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 45. 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.

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."

High-Risk Individuals: How Often Should You Get Screened for a Colonoscopy?

Colonoscopy is the gold standard for detecting and preventing colorectal cancer, and while this screening tool is important for everyone, it is especially critical for individuals who are at high risk for the disease. Factors such as family history, personal history of colon polyps or cancer, and certain genetic syndromes can significantly increase a person's likelihood of developing colorectal cancer. In this blog post, we'll explore the guidelines for colonoscopy screening in high-risk individuals and discuss why regular screening is so important for this population.

Who is Considered High-Risk for Colorectal Cancer?

Several factors can increase a person's risk of developing colorectal cancer, including:

1. Family history: Having a first-degree relative (parent, sibling, or child) with colorectal cancer or advanced adenomas (precancerous polyps) increases your risk. The risk is even higher if the relative was diagnosed before age 50 or if multiple family members are affected.

2. Personal history: If you have a history of colorectal cancer or advanced adenomas, you are at increased risk for developing the disease again in the future.

3. Inflammatory bowel disease (IBD): People with IBD, such as ulcerative colitis or Crohn's disease, have a higher risk of colorectal cancer, especially if the disease has been present for many years or affects a large portion of the colon.

4. Genetic syndromes: Certain inherited genetic syndromes, such as Lynch syndrome (hereditary non-polyposis colorectal cancer) or familial adenomatous polyposis (FAP), greatly increase the risk of colorectal cancer.

   1. Race and ethnicity: African Americans have the highest rates of colorectal cancer incidence and mortality in the United States, and may benefit from earlier and more frequent screening.

   If you have any of these risk factors, it's important to discuss your individual screening needs with your healthcare provider.

   Colonoscopy Screening Guidelines for High-Risk Individuals

   The American Cancer Society and other professional organizations provide specific guidelines for colonoscopy screening in high-risk individuals:

   1. Family history of colorectal cancer or advanced adenomas:

      • If you have a first-degree relative diagnosed with colorectal cancer or advanced adenomas before age 50, or two first-degree relatives diagnosed at any age, you should begin screening at age 40 or 10 years before the youngest relative's diagnosis, whichever is earlier. Repeat screening every 5 years.

      • If you have a first-degree relative diagnosed with colorectal cancer or advanced adenomas after age 50, begin screening at age 40. Repeat screening every 10 years.

   2. Personal history of colorectal cancer or advanced adenomas:

      • If you have a history of colorectal cancer, you should have a colonoscopy within 1 year of your surgery, then repeat screening every 3-5 years based on your individual risk factors.

      • If you have a history of advanced adenomas, you should have a repeat colonoscopy within 3 years of your initial diagnosis, then every 5 years if no new adenomas are found.

   3. Inflammatory bowel disease (IBD):

      • If you have had IBD for 8-10 years, you should begin screening colonoscopy and repeat every 1-2 years.

      • If you have had IBD with extensive colitis for longer than 10 years, you may need to repeat screening every 1-2 years indefinitely.

   4. Genetic syndromes:

      • If you have Lynch syndrome, you should begin screening colonoscopy at age 20-25 or 2-5 years before the earliest diagnosis in your family, whichever is earlier. Repeat screening every 1-2 years.

      • If you have FAP, you should begin screening sigmoidoscopy at age 10-12 and continue annually until polyps are found, then proceed to colonoscopy. Surgery to remove the colon is typically recommended once polyps are detected.

   It's important to note that these are general guidelines, and your individual screening plan may vary based on your specific risk factors and personal history. Your healthcare provider can help you determine the most appropriate screening schedule for your needs.

   The Importance of Regular Colonoscopy Screening for High-Risk Individuals

   Regular colonoscopy screening is critical for high-risk individuals because it allows for the early detection and removal of precancerous polyps before they have a chance to develop into cancer. Studies have shown that colonoscopy can reduce the incidence of colorectal cancer by up to 80% in high-risk populations.

   In addition, if colorectal cancer is detected early through regular screening, it is highly treatable, with a 5-year survival rate of over 90%. However, if cancer is not detected until it has spread to other parts of the body, the 5-year survival rate drops to less than 15%.

   DON'T DELAY YOUR COLONOSCOPY SCREENING IF YOU ARE AT HIGH RISK

   If you have a family history of colorectal cancer, a personal history of polyps or cancer, or other risk factors that place you at increased risk for the disease, it's essential to prioritize regular colonoscopy screening. While the preparation and procedure may be uncomfortable, the benefits of early detection and prevention far outweigh any temporary discomfort.

   Contact me today to schedule a consultation and discuss your individual risk factors and screening needs. As a gastroenterologist with expertise in colorectal cancer prevention, I am committed to providing the highest quality care and support to help you stay healthy and reduce your risk of this potentially deadly disease.

   Remember, when it comes to colorectal cancer, an ounce of prevention is worth a pound of cure. By staying proactive about your screening needs and working closely with your healthcare team, you can take control of your digestive health and enjoy a long, healthy life.