| Introduction
Together, cancers of the colon and rectum (often referred
to as "colorectal cancer") are among the most common
cancers in the United States. So many things seem to cause
it. So many people seem to get it. So many factors are thought
to come into play in determining who gets colorectal cancer
and who doesn’t that it’s hard to choose one as
the most important. Many people fear that cancer is practically
inevitable. But we now know that 65% to 85% of cancers could
be prevented through diet and lifestyle changes. And more
cancers could be successfully treated if they were detected
early. Colorectal cancer is the second leading cause of cancer
death but, if detected and treated at its early stages, is
95% curable.
 Health
& Nutrition
According to the National Cancer Institute, about one-third
of all cancer deaths are related to malnutrition. For cancer
patients, optimal nutrition is important. Cancer can deplete
your body's nutrients and cause weight loss. Cancer and cancer
treatment can also have a negative effect on your appetite,
and your body's ability to digest foods. These factors may
leave you in a vulnerable condition - high nutrient need,
and low nutrient intake. 
Colorectal cancers are linked to diets that are high in fat
and calories; so a diet that is low in fat and red meat and
high in calcium and folate may contribute to preventing colorectal
cancer, and although the latest research shows that the benefits
of fiber are questionable, a diet rich in fruits and vegetables
with a high fiber content would be beneficial in many ways,
particularly if you have a family history of colorectal cancer.
 The
Benefits of Water
Something as simple as drinking a decent amount of water while
maintaining an active lifestyle appears to reduce the risk
of colorectal cancer in men. These findings add to the evidence
that leisure-time activity may reduce colon-cancer risk, not
only in high-risk but also in low-risk populations, and support
the potential beneficial effect of increased water intake
in reducing colorectal cancer risk.
Those men who consumed the most water had a 92% lower
risk of rectal cancer than those who drank the least
water. What's more, those men with the most active lifestyles
had 83% lower risk of colon cancer compared to men with sedentary
lifestyles.
The study could not determine why water intake or physical
activity decreased the cancer risk. However, one hypothesis
is that exercise stimulates the colon and decreases the period
of time that potential carcinogens in partially digested food
are in contact with the intestinal lining. Similarly, increased
water intake may be an important factor in reducing colon
cancer risk by decreasing bowel transit time or by decreasing
the concentration of carcinogenic compounds in the water phase.
(Tang R, Wang JY, Lo SK, Hsieh LL.
Physical activity, water intake, and risk of colorectal cancer
in Taiwan: a hospital-based case-control study. Int. J Cancer
1999;82:484-489.)
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 Fiber
reduces the risk of colorectal cancer right?
A recent study says no. Over the past two decades, reports
have linked a high daily consumption of dietary fiber to reduced
risk of cancers of the colon, rectum, and other gastrointestinal
sites. However, a Boston team notes that other studies of
dietary fiber produced conflicting results. Many of these
studies did not permit a clear distinction to be made between
the effects of fiber and those of other constituents of plant
foods. In one of the largest and longest prospective studies
of its kind to date, the investigators followed the 16-year
dietary and medical histories of nearly 89,000 women as part
of the ongoing Nurses' Health Study.
Results: After adjustment for age, established risk
factors, and total energy intake, we found no association
between the intake of dietary fiber and the risk of colorectal
cancer; the relative risk for the highest as compared with
the lowest quintile group with respect to fiber intake was
0.95 (95 percent confidence interval, 0.73 to 1.25). No
protective effect of dietary fiber was observed when we
omitted adjustment for total energy intake, when events
during the first six years of follow-up were excluded, or
when we excluded women who altered their fiber intake during
the follow-up period. No significant association between
fiber intake and the risk of colorectal adenoma was found.
Conclusions Our data do not support the existence of
an important protective effect of dietary fiber against
colorectal cancer or adenoma.
The New England Journal of Medicine January 21,1999;340:169-176,
223-224
Diet and exercise are only part of your health program, especially
for those with a family history of colorectal cancer; but
they can be useful weapons, along with regular screening,
in your fight to keep colorectal cancer away.
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