This month, health care providers are trying to save lives by preventing or detecting colorectal cancer.
New guidelines recommend most U.S. adults start colon cancer screening earlier, at age 45 instead of 50.
Although it is not a glamorous subject to talk about, it is definitely an important one.
“Colon and rectal cancer affects 150,000 Americans every year, and some 60,000-70,000 deaths every year due to colon and rectal cancer,” said Corpus Christi Medical Center Colon and Rectal Surgeon Dr. C. Richard Varin.
The primary risk factor for colon and rectal cancer is age, with more than 90 percent of cases diagnosed in individuals older than 50.
“It is extremely important. Now to have it done on your 50 birthday is not that critical, if you get it done at age 50, 51, 52, it is still okay. That is in that age range, but the point is get it done,” said Varin.
Having a colonoscopy is the gold standard for colon cancer screening. It’s about a 20-minute exam that doctors say could potentially save your life.
“But it is not only diagnostic, it can find abnormalities in the colon but there in a channel in the colonoscope through which instruments can be passed, and biopsy removed anything that can be found in the colon. The whole procedure takes about 15 minutes, and there is really very little discomfort,” said Varin.
Cancer of the colon or rectum is the third most common cancer in men and women and the second leading cause of cancer deaths in the U.S.
“Most patients, when they begin with colon cancer have no symptoms whatsoever. By the time they present with vague symptoms like abdominal pain, rectal bleeding, changes in bowel habits, weight loss, unexpected weight loss and by then the cancer is usually large enough to cause those symptoms, and at that point, it requires usually a big surgery to treat this, and sometimes it is too late,” said Varin.
There are several risk factors that have been linked to colon cancer, some of which you can change.
“If we can find colon cancer at an early stage it is 100 percent curable. With surgery, perhaps a little bit of additional radiation and chemotherapy where indicated, we can make this cancer go away. It can be eradicated, gone forever. The point is to get there in time,” said Varin.
Overview: A colonoscopy is an exam used to detect changes or abnormalities in the large intestine (colon) and rectum.
During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.
If necessary, polyps or other types of abnormal tissue can be removed through the scope during a colonoscopy. Tissue samples (biopsies) can be taken during a colonoscopy as well.
Why is it done?
Your doctor may recommend a colonoscopy to:
- Investigate intestinal signs and symptoms. A colonoscopy can help your doctor explore possible causes of abdominal pain, rectal bleeding, chronic constipation, chronic diarrhea and other intestinal problems.
- Screen for colon cancer. If you’re age 50 or older and at average risk of colon cancer — you have no colon cancer risk factors other than age — your doctor may recommend a colonoscopy every 10 years or sometimes sooner to screen for colon cancer. Colonoscopy is one option for colon cancer screening. Talk with your doctor about your options.
- Look for more polyps. If you have had polyps before, your doctor may recommend a follow-up colonoscopy to look for and remove any additional polyps. This is done to reduce your risk of colon cancer.
What you can expect during the procedure:
During a colonoscopy, you’ll wear a gown, but likely nothing else. Sedation is usually recommended. Sometimes a mild sedative is given in pill form. In other cases, the sedative is combined with an intravenous pain medication to minimize any discomfort.
You’ll begin the exam lying on your side on the exam table, usually with your knees drawn toward your chest. The doctor will insert a colonoscope into your rectum.
The scope — which is long enough to reach the entire length of your colon — contains a light and a tube (channel) that allows the doctor to pump air or carbon dioxide into your colon.
The air or carbon dioxide inflates the colon, which provides a better view of the lining of the colon. When the scope is moved or air is introduced, you may feel abdominal cramping or the urge to have a bowel movement. The colonoscope also contains a tiny video camera at its tip.
The camera sends images to an external monitor so that the doctor can study the inside of your colon.
The doctor can also insert instruments through the channel to take tissue samples (biopsies) or remove polyps or other areas of abnormal tissue. A colonoscopy typically takes about 30 to 60 minutes.
After the procedure:
After the exam, it takes about an hour to begin to recover from the sedative. You’ll need someone to take you home because it can take up to a day for the full effects of the sedative to wear off. Don’t drive or make important decisions or go back to work for the rest of the day.
If your doctor removed a polyp during your colonoscopy, you may be advised to eat a special diet temporarily. You may feel bloated or pass gas for a few hours after the exam, as you clear the air from your colon. Walking may help relieve any discomfort.
You may also notice a small amount of blood with your first bowel movement after the exam. Usually this isn’t cause for alarm. Consult your doctor if you continue to pass blood or blood clots or if you have persistent abdominal pain or a fever.
While unlikely, this may occur immediately or in the first few days after the procedure, but may be delayed for up to one to two weeks.
A colonoscopy is considered negative if the doctor doesn’t find any abnormalities in the colon.
Your doctor may recommend that you have another colonoscopy:
- In 10 years, if you’re at average risk of colon cancer — you have no colon cancer risk factors other than age
- In five years, if you have a history of polyps in previous colonoscopy procedures
- In one year, if there was residual stool in the colon that prevented complete examination of your colon
A colonoscopy is considered positive if the doctor finds any polyps or abnormal tissue in the colon.
Most polyps aren’t cancerous, but some can be precancerous. Polyps removed during colonoscopy are sent to a laboratory for analysis to determine whether they are cancerous, precancerous or noncancerous.
Depending on the size and number of polyps, you may need to follow a more rigorous surveillance schedule in the future to look for more polyps.
If your doctor finds one or two polyps less than 0.4 inch (1 centimeter) in diameter, he or she may recommend a repeat colonoscopy in five to 10 years, depending on your other risk factors for colon cancer.
Your doctor will recommend another colonoscopy sooner if you have:
- More than two polyps
- A large polyp — larger than 0.4 inch (1 centimeter)
- Polyps and also residual stool in the colon that prevents complete examination of the colon
- Polyps with certain cell characteristics that indicate a higher risk of future cancer
- Cancerous polyps
If you have a polyp or other abnormal tissue that couldn’t be removed during the colonoscopy, your doctor may recommend a repeat exam with a gastroenterologist who has special expertise in removing large polyps, or surgery.
Problems with your exam:
If your doctor is concerned about the quality of the view through the scope, he or she may recommend a repeat colonoscopy or a shorter time until your next colonoscopy.
If your doctor wasn’t able to advance the scope through your entire colon, a barium enema or virtual colonoscopy may be recommended to examine the rest of your colon.