The words “Colon Cancer” are frightening to hear, especially when those words refer to a diagnosis that you or a loved one has received recently. The very good thing (when looking for some sort of a silver lining) is that of the most frequent cancers diagnosed, colon cancer has had some of the most extensive research done and is, when detected early, one of the most curable cancers. If not detected and treated early, however, it is one of the most deadly.
Since the early 1980’s, the colon cancer survival has been steadily improving and increasing, mostly because of awareness and the improvements made in the screening methods. When medical professionals find polyps (small clumps of cells that form on the lining of the colon), the screening, scans and treatment of those polyps has had a huge impact in the survival rates of colon and rectal (colorectal) cancers.
The survival rates for colorectal cancer along with the stages of these cancers breaks down like this:
- The five-year survival rate found at the local stage (stage 1-2 cancers) is currently 90%+.
- The five-year survival rate for colorectal cancer found at the regional stage (stage 2-3 cancers) is currently 71%.
- The five-year survival rate for this cancer found at the distant stage (stage 4 cancers) is currently at a dismal 14%.
These current statistics show that early screening and scanning for colorectal cancer is of absolute importance. (In colorectal cancer, even non or pre-cancerous polyps are assigned a stage, stage 0, and they are removed when found, so the survival rate for this stage is nearly 100%.) When it is found early, it can be cured early. As a rule, the lower the stage number, the less the cancer has spread. A high number, like stage 4, means the cancer has spread significantly.
Who Shoud Get A Colonoscopy?
In the United States, and many other parts of the world, it is medically recommended everyone should get screened for colon and rectal cancer. The only questions are when (what age) should screening start, what method of screening should be used, and how often should re-screening be done? When you should be screened:
- All men and women should be screened for colon cancer beginning at age 50, and earlier if circumstances suggest it may be needed.
- People with a personal or family history of colorectal cancer, inflammatory bowel disease, or are experiencing symptoms considered “high risk”.
- If you are experiencing any signs or symptoms of colon, rectal or bowel problems, regardless of age or family history, you should be screened.
- Re-screening, after your initial screening for colorectal cancer, will be up to your medical professional and depends entirely on his/her initial exam and the results of your first screening.
There are several medical scans that may be (or will) be used in screening, diagnosing, and treating colorectal cancer. The very first screen will be a colonoscopy; either a virtual colonoscopy or a traditional one. A virtual colonoscopy is a fairly new procedure that produces remarkable results with more comfort and a lot more “non-invasiveness” over a traditional one. Virtual colonoscopy is also called CT scan(or CAT scan: Computerized Axial Tomography) colonography. A CT scanner takes many x-rays of the colon that are processed by a computer. The computer then puts all the x-rays together to create 3-D (three dimensional) images of your colon and rectum. The images can then be “read” (looked at and studied) by health care professional to determine if any colorectal cancer, pre-cancer, polyps, or any other abnormality is present. A virtual colonoscopy has these benefits over a traditional colonoscopy:
- It is less uncomfortable and invasive. It usually does not need to include pain medication or anesthesia.
- It takes less time – just minutes compared to an hour or more.
- It poses less risk of harming the large intestine.
- It can be used for people who are not able to have a traditional colonoscopy, such as individuals who have problems with swelling, bleeding or breathing issues.
- It may be able to show areas of the large intestine that regular (traditional) colonoscopies can’t reach. This can be the case if part of the intestine is narrowed or blocked.
A traditional colonoscopy is a procedure that lets the examiner (usually a gastroenterologist) evaluate the inside of the colon using a colonoscope. This is a four-foot long, flexible tube about the thickness of an adult finger with a camera and a light source at the tip. The tip of the colonoscope is inserted into the anus and is then advanced slowly, always under visual control of the medical professional, into the rectum and through the colon. It is moved through the entire colon: the sigmoid colon, the descending colon, the transverse colon, the ascending colon, and ends at the cecum. Live camera footage is available to the examiner during the process. The patient is under general anesthesia for this procedure. The procedure will take about an hour itself, but to check in, have the anesthesia administered, have the procedure, wait in recovery for the anesthesia to wear off and schedule someone to pick you up (you will not be allowed to drive yourself), requires a day free from any other commitments.
Both a virtual and a traditional colonoscopy require a few “pre-op” procedures. Before having either scope, you will be told to do the following things:
- Your provider may ask you to limit your diet to clear liquids for 1 to 2 days before the procedure. These may be water, clear broth or and electrolyte solution.
- The day before the procedure, you will be given a strong laxative in a pill or liquid form to help you empty your colon. You will have several very loose, liquid bowel movements in the next hours. The entire colon must be free from all fecal matter.
- You may be given a type of liquid to drink called a “contrast media” right before the procedure. This is to let the inside of your colon show up more clearly for the x-rays, but this is not always given. It is up to your health care provider.
The virtual and the traditional colonoscopy are the “standard” scans in the prevention, diagnosis, and treatment of colon and rectal cancer. If either of these scans show any abnormalities and further testing is necessary, an MRI (Magnetic Resonance Imaging) may be needed to further clarify issues you may have. With these scans so readily available to health care professionals, colorectal cancer is being treated and cured at rates that were unheard of even 20 years ago. These are standard life saving scans. Always remember: No symptom is usually the only symptom of colon or rectal cancer. Get screened!