Healthy Aging

A Test That Can Save Lives

By Sheryl Kraft

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You probably wouldn't have wanted to be me.

As I mentioned in a , the hidden promise of spring makes me want to clean out and organize. But what I didn't mention is that some of the cleaning out involved things from a much more, um, personal location.

The high point of that particular personal clean-out day—in preparation for my colonoscopy—was choosing between apple juice, cranberry juice or any other clear liquid to ease my thirst and hunger. I drank my coffee black, forcing myself to ignore the fact that I abhor black coffee and would usually rather skip it altogether than drink it without my half-and-half. I tried to pretend that those low, rumbling sounds were not coming from my body but, instead, the boiler downstairs. But when the noises got too loud to ignore, I attempted to silence them with popsicles, chicken broth and Jell-O. Never mind these were foods that held little to no appeal: they were allowed. Sometimes a girl's gotta take what she can get.

Five days earlier, I stuck a note in clear sight that had a big red "X" in front of the words: No Advil, Advil, Aleve, Ibuprofen, Vitamin E or C, Gingko or Iron!

And three days before my "big day" another note, taped to the door of my refrigerator sporting another ruby red "X," reading, "NO fruits or veggies with small seeds, breads with poppy or sesame seeds, preserves, berries, kiwi and tomato. And no nuts!"

As if all of this weren't quite enough, I had to take the next day off from work, and my husband had to give up his busy morning—and listen to my moans the night before, about having to wash down laxatives and anti-gas pills with copious amounts of sludgy liquid, followed by countless trips (I think I stopped counting at 11) to the bathroom. But, eager to get through this with a good (or good-enough) attitude and a minimum of complaint, I gulped that sludgy liquid from my favorite wine glass and kept reminding myself that it's a good thing there are tests like these … early detection is the best treatment … it's part of growing old(er).…

Rah, rah, sis-boom-bah!

Was I dreading the test? You bet.

You, too? Perhaps this will help: There's now strong evidence that colonoscopies save lives.

A new study appearing in the New England Journal of Medicine reports that a team at Memorial Sloan–Kettering Cancer Center in New York found that when precancerous polyps (known as adenomas) are removed during colonoscopy, the risk of dying from colon cancer can be cut by a significant amount. During the about-30 minute procedure, these polyps are detected by a tiny camera that's threaded up the rectum through a long, flexible lighted tube. On the end of this camera is a tiny pair of handy clippers that can remove suspicious-looking growths, which are then sent to the lab to see if they might turn into cancer.

When this study was compared to another study from a national cancer tracking effort (known as the Surveillance Epidemiology and End Results, or SEER, program) over a 23-year period, the rate from colon cancer among the 2,600- people who originally had adenomas removed was 53 percent lower than would have been expected based on the rates seen in the government study.

Encouraging, right?

But the number of people going for colonoscopies is discouraging: only about half the people recommended for the tests actually get them. Not a good track record, especially considering that one in 20 Americans will develop colorectal cancer—the third most common cancer worldwide—and that the 140,000 cases diagnosed each year in the United States results in about 49,000 deaths.

I'd say the evidence is clear that this much-dreaded test is a worthwhile one, and that's a step in the right direction, especially since the jury is still out on other screening tests including the PSA for men and mammograms for women. (When, oh when, will that debate ever end? Recently, there was a bit of encouraging news on that front: that .

Should you get a colonoscopy? The government's recommendations: “Routine colonoscopy to look for early signs of cancer should begin at age 50 for most people—earlier if there is a family history of colorectal cancer, a personal history of inflammatory bowel disease, or other risk factors. The doctor can advise patients about how often to get a colonoscopy.”

A test that's uncomfortable to prepare for? Not fun. But a test that is uncomfortable to prepare for and can save countless lives? Not fun … but definitely worthwhile. And since March is National Colorectal Cancer Awareness Month, it's a good excuse to think about a topic you might otherwise shun.

This Matters: Some signs of possible colorectal cancer to be aware of:

• bleeding from your rectum
• dark stools or blood in the stool or toilet after you have a bowel movement
• a change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days
• cramping pain in your lower stomach
• weakness, fatigue, unintended weight loss

You might also want to read:

Too Few Americans Getting Screened for Common Cancers

Comments

No, these are not fun and I've been dreading the day when I have to have another. My last experience with this was so unnerving for my husband that he now refuses (51) to go and have one done.

Tell your husband that all the men I know breezed through it! Truly. I wish I knew what their secret was.

Great advice, Sheryl. But I do look forward to the long-promised virtual colonoscopy.

Ruth, Hate to tell you this, but the virtual colonoscopies still require the cleansing. The only difference is that they are non-invasive...but if a polyp is found during that type of procedure, it cannot be removed, and a "regular" colonoscopy would have to be performed. Sorry to say but there are not any easy answers - at least, not yet.

I was feeling the same way about my first colonoscopy. I cannot say I am exactly looking forward to the next one, but thanks for this reminder. My husband mentioned to me this weekend that colonoscopies are not obligatory in Sweden. And, they should be.

Hmmm...I wonder if there's a greater death rate from colon cancer in Sweden, since the test is not obligatory.

I agree the prep is difficult. I put off having one for several years b/c a prescription medication I cannot function without was on the list of things I had to be off. I finally told them this was why I couldn't do it. The Dr okay'ed my continuing the med. Apparently it was a just in case thing and I didn't have any other possible problems. I'm glad I asked. I had my test and the results were normal. Yay.

Oh yeah. Such fun. I dutifully do it because I tend to have an assortment of bowel problems with all the symptoms (except blood) that are mentioned above. Fortunately those symptoms have proven to be non-serious and the test (which is a walk in the park compared to the prep) has always proved that I'm healthy. Much as I hate it, I take it seriously, since I had a dearly loved friend who died of that awful cancer.

Glad to know that you are keeping up with this test, Vera, and that your results are good. And you are so right about the test itself; to me, it's a relief compared to the prep!

I was diagnosed with colon cancer at age 27 (27 years ago.)
I wrote about it here

So happy that you have survived this cancer after being diagnosed at such a young age, Claudia~

Oh that which is good for us is so.... uncomfortable.

Uncomfortable in the short term - I guess that is one positive way of looking at things! The test itself is absolutely painless, since you're OUT.

Well, I passed over the 50 mark a year and a half ago, so guess I'd better start thinking about getting a colonoscopy. I keep hoping they'll come up with a better method before I get my first one.

Happy belated birthday, Jane...and happy colonoscopy. C'mon, if I can do it, you can, too!

I emailed that NYTimes article to some friends who had been very hesitant to have the test. Just had my, ahem, first, and it was not terrible, mostly because of the sleep medicine. Recovery is very easy. And the relief of knowing all is well is terrific.

As much as everyone dreads a colonoscopy, the alternative is so much worse - I'm in the "ounce of prevention" camp on this one. Plus, colon cancer has run in my family, so there's no getting around the test.

I'm not there yet. I wish there were some easier taste--please give us some hope that some day it won't be so bad?

Okay, something else to add to the over 50 to-do list, as that date looms (well, a few years to go yet). Just curious: How often is one expected to have this test? I'm hoping there's a good 5-10 year window in between test dates.

Ok, not to sweat...yet. But the recommendations are for first screening at 50 if you're at average risk or 40 if you're at high risk. If a close relative had colon cancer, you need to screen when you are 10 years younger than the age at which they were diagnosed. Depending on your results, you could go anywhere from five to ten years between screenings (of course, if something is suspicious, you may have to be monitored more frequently).

I'm only 19 and, due to a nasty condition that remains undiagnosed, I've had just about every GI test there is...a colonoscopy is pretty much the easiest! A little bit of IV sedation, and most people won't remember a thing! It doesn't hurt, and although the prep isn't fun, there are much worse tests out there, believe me!

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