True story:
On my way into church yesterday I ran into a woman I've known for over thirty years. I greeted her, but she didn't respond with her usual sunny smile, so I knew something was wrong.
"I have to have part of my colon removed," she said. Then she proceeded to tell me her story.
She'd recently undergone a routine screening colonoscopy. Her last one, ten years earlier, had been clear. But, as a nurse, she was aware that she was due to have another one this year. That's what the experts recommend for low risk patients like her...of a certain age with no symptoms, and no personal or family history of colon polyps or cancer. Well, maybe she had seen one spot of bright red blood a while back, but she blamed that on a hemorrhoid...like we all do.
Nevertheless, she signed on for her colonoscopy. To her surprise and dismay, her doctor found eight polyps this time around. Seven of them were easily removed during the procedure, and all tested negative for cancer. But they had to leave one behind, a large, flat polyp deep in the proximal colon, near where the appendix is. These polyps are notoriously difficult to anticipate. They don't cause symptoms until after they spread. If they bleed, you don't see it. Patients are more likely to present with a profound anemia from an imperceptible leak of blood over a long, asymptomatic period of time, so they tend to present in a more advanced malignant stage. They definitely don't cause bright red rectal bleeding. Although that's what prompted my friend to proceed, it was a red herring in her case, so in a way, she lucked out...if a partial colon resection can be considered lucky. Her polyps were detected early because she followed the rules. Her prognosis is excellent. Undetected, these polyps can be killers.
"Once colon cancer becomes symptomatic,
nine times out of ten
it is too late."
~Kevin Richardson~
The message here is that colon cancer is preventable with early screening. These cancers grow slowly and seldom cause symptoms until they are fairly advanced. The goal is to detect and remove them before they become cancerous. But the guidelines for colon cancer screening are complicated:
Recommendations take into consideration your age, the presence or absence of symptoms (which can overlap with many other conditions), a family history of colon polyps or colon cancer, whether the polyp is benign, precancerous, or frankly malignant on biopsy, its size, the depth of penetration into the wall of the colon, and whether or not it has spread to nearby lymph nodes. All these factors affect risk, prognosis, and treatment. It's all pretty complicated, and as new technologies are developed, the guidelines change frequently.
The best advice I can offer is this:
Yes...talk to your doctor. Let him figure out when it's time for you to be screened and what kind of testing you should have.
Don't be embarrassed. Don't be shy. If you're afraid, call up a friend and go together. He/she is probably due for screening, too. Most of all...don't be stupid. The life you save may be your own.
For more information than you probably want or need, go to:
jan
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