March is National Colorectal Cancer Awareness Month. In an earlier post, WVFC’s Dr. Patricia Yarberry Allen and gastroenterologist Dr. Brian R. Landzberg called attention to patients’ unfortunate reluctance to have a colonoscopy—the colon-cancer screening test—and cited recent research that confirms what everyone suspected: Colonoscopies save lives. —Ed.
Why do people shy away from having this potentially lifesaving screening test? Let’s look at 7 harmful myths.
Myth No. 1: Colon cancer mainly affects men.
Fact: Roughly equal numbers of men and women are diagnosed with colon cancer.
Myth No. 2: Only people with a family history of colon cancer should be concerned about their risk.
Fact: In almost 75 percent of colon cancer cases, the patient does not have a family history of colon cancer.
Myth No. 3: I don’t have symptoms, so I don’t need to be screened.
Fact: In the early stage of colon cancer development there are often no symptoms. When symptoms of bleeding, change in bowel function, constipation, or the development of an iron deficiency anemia develop, the colon cancer may be at a stage too late to cure.
Myth No. 4: Colonoscopies are time-consuming and painful.
Fact: The procedure takes 15 to 30 minutes, and modern use of sedation makes this a painless test. Regular activities can be resumed the next day.
Myth No. 5: Colon cancer cannot be prevented or cured and is always deadly, so don’t bother looking for it.
Fact: Long-term follow-up data from the National Polyp Study confirms that colorectal cancer deaths can be dramatically reduced by colonoscopy and polyp removal. If colon cancer is caught at an early stage, the five-year survival rate is 90 percent.
Myth No. 6: Age is irrelevant for the performance of colonoscopy.
Fact: Over 90 percent of colon cancer occurs in people over the age of 50, which is why that is the age that was chosen for general screening to begin. Some patients may need to start screening or surveillance at a younger age if risk factors such as a family history of colon cancer or inflammatory bowel disease are present.
Myth No. 7: The preparation involves drinking a huge volume of an awful-tasting liquid and causes great discomfort.
Fact: Most gastroenterologists have switched from the older preparation of a gallon of unpalatable solution to combinations of a 64-ounce bottle of sports electrolyte drink (like Gatorade) mixed with flavorless polyethylene glycol (Miralax) and taken with bisacodyl (Dulcolax) tablets. Drinking the bowel preparation is a little unpleasant, but that is the worst part. It is critical, however: If the colon has not been well cleaned out, the entire area of the lining of the colon cannot be fully examined.
For women, who often have slower bowel motility than men, or patients with a history of constipation, a better prep would include two days of clear liquid diet (chicken broth, green Gatorade, ginger ale, apple juice, yellow or green Jell-O, and lots of water). At 2 p.m. (two days before the procedure) the patient should take one over-the-counter Dulcolax tablet. This removes much of the solid material from the colon. On the next day, the patient would follow the instructions given by the doctor, which will involve more laxatives but these will be easier to tolerate and be more effective in complete colon preparation than if only a one-day clean-out is done.