Colonoscopy Concerns? Take a Friend With You
Hardly a week goes by that I don’t hear about someone losing the battle to colon cancer. And each and every time I ask how this could happen, when today we have the ability to diagnose colon cancer years before it will spread — and often in a precancerous polyp stage.
Why weren’t they screened for colon cancer? Didn’t they know the statistics? Except for lung cancer, which is usually caused by smoking and diagnosed in late stages because there are no reliable early screening tests, colon cancer is the leading cause of cancer death in men and second only to breast cancer as a cause of cancer death in women.
While it’s tempting to simply avoid getting checked for colon cancer — and surveys show that less than half of us are getting checked because of what many patients refer to as the big “hassle factor” — the feeling of relief after being tested and the assurance you have done all you can to prevent this disease is tremendous after the exam.
I am proud to say that I have had my colonoscopy so I can speak directly from experience. The hassle of being checked is well worth the peace of mind.
Screening Recommendations
Last week the U.S. Preventive Services Task Force updated its 2002 recommendations on colorectal cancer screening. The group is emphatic that standard colonoscopies should be performed every 10 years, beginning at age 50 and continuing until age 75. Additionally, the group recommends a stool sample test for hidden or microscopic blood be performed each year starting at age 50.
The task force recommends against routine screening for adults 76 to 85 years old, unless doctors feel that the patient’s personal history warrants it. They make this recommendation for our oldest seniors because current research shows that, in this age group, finding an early polyp or precancerous or even cancerous problem is unlikely to change the ultimate outcome.
It is thought that many older seniors will die sooner from heart disease or another problem long before any colon problem will be evident. However, if you are a healthy 80-year-old with no serious health problems, talk to your doctor about getting screened.
After age 85, the task force recommends that no screening for colon cancer (or other cancers for that matter) should be done, because research suggests that the risks outweigh the benefits in our very oldest seniors.
Virtual Colonoscopies
The U.S. Preventive Services Task Force, unlike the American Cancer Society, does not recommend virtual colonoscopies over the traditional approach. The group emphasizes that despite recent studies showing some possible benefit, more research is needed.
Yet many people are now talking about getting this newer X-ray test in hopes of: 1) avoiding the bowel preparation they have heard so much about (even though a completely empty bowel is still needed so the preparation/liquid drink can’t be avoided); and 2) avoiding the anesthesia required for the colonoscopy. (You do avoid the anesthesia, but the installation of air to keep the bowel wall open during the exam can be uncomfortable.)
And to complicate things further, if your doctor finds a small polyp or abnormality on the virtual X-ray test, you will need to take the bowel preparation all over again and return for the standard colonoscopy. Only during the standard colonoscopy can your doctor take a biopsy of a suspicious area or remove a polyp.
So far, most experts say they believe there is nothing better than the full, standard colonoscopy done by a doctor with lots of experience. And the good news is that most GI doctors now have tons of experience doing colonoscopies, so not finding the right doctor is rarely a good excuse.
Far fewer doctors and facilities today have the experience it may take to get the best results with virtual colonoscopy. So stay tuned for more doctor research and experience!
Getting Screened
So what do I recommend for all adults?
Starting at age 40 everyone should have a regular rectal exam, which is a preliminary test for colon cancer. It’s simple. You roll over on your side and your doctor inserts a gloved finger in your anus. Or you can have the test done during your pelvic exam. It should be routinely performed as part of the bimanual exam; while the patient is in stirrups, the doctor inserts a finger in the rectum to check for masses and to get stool to check for hidden blood.
Starting at age 50 everyone should talk to their doctor about the following:
Colonoscopy: This an examination of the colon with a flexible, lighted tube. It should be performed every 10 years to help screen for colon cancer. If a polyp is found, the test will be repeated more often.
Stool Occult Blood Test: This test is designed to find hidden (occult) blood in the stool. You do it yourself at home using stool cards that you return to your doctor. Your doctor will give you the cards with instructions. The presence of blood can signal precancerous or cancerous polyps in the colon or intestinal bleeding from such causes as a stomach ulcer, internal hemorrhoids or severe colitis. All men and women ages 50 or older should do this test every year.
If you have a family history of polyps, colon cancer or severe colitis, you should talk to your doctor about colon cancer screening earlier and more often. For some, your doctor may suggest you begin with an annual stool check and periodic colonoscopy at age 40, or five years earlier than the age of disease onset for any family member.
Finally, consider asking a friend or family member to get a screening colonoscopy with you. I call it a form of “paying it forward.” By encouraging a friend or family member to be tested along with you, one more person will be assured they have done their part to prevent colon cancer.
I encouraged my best friend to have her colonoscopy along with me — and we laughed and empathized with each other as we drank the necessary liquid to prepare us for the procedure. My friend had a family history of colon cancer, yet she was afraid to be tested. She had tremendous peace of mind when she learned her exam was normal.
With today’s technologies, there is no reason anyone should be diagnosed with colon cancer.
Have you been tested for colon cancer? Consider encouraging your partner or friend to be tested, too.
Wishing you good health.
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January 2nd, 2009 at 4:01 pm
Was your Buddy present during your colonoscopy?
I have requested my wife be present during my colonoscopy but was refused, no grounds were given.My wife and I are both in the medical profession and felt this was simply a power play.
I think it would be an interesting experience for her to view the test as it was being viewed on the monitor.
I beleive Katie Copuric had one done which was televised on T.V. so whats the problem with having a spouse present?
Thanks.
January 5th, 2009 at 10:18 am
I asked my doctor if my wife could accompany me to observe my colonoscopy exam. He said no but gave no reason. I suspect it was a situation of :” my way or the highway attitude by the Dr.:
As health care professional’s both my wife and I were surprised at this attitude as we have always attended each others exams, intimate and otherwise without a problem.
Any suggeestions??
Norm
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Please talk about how to deal with acid reflex. I am 56, slim at 5′3″, 105 pounds. Iwalk daily, do yoga, meditate, help others in need, have a mostly vegan diet, take Stoneyfield yogurt and/or kefir daily, fish oil, vitamin D. My relux was subwhat under control by avoiding the obvious: little coffee, citrus, heavy spices, etc.
But, I found it was triggered in a more severe manner by the prep for the colonoscopy. (might that be really true? drinking the citrate magnesium? ) After the procedure, I found it hard to return to eating without a painful stomach and lots of reflux, and heartburn. (Dr. suggested stomach x-ray…want to avoid putting more unneccesary barium or substances in my body…had one two years ago, showed a slight lag time in swallowing…father had a sliding hatial hernia.) I was told to take prilosec OT for 14 days, which did allow me to eat normally, (even have two morning cups of coffee). The label says do NOT use again for four months. So, I am wondering if you could address this in one of your articles: acid reflux, what to eat as opposed to what NOT to eat, and what one might SAFELY take when heartburn or relux arises. There are SO many choices over the counter, it is hard to know what few things might work without harming the body. OR, what alternative diet or other things might work. Thank you for your efforts. I do pay attention to your words on the morning show and contained in this site. I find little in the way of literature available, and the Dr. has little time to answer these questions. On behalf of all women my age, we appreciate your efforts.
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