In the month of March we celebrate Colon Cancer Awareness.
Colon cancer is one of the few cancers we can prevent successfully with colonoscopy, better than breast cancer or any other cancer with the exception of cervical cancer.
It takes usually about 5-10 years to develop colon cancer, which gives us a great window of opportunity to screen. We know that usually we see polyps first, which can develop into cancer, but that normally takes years. With screening we can see polyps and remove them before they develop into cancer.
Because of this prolonged development, the recommendation have been a baseline colonoscopy at age 50 and then every 5-10 years, but if any polyps are seen repeat colonoscopy in a year except if the polyps are hyperplastic.
Yes, we can prevent colon cancer. There is no discussion that we can.
The dilemma we have is that we still see many patients in their twenties, thirties, and forties with metastatic disease who have some symptoms but are told by their physician it is upset stomach and it can’t be colon cancer because they are too young.
We need to take these symptoms seriously! Any ongoing abdominal discomfort which is not explained should include a colonoscopy as a diagnostic tool even in a young patient.
It is also critical to know that any family history, ANY, will increase your risk and particularly if the family member was diagnosed at a young age. Screening should start about 10 years younger than the family member with cancer.
It is also important to know if there is a genetic predisposition, that colonoscopies need to be done yearly, because in these patients colon cancer can develop much faster and it is possible to see cancer within a year. This syndrome is called HNPCC, hereditary non- polyposis colon cancer. As you probably noticed these patients usually have no polyps but flat lesions which are much more difficult to see on colonoscopy. It is critical to have an experienced gastroenterologist who takes his time to evaluate the colon. It has been shown that up to 20% of the lesions in the right side of the colon (the furthest away from the anus) are easily overseen if you rush in and out.
It is also important that the location of the tumor also is important for symptoms. When the tumor is on the right side, patients have some change in bowel movement habits, some abdominal discomfort, and a feeling like an upset stomach. If the tumor is on the left side, symptoms are more typical including like diarrhea, blood in the stool, and pain with bowel movements.
Please make sure you talk to your family and friends about doing a colonoscopy.
Yes we can prevent this disease.