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    Colon Screening Saves Lives – A Patient’s Perspective

    Dr. Rubin Bahuva Deaconess Clinic Gastroenterologist 03/09/2020

    You’ve heard that colon cancer screening saves lives. In this article, a patient shares his story about how a routine colonoscopy may’ve saved his life at the age of 61. He and his doctor together explain what a colonoscopy is, and why it’s important. 

    Dr. Bahuva: I’m glad to be talking about this because I’ve seen many lives saved due to colonoscopy/colon cancer screening. It’s something I want more people to decide to do for themselves and for their families.

    Grant: Ever since my colonoscopy and colon cancer diagnosis, I’ve been telling everyone I know to get their colonoscopy, so I decided to talk to a larger audience about this issue that is important to me.

    What is colon cancer?
    Dr. Bahuva: Colon cancer is the second leading cause of cancer death among men and women combined (second to lung cancer). The colon is also called our large intestine.

    Colon cancer is most common in adults over age 50, which is why colonoscopies and other screenings are recommended to begin at that age. However, if there is a family history of colon cancer, earlier screening may be recommended.

    Nine out of 10 cases of colon cancer can be successfully treated if caught early. But currently, only 4 in 10 cases of colon cancers are caught early, in part due to low screening rates.

    What is a colonoscopy?
    A colonoscopy is done via a scope with a camera that is inserted into the rectum of a patient, and it is extended through the length of the colon to see the entire inside. This is done under sedation, and as you can imagine, it takes place after a thorough cleansing of the colon.

    What is unique about colonoscopy is that it is the only cancer screening that can also HELP PREVENT colon cancer. Meaning, during the colonoscopy, if a polyp (a small growth) is found, it is removed at that time. Sometimes these polyps are precancerous, so by removing it during a colonoscopy, it prevents cancer from developing in that polyp.
     
    The overall colonoscopy procedure takes about 30 minutes. Someone does need to drive the patient home after the procedure because of the sedation.

    Grant’s story
    Grant: I had my first colonoscopy in my early 40s due to a GI issue I was having, as well as a family history of colon cancer (a grandparent). That colonoscopy was fine, so I had another in my early 50s as recommended by my primary care doctor.  It, too, was normal. So last December, at age 61, I had my third screening colonoscopy, again, as recommended by my PCP.

    When I woke from this colonoscopy, Dr. Bahuva said that he’d found a polyp—just one—and that it would be going to the lab to be examined under a microscope to look for any abnormal/cancer cells.

    That was on a Wednesday. On Monday, Dr. Bahuva called me and said that the lab tests showed some abnormal cells, and that he wanted to re-examine the area where that polyp had been removed. So I came in for another colonoscopy later that week. During that colonoscopy, Dr. Bahuva examined that section of my colon very carefully, and removed more surrounding tissue for additional testing to confirm that no cancer cells were left behind. He also made a permanent mark (like a tattoo—I now have ink!) inside that spot in my colon so he would always know exactly where it had been.

    After all the tests were complete, it was determined that the cancer cells were all contained in the polyp, and that it had not spread into my colon walls or anywhere else.

    To say that I and my family are relieved is an understatement. I now tell everyone I know over 50 that they need to get their colonoscopy, and am still surprised at the number who haven’t.

    Why some people don’t get screened
    Grant: In conversations that I have had, two of the main reasons that people don’t want to have a colonoscopy is because they’re embarrassed, and they don’t want to do the prep. (Dr. Bahuva agrees—he hears this a lot.)

    First of all, I can tell you that with the sedation, you’re not really aware of anything at all. Also, these doctors and nurses have seen thousands of rear ends, and so it’s not a big deal to them.

    Secondly, while I can’t say that the colon cleansing fluid (prep) is really tasty, or that the process is what I’d call a lot of fun, it’s not a big deal. And it’s most certainly worth saving your life.
     
    Get screened--whether you think you “need to” or not

    Grant: Finally, I want to note this…. In general, I have taken good care of myself. I’ve been a lifelong athlete and have always kept a healthy weight. Since my diagnosis in December, I’ve further improved my diet. I’ve cut out fast food, eat carefully prepared lunches I bring to work, cut way back on diet sodas, and I exercise more purposefully.

    The point of me telling you this is that colon cancer can happen to anyone—even if they are “the picture of health.” Follow your doctor’s recommendations about screening, and just do it. One of two things will happen: you’ll either have an earlier diagnosis that gives you a better outcome, or you’ll have peace of mind as you move on with your life.

    Colon cancer risks
    Dr. Bahuva: Colon cancer can run in families, so find out your family history to learn if you may need to be screened earlier than those without a family history.

    However, I want to re-emphasize that everyone should be screened. You don’t have to have a family history to be diagnosed with colon cancer. The lifetime risk of colon cancer is 4-5%. If you have an immediate family member with colon cancer, your risk doubles, to 8-10%.

    Also, I’m glad Grant mentioned his lifestyle, because lifestyle factors can significantly impact colon cancer risk.

    For example, some of the most important things to do to reduce colon cancer risk include:

    • Being physically active – about 30 minutes each day.
    • Eating healthfully—lots of produce and whole grains; limiting red meat and processed meats
    • Not smoking.
    • Limit alcohol. However, even if someone is overall very healthy, colon cancer can still happen, which is why screening is so important.

    Screening options, details

    Dr. Bahuva: I feel very strongly about colonoscopy. It’s the best way to detect cancer at early stages, and as I mentioned earlier, it can help remove polyps prior to them possibly becoming cancerous.

    However, if someone doesn’t want to do a colonoscopy, there are other options (see chart below). There are pros and cons to both, but overall, I think the best screening is the one the patient will actually do.

    I want to assure patients that colon cancer screenings are nearly always covered by insurance (as recommended by your primary care doctor). Insurance companies also want to detect cancer early.  It’s in everyone’s best interest.

     

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