Scoping Out Colon Cancer

Colorectal cancer is the third leading cause of cancer-related deaths in the United States when men and women are considered separately, and the second leading cause when both sexes are combined.
PUBLISHED August 03, 2015

Georgia Hurst is a patient advocate for those with Lynch syndrome. She has the MLH1 mutation and fortunately has never had any cancer. She is the co-creator of #GenCSM (Genetic Cancer Social Media) on Twitter, and her advocacy work has afforded her opportunities to write for medical journals, various websites and genetic testing companies, as well as collaborate as a stakeholder for the National Academy of Sciences: Genomics and Population Health Collaborative. Her loves include: her son, her dog, books, photography, long walks in the woods, and seeking out fungi after the rain. Her motto is: "There is enough misery in the world – there’s no need to contribute to it.”

Colorectal cancer is the third leading cause of cancer-related deaths in the United States when men and women are considered separately, and the second leading cause when both sexes are combined. It is expected to be responsible for 50,000 deaths in 2015 (http://www.cancer.org).

If you notice any changes in your bowel habits, abdominal pain, bleeding from the anus or weight loss, please do not ever ignore these symptoms — contact your doctor immediately as these may be symptoms of colorectal cancer.

Gastroenterologists recommend the following for colon cancer screening:
  • Age 50 for people who are not at increased risk of the disease
  • Age 45 for African Americans because they have an increased risk developing the disease
  • Earlier ages for people with a family history of colon cancer, inflammatory bowel disease (a long-lasting disorder that causes irritation and sores in the GI tract) or those who carry a genetic mutation like BRCA or Lynch syndrome. All of these risk factors should be discussed with your doctor.
  • BRCA1 mutation carriers should be counseled about their increased risk for early-onset colorectal cancer, and offered colonoscopy at three- to five-year intervals between the ages of 40 and 50 years.
  • Lynch syndrome carriers should be counseled about their increased risk for colon cancer and, if offered, colonoscopy every year starting at age every one to two years starting at age 20 to 25 or two to five years younger than the youngest colorectal cancer in the family, whichever is earliest.
Why do doctors encourage men and women to have a colonoscopy? Unfortunately, the typical high fat Western diet and sedentary lifestyle is the perfect recipe for developing colorectal cancer. Having a colonoscopy can be lifesaving; it is the best way to screen for colon cancer.

Why are men and women reluctant to have a colonoscopy? People may be put off by the procedure due to the placement of the scope. It’s important to know that you can be sedated for this procedure and therefore there will minimal discomfort.

Colonoscopy may find polyps in your colon, which, if not removed, have the potential to become cancerous. The scope is able to remove such polyps. If colon cancer is detected at an early stage, a doctor has a better chance of treating or curing the disease. If not caught early, colon cancer can be deadly. Unfortunately, many who develop colon cancer do not exhibit symptoms until its later stages and this is why frequent colonoscopies are beneficial.

Before your colonoscopy, you will be sedated and the doctor will insert a long, flexible, narrow tube with a light and tiny camera on one end, called a colonoscope or scope, to look inside the rectum and entire colon. Colonoscopy can show irritated and swollen tissue, ulcers, and polyps — extra pieces of tissue that grow on the lining of the intestine. It is the most valuable screening test for colon cancer. You will not feel a thing.

I am currently 44 years old and began having colonoscopies in my twenties because of my strong family history of colon cancer — way before I was diagnosed with Lynch syndrome. To date, I have had 13 colonoscopies and can honestly say it is truly not a big deal.

Here are some tips to make your colonoscopy go as smoothly as possible:

First of all, try and schedule your scope for first thing in the morning. You will be dehydrated, possibly nauseated, and a bit out of sorts from the prep. You will want to get it over with as soon as possible.

Secondly, do yourself a huge favor and try not to eat too much a couple of days before your scope. It will make the process of cleaning out your colon easier.

Third, everyone I know complains about the prep. My personal favorite, and I have tried them all, is Prepopik. I have found it to be far more tolerable than other preps and its taste is comparable to Tang — it’s orange-flavored and you do not need to drink an obscene amount of it for the desired effects. You are only required to consume 10 ounces of the prep, followed by 64 additional ounces of other clear fluids such as water, tea, ginger ale, etc. For more information about the prep, please go to prepopik.com. Usually, you start the prep around 4:00 p.m. and then take another dose later in the evening. Some doctors are now requesting the second dose be taken the morning of the scope. It varies, so please check with your doctor.

Fourth, right before your scope ask for the anesthesiologist or their nurse to insert the IV — you will be very dehydrated and it may be difficult for them to find good veins.

Fifth, some people are concerned about the placement of the scope in the rectum. This is completely warranted but please note that you may request to be sedated for this procedure; you do not need to be awake for it. I have always been sedated for my scopes and have never had any issues or recollection of any of my procedures whatsoever.

Lastly, when you wake up you will feel a bit groggy, gassy, bloated and possibly very hungry. You will be offered light snacks in the recovery room; eat and drink whatever is made available to you — for me, it’s usually juice and toast. Please be sure to bring someone with you to drive you home.

Remember to check with your insurance company to find out how often you can get a screening colonoscopy that your insurance will cover. If you need financial assistance, you may qualify for a free or a colonoscopy at a reduced rate. Please see here for more information.

My brother Jimmy died from colon cancer due to Lynch syndrome at the age of 36. His death fuels my advocacy efforts for those with hereditary cancer syndromes. Please do not ignore any of the symptoms mentioned previously and please do not hesitate to reach out to me if you have any further question or concerns regarding colonoscopy. I would be more than happy to answer them.

Georgia M. Hurst, MA

Website: ihavelynchsyndrome.com
Twitter: @ShewithLynch
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