Let’s talk first about some numbers. If you wouldn’t mind, throw out some statistics about the importance of colon cancer and how maybe completing a screening can impact the outcome?
Thank you for having me here to talk about colon cancer. Let’s start with the question: what is colon cancer? Colon cancer, strictly speaking, refers to a combination of cancer located in the colon and in the rectum. The rectum is the last few inches of the large intestine. We hear colon cancer and colorectal cancer used interchangeably. Colon cancer is a type of malignant tumor originating from the abnormal growth of the lining of the lower intestinal tract which refers to the colon and the rectum.
It is a very common cancer. Colon cancer is the fourth most common cancer in both men and women. It is the second leading cause of death by cancer in the United States. Averagely speaking, your lifetime risk of developing cancer, specifically colon cancer, is close to 5 percent.
So obviously if you have a screening it is going to have an impact on that. What are the different ways that you screen for colon cancer?
There are several available options for colon cancer screening. Generally speaking your doctor can help you choose the best option based on your medical and family history. The tests that are currently available are trying to look into concerns such as a trace amount of blood in the stool that sometimes symbolizes the early stage of colon cancer. We can look at your DNA or abnormal contents of the DNA that comes from the mucosa or shell that is shed from the intestinal tract. We also have x-rays with contrast to see the contours of the colon. Of course, of most importance, is the colonoscopy which we use to directly visualize the colon and rectum. The screening, specifically the colonoscopy, reduces the colorectal mortality rate by greater than 60 percent. Other screening tests also have been beneficial in detecting colon cancer and polyps before they cause any symptoms such as pain or bleeding.
At what age should we start looking at having this screening completed?
Several professional societies recommend beginning colorectal screening at age 50 if no one in the family has been diagnosed with colon cancer or certain types of polyps or several conditions that are associated with increased risk of colon cancer. The American College of Gastroenterology recommends that you begin screening at age 45 rather than 50 for African Americans. They also recommend colonoscopy as the preferred test, although there has not been a consensus at this point.
You mentioned the colonoscopy. What should we expect to happen? We have heard all kinds of crazy stories about that. Explain what takes place before, during and after that procedure.
Before colonoscopy, there are probably a few things that your provider will instruct you about. One of the things that the provider will discuss is that sometimes medications need to be adjusted specifically for those patients who have for example, diabetes or are on blood thinners. The provider, doctor, will let you know which of the medicines you should take and the adjustments in the dosage. The second thing is that your diet has to be changed prior to colonoscopy into a much simpler, or what we call, liquid or clear liquid diet. The last one, which is the most important one, is that you will need to take a colon prep which consists of a large volume lavage liquid to clean out the colon. That is something we do before colonoscopy. Also, prior to colonoscopy the provider usually talks about the ways that sedation can be administered or ways you can be made comfortable and relaxed. After the colonoscopy, the gastroenterologist or surgeon doing the colonoscopy, will give instructions regarding diet and activities afterward. It is very important to know that colonoscopy is a very simple and non-invasive test not to be feared.
How can families support each other when it comes to these types of screenings?
Not uncommonly we see patients who take initiative because family members have been diagnosed with colon cancer or polyps. Communication among the family, I think, is a very important initiative for colon cancer screening.
Also, studies show that African Americans are more likely to report that their main influence for colon cancer screening is a family member. The reason this study was done was because there was an increase in colorectal cancer in African Americans.
It is understandable that family is where you want to go to discuss a difficult and sometimes embarrassing topic. Another example is that we hear questions like: I have no problems with my bowels. Why does my doctor recommend that I have colorectal screening? If a family member works in the health care field or has had a colonoscopy, they can talk about the purpose of the screening and talk about that the screening is a very important way to prevent cancer in the long term. I think they can have a major influence on their family member to start screening on their own. I think it can make a big difference. In fact, studies have shown that family support is related to having a very positive attitude about the purpose of screening and in some cases has led to increased screening goals.
I want to remind folks that they can contact you if they have any questions and the number for you is 636- 916-9615. They can always contact Barnes-Jewish St. Peters Hospital to contact you. The first step is checking into it. Isn’t it?
Yes absolutely!
Dr. Huang, thank you so much for being with us. I appreciate it.
Thank you very much.