescribe a colonoscopy to check for polyps.

"Because we know colon cancer comes—for the most part—from pre-cancerous polyps, [we also know it's] a preventable disease," says Dr. Raval. "So get screened, and don't ignore your symptoms. If everyone got screened, I'd be out of a job—and that would be great."

All in the family
Now 38 years old, Amy is the mother of three young children herself. She goes out of her way to live a healthy lifestyle, which means going for routine colonoscopies, eating lots of fibre, monitoring her bowel movements for any irregularities and exercising. "The doctors think my mother's cancer might have been there 10 years earlier," says Amy. "Don't ignore your symptoms. Talk to your family members to find out if there's a history of colon cancer. People don't have to go through the tragedy we went through."

Manage your risk:

Drink Milk: According to a study in Nutrition and Cancer, a higher consumption of milk and dairy products can reduce your risk of colon cancer.

Take Aspirin: Studies have shown that taking Aspirin daily may help reduce the growth of certain types of polyps in the colon.  

Get your vitamin D: A study in the Canadian Journal of Public Health suggests that having higher levels of vitamin D in your blood may be linked with a lower risk of developing colon cancer.

Beat colon cancer: Although research has shown that lifestyle factors including obesity, diabetes, smoking, eating red or cured meats, alcohol consumption and being sedentary are associated with colon cancer, Dr. Raval says none of these things conclusively lead to the disease.

Check out how your gut health is connected to your overall well-being.
                                               

This story was originally titled "Listen to Your Gut" in the April 2014 issue.             Subscribe to Canadian Living today and never miss an issue!