Preventing colorectal cancer

by Dr. Susan Blatt
Posted 6/30/19

Colon cancer is, like most cancers, very serious. Most of us would try hard to avoid it. Today’s technology makes it possible for us to follow guidelines and usually stay free from cancer of the …

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Preventing colorectal cancer

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Colon cancer is, like most cancers, very serious.

Most of us would try hard to avoid it. Today’s technology makes it possible for us to follow guidelines and usually stay free from cancer of the colon. If you have not begun screening and you are 50-years-old or older, talk to your primary care doctor about proceeding.

The guidelines are different for those with particular risk factors and those without these risks. Risk factors include a family history of colon cancer and certain diseases such as Crohn’s disease and ulcerative colitis.

If you have these risks, talk to your primary doctor or your specialist about being tested early for colon cancer. Also, if you are having symptoms that might indicate cancer of the colon, including changing bowel habits, bleeding with bowel movements, weight loss, or abdominal pain you may need testing for colon cancer, no matter what your age. African Americans may need testing at the age 45 instead of 50.

For those without symptoms or risk factors, testing is recommended at age 50. Your doctor may recommend beginning with colonoscopy, or he or she may start with a different test such as CT scan, stool testing, or sigmoidoscopy. Currently many doctors feel the latter types of testing are less meaningful. Research is on-going regarding these guidelines.

There are now official guidelines that physicians can follow to help patients avoid colon cancer. The guidelines apply to everyone, so it is good be ready for your doctor’s suggestions. Most important preventive approach is colonoscopy. This test has the unusual characteristic of finding abnormalities and (in most cases) eliminating the problem. Most often the abnormality is a small polyp and it is easily removed as part of the procedure.

Polyps are shaped somewhat like a mushroom and grow from the inside wall of the colon or rectum. Most polyps are benign (not cancerous), but they may turn into cancer over several years. During colonoscopy the doctor is looking for these polyps and removing them.

There are several types of screening tests that do not involve colonoscopy. In some, the patient sends a small stool sample to the lab and either it is checked for blood (guiac test or fecal occult blood test) or the stool is checked for DNA from colon cancer (FIT-DNA test). If either test is abnormal, colonoscopy is recommended.

If you need a colonoscopy you will be sent to a gastro-intestinal (GI) doctor who will discuss your options. If you proceed with colonoscopy it will be scheduled in a hospital or surgical unit. A “prep” will be prescribed. This is started the evening before the procedure. You will drink a large amount of fluid with medication that will cause diarrhea. After a few hours, your colon will be clean inside. The cleansing procedure may be done twice.

When you show up for your appointment the next day, an IV will be started. You will talk to the anesthesiologist who puts patients to sleep, the nurses, and the GI doctor. Once in the procedure room the anesthesiologist will inject medicine to put you to sleep. The GI doctor will put a long tube through the anus and into the colon. There is a light and the doctor will see any problem areas and usually will remove them. The procedure takes less than half and hour and most people feel fine afterwards.

You will return to the GI doctor, in a few days, who will discuss any findings. If polyps were removed, they will tell you if the polyps were or weren’t cancerous. Based on the findings, the next colonoscopy will be scheduled. It might be fairly soon, if there was a problem. If not it should be no longer than 10 years.

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