Tell us a little about colon cancer – how prevalent is it?
Colon cancer is very common and can be a lethal disease if not detected in time. The risk of developing colon cancer is influenced by environmental and genetic factors. It is the #2 killer among cancers in the United States. The likelihood of developing colon cancer in one’s lifetime is one in twenty. Every year, 135,000 cases of colon cancer are diagnosed. In 2016, 50,000 people are expected to die from colon cancer. That’s a significant number and colon cancer screenings could save over half of these lives. One in three American adults are not screened for colon cancer as recommended. The number of years recommended between colonoscopies for patients at average risk beginning at age 50 is 10 years.
Is 50 the age when we should start having colon screenings?
That is exactly right. The lifetime risk of developing colon cancer is 6 percent. This risk is doubled if your first degree relative (parent, sibling, child) has had colon cancer. There are certain inherited disorders with polyps in the colon – that can increase the risk of colon cancer even more. Other risk factors include being overweight/obese, smoking, certain conditions of the colon which cause inflammation/irritation of the lining of the colon (Crohn’s Disease) and excessive alcohol consumption.
What is a colonoscopy and what are the benefits of having a colonoscopy completed?
It’s interesting, if you mention colonoscopies, many people have heard anecdotal experiences from other people who had a colonoscopy 15-20 years ago. At that time, the sedation was different and the instruments were different. These days, the patient doesn’t feel any pain during the procedure.
A colonoscopy is a procedure with a scope, light and camera. A specially-trained physician examines the entire length of the colon. The colon is approximate 3-4 feet in length, and the entire length is examined. During the colonoscopy, if small growths called polyps are found, they can be easily removed. If there is swelling or inflammation in the lining of the colon, it can be biopsied and a diagnosis can be made. The basic premise to diagnose colon cancer at an early stage or even better, remove the polyps which can grow into colon cancer.
This is a painless procedure. Patients actually do not remember the procedure at all.
What can we expect before, during, and after the procedure?
One of the things patients tend to be afraid of is the colonoscopy prep. The day before the colonoscopy, you’re actually on a clear liquid diet because we need the colon to be clear of stool so we can see the inside of the colon the next day. The day before the colonoscopy, we give you detailed written instructions to get ready. You drink a laxative to clear the stool out of the colon – it used to be almost a gallon that you had to drink, but now it has changed and is much smaller. It is done in two stages – you drink one small bottle the day before and one the morning of the procedure. You come with a driver or family member and change your clothes and meet with the physician who’ll be doing your colonoscopy. You go to sleep, but you’ll come out of the sleep almost as soon as the procedure is done. After the procedure, the gastroenterologist will discuss the findings with you and your family member.
What if something is found during the procedure?
The physician doing the colonoscopy is very well equipped to handle any situation they find in the colon. The most common finding we have is polyps, or small tumors, that grow in the colon. They grow very slowly. When we do the colonoscopy, we remove them with special instrument – it is a painless procedure. We then send the specimens off to the pathologist and get the results back. This determines when the next colonoscopy should be done. If it’s clean with no polyps, the recommendation is 10 years. If we find polyps, the recommendation is given on an individual basis depending on the size of the polyps found during the colonoscopy.
Where can we go to learn more?
An excellent website is from American College of Gastroenterology - gi.org. It has videos on risk factors, how polyps are removed. This is something I passionately believe in. We see this in action on a daily basis – how many patients’ lives are saved by colonoscopies. They go home very happy. First, they are apprehensive about coming in but once they go through the experience, they are extremely pleased.