As a general surgeon, a large part of my practice deals with colorectal cancer (CRC) screening and treatment. Did you know that among cancers that affect both men and women, CRC is the second leading cause of cancer death in the United States?
More than 140,000 Americans are diagnosed with the disease every year and more than 50,000 of them will die. This translates into a lifetime risk of about 1 in 20 for the average person, and can be two to three times higher if you have a family history of colon cancer or polyps.
Fortunately, over 90 percent of these cancers and deaths could be prevented. Despite its high incidence, CRC is one of the most easily detected and successfully treated forms of cancer, especially when found early.
In the past decade, CRC rates have decreased by 3 percent every year. This can be directly attributed to the increased use of colonoscopy, the gold standard tool used for CRC screening.
Colonoscopy uses a long, thin, flexible fiberoptic tube attached to a video camera to evaluate the lining of the colon (large intestine) and rectum. It is done under sedation, and if any abnormalities are found, we can then pass surgical instruments through the scope to painlessly sample and usually
remove the growths, or polyps. These polyps start as non-cancerous, benign tumors, but over time have the potential to develop into cancer.
Colonoscopy is therefore unlike any screening tool we have in medicine because it allows us to not only detect cancers, but also prevent future cancers. It also increases the likelihood that if cancer is found, it will be at an earlier stage when it is more likely to be cured.
The American Cancer Society, the American College of Surgeons and the American Society of Colon and Rectal Surgeons all recommend starting colonoscopies at age 50 (younger for those at increased risk). Unfortunately, only about 50 percent of patients over 50 years old are being screened. Since colon polyps occur in at least 20 percent of the adult population, and 90 percent of those people are 50 years or older, this leaves a huge potential pool for cancers to occur.
When asked what are the symptoms of CRC, I recite a long laundry list, including: change in bowel habits with constipation or diarrhea, narrowed stools, blood in the stool, abdominal pain or cramps, bloating, weight loss, weakness, nausea, vomiting and fatigue.
But the first symptom is No symptoms at all.
By the time symptoms occur, the cancer is less likely to be at an early state where a definitive cure is possible.
For full disclosure, I not only screen for and treat CRC, but I am also a CRC survivor. When my patients ask, Why do I need a colonoscopy if I have no symptoms, I tell them my story Like many of you, I was just too busy to take the time to have my first colonoscopy screening. But, luckily, my wife reminded me of my own advice, so I had my first colonoscopy one year past my own recommendations.
During the colonoscopy, they found a cancer. At 51 years old, I was diagnosed with colorectal cancer. I had not experienced any symptoms: I had no change in my bowel habits; I had no narrowed stools, bleeding, pain, bloating, weight loss, weakness, nausea, vomiting or fatigue I had No symptoms at all.
My cancer was found at an early stage, however; I will always wonder if I could have avoided cancer and the subsequent surgery if I had listened to my wife and followed my own recommendations that I have been giving my patients for the past 25 years.
So, my recommendations for reducing your risk of colorectal cancer are these:
1 Maintain a healthy body weight.
2 Participate in regular exercise.
3 Limit the amount of red meats, processed meats and alcohol.
5 Most importantly, GET SCREENED.
Together, with the use of colonoscopy, we can give colorectal cancer a kick in the butt!
Dr. Keith J. Thomas, FACS, is a board-certified General Surgeon at Blue Mountain Surgery in John Day.