Colorectal Cancer is the one people don't talk about so much.
The colon and rectum involve body parts we deal with behind a closed bathroom door.
That attitude might kill you.
Colorectal cancer is on my mind because I had a colonoscopy procedure yesterday. I am fine. Once again they found a polyp somewhere up there and removed it. It is gone and won't turn cancerous and it won't kill me. I am feeling great about it.
Colorectal cancer is the second leading cause of cancer deaths in Americans, behind lung cancer and just ahead of breast cancer. 150,000 Americans will be diagnosed with it this year. 50,000 Americans will die from it. Some people catch it early enough to get treated.
The good news is that death rates are dropping slowly. More people are being screened through colonoscopies which find and remove the cancerous or pre-cancerous polyps. Twice a year a physician looks at the moles on my back. I cannot see back there. If any look suspicious they can be removed. Once every five years a physician looks for polyps in my lower intestine. Apparently I am a polyp-maker.
People procrastinate on getting the screen. They would cost about $3,000 if paid for directly. Health insurance plans typically pay for it beginning at age 50 and then once every ten years. Medicare pays for it. If suspicious polyps are found the screening is more frequent. I am scheduled for every five years because I make polyps.
People procrastinate on the screening. It is a mildly unpleasant procedure in part of the body we don't talk about much. Let me de-mystify it.
1. Two days before the procedure avoid high fiber foods like granola and berries with seeds. No big deal.
2. The day before the procedure don't eat. You can drink coffee, clear protein drinks, and jello, but it is basically a day without food. It won't kill you.
3. Then, 12 hours before the procedure, take the prescription laxative pills they give you and drink lots of water. Then more water. Pretty soon you will be in the bathroom voiding everything left inside you.
4. Then, six hours before the procedure, you again do another dose of prescription laxative and water. You will be voiding essentially clear water.
5. Then you go to the Endoscopy center and people get you into an open-back gown, put in an IV probe, hook you up to a blood pressure and heart monitor machine, then tell you to lay on your side. They roll you into a procedure room, put some propofal sedative into the IV. They tell you to count down from 100. You will get to 97.
6. --------------
7. About 30 minutes later you wake up back in the room where you got into the gown. Your rear end does not feel raw or like anything at all happened back there. You drink some coffee and the doctor comes in to tell you whether they found anything interesting. You get dressed and someone drives you home.
What about Number Six? Unbeknownst to you the doctor put a flexible thin tube with a light and snippers and examined three feet of lower intestine and did whatever was necessary. You felt nothing and remember nothing. Zero. Time didn't exist for you.
The procedure is more trouble than a vaccination, and if you are feeling lucky, don't bother. Eventually you will die of something, and there is only a three to four percent chance it will be colorectal cancer. But it is preventable if you do your part.
If you are vaccinated and boosted I suspect you are far more likely to die of colorectal cancer than you are of COVID. You got vaccinated, didn't you?
15 comments:
Glad it was easy, and limited polyp removal necessary. I had one a couple of months ago, the Doc removed two, one was precancerous, so I'll get another in 3 or 4 years. As usual, the prep is more onerous than the procedure, but much better than the one from 2005.
For the prep, I had to drink a small bottle of laxative (not the large bottle of white stuff, which makes me vomit).
It was working. Then I passed out in the bathroom and woke up on the floor. Went to the Emergency Department. Was told I had low blood pressure and dehydration, and was given IV fluids until my blood pressure improved.
Never tried that again. You should have mentioned the lab stool tests that are noninvasive.
Perforation during the procedure is another real risk. Also the anesthesia.
Risks:
There is about one death in 125,000 cases attributable to the procedure itself. It is possible for there to be an accidental puncture. Possible.
People sometimes get dehydrated from diarrhea, from whatever cause, but it is a risk. I drank all the water they tell you to drink, which is a lot. You take the laxative with multiple glasses of water. I followed instructions. Besides, since the whole goal was to wash everything clean, I wanted there to be lots of water to do it.
Peter Sage
I wouldn’t wager on that death risk comparison.
Eg, from July 2020.
“More than 600,000 Americans die from cancer each year, compared to approximately 150,000 deaths from the coronavirus so far in the United States.”
Note, those are ALL cancers, and the 150,000 figure did not age well.
https://www.nfcr.org/blog/deadly-decisions-covid-19-or-cancer/
US Prevention and screening task force is one of our better agencies.
Colon cancer screening (various modalities) are one of the better recommended screenings. Many are not.
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening#tab1
Follow up comment:
I am the one who passed out and went to the ED. I too followed ALL of the instructions. I too drank ALL the water I was told to drink. Etc.
Every person is an individual. People's bodies respond differently. To imply that it was the person's fault is wrong.
Everyone should consider ALL of the alternatives to an invasive procedure under anesthesia. I speak from experience. I also became permanently disabled after having a common surgery. Get the facts before having any type of invasive procedure or taking any medication.
Maybe write a blog about the alarmingly high number of medical errors and the dysfunction of the health care system in the U.S. Many excellent books and articles have been written on the subject. An educated medical consumer is the best patient.
True you can be screened for bleeding with a stool test. When you're young the source of the blood is most likely from something other than cancer. When you're my age and the lab stool test is positive it's too late. You have bleeding that most likely resulted from cancer. I should add, colorectal cancer is a most unpleasant way to end your existence. I intend to avoid that possible cause of death for myself. Early detection of precancerous growths are easily removed before the cancerous growth developes and metastatsized.
Glad yours was fairly easy, and clean, Peter. I found the orep to be more onerous th han the procedure, but worth the peace if mind.
Any stats on Republican anti-laxxers?
I hear it's a movement...
It’s a movement: Bowel Laxatives Matter.
I agree that health care consumers need to be educated. However, Facebook posts are not education.
The US has the best health care system on the planet- that is, if you realize the goal is to make money and not save lives. That's capitalism for you.
Thank you, Peter, for writing this.
I have a family history of colon cancer and a close relative who died of complications following cancer surgery.
So I remind my doctor when I'm due and not the other way around.
As for the at-home tests (where you send a stool sample to a lab) those are not suitable for those who have had polyps, I'm told.
Anonymous- in my prior post I didn't mean to make light of your experience. I apologize if it came out that way.
Bathroom jokes? How old are we?
I should add, to avoid any needless panic, that the surgery was successful. The death was many years later and the cancer was a contributing factor.
Had this relative not had early detection and the surgery death would have been much much sooner.
So early detection and a successful surgery (including two dose of radiation) resulted in many more years of life.
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