Do You Know That Embarrassment Could Kill You?

Last week we mentioned that colorectal cancer is the most preventable and treatable cancer, yet over 55,000 people die every year from this form of cancer.

Most people often ignore signs and symptoms of colorectal cancer, because they are “too embarrassed to talk about it.”   Or, they are too embarrassed to undergo the preventative screening of  a colonoscopy which is recommended for ALL adults age 50 beyond.

Well, this embarrassment could kill you!

If you remember anything from this article, remember that there are tests that can help detect this cancer in its earliest stages, while it is still small, has not spread, and when it is easiest to treat!  Check out the Sunday House Call video to hear about the latest breakthrough in non-invasive colon cancer screenings.

Colorectal cancer is very treatable, if diagnosed early by an examination by your doctor and a follow-up test.

Colorectal cancer usually begins as a benign (noncancerous) polyp that grows and spreads in the inner lining of the colon or rectum.  It can appear as a flat or raised appearing growth, which are common after age 50.   However, there is a certain type of polyp that may develop into cancer, which is called an adenoma.

What are some of the common types of screenings?

Medical experts recommend three common screenings which are:

  • A highly sensitive fecal occult blood test (FOBT)
  • A sigmoidoscopy
  • A colonoscopy

Everyone should be have a colorectal cancer screening when the reach age 50 and on a regular basis per their doctor’s recommendation.

People who should be tested earlier than age 50 are those in high risk categories, such as having a strong family history of colorectal cancer, and inflammatory diseases such as ulcerative colitis and Crohn’s disease.

image-sfl-couric-250x200Generally, the first screening the doctor will require for most patients is a FOBT, which consists of the patient placing a smear of stool onto a lab card that is sent to a laboratory.  Studies have shown that people aged 50 to 80 years old who have a FOBT performed every 1-2 years have a reduction in the number of deaths due to colorectal cancer by 15 to 33 percent.   Experts do recommend that if a FOBT is the only test performed, that it be done yearly.

A sigmoidoscopy is an exam performed with a flexible tube inserted into the rectum and lower colon, or sigmoid section of the colon.  Air or carbon dioxide in injected into the area to expand the walls of the colon and any polyps found are removed and checked in a lab for pre-cancerous growths.  The cleansing for this procedure entails just the lower area of the colon;however, since the sigmoidoscopy does not examine all of the colon, most doctors recommend a colonoscopy.

The colonoscopy test can easily identify benign (pre-cancerous) and cancerous polyps in the colorectal area.  A thorough cleansing (aka edema) of the colon and rectum the evening prior is required prior to the test and techniques include liquid or pill-form laxatives.  A flexible tube called an endoscope with a camera on the tip is used to examine the colon and search for any polyps or tumors.  The patient is put under a “twilight or procedural sedation” and feels no discomfort during the procedure which usually takes only 20 to 30 minutes. During the colonoscopy, the surgeon removes any polyps and will have them checked for pre-cancerous cells.  Any polyps over 2 centimeters have a 75% chance of having cancer in them.


There are other methods of screenings for colorectal cancer such as the virtual colonoscopy (computed tomographic (CT) colonography) and double contrast barium enema.

These two procedures are completed from outside the body, and may not be as effective in detecting small polyps and cancer.  The virtual colonoscopy is a fairly new method of screening, however if the computer images show any polyps or abnormalities a standard colonoscopy has to be performed to remove them.  Medicare and most insurance companies are not reimbursing for virtual colonoscopies at this time.

Colorectal cancer is the third most common cancer in both men and women.

It is the second leading cause of death after lung cancer.  Recommended screenings for colorectal cancer have been very effective in preventing colorectal cancer and Medicare and most insurance will pay for colorectal screenings at age 50 and beyond.

Next week I will discuss the impact of diet and how associated risk factors that can be eliminated to prevent development of colorectal cancer.

Want to find out more?

Thomas F. Imperiale, M.D., David F. Ransohoff, M.D., Steven H. Itzkowitz, M.D., Theodore R. Levin, M.D., Philip Lavin, Ph.D., Graham P. Lidgard, Ph.D., David A. Ahlquist, M.D., and Barry M. Berger, M.D.,Multitarget Stool DNA Testing for Colorectal-Cancer Screening, The New England Journal of Medicine, April 3, 2014; 370:1287-1297

National Cancer Institute
Tests to Detect Colorectal Cancer and Polyps

Centers for Disease Control and Prevention
Basic Information About Colorectal Cancer

Mayo Clinic
Diseases and Conditions: Colon Cancer

WebMD – Colon Cancer Health Center

Daily News – Daily Checkup: Screening is the key to fighting colorectal cancer

Helen Trowsdale, President of AA Care Services, is a nurse administrator with over 30 years of experience as a BSN, psychiatric nurse, and geriatric care manager with adults as well as pediatrics in hospitals, private duty home health care agencies, and residential home health care. Her team of caregivers are dedicated to serving their clients with home care in San Antonio, New Braunfels, and Austin; providing clients with consistent, quality care while minimizing the number of caregivers in the home. Learn more about AA Care Services.

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