DID YOU KNOW?
Calvert County has a
higher rate of colorectal
cancer than both the statewide
and national average,
according the Centers for
Disease Control and Prevention.
“The fact is, getting screened
for colorectal cancer can save
your life,” said board-certified
gastroenterologist Dr. Renee
Bright.
“A colonoscopy allows
your doctor to find polyps so
they can be removed before they turn
into cancer.”
The fear and myths associated with colonoscopies tend to shy
people away from getting the very screening that could save
their life. Colorectal cancer is the third most common cancer in
both men and women. More than half of those cases could be
prevented with proper screening.
Statistics tell us about three in 10 of eligible adults avoid or
delay getting a colonoscopy for one reason or another.
Recently, we sat down with board-certified gastroenterologists
Dr. Renee Bright and
Dr. Dolores Rhodes-Height of Calvert
Digestive Diseases Associates to set the record straight about
screening for colorectal cancer.
Q. How common is colorectal cancer?
It is very common. Colorectal cancer is the third
leading cause of cancer death in the U.S. More
importantly, it is a cancer that is highly treatable
if detected early and largely preventable, if you
get screened regularly. Every year, there are about
150,000 new cases. Unfortunately, about a third of
them will die because they often present late when
the cancer is more advanced.
Q. Who is at risk for colorectal cancer?
The reality is everyone is at risk regardless of
ethnicity or gender. Everyone needs to get screened
starting at age 45. Those with a personal or family
history of polyps, colorectal cancer or inflammatory
bowel disease need to be screened earlier. Do not
wait until you have symptoms because many people
do not have any. The goal with screening is to catch
it before symptoms appear.
Q. Why is it important to know your family history?
Family history is important because it determines
how soon and how often you test for colorectal
cancer. If you have a first-degree relative (mom,
dad, brother or sister) that had colorectal cancer
or polyps it puts you at a higher risk. So, you would
start screening at age 40 and then every five years.
Try to get a family history as best you can. It is
especially helpful to find out whether they had any
polyps or malignancies and at what age.
Q. How can I lower my risk?
Well certainly, tobacco increases your
risk of all malignancies, particularly pancreatic,
colon and lung. Fiber is your friend – it’s great for
the colon and it’s great for the heart. If you are eating a diet high in fat and red meat this
certainly increases your risk. Obesity and
sedentary lifestyle, too. Studies suggest
increasing your physical activity and
keeping a healthy weight can help reduce
your risk of colorectal cancer.
Q. Why is screening important?
This is a cancer where screening really
matters – we can find and remove polyps
before they turn cancerous in the first
place. I tell people you cannot feel a
polyp. Waiting until you have symptoms
is not ideal. You can have a growth and
it will not be obvious until it is very large
or bleeds and by then it is probably
malignant.
Q. Which tests are used to screen for colorectal cancer?
A colonoscopy is the gold standard for
a reason. It is the only test that allows
your doctor to find and remove polyps
during the same exam – before they grow
into cancer. A “virtual” colonoscopy is a
non-invasive option that uses computed
tomography or CT scans to provide an
in-depth view of the colon. However, it
requires the same prep as a colonoscopy.
And if polyps are found that need to be
removed, a traditional colonoscopy is
still required.
The same holds true for stoolbased
tests. There are some who prefer
these alternative screening options
because they are less invasive, but
positive results often require a follow-up
colonoscopy. Examples include FIT (fecal
immunochemical test) that checks for
hidden blood in the stool and FIT DNA
(Cologuard®), which is intended for those
who are at average risk and requires a
prescription.
Q. What is the purpose of the prep?
We know this is a big issue for some
people and we have modified the prep to
make it more tolerable. A lot depends on
the individual’s bowel habits. We try to
match the right prep for the right patient.
What is important to understand is that
your doctor needs a clear view of your
colon during the procedure in order to
find and remove polyps.
Q. What are some common misconceptions about having a colonoscopy?
Some people think because they
have no family history they are not
at risk. About 85 percent of those
who are diagnosed with colorectal
cancer have no family history. Or they
think screening is only for those with
symptoms. The truth is most people do
not have any. Some are fearful about
the procedure itself because they heard
it was uncomfortable. It is actually
very short and you are sedated. Most
people do not remember anything. Cost
should not be an issue. Medicare and
most insurance plans cover screening
and there are grant programs for those
without insurance.
Don’t Sweat the Prep
Here are some tips for making the process more bearable:
Adjusting your
diet days before
your colonoscopy
by eating less and choosing low-fiber
foods can make the prep go smoother
and easier.
Refrigerate the prep at least 24 hours
ahead of time. A cold prep goes down
much easier. Using a straw can help
with the taste.
On the day before your colonoscopy,
you will have to stick to a liquid diet.
What you choose to eat and drink can
make or break your prep experience.
Pick up some low-sodium broth,
gelatin / frozen pops (no red, orange
or purple), apple or white grape juice,
flavored sparking water, 7-UP® or
Sprite®. Black coffee and tea (hot and
iced) are okay.
Keep yourself hydrated. Electrolyte
drinks like Gatorade® may help (no red,
orange or purple).
Stretchy pants will be a lifesaver once
the laxative begins working – you
won’t have time to mess with buttons!
Stock up on soft toilet paper. And blot,
rather than wiping too hard to reduce
irritation.
Use skin-soothing products such as
baby wipes or baby rash ointment.
Medicated pads and lidocaine cream
can also help reduce discomfort.
Whether you plan to be on your
phone, laptop or tablet, find your
chargers before your laxative kicks in.
Read the prep directions well in
advance and be sure to coordinate
the prep with instructions from your
doctor’s office.