Forget embarrassment and learn colon cancer facts

By an act of Congress, March is National Colon Cancer Awareness Month and it is a reminder to us all to be proactive in saving the life of a loved one by encouraging colorectal cancer screening.

Colon cancer is the second most common cause of death from cancer and is nearly 90 percent preventable. We are seeing a marked decline in the death rate from colon cancer in Central Virginia due to early detection and treatment.

However, despite these efforts, data from the Center for Disease Control and Prevention show that only 50 percent of Virginians have been screened by any method, which range from getting a stool test for the detection of blood to a colonoscopy.

Some common reasons cited for not being screened are being “too busy,” “embarrassment,” “inconvenience” or “my primary health care provider did not recommend it.”

I think most would agree these are trivial reasons, given the alternative risk.

There have been many advances in our understanding of this cancer and improvements in the ease of patient screening exams.

Here are some facts and current recommendations:

Who should be screened?

Men and women can equally develop colon cancer and should start having screening at the age of 50 to prevent benign polyps from becoming cancers by the age of 60 to 70.

Preferred method?

Colonoscopy is the gold standard of screening because it is a visual inspection of the entire colon and is therapeutic in that polyps can be removed during the same exam.

It is performed as an outpatient in the hospital setting or in ambulatory endoscopy units.

These endoscopy centers and staffs strive to make the exams convenient in terms of patient comfort and privacy. Recent advances have made the cleansing preparation less onerous, with lesser volumes to drink.

Comfort during the exam also has improved with the use of medications that allow sedation and pain prevention without the risks of general anesthesia.

Although colonoscopy is the preferred method of screening, any method is better than none.

A stool test for the detection of blood (stool hemocult) on a yearly basis, barium enema or flexible sigmoidoscopy (an exam of the lower fourth of the colon) are alternatives.

Who is at higher risk?

Individuals with a family history of colon cancer, polyps, or familial syndromes in their parents or siblings are at higher risk, as are individuals with a personal history of ulcerative colitis or crohns.

African-Americans are diagnosed with colon cancer at a younger age than Caucasians and have a decreased survival rate. Screening in African-Americans should begin at age 45, rather than 50, and colonoscopy is the preferred method.

What are symptoms?

Colon cancers progress from polyps without symptoms until they are advanced and cause symptoms of change in bowel habit, bloody bowel movements, abdominal pain, weight loss or anemia (a drop in blood count).

The evaluation of any symptoms can result in the early detection of cancer that can be cured in large percentage of people with surgical removal. Surgeons at Martha Jefferson Hospital have been using an advanced technique with laparoscopic removal of the involved segment of colon.

This has resulted in faster recuperation with less postoperative pain and shorter hospital stays.

In summary, please don’t be “embarrassed to death” and instead, seek advice and information from your primary care physicians and health care providers regarding colon cancer prevention.

You also can find information online at American Cancer Society (www.cancer.org), American College of Gastroenterology (www.acg.gi.org) or Martha Jefferson Hospital Digestive Care Center (www.marthajefferson.org)