|
Getting your Trinity Audio player ready...
|
by MARK POWELL
***
Let’s face it, discussing most diseases isn’t fun. But one in particular makes people change the subject whenever it comes up in conversation. Unfortunately, the disease uses that silence to its advantage. While we put off thinking about it – much less talking about it – colorectal cancer can spread and become an even greater threat.
Colorectal cancer doesn’t wait for delays and postponements, as the numbers show.
South Carolina’s Department of Public Health (SCDPH) rates colorectal cancer as the third most common form of cancer (excluding skin cancers). According to the South Carolina Cancer Alliance, as many as 2,600 South Carolinians are diagnosed with the disease annually – and just under 1,000 people will die from it each year.
All from an illness they might have survived if it had been caught early and properly treated…
“There are a few cancers we can screen for that have really good screening tests – but this is one of them,” said Sarah Cottingham MD, a physician with Lexington Family Practice Forest Acres. “Getting screened is hugely important because there’s a one in 23 lifetime risk of colorectal cancer for men and one in 25 for women.”
***
Historically, having a colonoscopy at age fifty has been viewed (and dreaded) as a rite of passage; the finale to middle age and the start of one’s transition into senior status. But that half-century milestone is now a thing of the past.
“The recommended age for screening today is forty-five,” Cottingham says. “So, if you’re over forty-five and haven’t gotten it done, you need to talk to your doctor. In fact, it’s unfortunately on the rise in younger people.”
That’s right: a disease commonly associated with the middle and latter stages of life is now increasing in those in their peak years.
“We’re finding it more in young people,” Dr. Cottingham acknowledged. “Those born in the 1990s and later, in particular, have a higher risk. A lot of it is believed to be associated with diet – how bad the American diet is – and then you throw in a lack of physical activity. So, people born around 1990 have twice the risk of colon cancer and four times the risk of rectal cancer than those born around 1950.”
***
***
Knowing what to do is one thing; actually doing it is something different. While many people are aware they should be screened for colorectal cancer, they procrastinate. In many cases, there is one main reason why.
It’s due to what the medical community delicately refers to as the “prep” before the screening. In layman’s terms, that means cleaning your insides out so doctors can get a good look at the colon’s lining.
“The gold standard for screening is a colonoscopy,” Dr. Cottingham continued. “That’s what is recommended. If I’m getting screened for cancer, I want the gold standard. I tell my patients they should want the gold standard, too.”
“The prep itself isn’t fun,” Dr. Cottingham admitted. “It’s twelve hours the day before you have the procedure. The provider may talk with you and give you some choices based on your personal history, but there are lots of ways to prep these days.”
While many familiar with the process recall the gallon-sized jugs associated with screening prep, Dr. Cottingham said other options are available.
“There are smaller things like pills combined with certain drinks,” she said. “There’s even a MiraLax prep. But it’s very provider-specific as to what they feel will get the best outcome.”
In addition to a colonoscopy, several other screening methods are available.
“The fecal immunochemical test (FIT) is where we send people home with cards to check their stool and send back for us to test,” she said. “It’s easy and is increasingly used for screening. If it’s been ten years since your last colonoscopy, you may want to screen every three years or so just to make sure nothing’s going on.”
***
RELATED | HAVE A HEART FOR HEART HEALTH
***
Cottingham also referenced Cologuard, a screening test for adults over forty-five years of age at average risk that detects 92% of colon cancers.
“That goes a step further,” she said. “It checks your stool for blood and also checks for DNA changes shed by precancerous or cancerous polyps. It’s a good test for detecting those polyps.”
“But the problem again is if it’s positive, or if the FIT test is positive, you’ll still have to have a colonoscopy,” Dr. Cottingham warned. “So why not skip them and go straight to the gold standard?”
Regardless of which method you select, they all share one thing in common: a ticking clock. Time matters. Because successful treatment depends on how soon the disease is detected.
“It all depends on the stage, obviously,” Dr. Cottingham said. “So if you have a small polyp or a larger one, pre-cancerous or cancerous, they can remove it. Sometimes they have to take out part of the colon, depending on how big the polyp is. But as long as it’s not outside the colon wall and there’s no spread – that may be all the treatment you need. Now, if it’s spread to more lymph nodes and elsewhere, then we’re talking about a different stage of cancer, a whole different treatment: chemo, radiation, surgery, those kinds of things are necessary. So, the sooner it’s detected, the better.”
Which means the sooner people over the age of forty-five schedule their test, the better…
***
ABOUT THE AUTHOR…
J. Mark Powell is an award-winning former TV journalist, government communications veteran, and a political consultant. He is also an author and an avid Civil War enthusiast. Got a tip or a story idea for Mark? Email him at mark@fitsnews.com.
***
WANNA SOUND OFF?
Got something you’d like to say in response to one of our articles? Or an issue you’d like to address proactively? We have an open microphone policy! Submit your letter to the editor (or guest column) via email HERE. Got a tip for a story? CLICK HERE. Got a technical question or a glitch to report? CLICK HERE.
