Feb 27, 2019
Not too long ago, a vivacious 44-year-old wife and mother got some unexpected news. She had metastatic colon cancer. It was a cruel blow for a woman who didn’t have any symptoms or family history of the disease. She only had a colonoscopy because her husband—10 years her senior—had been putting his off, so she offered to go along for moral support. He got a clean bill of health. She started the battle for her life—and lost it just four months after her 49th birthday. Her colon cancer had been found too late.
Colorectal cancer is increasing among younger adults.
“When it comes to cancer, only lung cancer kills more Americans each year than colon cancer,” says Anna Toker, MD, a board-certified colorectal surgeon with USMD Arlington South Colon Rectal Clinic. “But with early detection, 90 percent of colon cancer is very treatable. A lot of people think age is a factor, but a recent study by the American Cancer Society reveals that the death rate for colorectal cancer among adults 20 to 54 has been increasing since the mid-2000s.”
When colon cancer is diagnosed in younger individuals, it’s often an advanced stage cancer that has spread to other parts of the body—making it much harder to treat. That’s why early and regular screening is so important.
“Everyone should begin having an annual digital rectal exam (DRE) at age 40, along with a fecal occult blood test,” Dr. Toker advises. “The American Cancer Society recently lowered is recommended screening age by five years. They recommend people with an average risk begin having a colonoscopy at 45 rather than 50, with a follow-up colonoscopy every five years. If colon cancer runs in your family or you have other risk factors, talk with your doctor to see if you should be screen earlier than age 45.”
Know the warning signs.
Of course, if you notice any of the warning signs—rectal bleeding, change in bowel habits, mucoid discharge, decrease in stool diameter, unexplained weight loss, abdominal pain or bloating, anemia—see your doctor right away.
Although all rectal bleeding is abnormal, it can be caused by several conditions besides cancer—hemorrhoids, diverticulosis, colitis, ulcers may be the culprits, but your physician will most likely want you to undergo a colonoscopy to look for suspicious polyps or tumors that may be the cause of the bleeding.
Having a colonoscopy beats the alternative.
“Many people are anxious about having a colonoscopy and hate the prep,” Dr. Toker admits. “But undergoing a colonoscopy is easier than undergoing treatment for colon cancer. Done under anesthesia, there isn’t any pain and most people have no recollection of the procedure.”
New prep liquids have reduced the amount of fluid required to flush the colon clean before your colonoscopy. And for patients who don’t want to chug a gallon of a chalky-tasting laxative, there is a pill prep, due to possible kidney side effects, it’s not right for everyone so talk with your doctor.
Virtual colonoscopies—in essence a CAT scan of the colon—are becoming more popular, but they still require the same prep and there are some disadvantages. Some healthcare insurance providers do not cover virtual colonoscopies—including Medicare. Secondly, because they are conducted in radiology, patients don’t receive sedation. While a tube isn’t inserted into the rectum, air is still pumped into the body to help make the area more visible, so there is some discomfort.
“If the radiologist sees something suspicious during a virtual colonoscopy, then the patient will need to undergo a traditional colonoscopy to confirm the findings and remove the polyp or biopsy the tumor,” Dr. Toker adds.
What happens if your colonoscopy reveals a polyp or tumor?
“A colorectal surgeon like myself will either remove the growth or get a tissue sample and send it to the lab for a biopsy,” Dr. Toker explains. “If it is determined that the growth is malignant, a CT scan will be ordered to look at all the internal organs to see if the colon cancer has spread. Depending on the results of the CT scan, an individualized course of treatment for colon cancer will be prescribed.”
While the thought of being diagnosed with colon cancer can be scary, Dr. Toker reminds people of a very important point.
“Because colon cancer is slow growing, regular colonoscopies are your best defense against the disease,” she says. “It takes about three years for a polyp to become large enough for us to see. People who have a polyp removed have a 10 percent higher chance of having a polyp again, so it’s important to have routine colonoscopies.”
If you to like to schedule a consultation with Dr. Toker, please call USMD Arlington South Colon Rectal Clinic at 214.942.3740.