The best way to screen for colorectal cancer is with a colonoscopy. Howard Regional Health System's Dr. John Salter, a medical oncologist and hematologist, just can't say it any plainer than that.
March is Colon Cancer Awareness Month, and it brings to mind a body part that a lot of people don't like to talk about.
"People will occasionally pass blood in their stool – and I'm not talking about going to the bathroom and wiping and finding some blood on the toilet tissue, which is usually minor bleeding from hemorrhoids or diverticulitis, but I'm talking about where the water in the bowl turns red with all the blood – for weeks or longer before seeking medical attention because they're so embarrassed about talking about their bowel movements," said Salter. "The colon is dirty. It excretes waste. There's a lot of negative connotation to it."
"What upsets me is colon cancer's very treatable," Salter said. "It's preventable if caught early."
Someone who dreads talking to a doctor about bowel movements, the colon and rectum and fear having a colonoscopy should consider the alternative: Polyps can become cancerous, possibly leading to surgery, chemotherapy, radiation and excreting waste through an ostomy bag.
"It's terrible to think that a patient will be forced to use an ostomy for the rest of his or her life when this outcome is potentially preventable for most patients," Salter said.
Because a person is given general sedation, it's not painful to undergo a colonoscopy.
During the colonoscopy, a gastroenterologist or surgeon (depending on the patient's choice) will remove any polyps and perform any needed biopsies.
"The great thing about a colonoscopy is we can find anything and remove it right there and then," Salter said. "That's why having a colonoscopy is so important. If a polyp is precancerous, we can remove it before it becomes cancer."
Left undetected and untreated, colon cancer can spread to other organs, increasing a person's chance of dying from the disease.
Some colon cancers are genetic, just like with breast cancer.
According to the American Cancer Society, "Genetic tests can help determine if members of certain families have inherited a high risk for developing colorectal cancer due to syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (HNPCC). Without genetic testing, all members of a family known to have an inherited form of colorectal cancer should start screening at an early age and get screened frequently. If genetic testing is done for a known mutation within a family, those members who are found not to have the mutated gene may be able to be screened at the same age and frequency as people at average risk.
"When looking at whether testing might be appropriate, a genetic counselor will try to get a detailed view of your family history. For example, doctors have found that many families with HNPCC tend to have certain characteristics:
A least three relatives have colorectal cancer.
One should be a first-degree relative (parent, sibling, or child) of the other two relatives.
At least two successive generations are involved.
At least one relative had cancer when that person was younger than age 50.
Tumors should be verified by pathologic examination."
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