Colonoscopy

Stop running! STUBBORNNESS: the silent killer.

 
 

Hi friends!  

I want to bring something really important to your attention.  Everyone knows how stern I am with promoting the importance of the colonoscopy — especially if you’re over the age of 50.

The Washington Post has a great article titled, “5 reasons to stop avoiding that colonoscopy,” and it really should be read by everyone.

Colon cancer is the second-deadliest type of cancer!  Don’t let your stubbornness keep you from asking me or your primary doctor how to takes steps toward this life-saving procedure.  I’m here to help you!  All it takes is an understanding of the 5 concerns below, and you’ll feel much better.  I promise.

DON’T LET THESE FEARS SCARE YOU.   Or kill you.

I got you.

-- Dr. Dale


http://www.washingtonpost.com/national/health-science/5-reasons-to-stop-avoiding-that-colonoscopy/2013/12/20/a9408568-27a8-11e3-b3e9-d97fb087acd6_story.html

5 reasons to stop avoiding that colonoscopy

By Consumer Reports, Published: December 23

Colonoscopy is highly effective at preventing colorectal cancer, the second-deadliest type of cancer, because it allows a doctor to detect precancerous growths in the colon and remove them on the spot.

Yet only about half of Americans age 50 and older get any kind of screening for colorectal cancer, colonoscopy or otherwise, according to Otis Brawley, chief medical officer of the American Cancer Society. He estimates that an additional 15,000 to 20,000 lives could be saved each year if that rate rose to 90 or 95 percent.

Here are five common barriers to this important test and how to overcome them.

The concern: You’ll get bad news.

The fix: Colorectal cancer grows slowly, typically taking 10 to 15 years to develop. Getting screened at recommended intervals increases the likelihood of catching it early, when you have the best chance of being successfully treated. A study of 1,071 colon-cancer patients published in June in JAMA Surgery found that those whose disease was detected by a screening colonoscopy tended to have it diagnosed earlier and to have longer survival rates than people whose tumors were detected in other ways.

The concern: Preparation for the test is a nightmare.

The fix: You’re limited to a clear-liquid diet for about 24 hours before the procedure, and you may also have to drink up to a gallon of a laxative solution. To improve the solution’s taste, chill it first or ask your doctor whether it’s okay to add lemon, lime, ginger or a flavor enhancer such as Crystal Light. Other steps that might help include eating lighter than usual a day or two before your prep, using a straw to drink the solution, staying near a bathroom and using flushable wipes and diaper ointment to prevent irritation.

The concern: Complications.

The fix: It’s true that both colonoscopy and the less invasive flexible sigmoidoscopy (in which only the lower colon is checked) pose a small risk of bowel perforation or infection. And the sedating drugs under which colonoscopy is typically performed — such as propofol (Diprivan and generic) or midazolam (Versed and generic) — have rare but potentially serious risks, such as difficulty breathing. But the benefits of the procedure far outweigh the dangers for people age 50 to 75, says Carla H. Ginsburg, a gastroenterologist in Newton, Mass.

If even the small risk of complications is intolerable, you can do an annual stool test instead, though you’ll need to follow up with a colonoscopy if the result is positive.

The concern: You can’t afford it.

The fix: Under the health-care law passed in 2010, Medicare and private insurers are required to cover most types of colorectal-cancer screening, including colonoscopy. (They might not fully cover removal of polyps during the procedure.) The requirement is already in effect for Medicare; group and individual plans must comply by 2014. But you’ll probably be billed separately for the procedure and the anesthesia, so find out ahead of time whether the anesthesiologist is in your insurance plan’s network.

The concern: You feel generally squeamish about the whole thing.

The fix: Meet with the gastroenterologist who will do the procedure ahead of time to talk about the test. (For example, you can ask who else will be in the room.) Also keep in mind that the average procedure takes only 10 to 15 minutes, and you won’t be cognizant enough to feel bashful. By the time you’re lucid, it will all be over.

Is Screening Colonoscopy Worth It?

Hey guys, 

As you prepare for fall... the jackets, scarves and pumpkin spice lattes are sure to keep you comfortable as Los Angeles attempts to drop in temperature.  As the new season welcomes leaves to your lawn, it's also a great opportunity to turn over a new leaf yourself, and end the year in tip-top shape.

Did you know?  Colon Cancer is the second leading cause of cancer death in America, responsible for 58,000 deaths per year.  Did you know that a colonoscopy screening can prevent over 90% of these?

Everybody age 50 to 75 should be screened for colorectal cancer.  Patients at high risk—notably those with a family history, a known genetic risk, inflammatory bowel disease or certain other disorders—should start earlier.  

What are you afraid of?  A lot of people are unaware of their need to be screened with a colonoscopy. And even worse, many know they need it, though they are afraid of the procedure.  

Please, don’t be scared.  And please don't be stubborn. Do yourself and your family a favor and strongly consider giving me a call so we can take care of you.  And if you're under the recommended age of 50, please share this and encourage a loved one.  

Let's check-off the "I'm healthy!" box as you close 2014 safe and sound.  

It's a proven lifesaver.  And I'll be by your side the entire time.

Live well, 

-- Dr. Dale

 

The Elderly & Colon Cancer

This is interesting.  Please be share with your elderly friends and family. -- Dr. Dale

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Older Patients Fare Less Well After Colorectal Cancer Surgery

By David Douglas

April 15, 2014

NEW YORK (Reuters Health) - Although there's been a reduction in US colorectal cancer operations as well as improved outcome in recent years, the elderly still don't do as well as younger patients, according to California-based researchers.

As Dr. Michael J. Stamos told Reuters Health by email, "Although we were pleased to observe an overall decrease in the number of cases performed as well as a steady decrease in mortality, the risk adjusted mortality and morbidity of the elderly group remains substantially higher than the younger cohort."

In an April 9th online paper in JAMA Surgery, Dr. Stamos and colleagues at the University of California, Irvine note that an estimated 50% of all cancers and 70% of all cancer deaths occur in the elderly.

"With the 'graying' of the US population," continued Dr. Stamos, "more elderly patients can be expected to seek care, including for colorectal cancer. We therefore aimed to examine the trends and outcomes of colorectal cancer resection in the elderly by comparing patients over 65 years with patients between 45 and 64 years old."

The investigators used the Nationwide Inpatient Sample for the years 2001 to 2010. Over half (63.3%) of the more than 1 million patients estimated to have had colorectal cancer resection were more than 64 years old and 22.6% were 80 years old or older.

Elective laparoscopies were much more frequent in patients under 65 compared to those age 80 and above (46.0% vs 14.1%).

Patients age 80 and older were also 1.7 times more likely to undergo urgent admission than those younger than 65 years. Moreover, the older patients were more likely to stay at least 2.5 days and have hospital charges that were almost $9500 higher.

Over the study period, mortality decreased by a mean of 6.6%, with the most considerable decrease observed in the population 85 years old and older (9.1%).

Nevertheless, there was higher risk-adjusted in-hospital mortality with advancing age. The odds ratio ranged from 1.32 in patients aged 65 to 69 to 4.72 in those age 85 and older. Corresponding ratios for risk-adjusted morbidity were 1.25 and 1.96.

The researchers conclude that the data will help surgeons counsel patients and will "also reveal a demand for a reevaluation of current care patterns, reinforcing the need for future studies to account for the changing population landscape."

#Winning

THIS IS GOOD NEWS!!!!! -- Dr. Dale

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http://www.medscape.com/viewarticle/822296

Dramatic Decline in CRC in US Attributed to Colonoscopy

The latest statistics on colorectal cancer (CRC) in the United States, which go up to 2010, show that both incidence and mortality rates continue to fall.

Overall, deaths from CRC have been falling at around 3% per year over the last decade (2001 to 2010). Overall incidence rates have also been falling, by an average of 3.4% per year, but there is a marked variation by age. Incidence is decreasing in adults over 50 years of age, with a particularly sharp drop in the over-65s, attributed to colonoscopy, but it has increased slightly in younger adults under the age of 50. And blacks still have the highest burden of disease; they are 25% more likely to be diagnosed with colorectal cancer and 50% more likely to die from the disease than whites.

The findings, by Rebecca Siegel, MPH, and colleagues from the American Cancer Society, were published online March 17 in CA: A Cancer Journal for Clinicians.

The team analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the Centers for Disease Control and Prevention's National Program of Cancer Registries, as provided by the North American Association of Central Cancer Registries (NAACCR).

Dramatic Decline in the Over-65s

The researchers highlight the "dramatic decline" in CRC incidence seen in older adults (over 65s); it was falling at a rate of 3.6% from 2001 to 2008, but this decline accelerated in the last 2 years for which data are available, to 7.2% from 2008 to 2010.

This fall is probably related to the higher screening rates in this age group, Siegel told Medscape Medical News. Adults 65 and older have fewer barriers to screening related to cost because they are eligible for Medicare, which has covered colorectal cancer screening even for those at average disease risk since 2001.

In 2010, 64% of adults 65 and older reported being current for colorectal cancer screening versus 55% of adults 50 to 64, she noted. Although there are several different tests available for CRC screening, the "dramatic declines in incidence in recent years have been largely attributed to the uptick in colonoscopy because it is the only test for which use increased from 2000 to 2010; use of fecal immunochemical testing and sigmoidoscopy declined during that time period," she explained.

Colonoscopy offers a double whammy in that it can both prevent CRC by detecting and removing precancerous polyps and detect the cancer in its early stages, when there is a better chance of successful treatment.

Stool tests are very good for detecting cancer early, but much less able to lower incidence by detecting precancerous lesions, Siegel told Medscape Medical News.

Used to Be Top Cancer Killer

Back in the late 1940 and early 1950s, CRC was the most common cause of cancer death, the researchers note.

Now it has dropped to the third leading cause of cancer death (after lung cancer and prostate cancer in men and breast cancer in women).

This is in part due to historic changes in risk factors (such as decreased smoking, decreased red meat consumption, and increased use of aspirin), as well as the introduction and dissemination of early detection tests and improvements in treatment, the researchers write.

"This is great news," Siegel commented. "Colorectal cancer is 1 of only 2 cancers that we can actually prevent through screening, with cervical cancer being the other."

"Unfortunately, many adults — 23 million Americans — who should be screened for colorectal cancer have never been tested. It's important to get the word out about how life-saving these screening tests are," she said.

This point was highlighted in a press release from the American Cancer Society (ACS). The continuing drops in CRC incidence and mortality "show the lifesaving potential of colon cancer screening," commented Richard Wender, MD, chief cancer control officer at the organization.

The data in the study show that colonoscopy screening (in adults aged 50 to 75 years) increased from 19% in 2000 to 55% in 2010.

Dr. Wender highlighted an initiative from the National Colorectal Cancer Roundtable that aims to increase screening rates to 80% by 2018.

Disturbing Increase in Younger Adults

While the overall incidence of CRC has been falling over the last decade, the researchers note a distinct age divide — with a decrease of 3.9% per year among adults aged over 50 years, but an increase in incidence of 1.1% per year among adults under 50 years of age.

This increase in CRC among younger adults was confined to tumors of the distal colon (increasing by 1.3% per year) and the rectum (1.8% annually).

"Although the cause of this increase is unknown, the rise in obesity prevalence and the emergence of unfavorable dietary patterns have been implicated," they write.

A similar trend has been reported in Norway, the researchers note.

"We were actually among the first to publish this disturbing trend in 2009," Siegel commented. "Although the obesity epidemic is the obvious culprit, the rise is the strongest for rectal cancer and a link between obesity and rectal cancer has not been firmly established in women."

"It's important to note that ACS guidelines do recommend colorectal cancer screening beginning at age 40 for adults with first-degree relatives who were diagnosed with 1 or more polyps before age 60," she said.

 

[Follow up is important] even in young adults who are unlikely candidates for the disease.

 

"It is also important that clinicians are diligent about follow-up of colorectal cancer symptoms, even in young adults who are unlikely candidates for the disease," she added.

Higher Burden in Blacks

The review shows blacks continue to have the highest burden of disease.

The incidence of CRC is highest in blacks (approximately 25% higher than in whites), and there is an even greater disparity for CRC mortality rates, which are approximately 50% higher in blacks compared with whites (29.4 vs 19.2 per 100,000 population).

"A higher prevalence of risk factors and lower screening prevalence contributes to both the higher incidence and mortality in blacks," Siegel commented.

"In addition, blacks have lower survival than whites even for similar-stage disease. This is because blacks are less likely to receive standard-of-care treatment, including surgery, adjuvant chemotherapy, and radiation," she explained. Studies show that for similar-stage disease, equal treatment results in equal outcomes, she added.

In the study, the researchers trace back the history of this disparity. CRC mortality used to be lower in blacks compared with whites in the 1960s, and the racial crossover occurred around 1970 for women and 1980 for men. After that, rates diverged rapidly over the next 3 decades. During the 1980s and 1990s, steep declines had begun in whites, but the rates in blacks were still increasing (in men) or were stable (in women). This mortality gap appears to have leveled off in recent years, the researchers write. From 2006 to 2010, annual declines in mortality rates were similar among black and white men, and slightly larger among black than white women.

"The good news is that the gap in mortality rates between blacks and whites appears to have peaked in the mid-2000s and may be slowly growing smaller," Siegel commented.

A less scary colonoscopy?!

This is great research!!  Just had to share. -- Dr. Dale

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http://www.medscape.com/viewarticle/822198

Novel Stool DNA Test May Enhance Colon Cancer Screening

March 19, 2014

An investigational multi-target stool DNA test for screening colorectal cancer detects significantly more cancers than the currently available fecal immunochemical test (FIT), researchers report.

But it does so at the cost of more false-positive results.

"This new test is the most sensitive noninvasive test for detecting colorectal cancer," said lead study author Thomas F. Imperiale, professor of medicine at the Indiana University School of Medicine in Indianapolis.

"The advantages are that it could be done less frequently than annually. We are going to have to have computer simulation analyses tell us what an appropriate interval would be," he told Medscape Medical News in a telephone interview.

"The new test is very good at detecting curable-stage cancers. If there is a downside, it's that the specificity is not as good as FIT. That's the way it goes with diagnostic tests. The more sensitive they are, usually the less specific they are," he said.

The study was published online March 19 in the New England Journal of Medicine.

The test, known as Cologuard, is produced by Exact Sciences and was codeveloped by the Mayo Clinic. It consists of quantitative molecular assays for KRAS mutations, aberrant NDRG4 and BMP3 methylation, and β-actin, plus a hemoglobin immunoassay. The test is currently under review at the US Food and Drug Administration; the company is scheduled to appear before the Molecular and Clinical Genetics Panel of the Medical Advisory Committee on March 27.

Noninvasive Alternative to Colonoscopy

Despite widespread recommendations and the availability of several screening tests, a substantial proportion of the American population does not get screened. The noninvasive nature of this stool DNA test might make colorectal cancer screening more acceptable, Dr. Imperiale said.

He and his team evaluated 9989 asymptomatic people 50 to 84 years of age who were considered to be at average risk for colorectal cancer and who were scheduled to undergo a screening colonoscopy.

All participants provided a stool specimen before routine bowel preparation for colonoscopy.

On colonoscopy, colorectal cancer was identified in 65 participants — a prevalence of 0.7%. Of these, 60 had stage I to III cancers. In addition, advanced precancerous lesions were identified in 757 (7.6%) participants.

Stool DNA testing identified 60 of the 65 participants with cancer, for a sensitivity of 92.3%, including 56 of the 60 participants with stage I to III cancers, for a sensitivity of 93.3%.

DNA testing sensitivity did not vary significantly by cancer stage or location in the colon, Dr. Imperiale reported.

DNA testing also identified 321 of the 757 advanced precancerous lesions, 27 of the 39 (69.2%) participants with high-grade dysplasia, and 42 of the 99 (42.4%) participants with sessile serrated polyps 1 cm or larger.

The sensitivity of the DNA test increased as lesion size increased, and was higher for distal advanced precancerous lesions than for proximal lesions (54.5% vs 33.2%).

Age did not affect its sensitivity for detecting cancer.

For the 9167 participants who had colonoscopy findings other than colorectal cancer or advanced precancerous lesions, such as nonadvanced adenomas or negative results, the specificity of the DNA test was 86.6%.

For the 4457 participants with negative colonoscopy results, the specificity of the DNA test was 89.8%. In this subgroup, specificity was 94.0% for participants younger than 65 years and 87.1% for those 65 years and older.

For colorectal cancer, overall sensitivity was significantly better with DNA testing than with FIT (92.3% vs 73.8%; P = .002).

The sensitivity of DNA testing was also better than of FIT for advanced precancerous lesions (42.4% vs 23.8%; P < .001).

However, for people with nonadvanced or negative findings on colonoscopy, specificity was worse with DNA testing than with FIT (86.6% vs 96.4%; P < .001).

To detect 1 cancer, 154 people would need to be screened with colonoscopy, 166 with DNA testing, and 208 with FIT.

Number of False-Positives With Stool DNA Concerning

Results with this stool DNA test are "encouraging", said Douglas Robertson, MD, chief of gastroenterology at the White River Junction Veterans Affairs (VA) Medical Center in Vermont and associate professor of medicine at the Dartmouth Medical School in Hanover, New Hampshire.

He and his colleague, Jason A. Dominitz, MD, from the VA Puget Sound Health Care System and the University of Seattle, coauthored an accompanying editorial.

"The test is showing progress in terms of being able to detect cancer, but it remains to be seen how it will function in real-world clinical practice," Dr. Robertson told Medscape Medical News.

 

Dr. Douglas Robertson

"Ultimately, one of the dictums of colorectal cancer screening is that the best test is the one that gets done," he noted.

Another concern is the false-positive rate. The more frequently the test returns a false-positive result, the more colonoscopy exams will be required, he explained.

The interval with which this test would be applied in clinical practice is also not clear, Dr. Robertson said. "It probably can't be applied every year because the false-positive rate would be pretty high and you might end up doing colonoscopies on everybody over time anyway," he said.

"These are real-world practical issues that still need to be sorted out with stool DNA testing," he said. "It's exciting because the test clearly is functioning better than FIT, but how it will translate into clinical outcomes in practice we don't yet know."

Dr. Robertson said the results of this study could help to inform the US Preventive Services Task Force (USPSTF) as it re-evaluates recommendations for colorectal cancer screening.

"Right now, the USPSTF recommends 3 tests: colonoscopy, sigmoidoscopy, and stool testing with FIT. The last time they looked at the data, they didn't think there was enough support for fecal DNA testing so they did not endorse or recommend its use. This study might change that. Before, fecal DNA technology picked up about 50% of the cancers; now, in a similar study years later and with a newer version of the test, fecal DNA is detecting more than 90% of cancers," he explained.

"It is definitely working better than it used to; there's no question about that, Dr. Robertson said. "Whether the USPSTF will recommend it as an option remains to be seen."

The study was supported by Exact Sciences Inc. Dr. Imperiale has disclosed no relevant financial relationships. Dr. Robertson reports being on the advisory board of Pill Cam Colon (Given Imaging).

I love this so much #ColonoscopyFearsBEGONE

This is just perfect...and something I can't stop emphasizing.  Don't let your fear in the colonoscopy discourage you from being tested and saving your life.   Don't be sacred; let me help you.  I even have a gift for you once you're done! :) -- Dr. Dale

http://www.greatfallstribune.com/article/20140218/LIFESTYLE20/302180006/

Written by Minding Your Meds Randy L. Kuiper

March is National Colorectal Cancer Awareness Month. Colorectal cancer is one of the leading causes of cancer deaths in the United States. Approximately 140,000 Americans are diagnosed with colorectal cancer every year, with more than 50,000 people dying from it. Up to 60 percent of these deaths could be prevented with proper screening.

The risk of getting colorectal cancer increases with age, with more than 90 percent of cases occurring in people ages 50 or older. For this reason, routine initial screening is recommended for most people after they reach the age of 50. For the majority of people, a follow-up screening is recommended every 10 years until age 75.

These screening tests literally can save your life. Screening is essential because patients with early colorectal cancer often do not show any notable symptoms.

The screening procedure used most often is a colonoscopy. Colonoscopies can detect precancerous polyps that can be removed easily during the procedure before they turn into cancer. In addition, colonoscopy procedures done as recommended also can potentially detect colorectal cancer in an earlier stage before it spreads to other areas of the body. Effective treatment at an early stage often can be curative.

Unfortunately, too many people are still not getting colorectal cancer screening. Recent data indicates that almost one-third of adults aged 50 to 75 years have never been screened.

Lack of health insurance and not having a regular health care provider were major reasons most people cited for not getting screened. However, I believe many people use their unpleasant perceptions of undergoing the colon cleansing process as an excuse for not getting screened. This is unfortunate as both the preparation process and the actual colonoscopy procedure are actually tolerated very well by patients.

The accuracy of a colonoscopy relies heavily on the proper evacuation of the bowel of fecal material. The preparation usually begins the day before the procedure and involves a liquid diet along with taking various laxatives and bowel evacuation solutions until the bowel is fully cleansed. There are multiple types of regimens used to effectively clean out the bowel. Many involve drinking a large bottle of polyethylene glycol (PEG) with electrolytes (e.g. GoLytely, Nulytely, etc).

Colonoscopy providers will provide you with detailed instructions outlining exactly what you are to do and when you are to do it.

Many people have heard that some of the PEG products taste horrible, mainly related to a salty taste and rotten egg smell. There are measures that can dramatically reduce these complaints.

The actual colonoscopy procedure usually lasts about 30 minutes. Patients typically receive sedative and pain medications. Pain related to the procedure is usually minimal. Patients may experience a minor gas discomfort related to the air that is introduced into the colon as part of the procedure to allow for better visualization.

Although many patients say they were awake during the procedure, most will not be able to recall the actual events of the colonoscopy because of sedation.

The Centers for Disease Control and Prevention’s Colorectal Cancer Control Program has set a goal of increasing the screening rate from 65 percent to 80 percent in 2014.

Make a serious effort to urge your family members and friends who are older than 50 and who have not been screened as recommended to get it done. You may just be saving their lives.

Randy L. Kuiper has been a registered pharmacist in Montana since 1981. He is the clinical coordinator for Benefis Hospitals Pharmacy. He can be contacted by email at randykuiper@benefis.org.

I love this story. G E T...C H E C K E D!

I could go on and on about all the different times unexpected things like this have happened in my office. Don't be scared, friends.  I got you.

-- Dr. Dale l

 

http://www.miamiherald.com/2014/02/03/3910400/flush-away-those-colonoscopy-fears.html

The Miami Herald

Flush away those colonoscopy fears

By Lisa Gutierrez The Kansas City Star

<br />
Colon cancer survivor Danielle Ripley-Burgess, of Lee's Summit, Mo., supports an organization that takes an educational traveling exhibit about the disease. It features a 40-foot-long model of a colon that young and old can crawl through, as seen Dec. 14, 2013, at New Summit Church in Lee's Summit. </p>
<p>
FRED BLOCHER / MCT
Colon cancer survivor Danielle Ripley-Burgess, of Lee's Summit, Mo., supports an organization that takes an educational traveling exhibit about the disease. It features a 40-foot-long model of a colon that young and old can crawl through, as seen Dec. 14, 2013, at New Summit Church in Lee's Summit.
She couldn’t tell her mom that something was wrong because it was way too embarrassing.She didn’t even like to walk down the toilet paper aisle at the grocery store.So when Danielle Ripley-Burgess, 30, of Lee’s Summit, Mo., was in junior high school and began finding blood in the toilet after going to the bathroom, “I didn’t say anything about it for a long, long time. I was mortified.”

When she finally did, she and her mom, at first, did their own research on the Internet and figured that because Danielle was so young, the problem had to be something benign, like hemorrhoids.

Wrong.

Just a few weeks after her 17th birthday in 2001 she was diagnosed with stage 3 colon cancer, going from prom plans to hospital stays in the blink of an eye.

Today, at 30, she’s a wife and mother running a marketing firm – Semicolon Communications, wink, wink – and doing what she can to get people talking about what she once feared.

She’s not above using props, either. Big ones. In early December she arranged to have a 40-foot crawl-through model of a colon trucked into town.

The message? Being afraid to talk about what happens in the bathroom could kill you.

Colorectal cancer is the second-most deadly cancer, but the majority of cases are preventable with the use of a common screening procedure called a colonoscopy.

Precancerous growths found during a colonoscopy – recommended every 10 years beginning at 50 – can be removed on the spot. That’s important because those growths, or polyps, can stick around in your colon for years and become full-blown cancer.

“This is the only situation in all of medicine where the test used to screen for a cancer is also the method for preventing that same cancer,” said Larry Geier, a genetics oncologist at the University of Kansas Cancer Center and one of Ripley-Burgess’ doctors.

“In all other situations – mammogram, Pap smear – the screening test may be effective for early detection but provides no ability to prevent the cancer itself.”

And yet, people fear the colonoscopy. Statistics show that only half of Americans older than 50 have ever had one, or any other type of colorectal cancer screening process.

The ick factor is high. Here are the excuses patients give Geier.

• “I don’t like the idea of a doctor sticking a scope up my rectum. I am too modest for that.”

• “I hear the preparation for the test is very difficult, and I don’t want to do that.”

• “I am not having any symptoms, therefore I don’t have cancer.”

• “I just don’t have time for that.”

“I have heard each of these reasons too many times over the years, and none of them are worth taking the chance, or what I consider to be playing ‘Russian roulette' with your colon,” Geier said.

Only 10 percent of all people diagnosed with the disease are younger than 50.

But while cases of colon cancer among adults 50 and older are falling, rates among younger adults like Ripley-Burgess are rising, according to the Colon Cancer Alliance.

“There is definitely a trend toward younger age at the time of diagnosis of colon cancer over the last two decades,” Geier said. “Changes in diet, better screening and more awareness of early symptoms may each have a role but still don’t provide adequate explanation.”

What happened to Ripley-Burgess was rare. She was diagnosed with colon cancer at 17 and again at 25, when all but a foot of her large intestine had to be removed.

“I have to be kind of careful with what I eat, when I eat.” No big chili dogs for lunch, for example. “It’s normal for me now.”

It was her bad luck to be, Geier put it, “genetically programmed” to develop colon cancer at such a young age. She has a genetic trait known as Lynch syndrome, which affects about 1 in every 4 to 5 Americans and is largely underdiagnosed. 

Colon Cancer Warning Signs 

• Blood in the stool (frequently not visible to the naked eye), a change in stool habits, a gradual decrease in the size of the stool, increasing abdominal pain, unexplained weight loss

• Those symptoms are much more likely to occur when the tumor is in the rectum or the very last part of the colon. Cancers that are higher up in the colon frequently don’t signal their presence with these symptoms until the tumor is quite large. That’s why screening for the cancer when there are no symptoms is critical.

• Anyone with one or more of these symptoms should tell their doctor.

 

Source: Larry Geier, genetics oncologist at the University of Kansas Cancer Center.

Read more here: http://www.miamiherald.com/2014/02/03/v-print/3910400/flush-away-those-colonoscopy-fears.html#storylink=cpy

 

Director's Briefing: Testing to Prevent Colon Cancer

In the latest Director’s Briefing video, CDC Director Dr. Tom Frieden talks about the importance of testing to prevent colon cancer. About 23 million adults haven’t gotten the life-saving tests they need to find colon cancer early. Testing can find precancerous growths and saves lives. People are encouraged to talk with their doc about testing options. The best test is the test that gets done.

Alternatives to colonoscopy.

So, guess what?  Colorectal cancer is the second-leading cause of cancer deaths in the U.S. for men and women combined, the illness is highly curable when detected early. BUT, there are alternatives to the often uncomfortable colonoscopy.

Virtual (CT Scan)

  • *no sedation
  • *still have to drink the "prep drink"
  • *misses polups less than a centimeter, which means the results could lead to a false sense of security.

Blood Stool Test

  • *have your doctor test your stool for blood.
  • *very good to DETECT colon cancer hopefully at an early stage, but does NOT prevent colon cancer.

I got you.

-- Dr. Dale

l

Reminder: Aspirin + Everyday = Lower Risk for Colon Cancer

Q U I C KN O T E

I just wanted to remind everyone that taking a baby aspirin, or 81mg per day, helps lower the risk of colon cancer by 30%.

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Cancer.org

Screening still crucial

One proven method for preventing colon cancer is to get screened for the disease. "It is still very important to get screened for colorectal cancer so that colorectal polyps can be detected and removed before they ever turn into cancer," says Eric Jacobs, PhD, strategic director of epidemiology at the American Cancer Society.

The American Cancer Society recommends regular colon cancer screening for men and women starting at age 50. People who are at a higher-than-average risk of the disease (such as those with a family history of colon cancer) may need to begin getting tested earlier, or have more frequent tests.

That goes even for people who take aspirin regularly for other reasons, Jacobs notes. "Aspirin use will not prevent most cases of colorectal cancer."