Colon cancer can be prevented

Published 7:14 pm Saturday, March 8, 2014

Think about this. Suppose the entire population of Beaufort County died of the same disease in just one year. Or what if we filled up Minges Coliseum five times and all the fans died of a preventable illness. This would all be pretty dramatic.

As we try to comprehend the magnitude of these fatal events, we should realize that this is actually happening in other ways. Each year in the United States over 60,000 people die of a preventable illness. Yet we still find people who won’t take the simple steps to prevent getting this disease.

Colorectal cancer is a silent killer. The sad reality is that most cases of colon cancer are preventable. The good news is that screening exams to detect colon cancer are effective, and are readily available.

The month of March has been designated Colorectal Cancer Awareness Month. The emphasis is on cancer prevention — taking action to lower your risk of developing this potentially fatal disease.

In my practice, there is hardly a week that goes by without my identifying a new colon cancer in a patient. What is frustrating is that upon questioning, many of these patients had the opportunity to undergo colon cancer screening in their past but elected not to. Up to one-third of the patients I find precancerous polyps that are easily removed are eliminated at the time of their procedures. The patient has saved herself or himself from a potential cancer.

So you might ask: what is the problem?

The simple answer is that despite widespread availability of screening tools, only about one-third of eligible patients actually have a screening test performed. The rest refuse, ignore their physician’s advice or choose to take their chances.

In the next several paragraphs, I have outlined the current recommendations for colorectal cancer screening as advocated by various national organizations on colon cancer prevention and detection. These guidelines apply to both men and women as both genders are equally susceptible to the consequences of this disease.

• The simplest screening test is known as the fecal occult blood test.

This is actually a quick test to determine if blood is present in your stool.

It is an easy test to do, but unfortunately doesn’t detect non-bleeding polyps. Therefore, this test has limited value. The fecal occult blood test should be performed yearly after age 40.

• A second available test is a known as a flexible sigmoidoscopy exam.

This is where a thin flexible lighted tube is advanced into the rectum and distal colon. This is usually done in an office setting. It is often performed without the need for a sedative. Its main drawback is that it typically views less than one third of the colon and rectum.  More proximally located polyps might be missed

• The “gold standard” in colon cancer prevention is to perform a colonoscopy.  This is an endoscopic procedure designed to look inside the entire colon with a long flexible lighted tube. It is a very safe and relatively comfortable procedure (aided by the administration of sedation). With colonoscopy most identified polyps can be safely removed during the procedure. This alone can significantly reduce the incidence of colon cancer. This is the preferred screening test for detection and removal of colon polyps.

Most experts agree that colonoscopy is the screening tool of choice. It should generally be performed initially at age 50, and then every 10 years if no polyps were seen. If there is a family history of colon cancer or polyps an earlier colonoscopy might be advised. African-Americans are advised to start colon cancer screening around age 45.

Obviously, screening exams are designed to find disease at an early stage before symptoms arise. Although polyps and the early stages of colorectal cancer usually present with no symptoms, there are warning signs to watch for.

These include:

• A change in bowel habits;

• Blood in the stool (even “fresh” blood);

• Narrowed stool;

• Bloating and fullness or a feeling that the bowel cannot empty completely;

• Frequent gas pains;

• Unexplained weight loss without dieting;

• Continued fatigue;

• Unexplained anemia.

These are all potential warning signs for colon and rectal cancer. If present, you should consider having a formal evaluation of your colon, even if under age 50.

Don’t let yourself or your loved ones become a cancer statistic. When you think about colon cancer, know that it is a preventable disease. And prevention is only effective if you are willing to undergo the proper screening tests.

Talk to your physician. And if you are over age 50, celebrate Colon Cancer Awareness month by taking a few minutes to schedule your screening exam.

Thomas Ruffolo, MD, is a gastroenterologist with Vidant Gastroenterology – Washington.