A screening colonoscopy can detect and remove polyps that could potentially develop into cancer.
Colorectal cancer is the third most common cancer for both men and women, and the second leading cause of death of all cancers. An estimated 130,000 new cases of colorectal cancer are diagnosed every year. In 2016, approximately 50,000 people diagnosed with colorectal cancer will die from this disease. The best news about colorectal cancer is that it is detectable and treatable. A high-quality screening colonoscopy by an experienced gastroenterologist can detect and remove polyps that could potentially develop into cancer.
The United States Preventive Services Task Force recommends everyone over the age of 50 (or earlier, if there is family history of colon cancer) undergo a colonoscopy for screening purposes. Furthermore, the Affordable Care Act has required most insurance plans to cover a screening colonoscopy without added cost to patients. The most important thing is to be aware of the warning signs of colon cancer, such as rectal bleeding, change in stool or sudden weight loss. These symptoms should not be ignored, as some recent studies have shown that up to 15 percent of colon cancers occur in those less than 50 years of age.
As a physician, it would be easy for me to use statistics to explain why you should or shouldn’t take certain actions, but instead, let me share a story from one of our patients.
A Patient’s Story
“August 29, 2013 is a date that I will never forget. It was the date of my first colonoscopy. After having my doctor tell me I should get a colonoscopy every year for the past seven years, why do it now? The reason is that I started passing blood in January. I still waited, thinking it was a side effect of the arthritis pain medication I was taking. I immediately quit taking the medication, and there were no more problems.
“A couple months later, I was expecting an active day and took the medication again. The blood showed up again. I tell my doctors in June at my annual wellness check; he tells me I need to get a colonoscopy. Again, I put it off; my wife and I are taking a short trip in early July, and I don’t want to deal with it. When we get back, I am having problems more frequently and get my colonoscopy scheduled… About three weeks before my appointment, I told my wife the problems I had been having and there was a good possibility I had cancer.
“When I awoke from the procedure, they told me four polyps had been removed and a mass had been biopsied. The doctor told me he was relatively certain that it was rectal cancer. Before I was released, I had an appointment for a CAT scan and an appointment to see a surgeon. The next step was to see an oncologist and a radiologist. They coordinated a 28-day regiment of chemotherapy and radiation. Thanks to the support and prayers of my family and friends, I finished these on November 14th without even getting a cold. I had the best possible outcome from this treatment: the mass was completely eliminated.
“Surgery was scheduled for January 7, 2014. All went well, and I went home with an ileostomy. Testing of the removed portion of my colon showed no sign of cancer. Six weeks after my surgery, I started a 24-week chemo regimen. It consisted of 12 treatments, one every two weeks. These treatments included going home with a chemo pump and wearing it for 46 hours, besides the chemo drugs given to me at the cancer center. The pump was taken off for the last time on July 16th. My takedown surgery (reversal of my ileostomy) was scheduled for August 20th.
“I don’t know how anyone makes it through this without faith, family and friends. I cannot thank them enough for their support and prayers over the entire year of treatment. Even my two-year-old grandson would pray at meals, ‘Thank you God that Grandpa feels better.’ With prayers like that being lifted up for me, how can I complain about anything?
“This is probably the most preventable cancer for people my age. A colonoscopy at age 50 would have prevented it.”
A Preventative Mission
A colonoscopy is at the heart of colorectal cancer prevention. Technological advances have enhanced safety and comfort, and improved the detection of precancerous polyps. Physicians are now using high-definition scopes, which allow greater detail and clarity of the exam area; previously missed lesions—such as flat, “serrated” polyps and smaller polyps that were missed in the past—can now be identified. Safety standards during the procedure have also vastly improved, as endoscopy facilities are under the strict guidelines of accreditation health organizations and state and federal governmental agencies.
I am frequently told by patients that the worst part of the colonoscopy process is the liquid prep that is taken prior to the procedure, which is critical to the overall success of the procedure. Several different products are available, including a low-volume prep that is comparable to the volume of liquid you would drink normally. In combination with a modified diet, it provides patients with additional options while they prepare for procedures that were not practiced even a few years ago.
Our mission is to educate the public about the need for colon cancer screenings as a critical step in prevention. We have joined with the American Cancer Society in the “80% by 2018” initiative to increase the colon cancer screening rate to 80 percent by 2018. The success of this initiative will result in thousands of people each year not having to live the story shared above. iBi
Scott Wu, MD, FACP, AGAF is a physician at the Central Illinois Endoscopy Center and assistant clinical professor at the University of Illinois College of Medicine at Peoria.