What makes this disease so deadly? It develops in a region of the body that’s not easily seen, and the best test for it – the colonoscopy – is a somewhat arduous medical procedure.
Colon cancer is an equal-opportunity disease for men and women up to age 39. After that, men are more susceptible and have higher rates of colon cancer. African-Americans are particularly at risk, having higher incidents of developing colon cancer and greater mortality when it is detected.
While overall colon cancer rates and deaths are declining in the general population, mostly because of more screening and earlier detections, it’s still a major concern because the risk factors are high among the general population. Age, the growing number of obese people, physical inactivity, smoking, lots of alcohol drinking and particularly a family history of colon cancer are all prominent in the chances of whether an individual may be susceptible to developing the disease.
Where Does It Begin?
Colorectal cancer typically begins in the cells lining the colon that release fluids to propel food along the digestive tract. Eventually, polyps can occur, small growths that form along the inner wall. Once in place, they could develop into cancer and must be surgically removed, with the patient then subjected to chemotherapy, radiation therapy or other treatments. Close to $14 billion is spent on colorectal cancer care in the United States each year.
The deaths from this disease don’t necessarily have to happen. Early screening, detection and treatment can head off a lot of major problems, particularly for those people aged 50 and older. The detection of adenomatous polyps is the key. While most will not develop into cancer, removing them can prevent the possibility of cancer in the area.
These are usually found through a procedure known as a colonoscopy. This is a method where a doctor inserts a long tube into the rectum while the patient is sedated. The camera is manipulated further into the colon to find polyps and remove them if discovered.
But many people who might benefit from the early screening and detection don’t bother to have the test. The reasons are a combination of fear, ignorance and wishful thinking. Because a colonoscopy involves several doctor visits, sometimes unpleasant preparation involving drinking a lot of fluids, and then a hospital procedure, it’s just one of those things where it’s easier to kick the can down the road, saving the tests for some imagined “someday” that may never come.
There Are Other Ways
Those who suffer from colonoscopy fears can be helped. There are alternatives to a full-on colonoscopy. While the colonoscopy procedure remains the best and most complete test for the disease, there are other ways to measure what’s going on in this sensitive region.
There are three tests that can be performed at home by the patient. All involve collecting stool samples and smearing the results on a special sampling card, then getting the results to a laboratory for analysis.
The tests:
1) Fecal occult blood test – As the name implies, this is a test looking for the tell-tale sign of blood in the stool. It’s not comprehensive -- it only picks up roughly 30 percent of polyps. But it does detect cancers about 70 percent of the time. Your medical professional can provide you with the card and directions. It is typically recommended that this test be done every year.
2) Fecal immunochemical test – This is another procedure similar to the blood test, which uses special chemicals to detect the presence of potential cancers. Like the blood test, your medical professional can provide the card and instructions on using it. It should be performed every year.
3) Cologuard – This is a relatively new test that was recently approved by the Food and Drug Administration. It will detect DNA mutations and blood in the stool and is believed to detect 40 percent of polyps and 90 percent of colon cancers. This is a commercial test available directly from the Cologuard company. It likely needs to be repeated every three years.
Another potential test is the CT Colonography. This is a procedure somewhat similar to the colonoscopy but is performed by a radiologist who inserts a tube into the rectum. The colon is then filled with air while a CT scan is performed. This is sometimes referred to as a “virtual colonoscopy,” but it is not as effective as a traditional colonoscopy in finding the flat lesions and smaller polyps that may be in your system. The procedure is usually done without sedation. You will have to undergo the same ritual cleansing procedure as a regular colonoscopy, including ingesting a large amount of fluid.
Finally, there is the test known as a sigmoidoscopy. This is an exam that also uses a thin tube with a camera inserted into the rectum. Like the colonoscopy, you ingest only clear liquids the day before the test to clean out the colon and make for easier viewing. On the day of the test, you will be administered a laxative or enema to clear the area further. The test takes about 20 minutes and is performed without sedation but only looks at the lower colon. That leaves the upper colon unexamined, and any polyps there will not be detected. This is a test that can be performed once every five years.
With any of these tests, any polyps or other discoveries will require a full-on colonoscopy to determine the exact nature of the problem. But at that point, it’s a crucial test, and any qualms about the procedure should be tempered by the grim reality that it could be a matter of life or death.
Although no treatment is as effective at detecting polyps or other colon problems as a full colonoscopy, doctors generally agree that performing any screening is better than doing nothing. Although it’s not the most pleasant way to spend a day, testing for colon cancer is a necessary part of living a long life and should be done by anyone with risk factors or at a certain age. It is a painless procedure and could prevent further cancer development and make for a quicker recovery.