What is colon cancer?
Colon is another name for the large intestine. The rectum is its terminal part. Colon cancer starts in normal tissue that turns into small growths called polyps, which can then turn into cancer. Colon cancer usually takes 10-15 years to develop.
What are the symptoms of colon cancer?
Colon cancer usually has no symptoms. (Your doctor may say it's asymptomatic.) That's why we recommend that everyone over 45 get screened. Some people do experience symptoms such as bloody stools, abdominal or back pain, weight loss, anemia, fatigue, and changes in bowel habits.
Am I at fair or high risk for colon cancer?
Getting the answer may require some awkward conversations with your family at the dinner table. Ask your parents if they have a history of colorectal cancer or if they had large polyps removed during a colonoscopy. Ask your brothers and sisters about their experiences. If your family has had colon cancer, you may need to start getting screened before age 45. If you have a history of inflammatory bowel disease, such as ulcerative colitis or Crohn's disease, you may need more frequent screenings because your risk may be higher.
What screening options are available?
A test called a colonoscopy is the gold standard. The doctor uses a long, flexible tube with a camera on the end to look at your large intestine. If they see any polyps, they can remove them before they turn into cancer. If your first colonoscopy results are normal, it may take 5-10 years before you need another colonoscopy.
Another option is a sigmoidoscopy, but it only allows the doctor to see part of the colon. Since the preparation is the same - drink laxatives the day before and take sedatives the day of - I recommend a complete colonoscopy.
We occasionally use CT scan colonoscopies, but this is usually limited by insurance coverage. The preparation is the same, but the test is not invasive. There are also test kits that can check stool samples for abnormal DNA or blood. If the result is positive, you will need to have a follow-up colonoscopy every 3 years.
How bad is a colonoscopy?
In the United States, most people receive some form of sedation before having a colonoscopy. This means you will fall asleep. This is a painless process. The day before your colonoscopy, you will need to fast and drink laxatives to clear stool from your colon. Today, there are a variety of laxative options, including better-tasting and smaller solutions than in years past. There are even pill-based options. Most insurances fully cover screening tests.
How to prevent colon cancer?
Sift, sift, sift! The goal is to detect high-risk lesions before they become more severe. When we catch colon cancer in its early stages, it is more likely to be cured, and treatment is less involved, making recovery easier.
Regarding lifestyle changes, research shows that eating red and processed meat increases the risk of colon cancer. Maintaining a healthy weight and exercising regularly can help. Avoid smoking and drink alcohol in moderation - one drink a day for women and two drinks a day for men. Arm yourself with the information and find out your family history to decide if you should be screened before age 45.
What I want to say is that a colonoscopy is an inconvenient day, but it can be reassuring to many people. If you don’t make time for your health now, you may have to make time for your illness later. Colon cancer should be preventable, treatable and beatable. A colonoscopy is the best way to ensure your gut is healthy.