How To Avoid Colon Cancer
by Robert Fusco, MD
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Richard D. is a 51 year old engineer who was recently referred to Three Rivers Endoscopy Center for a screening colonoscopy at the request of his family doctor. He said that he was referred for a routine "checkup" merely because he was over age 50. When questioned, he stated that his bowel habit was normal, never saw any rectal bleeding, and had no family history of colon cancer or polyps. He wasn't sure the exam was really necessary. When he awoke after his exam, he was surprised that the test was over. He was groggy, but didn't feel a thing. He was even more surprised to learn that a large polyp had been found just inside his rectum. Fortunately, it was possible to remove the polyp during the colonoscopy. When the biopsy returned a few days later, it was learned that the polyp was a villous adenoma, or highly precancerous polyp. Had he not been seen, a future rectal cancer was quite certain. Mr. D was relieved that a potential cancer had been prevented in such a simple fashion and encouraged his wife to schedule a screening exam as well. This case is just one example of dozens of similar cases seen every month at our endoscopy center.
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We have great news about colon cancer! It may seem impossible to think that anything about cancer can be called great, but most people don't realize that colon cancer is quite different than other malignancies. For example, we have screening techniques such as mammography for detection of breast cancer, but a woman has to have breast cancer before her mammogram can detect it. Mammography promotes the hope that should a woman develop breast cancer, it might be found in an early curable stage. The problem is that even if a woman survives the ordeal, she must endure the mental and physical trauma of cancer surgery, chemotherapy, and/or radiation therapy. Breast cancer cannot be prevented.
The same holds true for prostate cancer, another common malignancy. You must first have it to find it. There is no reliable way to prevent it. Colon cancer is quite different. It is one of the few cancers that can actually be detected before cancer develops and prevented. Here are the facts:
First The Bad News
It may not be fun to talk about, but colon cancer is a real threat to every man and woman in this country. It is a very common disease that currently afflicts 1 in 17 Americans in their lifetime. If colon cancer or colon polyps run in the family, the risk is even higher. Sadly, about 145,000 Americans will be told they have colon cancer this year. About every 3 1/2 minutes, an American is told they have colon cancer. We find new cases of colon cancer in our practice every week. It's the worst part of our job.
To make matters worse, colon cancer is also a silent disease without so-called "early warning" symptoms. About the time symptoms (rectal bleeding, change in bowel habit, abdominal pain, weight loss) do occur, it may already be too late. Unfortunately, not having a family history of colon cancer is not reassuring either since over 75% of individuals with colon cancer have no known family history of the disease.
This combination makes colon cancer a very deadly disease. An American dies of colon cancer every 9 minutes. Despite modern cancer therapy, this disease still takes over 56,000 U.S. lives each year. In fact, colon cancer is now the number one cancer-killer in non-smokers. Only lung cancer takes a greater toll.
Where Is The Good News?
If colon cancer is common, silent, and deadly, where is the good news? The good news is that when caught in an early stage, colon cancer can be cured over 90% of the time. CURED! The problem is that there are no early warning symptoms in the early stages. You have to see the doctor when you feel good. In this busy hectic world we all live in, that is difficult for many individuals.
Now For The Great News
The story gets even better. Most people don't realize that colon cancer is also one of the easiest cancers to prevent. That is because almost all colon cancers begin many years before as a small, non-cancerous growth within the colon called a polyp. Find and remove that polyp, and a potential colon cancer can be prevented! We find many such cases every day. That is the best part of our job.
In fact, when I turned 50, I had my first screening colonoscopy. Colon cancer does not run in my family and I had no symptoms of concern. I was surprised to learn that Dr. Stanley removed two precancerous polyps from my right colon. Fortunately, they were caught in time and no cancer cells were present. Since I am a "polyp maker," I now go back periodically for a follow up colonoscopy.
Screening Colonoscopy Saves Lives
Again there are no early warning symptoms of a polyp. However, even before they turn to cancer, colon polyps can be detected and removed during a screening colonoscopy, a painless outpatient procedure. When you think about it, this is a miraculous opportunity, not available with most other common malignancies. For this reason, the American Cancer Society now recommends screening exams such as colonoscopy about every 10 years for all adult men and women beginning at age 50. African-Americans have a slightly higher risk and should begin checkups at age 45. Individuals with a family history of colon cancer or polyps should start at age 40 and be tested more often.
With advances in medicine, having a screening colonoscopy can be quite simple. Health insurance was a barrier in the past, but Medicare and most private health plans now provide coverage. In the last few years, new easier preparations have become available. With modern conscious sedation, the procedure is painless and is done in a matter of minutes. After the examination, most patients wonder what the fuss was all about. Best of all, it is rare to get bad news from a screening examination. Almost all colon cancers are found in individuals with symptoms who never bothered to get a check-up. Since colon polyps are painless, people have to be tested periodically before they develop symptoms.
A Healthy Lifestyle
In addition to undergoing regular health screenings, it is also important to follow a healthy lifestyle. Eating a diet rich in fruits, vegetables, and whole grains, exercising regularly, and maintaining a healthy weight are vital to preventing cancer and other diseases. There have been many studies on dietary supplements. Some studies suggest that aspirin, NSAIDS like ibuprofen, vitamin D and calcium, vitamin B6, and folic acid may help decrease the number of polyps, but there are no definite conclusions.
Just Do It
The key point is that preventing a cancer is obviously better than even catching it early. That is the great news about colon cancer. Unlike other cancers, it can be effectively prevented with technology which has been perfected over the past 3 decades - screening colonoscopy.
Screening colonoscopy can help keep you healthy to enjoy the good life and family you have worked so hard to create. If you are old enough to remember candy cigarettes, Bonanza, and the Hula Hoop, you need to discuss this issue with your doctor. Take charge of your health and don't delay. Just do it! We did....
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