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Dreaded test is your best bet for combatting cancer.
Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States.
Last year, the American Cancer Society estimated that over 100,000 new cases of colorectal cancer would be diagnosed.
It was also expected to cause nearly 50,000 deaths, with slightly more women than men dying from the disease.
The good news, though, is that the rate has been dropping over the past 15 years as a result of better and more widespread screening methods. As a result, there are more than a million survivors of the disease in the U.S.
However, screening rates for colorectal cancer are lower than for other types, with estimates that only half of adults over age 50 had been screened for the disease in 2005.
Even after many years of work as a registered nurse in Hilton Head Hospital’s Endoscopy Department, I procrastinated too, before my first screening in 2003. My husband has the positive family history, but I had the polyp. Who would have suspected?
Risk factors for colorectal cancer include age over 50, a history of colon polyps, history of colon cancer in a family member, smoking, Caucasian or African-American ethnic background, smoking, a diet high in animal fats and sedentary lifestyle. Overall, the lifetime risk is about 5.4 percent. Regular screening and early detection offer the best chances for early diagnosis and cure — if diagnosed in its early stages, colorectal cancer is among the most curable of malignancies.
Symptoms of colon cancer may be subtle or dramatic. In its early stages, colon cancer may present no symptoms at all.
As the tumor grows, however, patients may experience blood in the stool, changes in bowel habits (diarrhea, constipation, changes in freother quency or appearance of bowel movements), or abdominal discomfort. If any of these symptoms occur, see your physician promptly for evaluation.
Let’s make colorectal cancer a disease we have conquered through prevention and early detection. If you haven’t had a screening, or know you are due for one, do yourself a favor and make an appointment today.
Screening
Several methods for screening exist, and patients over 50 years of age should discuss with their physicians which is most appropriate for them. It is worth noting that if a close family member has been diagnosed with colorectal cancer, screening should occur 10 years prior to the age when that relative was diagnosed. Most frequently, screening will include stool sampling to check for hidden blood, and/or colonoscopy.
Colonoscopy involves the insertion of a soft flexible tube equipped with a light source, camera and instrument and suction channels.
The scope travels approximately 4 to 5 feet inside the body during a normal procedure through the entire colon (large intestine). During the colonoscopy, the physician carefully examines all parts of the colon in real time with magnification to pinpoint even small lesions which may exist.
Colonoscopy is considered the standard against which other methods are compared and is not perfect but offers some advantages over freother screening methods. Occult blood testing can yield both false positive and false negative results, and provides only the broadest of screening techniques. A positive result is reason to schedule a colonoscopy. Sigmoidoscopy examines only the lowest portion of the colon and may miss tumors or polyps occurring higher up in the colon. Virtual colonoscopy in which a patient swallows a capsule which takes thousands of photographs of the colon still requires preparation to empty the bowel, involves radiation exposure and is limited to visualization without the possibility of diagnostic or therapeutic maneuvers.
The advantages of colonoscopy over other methods include direct visualization to examine the tissues inside the colon and the capacity, tissue marking for later surgical procedures, electrocautery, placement of clips and/or direct injection of drugs to stop bleeding. Most importantly for colon cancer screening, colonoscopy allows for immediate polyp removal.
Polyps, which are small growths inside the colon, look a bit like skin tags and are usually easily and painlessly excised. Approximately 35 percent of adults will have polyps at some time in their lives. Many polyps are simply overgrowth of normal tissue and will never cause a problem, but others, composed of glandular tissue, can become cancerous if allowed to grow larger.
Since it is not possible to detect the tissue type by visual exam, all polyps are removed as a matter of routine when they are detected, and sent to the laboratory for microscopic analysis.
What to Expect
So good for you, you’ve scheduled the procedure with your doctor and are looking forward to the experience with a bit of trepidation. Here’s what you can look forward to over the next several days before and after the procedure:
The preparation: Your doctor will give you instructions for a specific laxative(s) to take and a special diet to follow in the days before the procedure.
Follow the instructions closely and remember to drink plenty of fluids the day before the procedure to replace those lost by the laxative’s effects.
Plan to spend the evening before the procedure close to the bathroom and allow yourself time and privacy to complete the preparation. It can help to drink unpleasant tasting liquids chilled and through a straw, and also to “cleanse the palate” in between glasses of the laxative preparation with a sip of something tart or fizzy. You should take nothing by mouth for several hours before the procedure.
The procedure
Once in the endoscopy lab, you will be greeted, change your clothing, asked about any medical conditions, given an IV for fluids and medications, placed on nasal oxygen and made comfortable. The nurses and doctors will discuss in greater detail what to expect. Sedatives, customized for your medical condition, age and other risk factors, will be given by IV.
Once you awaken, it is unlikely that you will remember anything about the procedure.
The recovery: You will recover for approximately 30 minutes and receive something light to eat and drink.
You will need a ride home — the sedation affects your judgment, memory and coordination, so take it easy the rest of the day.
The only after effects to expect may include drowsiness, and perhaps some abdominal tenderness and gas. Much of this gas is simply excess air which should be expelled naturally over the course of the day.
Now, pat yourself on the back for doing such a good thing for yourself — and make sure your spouse and friends get their screening done, too.
Need More Information?
To learn more about colon cancer or for questions on other digestive problems, call Hilton Head Regional Healthcare’s referral line on digestive disorders at (877) 582-2737. You may also check out Web sites such as medlineplus.gov or cancer.org.
Advances in treatment
As of 2004, the latest year for which we have updated statistics, approximately 48 cases of colorectal cancer were diagnosed per 100,000 people in the United States. It is the third most commonly diagnosed cancer. Over the last two decades, colorectal cancer incidence rates have declined substantially, and, between 1984 and 2004, they fell by nearly 26 percent. About 65 percent of men and women diagnosed with colorectal cancer now survive their disease at least five years.
