Demystifying the Colonoscopy for Colorectal Cancer Month
By Susan Beane, M.D., Vice President and Medical Director, Healthfirst
March is National Colorectal Cancer Month, focusing on a disease that is the second leading cause of cancer deaths in the United States. Every year, about 140,000 men and women in America are diagnosed with colorectal cancer—cancer of the colon or rectum—and more than 50,000 people die from it. I spoke with my colleague, Dr. Yujin Guo, Assistant Clinical Professor, Surgery, Icahn School of Medicine at Mount Sinai, to get her recommendations for preventing this disease.
Dr. Susan Beane: How can you reduce your risk of colorectal cancer?
Dr. Yujin Guo: There are a few things you can do to reduce your risk. The most important is for men and women to get a regular colorectal cancer screening, which is called a colonoscopy, beginning at age 50.
Second, you should try to eat a low-fat, high-fiber diet, which is about 30 grams of fiber a day. Fiber can be found in green vegetables, fruits, and whole wheat bread. I tell my patients to drink Metamucil, too, if they can tolerate it. Regular exercise—about 30 minutes, three to four days a week—also reduces the risk of colon cancer. Smoking is also a big risk factor; so stop smoking. Alcohol use should be in moderation, too.
Dr. Beane: What are the symptoms of colorectal cancer?
Dr. Guo: The problem with colorectal cancer is that about 50 percent of patients don’t have any symptoms. The common symptom, if you do have symptoms, is rectal bleeding. Many patients think it is a hemorrhoid, which causes a delay in diagnosis. A second symptom is a change in bowel habits, such as suddenly becoming constipated or having a lot of diarrhea. If your symptoms last longer than a few weeks, see your doctor.
Dr. Beane: What is the screening test for colorectal cancer?
Dr. Guo: Most colorectal cancer comes in the form of a growth called a polyp. The best way to detect a polyp is colonoscopy. During a colonoscopy, a doctor can see and remove the growth before it becomes cancer.
Nowadays, the colonoscopy is relatively comfortable for patients. The procedure takes about two days. The day before the procedure, the patient has to drink lots of liquid to clean out the inside of the colon so that the doctor can look at the inside of the colon with a camera. The patient will have to run to the bathroom a lot, so it’s inconvenient to be at work.
The next day is the procedure. Most of the procedures are done during sedation and can either be done in a doctor’s office if an anesthesiologist is onsite, or in a hospital. Afterwards, the patient can do whatever they were doing before, with the exception of driving, since they were sedated during the procedure.
Dr. Beane: When should you begin to get screened?
Dr. Guo: Everybody over the age of 50 should get a colorectal cancer screening. If a patient has a normal colonoscopy, they typically can wait about five years for another screening. If you have rectal bleeding in your 30s or 40s, you need to see a doctor. If you have a family history of colorectal cancer, you should start getting screenings at age 40.
Dr. Beane: What questions do you get most frequently from your patients?
Dr. Guo: When patients come to me with colorectal cancer, they want to know how it is treated. When the patient comes to our office, the first thing we do is figure out what stage of cancer it is. We do all sorts of imaging studies: CT scans, PET scans, and ultrasounds. Treatment depends on the stage of colorectal cancer. If it’s detected early, then 80 to 90 percent of patients can lead normal lives after surgery. If the patient has late-stage cancer that has spread to the lymph nodes, liver, or lungs, the cure rate is less than 50 percent. Late-stage patients will likely need chemotherapy or radiation therapy.
Dr. Beane: What advice do you have for people with colorectal cancer?
Dr. Guo: Find a good colorectal cancer surgeon, because they are the best providers to take care of this condition. When you look for a surgeon, you should ask if the surgeon can do a laparoscopic procedure. This means you’ll have less pain, recover faster, and the incision is much smaller.
Dr. Beane is Vice President and Medical Director at Healthfirst. For more tips on leading a healthier lifestyle, visit the Healthfirst website at www.healthfirst.org.