Nipping colorectal cancer in the budBy Rafael Castillo
Philippine Daily Inquirer
Cancer in any part of the body is always bad news, but with modern medicine, there are some cancers which can be cured permanently with early detection and treatment. One such cancer is colorectal cancer.
With two of my brothers dying from colon cancer, I have waged a personal crusade against this third most common cancer worldwide, and I support any campaign on educating the people on how to prevent it. There’s good evidence to show that one could figuratively nip it in the bud with early detection and excision of precancerous polyps through colonoscopy.
Colonoscopy is a relatively simple but life-saving procedure to visualize the entire length of the colon. The device gastroenterologists use consists of a long slender tube with a tiny camera at the tip. The tube is inserted up through the rectum, and a little pair of clippers at the end can excise polyps and other suspicious-looking growths so they can be biopsied to find out if they are cancerous.
I have been a beneficiary to this modern technology when I first underwent it a little over two years ago at the Manila Doctor’s Hospital. Noted gastroenterologist Dr. Choy Nolasco did the procedure on me with Dr. Mon Pesigan giving the intravenous sedation. Dr. Nolasco expertly removed three polyps from my colon, one of which was quite big already and almost ripe to become a cancerous tissue in a few years.
Although I was still a bit drowsy with the mild sedation Mon had given me, I cried like a small boy when Choy told me about the polyps she had removed. I couldn’t help but be overcome by two emotions—gladness and gratitude that the polyps were discovered early enough before they could become a fully developed Big C perhaps in a few years; and sadness as I remembered my two elder brothers whose lives were taken by colon cancer at the prime of their lives.
It is unfortunate that only about half of people who have strong indications for a colonoscopy have it done, because of misconceptions about the procedure, like it’s “embarrassing, uncomfortable and risky.” In expert hands like those of Dr. Nolasco, the risk of complications is extremely low.
Colonoscopy usually takes less than an hour. Except for some cramping or bloating, one wakes up from the procedure feeling rested and relaxed from the short-acting sedative one is given for anesthesia.
A study recently published in the New England Journal of Medicine, shows that colonoscopies, by detecting and excising precancerous polyps, can cut the risk of dying from colon cancer by 53 percent. The study, which evaluated the long-term impact of polyp removal, was conducted by a team at the Memorial Sloan-Kettering Cancer Center in New York.
“This study is showing both a reduction in colon cancer incidence and colon cancer deaths by removing the adenomas, and it’s a long-term effect,” said Dr. Ann Zauber of the Memorial Sloan-Kettering Cancer Center in New York, and chief author of the study. “This is reassuring for people to come in for screening,” she was quoted in an interview.
Even if one has no symptoms, colonoscopy should ideally be done at age 50; but for those with a strong family history of colorectal cancer or polyps, it should be done earlier. If normal, it can be repeated every seven to 10 years; which is so little a price to pay for early detection of a potentially life-threatening illness. If there are findings like polyps, it should be done more frequently.
One year after polyps are removed, a repeat or “clean-up” colonoscopy is usually recommended. Dr. Choy did a repeat colonoscopy on me recently and thanks God my whole colon is clean now, without a trace of any of the polyps she found during my first colonoscopy almost two years earlier.
We also welcome the development of a new, simple stool test called fecal immunochemical testing (FIT) as a cost-effective screening test for colon polyps and cancerous tissues. It’s inexpensive and non-invasive, which makes it ideal. When used together with colonoscopy, many high-risk patients can be spared from the specter of colorectal cancer.
If you have a close relative diagnosed to have colorectal cancer or polyps, or if you have symptoms like blood in the stools or a change in your bowel movement, it’s about time you had yourself screened for colorectal cancer. Experts assure you—you can literally nip it in the bud. If you wait until it has blossomed into a flower, the story becomes entirely different.
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