colonoscopy-smallMarch Is Colon Cancer Awareness Month Each year in the United States, colorectal cancer, also known as colon cancer, affects more than 150,000 people and claims the lives of about 50,000. It is our third most commonly occurring cancer, and is the second leading cause of cancer-related deaths. Colon cancer is a non-discriminatory cancer, affecting men and women equally, according to the Colon Cancer Alliance, an awareness and research non-profit organization. ­­­­ The worst part about these statistics? They don’t have to be so drastic; colon cancer is different than most cancers because it is highly preventable and curable. When pre-cancerous growths in the colon are discovered during a colonoscopy, they can be removed before becoming malignant. According to the American Cancer Society (ACS), nine out of every 10 people with pre-cancerous lesions or polyps can beat the cancer if these areas are caught early enough. And while there are other ways to detect colon cancer and pre-cancerous cells, nothing is more comprehensive than the colonoscopy, which is considered the gold standard for finding and beating the disease. Since the early 2000s, it has remained the preferred test for finding and removing colon lesions and polyps. “A colonoscopy can detect cancers in their earliest and most treatable stage,” says Dr. Mike Bell, general surgeon at Saint Mary’s. “It can also detect pre-cancerous polyps that can be removed during the exam before they become cancerous.” According to the American Cancer Society, when colorectal cancer is found at an early stage before spreading, the five-year relative survival rate is around 90 percent. But because people are still resistant to having a colonoscopy, for whatever reason, only about four in 10 cancers are found this early. Success rates are lower if the disease has spread. What Is a Colonoscopy? A colonoscopy is a diagnostic and therapeutic test used by gastroenterologists and general surgeons, and is one of many endoscopic services available at Saint Mary’s. An endoscope instrument is used in these screenings; the instruments have a thin, flexible tube with an attached camera that allows medical professionals to see the internal organs without making large incisions. During a colonoscopy, the entire colon (the large intestine) is viewed. A colonoscope is placed into the rectum and colon, and no incision is involved. The patient is given a mild sedative beforehand, so the procedure is usually painless, although some slight discomfort may be present. The sedative causes drowsiness and the patient may sleep during the test and be unaware of what is happening. The procedure itself is brief, taking no more than 20 to 30 minutes in most cases, and is completed on an outpatient basis at Saint Mary’s. “The instrument used in a colonoscopy is very sensitive, which is why it gives us the impressive results we see,” says Dr. Bell. “It has a high-definition, high-resolution scope that can reveal even tiny pinpoint-sized lesions.” Should I Have a Colonoscopy? A colonoscopy is usually ordered by a primary caregiver for one of three reasons: either you are age 50 or over, or, if you are under age 50, you have higher than normal risk factors (such as a family history with the disease), or you are experiencing unusual abdominal pain, rectal bleeding, or changes in bowel habits, and need further testing. At age 50, the screening is recommended to check for colon cancer because about 90 percent of new cases, and 95 percent of deaths related to the disease occur after that age, says the Centers for Disease Control and Prevention (CDC). Those with risk factors, such as a family history of colon cancer, may need to begin screening several years earlier. When the test returns normal results, doctors recommend the screening to be repeated every 10 years, up to age 75. Colon cancer often does not present symptoms for many years, and most often the polyps discovered during screening are in a benign stage. Finding polyps in persons age 50 and up is not uncommon— it occurs about 30 percent of the time. On average, it takes up to 10 years for pre-cancerous lesions to become cancer. The slow growth is advantageous, allowing for more time to discover and remove the lesions before they have a chance to progress. But because of this, however, there are usually no symptoms, and people think it is ok to delay screening. “Don’t put off getting screened,” says Arkansas State Senator Greg Standridge (R-Russellville). Standridge, who was diagnosed with colon cancer at age 49 after having a colonoscopy at Saint Mary’s, has stage four cancer and will soon undergo surgery at MD Anderson Medical Center in Houston. “When I was 48, Dr. (Jeff) Yates ordered a colonoscopy at Saint Mary’s for me, and I was fortunate that the cancer was found. I encourage everyone to go to the doctor and get screened. If you don’t think you have time for a colonoscopy, go anyway.” Colonoscopy Gets a Bad Rap Most people find the idea of a colonoscopy off-putting, even though the exam is brief and relatively painless. The reasons are many—fear, lack of time, misinformation, or a belief that they are ok because they don’t exhibit symptoms. Some people mistakenly believe the test is risky. Yet risks are low. According to the CDC, there may be a reaction to the prescribed sedative or perhaps be some bleeding from the site where a polyp was removed. Most physicians agree that risks like these are small compared to the benefits of the test. Another concern may be insurance coverage for a colonoscopy. Coverage is required by the Affordable Care Act, but this doesn’t apply to plans that were in place before it was passed. Check with your insurance provider to see how much, if anything, you should expect to pay. Colonoscopy Saves Lives According to the NIH U.S. Library of Medicine, the rate at which people diagnosed with colon cancer and the rate of deaths from the disease have both dropped significantly since 2000. Many, however, are still not getting the tests as recommended—about 40 percent of people in the United States are not heeding the advice to get a colonoscopy by age 50 and again every 10 years thereafter. The American Cancer Society reports that if 80 percent of those age 50 and older were current with screening by 2018, an estimated 277,000 cases of colorectal cancer, and 203,000 deaths would be averted by 2030. Don’t Sit on This—Check Your Rear! If you have significant risk factors (see sidebar), are experiencing significant bowel changes, or are over age 50, speak to your primary caregiver about scheduling a colonoscopy at Saint Mary’s. If you are diagnosed with cancer, your treatment will depend on the stage in which your cancer is found. Preparing for your colonoscopy can be inconvenient; prepping for the procedure does take several hours. But remembering how effective the test is may deter the fears and end some of the dread. “Believe me, it is worth the hassle,” Greg Standridge says.