Colon Care: The Sooner, the Better

Even though colorectal cancer is the second leading cause of death from cancer in men and women in this country, some people are still hesitant to get screened. Honestly, though, the screening test is a rare occurrence in a person’s life. For people at average risk, a colonoscopy could be just once every 10 years.

The preparation is easy. The procedure is painless and safe. It reduces the risk of getting cancer and can save lives. It’s worth the time to get screened and go on with your life.

Early Screening: The Best Protection

It’s very important to get screened when you’re supposed to. We shouldn’t delay colon cancer screening because sometimes polyps can grow into cancer, and more advanced cancers are more difficult to treat.

Also, the higher the stage of the cancer, the lower the survival rate. So, we always want to treat patients before they develop the disease, by identifying it with screening and removing polyps before they turn cancerous.

Prep Tips

There are many types of preparations (preps) out there. Your healthcare provider discusses the prep with you in detail. It’s very important to follow the directions closely. The most common preps start the day before your procedure, where you:

• Drink laxatives and liquids
• Avoid solid food

Most preparations are split up: the first half is done the day before the scheduled colonoscopy and the second half is done later that day or the morning of the procedure. When we do that, the prep is more tolerable and can improve the view in the colon.

If we perform a colonoscopy and there’s not a good view, sometimes patients have to repeat the procedure. You can save time and money by following the prep diet instructions.

Best Age for Your First Screening

Most physicians would agree that, at age 50, people who are at average risk should get screened for colon cancer. People should get colonoscopies earlier if they have a close relative with colorectal polyps or cancer. The American Cancer Society recently recommended that we start screening at age 45.

If patients have any concerning symptoms like change in bowel habits, blood in stool, abdominal pain, or unexplained weight loss, they should get screened earlier.

The right age for you to have your first screening test is a discussion best had with your doctor.

African Americans at Higher Risk

Most providers recommend that African Americans start their screening earlier, at age 45. It is unclear why African Americans are at higher risk, although it is likely a combination of factors like genetics and access to care.

How Often Should You Be Screened?

• For patients at average risk, colonoscopy can be done every 10 years
• For patients who have a known risk factor like colon polyps or a family member with colon cancer, surveillance is every three to five years
• For patients who opt to do one of the stool DNA tests or the stool blood tests, sometimes retesting can be done every one to three years

The Gold Standard

It’s been proven in many studies that colonoscopies have the highest detection rate for polyps, which are abnormal growths that can develop into cancer. Other tests, such as the stool blood test and stool DNA test, can be good alternatives, especially for patients at average risk. There are pluses and minuses to these alternative tests, but the gold standard is still a colonoscopy. Besides, the procedure is painless and safe, and patients can go back to their usual activities the next day.

If you’re unsure about the right screening method for you, talk with your doctor. Keep in mind that the best test is a test that’s actually done.

Early Symptoms

Sometimes, patients have no symptoms. That’s why screening is critical. It’s important to let your doctor know if you have these symptoms:

• Rectal bleeding
• Abdominal pain or discomfort
• Weight loss
• Fatigue
• New changes in your bowel movements
  – Constipation
  – Not emptying the bowels very well
  – Change in the caliber of your stool

Family History and Lifestyle Risk Factors

One of the biggest risks of colon cancer is if you have had polyps in the past. If so, you’re at higher risk than average to get colon cancer. If a member of your immediate family has colon cancer or colon polyps, you are also at higher risk.

There are other genetic conditions that put people at higher risk of colon cancer, such as Lynch syndrome, familial adenomatous polyposis, and inflammatory bowel disease (ulcerative colitis and Crohn’s disease).

And then there are the lifestyle risks. Although not as strongly linked as the other factors, people should still be aware of these risk factors:

• Obesity
• Diabetes
• Diets high in red meat and low in fiber
• Smoking

An Inside Look at Reducing the Impact of Cancer

Usually during the screening procedure, we’re able to remove polyps completely. If you have colon polyps and they are not removed, they can grow into colon cancer.

Sometimes we perform a colonoscopy and find cancer. Usually the next step in that situation is a CT scan to ensure there is not spread of disease. Surgery is often performed for colon cancer. The survival rate and prognosis are very good for an early-stage colon cancer, usually 90% or higher five-year survival rate.

Stages of Colon Cancer

People should be aware of the stages of colon and rectal cancer:

• Stage 1 is cancer in the first layers of the wall of the colon
• Stage 2 is cancer into the deeper layers of the wall of the colon
• Stage 3 is cancer into the lymph nodes that drain the colon
• Stage 4 is when there is cancer outside of the colon and rectum

Treating the Disease

At MedStar Washington Hospital Center, we specialize in minimally invasive surgery and can treat the most complex conditions. We look at the whole patient and provide a multidisciplinary consensus plan for that person.

We always present our cancer cases at a tumor board: a multidisciplinary meeting with representation from surgeons, medical oncologists, radiation oncologists, and pathologists, and we discuss the case and together develop a consensus plan. Stage 4 cancers can be very complex. We may either recommend surgery, chemotherapy or radiation, or a combination of these three treatments.

Advantages of Minimally Invasive Approaches

We often use minimally invasive approaches for colorectal surgeries. For patients, the benefits of this include:

• Less pain
• Smaller incisions
• Faster recovery
• Quicker discharge from the hospital
• Faster return to eating meals
• Quicker return to usual activities
• Fewer complications

Enjoy a Colon-Healthy Lifestyle

We always recommend eating a heart-healthy, high-fiber diet. A high-fiber diet includes fruits and vegetables. We encourage people not to eat a lot of red meat or processed meat. We recommend quitting smoking and trying to exercise and stay fit.

Happy Patients, Satisfying Outcomes

It is very rewarding to be able to find and remove colon polyps before they turn into colon cancer.  Also, we like it when we are able to remove cancers through small incisions and patients are potentially cured of their disease.