It’s really not that bad…

March is Colon Cancer Awareness Month and I am writing today to try to convince those of you who have been putting off your colonoscopy that it is really not that bad. It is a relatively simple procedure that could save your life – the minor inconveniences involved with the prep will be worth the peace of mind if you are able to prevent or catch colon cancer in its early stages.

A few quick facts about colon (or colorectal) cancer:

  • Colorectal cancer is the second leading cause of death in men and women.
  • One in 20 people will be diagnosed with colorectal cancer.
  • One in three people are not up to date on their screenings.
  • Family history is a strong risk factor.
  • Colon cancer is preventable and treatable if detected early.
  • If you are at least 50 years old with no symptoms, your screening is normally covered by insurance.

(Source: https://www.cdc.gov/cancer/colorectal/pdf/no_pocket_brochure.pdf)

Personal experience

I will be 46 in June and have already had three colonoscopies, so I am speaking from personal experience. My first one was at age 34 and came about as a result of some concerning symptoms (blood in my stool) and a family history of colon cancer (maternal grandfather). I saw my primary care physician first and given the above factors, she sent me to a gastroenterologist. Both physicians suspected that it was just hemorrhoids, but my GI doctor recommended a colonoscopy due to my family history. Sure, I was a little apprehensive at first, but I wanted to be sure that it was not something serious.

I’ll spare you most of the details but as you’ve probably heard, the prep is the worst part. You have to avoid certain foods a few days prior to the procedure and then fast starting around noon the day before your procedure. Then you have to drink a large volume of the prep solution over several hours to help clear out your system. I can say that the manufacturers are working to make it taste better – the solution I used for my most recent screening last year was the best of the three that I have had. They are also working to make the prep easier – there are several options including oral medications and a “split” prep process where you drink some of the solution the night before and finish it the next morning.

The colonoscopy itself is rather simple. Most patients are sedated for the procedure – the anesthesiologist gives you a nice dose of propofol or similar sedative in your IV and you are out before you can count to five. Next thing you know, they are waking you up and bringing you to the recovery area. Your gastroenterologist will likely provide you with a procedure report including some pictures of your colon (I personally think it’s kind of cool to see what it looks like inside!). If there were any polyps that needed to be biopsied, you may need to wait a week or so to get the results back.

Most people need a colonoscopy every 10 years, but it may depend on what the physician finds. In my case, I was advised to come back in five years after the first one as I had some benign polyps (and the family history risk factor). The same thing happened after my second one. But at my last one in 2018, I was polyp free and thus, can wait 10 years before my next one (unless of course I have any symptoms or warning signs that would warrant coming in sooner). As much as I might fuss about the inconvenience of the prep process, it really is worth it knowing I am doing everything I can to help prevent colon cancer or increase my chances of survival if I were diagnosed with it.

A quick note about your colon cancer screening options:

There are stool-based tests that are non-invasive and do not require any special diet or bowel preparation. These tests are usually recommended for people who have an average risk for colorectal cancer: no personal history of pre-cancerous polyps, no colorectal cancer that runs in the family, or no other risk factors. However, if the test shows abnormal signs of blood or a possible cancer or pre-cancer, a colonoscopy will be needed anyway to confirm the result and to remove any abnormal findings or polyps. Thus, it might be best to skip the stool-based test and just have the colonoscopy. Bottom line: consult with your health care provider to determine the best screening test for you.

Now if you’ll excuse me, I need to go remind my husband, who just turned 50 at the end of February, that it is time for his annual physical and a referral for his first colonoscopy!

 

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