If there were an exam that could help prevent abnormal growths from developing into cancer, wouldn’t you want to sign up?
Sounds like a no-brainer. But when it comes to one of the most common and often fatal cancers, many adults are ignoring their doctor’s recommendations for screening.
Brenda Putman is in that group. At 56, she knew she was way past the recommended age for having a colon screening that could detect pre-cancerous or malignant growths.
She was an operating room nurse, and knew the American Cancer Society recommended people at average risk for colorectal cancer have a first screening at age 45.
She also knew the most widely recommended screening is a colonoscopy, a procedure that usually requires you to take laxatives to clean out your system.
With your colon clear, you’re usually sedated so a doctor can comfortably insert a long flexible tube equipped with a tiny camera through your rectum to look at the lining of your colon and rectum. An implement can be passed through the tube to remove any abnormal growths for analysis.
Putman wasn’t interested. She convinced herself she had nothing to worry about.
“I started reading things online and thinking: I’m not a high risk; I eat high fiber; I get exercise; I’m within my weight limit.”
Then Putman saw the blood in her stool. Just a few drops at first. Later, a “gush” that frightened her.
That changed her mind about having a colonoscopy. What it found was early stage rectal cancer she might have avoided if she’d had the procedure earlier.
Early detection can help prevent colorectal cancer
“Colorectal cancer takes seven to 10 years to develop, so there is a window of time for it to be removed and prevent people from having cancer,” said Dr. Glenn Gross, a gastroenterologist with University Health System and chief of Gastroenterology and Nutrition for UT Health San Antonio.
Dr. Gross says most people can avoid colorectal cancer with timely screening, though at least a third of adults recommended for screening don’t get it.
He warns that patients shouldn’t rely on symptoms like bleeding as an early indication of cancer. Sometimes there aren’t any obvious symptoms until the cancer has progressed.
A healthy lifestyle like Putnam’s doesn’t always prevent colorectal cancer, but Dr. Gross says there are some behaviors and conditions that place people at greater risk.
- A diet that includes a lot of red meat
- A low-fiber diet
- A family history of colorectal cancer
For these individuals doctors often recommend an exam before the regular screening age of 45. When screenings detect polyps and cancers early, the recovery rate is nearly 100%.
Dr. Gross, like most gastroenterology specialists, believes colonoscopy is the gold standard for detection, but he says some kind of screening is better than no screening. The American Cancer Society has identified six options that fall into two groups.
Stool-based tests. They look for blood or other markers in your feces.
- Less invasive than colonoscopy
- Samples can be collected at home.
- They don’t require “bowel prep” laxatives to clear out your system.
- They may miss some pre-cancerous polyps and cancers
- If there are abnormalities, the patient will still need a colonoscopy
These methods see inside the colon and rectum. They include colonoscopy and CT colonography, known as virtual colonoscopy. The CT colonography procedure uses x-rays to create a three-dimensional image.
CT Colonography Pluses:
- Better detection than stool samples
- Use of x-rays is less invasive than colonoscopy
- No sedation
CT Colonography Minuses:
- Requires laxatives to clear rectum and colon, causing diarrhea the night before
- Exposure to some radiation
- If there are abnormalities detected, the patient will still need a colonoscopy
- The most accurate screening for detecting abnormalities
- The only single screening allowing detection and removal of pre-cancerous polyps
- Requires laxatives which cause diarrhea the night before
- Usually requires sedation
- Remote chance rectum or colon will be punctured
The National Institutes of Cancer says the possibility the colonoscopy implement will puncture the colon or rectum causing complications is very small – about .057% or one in 1750 procedures.
Just do something
Brenda Putnam says patients should not hesitate because the chances of detecting and preventing cancer are so much greater.
After a year of surgeries, treatment, and living near a restroom, Putman reports she is cancer-free, able to work a regular schedule and can take part in most daily activities.
She considers herself lucky. Her mission now is to encourage others to do what she didn’t do: get a colorectal screening when your doctor recommends it.