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The Health Screening We Often Dread (But Shouldn't)

July 25, 2020

"One of the main things you can do to prevent Colon Cancer is actually getting the colonoscopy."

It's not a doctor's appointment anyone wants to make... but it can be one of the most beneficial steps to staying healthy.

In today’s episode with Dr. Keller Wortham, MD, we’re talking about the dreaded colonoscopy. There’s a lot of anxiety around this topic, so we’re going to dispel some of that. We'll talk what a colonoscopy can do (which is actually pretty cool), when to get one, and other lifestyle tips for keeping the colon in tip-top shape.

Video Highlights

  • 00:02: Dr. Keller’s Story
  • 01:15: Colon Cancer
  • 02:23: Colonoscopies as Prevention
  • 03:59: How do I know if I should get a colonoscopy? 
  • 05:34: Risk Factors
  • 06:58: Getting a Colonoscopy
  • 08:22: Wrap-Up

“This is Dr. Keller Wortham here, and today, I'm going to share a little bit of a personal story. You see a couple months ago, I had the dreaded colonoscopy. Yep, I went there. A lot of you probably have heard horror stories about colonoscopies — I have certainly had patients come to me with stories of their own — and every time I mentioned that I'd had a colonoscopy to a friend, they would say, 'Oh my gosh, how was it? I hear it's terrible.' 

So I was prepared for it to be terrible… and frankly, it just wasn't that bad. I mean, was it exciting? Was it fun? No. But was it terrible? Absolutely not. And I'm bringing this up because colonoscopies are so important, and while they might be slightly uncomfortable, they're a heck of a lot less uncomfortable than colon cancer. And colon cancer is what we are trying to prevent and screen for when we get a colonoscopy.” 

Colon Cancer

First, let’s talk about Colon Cancer, which is a devastating cancer. It is the third most common cancer in the United States and the third leading cause of cancer deaths within the United States. In fact, there are roughly 100,000 new cases of colon cancer per year in the United States alone. Colon cancer starts in the colon, which is your large intestine — the end of the intestinal tract — and it usually starts as something called the polyp, which is like a little benign growth of tissue that over time can evolve and start to morph into something more dangerous and then into a cancer. And cancer is basically when the cells of that particular area have lost control and start dividing uncontrollably, and then start to spread out throughout the body. 

Unfortunately, one of the first places that Colon Cancer often spreads is the liver, and once you end up with cancer in your liver, it's really hard to treat it and it can become pretty devastating and even terminal for people. 

Colonoscopies as Prevention

Because it’s such a serious issue, we need to do a great job of preventing Colon Cancer. The prevention techniques for Colon Cancer are actually exciting because a lot of cancers out there are hard to prevent. And a lot of the screening tests that we have for cancers do a great job at detecting cancer, sometimes early, but can't necessarily prevent them. This is not the case with Colon Cancer. When you get a colonoscopy, the idea is that you are looking at the health of the colon and looking for those signs of polyps that the gastroenterologist or doctor can actually remove, and those cells, those polyps, can be removed during a colonoscopy before they ever become cancerous or dangerous. That's what makes colonoscopies and colon cancer screening so different from other cancer screening. 

In the case of breast cancer, for example, you get a mammogram, so you can try to catch breast cancer really early on, but mammogram doesn't prevent breast cancer. The same is true of prostate cancer; when you go and get your prostate checked, you can detect prostate cancer much earlier but that test doesn't prevent prostate cancer. 

With colonoscopies, you're screening for colon cancer, but also if you catch things early, you can prevent the cancer from ever happening in the first place. This is very unique to this particular kind of cancer screening. So it’s very important for everyone to get colonoscopies when the time is right. 

How do I know if I should get a colonoscopy? 

First of all, you should be aware of the symptoms of colon cancer. These include:

  • Changes in bowel habit — more diarrhea or a change in your stool, or constipation
  • Feeling bloated or gassy 
  • Blood in the stool 
  • Sudden or unexplained weight loss 

However, many times you won't have symptoms like that until the cancer is much more advanced and sometimes not until after it has spread.

So, just because you don't have any symptoms, that doesn’t mean you should put off colon cancer screening. However, there are some guidelines for when to get screening. In general, you should get screened under the following circumstances:

  • If you're having those symptoms, go see your doctor and talk about whether screening is right for you. 
  • If you're over age 50, get a screening. 
  • If you're over age 40 and have other risk factors (which we’ll get into in a moment) then get a screening. 
  • If you're having any symptoms and are over age 40, go get a colonoscopy. 

Risk Factors

So what are some risk factors that make someone more likely to develop Colon Cancer than the general population? 

  • A personal history of polyps in your own colon. For example, if you've already had a colonoscopy, during which your doctor during which your doctor found and removed polyps, then you should have colonoscopies more frequently than other people. 
  • A family history of colon cancer. If any members of your family have had Colon Cancer, you're going to want to start screening much earlier. You should try to get screened 10 years earlier than when that person was diagnosed, or by age 40, whichever comes first. 
  • Race plays an important role here. If you're African-American, you have a higher risk of Colon Cancer, so talk to your doctor about when it would be appropriate to start screening for you. 
  • Other medical conditions — including inflammatory bowel disease, and Diabetes — can increase your risk for Colon Cancer. 
  • Smoking also increases your risk of Colon Cancer. 
  • Diets that are heavy in animal proteins and red meats and low in fiber, can also increase the risk.

If you fall into one of those categories, then definitely talk to your doctor about whether you should get your Colon Cancer screening earlier than age 50. 

Getting a Colonoscopy

As always, prevention is key. As we've discussed, one of the main things you can do to prevent Colon Cancer is actually getting the colonoscopy. 

This may seem scary, but according to Dr. Keller, it really wasn't that bad. Before you get your screening, you’ll have to drink an electrolyte fluid that will give you diarrhea, allowing you to clean out your colon ahead of time, so you will need to stay near a toilet the night before. However, it’s generally less unpleasant than food poisoning or a stomach bug.

When you go to the actual procedure (hopefully, you've got a good physician who's going to talk you through it), they will likely give you some kind of medication that will cause you to relax, or possibly even fall asleep. Because this is not the type of anesthetic that would be used to completely put you under for something like a surgery, these are referred to as “twilight medications”. As a result, you might remember parts of the procedure, but a lot of the discomfort and pain you probably won't remember at all. 

The procedure itself probably takes 20 to 30 minutes, but under the influence of the twilight medication, it may seem like it took only two or three. 

Wrap-Up

In conclusion, don't dread the colonoscopy. It is one of the best things you can do from a preventative standpoint. In addition to getting screened, you can take other steps to prevent Colon Cancer, including:

  • Follow a healthy diet that’s high in fiber and low in red meat and other animal proteins which can be inflammatory. 
  • Take steps to prevent developing diabetes, or if you have it, work to get it under control because diabetes will increase your risk of colon cancer. To do this, make sure you eat a healthy diet, engage in physical activity, and try to maintain a healthy body weight. 
  • Don't smoke. Tobacco increases your risk of Colon Cancer. 
  • Don’t consume a lot of alcohol, which also increases your risk of Colon Cancer. 

As you see, a few healthy lifestyle adjustments can really reduce the risk of developing this deadly disease. 

Make sure you get that screened when it's appropriate — at age 50 or older, and earlier if you fall into one of the risk categories we discussed, or are experiencing symptoms. We hope you found this information helpful!

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