Resistant strain of malaria on most effective drug in Southeast Asia

LONDON - Scientists warn the most effective drug used to treat malaria is becoming ineffective in parts of Southeast Asia — and unless rapid action is taken, it could lead to a global health emergency.

Writing in the Lancet journal, researchers from Thailand’s Mahidol University and Britain’s Oxford University say parasites that carry malaria are developing resistance to a key drug combination across multiple regions of Cambodia, Laos, Thailand and Vietnam.

The report warns that the parasite Plasmodium falciparum — which causes the most lethal form of human malaria — is becoming resistant to the first-choice drug, DHA-piperaquine, in parts of Southeast Asia, with patients seeing a failure rate of 50 percent or more.

The situation is so critical that scientists say the treatment should not be used in Cambodia, Vietnam and northeast Thailand, because it is ineffective and contributes to increased malaria transmission.

New treatments must be considered, says Sterghios Moschos of the University of Northumbria.

“It might be opportune at this point in time to explore whether or not we should bring together different new classes of medications so that when the problem starts becoming more substantial, there is a solution potentially that works at the multi-drug level,” said Moschos.

The report says urgent action is now needed to eliminate falciparum malaria from the region — otherwise the resistant strains of the parasite could further spread to other parts of Asia and Africa, potentially causing global health emergency.

“All it takes is a ship with infected individuals, or a pool of water where mosquitoes are, getting into Africa and then slowly that parasite establishing a foothold," he added. "The likely scenario, however, will be that improvement of health care on a day-to-day basis in Africa will create the opportunity for the parasite to evolve resistance.”

Currently, malaria vaccine trials are under way in several African countries. But drug combinations like DHA-piperaquine remain vital in treating malaria — especially in countries with poor health systems.

Since 2014, global progress against malaria has stalled. There were an estimated 219 million cases and 435,000 related deaths in 2017, most of them children under the age of five in sub-Saharan Africa.

Ringworm (Tinea Corporis)-The bug that reside on human skin

What is ringworm of the body?

Ringworm of the body is a skin infection caused by a fungus.

“Ringworm” is a misnomer — the infection has nothing to do with worms. Its name comes from the small, ring- or circle-shaped rash that appears on the body due to infection. In ringworm of the body, the rashes appear on skin regions except for the scalp, groin, palms of the hand, and soles of the feet.

The condition is common and highly contagious, but it’s not serious. It’s also sometimes referred to as “tinea corporis” after the type of fungus that causes the infection.

What causes ringworm of the body?

A group of fungi called dermatophytes cause ringworm. Dermatophytes live off a substance called keratin, a tissue found in many parts of a person’s body, including the nails, skin, and hair. In ringworm of the body, the fungus infects the skin.

Ringworm of the body is also called tinea corporisafter the specific dermatophyte, tinea. Other related ringworm fungal infections have similar names, including:

• tinea pedis, commonly called athlete’s foot
• tinea cruris, also known as jock itch
• tinea capitis, also known as ringworm of the scalp

Symptoms of ringworm of the body

Symptoms of ringworm of the body usually start about 4 to 10 days after contact with the fungus.

Ringworm of the body looks like ring- or circular-shaped rashes with edges that are slightly raised. The skin in the middle of these ring-shaped rashes appears healthy. Usually, the rashes are itchy. They will spread over the course of the infection

Symptoms of a more severe infection include rings that multiply and merge together. You may also develop blisters and pus-filled sores near the rings.

How is ringworm of the body spread?

A ringworm infection can be spread in many direct and indirect ways, including:

• Person to person: This happens through direct contact with the skin of a person infected with ringworm.
• Pet/animal to person: This occurs when you have direct contact with an infected pet. Both dogs and cats can spread the infection to people. Ferrets, horses, rabbits, goats, and pigs can also spread ringworm to people.
• Inanimate item to person: It’s possible to get ringworm through indirect contact with objects, including hair of an infected person, bedding, clothing, shower stalls, and floors.
• Soil to person: Rarely, a ringworm infection can be spread through contact with highly infected soil for an extended amount of time.

Who’s at risk for ringworm infection?

Children are more prone to infection by ringworm of the body compared with adults. However, pretty much everyone has some risk for being infected. According to the National Health Service of the United Kingdom, about 10 to 20 percent of people will be infected by a fungus at some point in their lives.

Factors that may increase your risk include:

• living in damp or humid areas
• excessive sweating
• participating in contact sports
• wearing tight clothing
• having a weak immune system
• sharing clothing, bedding, or towels with others

How is ringworm diagnosed?

If your doctor suspects that you may have ringworm, they’ll examine your skin and may do some tests to rule out other skin conditions not caused by fungus, like atopic dermatitis or psoriasis. Usually a skin examination will result in a diagnosis.

Your doctor may also observe skin scrapings from the affected area under a microscope to look for fungus. A sample may be sent to a laboratory for confirmation. The laboratory may perform a culture test to see if the fungus grows.

How is ringworm treated?

Over-the-counter (OTC) topical fungicidal medications are usually enough to treat the infection. The medication may be in the form of a powder, ointment, or cream. It’s applied directly to the affected areas of the skin. These medications include OTC products like:

• clotrimazole (Lotrimin AF)
• miconazole (Micatin)
• terbinafine (Lamisil)
• tolfaftate (Tinactin)

Shop for OTC antifungal medication.

Your pharmacist can also help you choose which one is right for you.

If the ringworm of the body is widespread, severe, or does not respond to the above medications, your doctor may prescribe a stronger topical medication or a fungicidal that you take by mouth. Griseofulvin is a commonly prescribed oral treatment for fungal infections.

Potential complications of ringworm infection

The infection is not serious and will rarely, if ever, spread below the surface of the skin. However, people with a weakened immune system, such as people with HIV or AIDS, may have trouble getting rid of the infection.

As with other types of skin infections and conditions, itchy, irritated, or broken skin can lead to secondary bacterial infections that may need treatment with antibiotics.

How can ringworm infections be prevented?

Ringworm of the body can be prevented by avoiding contact with someone who has the infection. This includes both indirect and direct contact with that person.

Take the following precautions:

• Avoid sharing towels, hats, hairbrushes, and clothing with someone who has the infection.
• Take your pet to see a vet if you suspect a ringworm infection.
• If you have ringworm of the body, be sure to maintain good personal hygiene around other people and avoid scratching the affected areas of your skin.
• After a shower, dry your skin well — especially between the toes and where skin touches skin, such as in the groin and armpits.

The causes and complications of menorrhagia and how to stop or treat heavy menstrual bleeding.

What is menorrhagia?

Menorrhagia, also known as prolonged bleeding or heavy menstrual periods, varies for each woman, so it may be difficult to tell what’s normal and what’s abnormal bleeding.

Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern, most women don't experience blood loss severe enough to be defined as menorrhagia.

Heavy menstruation is a common complaint that affects one in three women as they approach the menopause and Doctors say that normal menstrual bleeding is a period that lasts from three to seven days; while prolonged menstrual bleeding is defined as bleeding that goes beyond a week.

With menorrhagia, you can't maintain your usual activities when you have your period because you have so much blood loss and cramping. If you dread your period because you have such heavy menstrual bleeding, talk with your doctor. There are many effective treatments for menorrhagia.

Symptoms

Signs and symptoms of menorrhagia may include:

• Soaking through one or more sanitary pads or tampons every hour for several consecutive hours
• Needing to use double sanitary protection to control your menstrual flow
• Needing to wake up to change sanitary protection during the night
• Bleeding for longer than a week
• Passing blood clots larger than a quarter
• Restricting daily activities due to heavy menstrual flow
• Symptoms of anemia, such as tiredness, fatigue or shortness of breath
• depressed or moody, are signs that the excessive bleeding has reduced the amount of iron in the blood.

Causes of menorrhagia.

In some cases, the cause of heavy menstrual bleeding is unknown, but a number of conditions may cause menorrhagia. Common causes include:

• Hormone imbalance. In a normal menstrual cycle, a balance between the hormones estrogen and progesterone regulates the buildup of the lining of the uterus (endometrium), which is shed during menstruation. If a hormone imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding.
  A number of conditions can cause hormone imbalances, including polycystic ovary syndrome (PCOS), obesity, insulin resistance and thyroid problems.
• Dysfunction of the ovaries. If your ovaries don't release an egg (ovulate) during a menstrual cycle (anovulation), your body doesn't produce the hormone progesterone, as it would during a normal menstrual cycle. This leads to hormone imbalance and may result in menorrhagia.
• Uterine fibroids. These noncancerous (benign) tumors of the uterus appear during your childbearing years. Uterine fibroids may cause heavier than normal or prolonged menstrual bleeding.

• Polyps. Small, benign growths on the lining of the uterus (uterine polyps) may cause heavy or prolonged menstrual bleeding.
• Adenomyosis. This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and painful periods.
• Intrauterine device (IUD). Menorrhagia is a well-known side effect of using a nonhormonal intrauterine device for birth control which is placed in the uterus, can also cause heavier menstrual bleeding than normal, especially during the first year of use, in older women, especially in post menopause women.. Your doctor will help you plan for alternative management options.
• Pregnancy complications. A single, heavy, late period may be due to a miscarriage. Another cause of heavy bleeding during pregnancy includes an unusual location of the placenta, such as a low-lying placenta or placenta previa.
• Cancer. Uterine ( endometrial) cancer and cervical cancer can cause excessive menstrual bleeding, especially if you are postmenopausal or have had an abnormal Pap test in the past.
• Inherited bleeding disorders. Some bleeding disorders such as von Willebrand's disease, a condition in which an important blood-clotting factor is deficient or impaired can cause abnormal menstrual bleeding.
• Medications. Certain medications, including anti-inflammatory medications, hormonal medications such as estrogen and progestins, and anticoagulants such as warfarin (Coumadin, Jantoven) or enoxaparin (Lovenox), can contribute to heavy or prolonged menstrual bleeding.
• Other medical conditions. A number of other medical conditions, including liver or kidney disease, may be associated with menorrhagia.

When to see a doctor

Seek medical help before your next scheduled exam if you experience:

• Vaginal bleeding so heavy it soaks at least one pad or tampon an hour for more than two hours
• Bleeding between periods or irregular vaginal bleeding
• Any vaginal bleeding after menopause

Treatment of menorrhagia.

The treatment depends on the cause; specific treatment is based on the number of factors which could include overall health and medical history, for instance, the capacity of a patient to tolerate some specific medication or therapies and most importantly, the patient’s preferences when it comes to child-bearing plans.

Some of the medication given includes; tranexamic acid; this helps to reduce excessive blood loss, oral contraceptives known as combined oral contraceptive pills, these help regulate menstrual cycles and reduce the episodes of prolonged and excessive bleeding.

Mirena intrauterine devices reduce the menstrual flow and cramping, if menorrhagia has caused anaemia, it is advised  that you take iron supplements.

Myomectomy can also be done; this is an operation to remove fibroids while preserving the uterus.

Hysteroscopic morcellation: A hysteroscope is inserted into the womb through the cervix and an instrument called a morcellator is used to cut or “shave” away small abnormalities, such as polyps.

Endometrial ablation: This destroys the womb lining with either laser, heat or ultrasound energy. It can be performed as a day case and usually takes just 15 minutes. Most women have no periods afterwards.

Uterine artery embolisation: This treats fibroids and involves inserting a small tube into the groin to block the blood vessels supplying blood to the fibroid.

Hysterectomy: A 100% effective procedure to remove the womb. It can be done vaginally, by keyhole surgery or by a surgical cut, which requires a hospital stay.

Other medications that can reduce on the bleeding, include, ibuprofen, non-steroid anti-inflammatory drugs (NSAIDs) such as  mefenamic acid  that reduces blood loss by around 20% while also alleviating pain., among other treatment.

Self-help tip for heavy periods

Incorporating plenty of magnesium-rich foods into your diet. These include dark leafy veg, nuts, seeds, beans and wholegrains. Magnesium is excellent for heavy periods and it acts as a gentle muscle relaxant so it can help take the edge off very strong contractions of the uterus which can give rise to very heavy periods.

Risk factors

Risk factors vary with age and whether you have other medical conditions that may explain your menorrhagia. In a normal cycle, the release of an egg from the ovaries stimulates the body's production of progesterone, the female hormone most responsible for keeping periods regular. When no egg is released, insufficient progesterone can cause heavy menstrual bleeding.

Menorrhagia in adolescent girls is typically due to anovulation. Adolescent girls are especially prone to anovulatory cycles in the first year after their first menstrual period (menarche).

Menorrhagia in older reproductive-age women is typically due to uterine pathology, including fibroids, polyps and adenomyosis. However, other problems, such as uterine cancer, bleeding disorders, medication side effects and liver or kidney disease must be ruled out.

Complications

Excessive or prolonged menstrual bleeding can lead to other medical conditions, including:

• Anemia. Menorrhagia can cause blood loss anemia by reducing the number of circulating red blood cells. The number of circulating red blood cells is measured by hemoglobin, a protein that enables red blood cells to carry oxygen to tissues.
  Iron deficiency anemia occurs as your body attempts to make up for the lost red blood cells by using your iron stores to make more hemoglobin, which can then carry oxygen on red blood cells. Menorrhagia may decrease iron levels enough to increase the risk of iron deficiency anemia.
  Signs and symptoms include pale skin, weakness and fatigue. Although diet plays a role in iron deficiency anemia, the problem is complicated by heavy menstrual periods.
• Severe pain. Along with heavy menstrual bleeding, you might have painful menstrual cramps (dysmenorrhea). Sometimes the cramps associated with menorrhagia are severe enough to require medical evaluation.

Testing HIV using saliva(oral fluids) with OraQuick

How Oral Testing Works

 Most people assume that blood is involved in HIV testing. But with OraQuick® an oral swab is used for testing and requires no blood. By collecting oral fluid from your gums, you collect fluid similar to that used in blood testing.

So the OraQuick Test detects antibodies for HIV, not the virus itself.

You just gently swipe the test swab along your upper gums once and your lower gums once. Then you insert the swab inside the test tube provided and get your results in just 20 minutes.

HIV antibodies from oral fluid are collected through the swab.

Once the device is inserted in to the test tube, the oral fluid mixes with the liquid and travels up the test stick.

If C-Line turns dark it confirms the test is working properly. If no C-Line appears, the test is not working.

If only C-Line appears, the test is negative.

HIV antibodies collecting at the T-Line indicate the test is positive.

Safe and approved by the FDA for use by adults (17 years of age or older), OraQuick is the first and only HIV test that delivers your results with all the comforts and privacy of home

Natural birth control method using the moon beads.

Family Planning with Beads?

We’ve heard it all… Is this jewelry? Should I wear Cycle Beads® around my neck? Are these rosary beads? And even a few responses that aren’t quite fit for print.

So why did we decide to use beads to help women use the Standard Days Method® of family planning?

A NATURAL FIT

When researchers first developed the Standard Days Method of family planning, they immediately realized that while the method is relatively simple, the information contained in the method was complex and it needed to be communicated clearly. How to do this?

Beads were actually the first option discussed.

For much of human existence and in cultures all over the world, beads have been used to count, tally property, trade for goods, and record information. It was a natural fit! Cycle Beads was created.

A FEW REASONS TO USE BEADS FOR A FAMILY PLANNING TOOL…

• They are universally recognized.
• They are relatively inexpensive to create.
• They can convey a lot of information in a simple, attractive way.

WHAT KINDS OF INFORMATION DO CYCLE BEADS CONVEY?

CycleBeads were created to help a woman use the Standard Days Method of family planning. The Standard Days Method is a fertility awareness family planning method that relies on keeping track of your period and knowing if you are on a potentially fertile or non-fertile day.

Cycle Beads

Cycle Beads…

• makes it easy to remember key days.
• ensures that users won’t make mistakes calculating.
• helps a woman track her cycle length so she’ll know that her cycles are in the range for using this method.
• gives a user a visual tool that she can use to communicate with her partner.

What other ideas did we consider?

A CALENDAR

Sounds simple. The Standard Days Method is technically a “calendar-based” family planning method so shouldn’t a woman just be able to use a calendar? The answer is that a woman could use a calendar, but it is easier to make mistakes. Using a calendar solely makes it much more likely that someone will miscount either her cycle length or the day of her cycle that she is on.

A DIAL

We loved the idea of creating a futuristic looking dial that could be used to track this information. Prototypes were made and we still have them in our office. But the dial made the method overly complicated and, frankly, expensive too. And let’s be honest…what looked futuristic 5 years ago, already looks a little dated today.

A CLOCK

What do people look at often to keep track of time? A clock was the obvious answer. So we designed a prototype of a wall clock with an extra feature – a series of color-coded notches around the edge and a marker that moved one notch per day. But this proved to be confusing and expensive. People had difficulty relating a clock that shows hours and minutes to a feature that tracks days.

BACK TO THE BEADS

After all this, we came back to the beads and realized that we had a product that filled a lot of needs. As one product designer we talked to said, “When you have something that is such an elegant solution, why would you spend energy trying to recreate the wheel?”

And while we agree that Cycle  Beads is an “elegant solution”, new technologies such as smartphones and other mobile devices give us exciting, new ways to offer this method. We embrace that Cycle Beads are a fantastic solution for conveying complex information, and we continue to look at new ways to offer this family planning method while still using the many benefits of “the bead idea”. With that in mind, iCycleBeads is already available on iPhone and Android devices, and new innovations are coming soon!

History of Phage therapy against Superbugs

Phage Therapy is the therapeutic use of lytic bacteriophages (virus that cause bacterial cell lysis) to treat pathogenic bacterial infections.Initially described almost a century ago by William Twort, and independently discovered shortly thereafter by Félix d'Herelle (considered by many as the founder of bacteriophages and its therapeutic implication: the phage therapy).D'Hérelle said that the phages always appeared in the stools of Shigella dysentery patients shortly before they began to recover.He "quickly learned that bacteriophages are found wherever bacteria thrive: in sewers, in rivers that catch waste runoff from pipes, and in the stools of convalescent patients".

Why scientist loose interest in first place on phages as antibacterial agent?

While knowledge was being accumulated regarding the biology of phages and how to use phage cocktails correctly, early uses of phage therapy were often unreliable.Since the early 20th century, research into the development of viable therapeutic antibiotics had also been underway, and by 1942 the antibiotic penicillin G had been successfully purified and saw use during the Second World War. The drug proved to be extraordinarily effective in the treatment of injured Allied soldiers whose wounds had become infected. By 1944, large-scale production of Penicillin had been made possible, and in 1945 it became publicly available in pharmacies. Due to the drug's success, it was marketed widely in the U.S. and Europe, leading Western scientists to mostly lose interest in further use and study of phage therapy for some time.

Read about: Bacteriphages used to treat cholera

Why there is renewed interest worldwide in the ability of phage therapy?

As a result of the development of antibiotic resistance since the 1950s and an advancement of scientific knowledge, there has been renewed interest worldwide in the ability of phage therapy to eradicate bacterial infections and chronic polymicrobial biofilm (including in industrial situations)

Read about:Are viruses the best weapon for fighting superbugs?

Advantage of using phages as antibacterial agent

Bacteriophage treatment offers a possible alternative to conventional antibiotic treatments for bacterial infection.

• It is conceivable that, although bacteria can develop resistance to phage, the resistance might be easier to overcome than resistance to antibiotics
• Bacteriophages are very specific, targeting only one or a few strains of bacteria. Traditional antibiotics have more wide-ranging effect, killing both harmful bacteria and useful bacteria such as those facilitating food digestion. The species and strain specificity of bacteriophages makes it unlikely that harmless or useful bacteria will be killed when fighting an infection.
•  Enzybiotics are a new development at Rockefeller University that create enzymes from phage. Purified recombinant phage enzymes can be used as separate antibacterial agents in their own right
• Phage Therapy also has the potential of preventing or treating infectious diseases of corals. This could assist with decline of coral around the world
• A few research groups in the West are engineering a broader spectrum phage, and also a variety of forms of MRSA treatments, including impregnated wound dressings, preventative treatment for burn victims, phage-impregnated sutures

Read about:Most lethal antibiotic resistant bacteria list

Obstacles and disadvantages of using phages

• The high bacterial strain specificity of phage therapy may make it necessary for clinics to make different cocktails for treatment of the same infection or disease because the bacterial components of such diseases may differ from region to region or even person to person. In addition, this means that 'banks' containing many different phages must be kept and regularly updated with new phages
• Further, bacteria can evolve different receptors either before or during treatment. This can prevent phages from completely eradicating bacteria.
• The need for banks of phages makes regulatory testing for safety harder and more expensive under current rules in most countries. Such a process would make difficult the large-scale use of phage therapy.
•  patent issues (specifically on living organisms) may complicate distribution for pharmaceutical companies wishing to have exclusive rights over their "invention", which would discourage a commercial corporation from investing capital in this
• No lytic phage has yet been discovered for Clostridium difficile, which is responsible for many nosocomial diseases, but some temperate phages (integrated in the genome, also called lysogenic) are known for this species; this opens encouraging avenues but with additional risks as discussed below. 
• Funding for phage therapy research and clinical trials is generally insufficient and difficult to obtain, since it is a lengthy and complex process to patent bacteriophage products. Scientists comment that 'the biggest hurdle is regulatory', whereas an official view is that individual phages would need proof individually because it would be too complicated to do as a combination, with many variables. Due to the specificity of phages, phage therapy would be most effective with a cocktail injection, which is generally rejected by the U.S. Food and Drug Administration (FDA). Researchers and observers predict that for phage therapy to be successful the FDA must change its regulatory stance on combination drug cocktails
• Public awareness and education about phage therapy are generally limited to scientific or independent research rather than mainstream media.The negative public perception of viruses may also play a role in the reluctance to embrace phage therapy

Read about:Dangerous bacteria can survive disinfectant, putting patients at risk

Comparison of the Prophylactic and/or
Therapeutic Use of Phages and Antibiotics

Bacteriophages	Antibiotics	Comments
Very specific (i.e., usually affect only the targeted bacterial species); therefore, dysbiosis and chances of developing secondary infections are avoided .	Antibiotics target both pathogenic microorganisms and normal microflora. This affects the microbial balance in the patient, which may lead to serious secondary infections.	High specificity may be considered to be a disadvantage of phages because the disease-causing bacterium must be identified before phage therapy can be successfully initiated. Antibiotics have a higher probability of being effective than phages when the identity of the etiologic agent has not been determined.
Replicate at the site of infection and are thus available where they are most needed .	They are metabolized and eliminated from the body and do not necessarily concentrate at the site of infection.	The "exponential growth" of phages at the site of infection may require less frequent phage administration in order to achieve the optimal therapeutic effect.
No serious side effects have been described.	Multiple side effects, including intestinal disorders, allergies, and secondary infections (e.g., yeast infections) have been reported .	A few minor side effects reported  for therapeutic phages may have been due to the liberation of endotoxins from bacteria lysed in vivo by the phages. Such effects also may be observed when antibiotics are used .
Phage-resistant bacteria remain susceptible to other phages having a similar target range.	Resistance to antibiotics is not limited to targeted bacteria.	Because of their more broad-spectrum activity, antibiotics select for many resistant bacterial species, not just for resistant mutants of the targeted bacteria .
Selecting new phages (e.g., against phage-resistant bacteria) is a relatively rapid process that can frequently be accomplished in days or weeks.	Developing a new antibiotic (e.g., against antibiotic-resistant bacteria) is a time-consuming process and may take several years .	Evolutionary arguments support the idea that active phages can be selected against every antibiotic-resistant or phage-resistant bacterium by the ever-ongoing process of natural selection.

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CANCER OF THE COLON

Did you know!!

Colon cancer happens when tumorous growths develop in the large intestine. It is the third most common type of cancer in the United States.

The colon, or large intestine, is where the body extracts water and salt from solid wastes. The waste then moves through the rectum and exits the body through the anus.

Regular screenings are recommended after the age of 50 years.

Colon cancer and rectal cancer may occur together. This is called colorectal cancer. Rectal cancer originates in the rectum, which is the last several inches of the large intestine, closest to the anus.

Fast facts on colon cancer:

Here are some key points about colon cancer.

Ø  Colon cancer affects the large intestine and it usually starts with polyps in the wall of the intestine.

Ø  Symptoms may not appear until a later stage, but if they do, gastrointestinal problems are common symptoms.

Ø  Treatment involves a combination of chemotherapy, radiationtherapy, and surgery, possibly resulting in a colostomy.

Ø  A healthy lifestyle with a high-fiber, low-fat diet can help prevent colon cancer, and screening can detect it in the early stages.

Symptoms and signs

Colon cancer affects the large intestine. It usually develops from benign polyps.

There are often no symptoms in the earliest stages, but symptoms may develop as the cancer advances.

They include:

Ø  diarrhea or constipation

Ø  changes in stool consistency

Ø  loose and narrow stools

Ø  rectal bleeding or blood in the stool

Ø  abdominal pain, cramps, bloating, or gas

Ø  pain during bowel movements

Ø  continual urges to defecate

Ø  weakness and fatigue

Ø  unexplained weight loss

Ø  irritablebowelsyndrome (IBS)

Ø  iron deficiency anemia

If the cancer spreads to a new location in the body, additional symptoms can appear in the new area. The liver is most commonly affected.

Stages

There are different ways of staging cancer. The stages depend on how far the cancer has spread.

Stage 0: The cancer is in a very early stage. It is known as carcinoma in situ. It has not grown further than the inner layer of the colon.

Stage 1: The cancer has grown into the next layer of tissue, but it has not reached the lymph nodes or other organs.

Stage 2: The cancer has reached the outer layers of the colon, but it has not spread beyond the colon.

Stage 3: The cancer has grown through outer layers of the colon and it has reached one to three lymph nodes. It has not spread to distant sites.

Stage 4: The cancer has reached other tissues beyond the wall of the colon. As stage 4 progresses, the cancer reaches distant parts of the body.

Cancer develops progressively. Each stage is not fixed but describes a phase during which certain developments take place.

Managment

Treatment will depend on the type and stage of the cancer, and the age, health status, and other characteristics of the patient.

There is no single treatment for any cancer, but the most common options for colon cancer are surgery, chemotherapy, and radiation therapy.

Treatments seek to remove the cancer and relieve any painful symptoms.

Surgery

Surgery for colorectal cancer often means a person will need a colostomy. A bag collects waste from a stoma, bypassing the need for the lower part of the large intestine.

Surgery to remove part or all of the colon is called a colectomy. The surgeon removes the part of the colon containing the cancer and the surrounding area.

Nearby lymph nodes are also usually removed. The healthy portion of the colon will either be reattached to the rectum or attached to a stoma depending on the extent of the colectomy.

A stoma is an opening made in the wall of the abdomen. Waste will pass into a bag, removing the need for the lower part of the colon. This is called a colostomy.

Some small, localized cancers can be removed using endoscopy.

Laparoscopic surgery, using several small incisions in the abdomen, may be an option to remove larger polyps.

Palliative surgery may relieve symptoms in cases of untreatable or advanced cancers. The aim is to relieve any blockage of the colon and manage pain, bleeding, and other symptoms.

Chemotherapy

Chemotherapy administers chemicals that interfere with the cell division process by damaging proteins or DNA in order to damage and kill cancer cells.

These treatments target any rapidly dividing cells, including healthy ones. The healthy cells can usually recover from any chemically-induced damage, but cancer cells cannot.

Chemotherapy is generally used to treat cancer that has spread because the medicines travel through the whole body. Treatment occurs in cycles, so the body has time to heal between doses.

Common side effects include:

Ø  hairloss

Ø  nausea

Ø  fatigue

Ø  vomiting

Ø   

Combination therapies often mix multiple types of chemotherapy or combine chemotherapy with other treatments.

Radiation

Radiation treatment damages and kills cancer cells by focusing high-energy gamma-rays on them.

Radioactive gamma-rays are emitted from metals such as radium, or from high-energy x-rays. Radiotherapy can be used as a standalone treatment to shrink a tumor or destroy cancer cells, or alongside other cancer treatments.

Radiation treatments are not often used until a later stage. They may be employed if early stage rectal cancer has penetrated the wall of the rectum or traveled to nearby lymph nodes.

Side effects may include:

Ø  mild skin changes resembling sunburn or suntan

Ø  nausea

Ø  vomiting

Ø  diarrhea

Ø  fatigue

Ø  appetite and weight loss

Most side effects resolve a few weeks after completing treatment.

Prevention

Standard preventive measures include:

Ø  maintaining a healthy weight

Ø  exercising

Ø  consuming plenty of fruits, vegetables, and whole grains

Ø  decreasing saturated fat and red meat intake

People are also recommended to limit alcohol consumption and quitsmoking.

Some causes

Normally, body cells follow an orderly process of growth, division, and death. Cancer happens when cells grow and divide uncontrollably, without dying.

Most colon cancer originates from noncancerous, or benign, tumors called adenomatous polyps that form on the inner walls of the large intestine.

Cancerous cells may spread from malignant tumors to other parts of the body through the blood and lymph systems.

These cancer cells can grow and invade healthy tissue nearby and throughout the body, in a process called metastasis. The result is a more serious, less treatable condition.

The exact causes are unknown, but colon cancer has several potential risk factors.

Polyps

Colon cancer usually derives from precancerous polyps that exist in the large intestine.

The most common types of polyps are:

• Adenomas: These can resemble the normal lining of the colon but look different under a microscope. They can become cancerous.
•   Hyperplastic polyps: Colon cancer rarely develops from hyperplastic polyps, as they are typically benign.

Some of these polyps may grow into malignant colon cancer over time, if they are not removed during the early stages of treatment.

Genes

Uncontrolled cell growth can happen if there is genetic damage, or if changes to the DNA affect cell division. A genetic predisposition can be inherited from family members, but most colon cancers occur in people without a family history.

Some people are born with certain genetic mutations that make them statistically more likely to develop cancer later in life. Sometimes, a person will have this genetic feature, but cancer will not develop unless an environmental factor triggers it.

Traits, habits, and diet

Age is an important risk factor for colon cancer. Around 91 percent of those who receive a diagnosis are over 50 years old.

Colon cancer is morelikely in people with sedentary lifestyles, those with obesity, and those who smoke tobacco.

As the colon is part of the digestive system, diet is an important factor. Diets that are low in fiber and high in fat, calories, red meat, alcohol, and processed meats have been linked to a higher risk of colon cancer.

Underlying conditions

Some conditions and treatments have been associated with an increased risk of colon cancer.

These include:

Ø  diabetes

Ø  acromegaly, a growth hormone disorder

Ø  radiation treatment for other cancers

Ø  inflammatory bowel disease, such as ulcerative colitis or Crohn's disease

Diagnosis

A physician will carry out a complete physical exam and ask about personal and family medical histories.

Diagnosis is usually made after colonoscopy or a barium enema x-ray.

Colonoscopy

A long, flexible tube with a camera on one end is inserted into the rectum to inspect the inside of the colon.

The patient may have to follow a special diet for 24 to 48 hours before the procedure. The colon will also require cleansing with strong laxatives, a process known as bowel prep.

If polyps are found in the colon, they are removed and sent to a pathologist for biopsy, an examination under a microscope that detects cancerous or precancerous cells.

A similar procedure, called a flexible sigmoidoscopy, examines a smaller portion of the colorectal area. This involves less preparation, and a full colonoscopy may not be needed if polyps are not found, or if they are located within a small area.

Double-contrast barium enema

This x-ray procedure uses a liquid called barium to provide clearer imaging results than a standard x-ray can give. Before a barium enema, the patient must fast for several hours.

A liquid solution containing the element barium is then injected into the colon through the rectum, followed by a brief pumping of air to smooth over barium layer for optimal results.

The x-ray of the colon and rectum is then taken. The barium will appear white on the x-ray, and tumors and polyps will appear as dark outlines.

If a biopsy suggests colon cancer, the doctor may order a chest x-ray, ultrasound, or CT scan of the lungs, liver, and abdomen to assess the spread of the cancer.

There may also be a blood test for a substance produced by some cancer cells called carcinoembryonic antigen (CEA).

Following a diagnosis, the doctor will determine the stage of the cancer based on the size and extent of the tumor, and on the spread to nearby lymph nodes and distant organs.

A cancer's stage will determine the treatment options and inform the prognosis, or the likely course the cancer will take.