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Colorectal cancer screenings early on might save your life

As a doctor, it’s hard to tell someone they have cancer. But it’s not the worst part of my job. The real tragedy is telling someone they have cancer and that it was completely preventable.

That’s why colorectal cancer is so hard for me to accept. When detected early, it’s one of the most curable cancers out there, yet it’s still the third-leading cancer killer in the United States.

Most people are embarrassed to talk about colorectal cancer, even with their doctors. My patients rarely bring it up, so I’m sparing you the awkwardness by putting out the info here.

QUESTION: What is colorectal cancer?

ANSWER: Colorectal cancer forms in the tissue of the colon or rectum. It affects men and women equally. It develops when abnormal cells in the colon or rectum grow into polyps, which eventually turn into cancer. It usually takes about 10 to 15 years for polyps to turn into cancer, and there are often no visible symptoms until the disease is in its late stages. Getting screened is the only way to help curb this deadly cancer trend.

Q: Why should I get screened?

A: Colorectal cancer is one of the slowest-progressing cancers. Since it takes so long to develop, polyps can be easily detected and removed with a colonoscopy. And even if the polyp has already turned into cancer, it’s much easier to treat in its early stages.

Q: How do I get tested?

A: There are three screening methods for colorectal cancer. Talk to your doctor about how often you should be tested and the right screening method for you:

» A highly sensitive fecal occult blood test checks for blood in the stool.

» During a flexible sigmoidoscopy, a doctor inserts a thin, lighted tube into the rectum to check for polyps in the rectum and lower colon.

» A colonoscopy is similar to a sigmoidoscopy except a longer tube checks the entire colon. Most polyps are removed during the process.

Q: How often should I get tested?

A: Based on the national guidelines, I urge most of my patients to begin routine colorectal cancer screenings starting at age 50 (or age 45 for African-Americans). But those with a family history or risk factors for the disease should get tested earlier or more often. Inflammatory bowel disease and disorders that cause frequent polyp growth are major risk factors.

The blood test is usually performed annually. Sigmoidoscopies are usually done every five years. Colonoscopies should be performed every 10 years, but doctors might recommend more frequent procedures if they discover abnormalities.

Q: Does it hurt?

A: No one looks forward to a colorectal cancer screening, but I assure my patients the test is simple and painless. During a colonoscopy, you might be given a sedative to relax you, and the procedure takes only about 30 minutes. Most people are back to work the next day. The most unpleasant part is preparing for the colonoscopy, which involves cleaning out your bowels. Even this process has become much easier over the years.

Q: What else can I do?

A: Colonoscopies and the other screenings are the best weapon against colorectal cancer. But you can help lower your risk of developing the disease (and many diseases) by eating a healthful diet and being physically active, and several studies have shown that excessive alcohol use and obesity can increase your risk.

Q. Why don’t people get tested?

A: I’ve heard every excuse under the sun from my patients to avoid colonoscopies. Some people are too busy, don’t like the preparation involved or are afraid it will hurt. Many people are shy and uncomfortable exposing their bottoms and thinking about bowel movements. But this could be a serious mistake, with a nearly 100 percent success rate of preventing early stages of colorectal cancer with colonoscopies.

Discussing colorectal cancer isn’t fun, and it might not be proper dinner conversation, but silence can kill you.

Dr. Larry Hsu is a board-certified internist. He has been a medical director for HMSA since 2002.


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