Story by Douglas Stutz, Naval Hospital Bremerton
Marcie West understands the significance with March as National Colorectal Cancer Awareness Month.
She never had a chance to meet her paternal grandfather, who passed away at age 52 to colon cancer before she was born.
“I would have met my grandfather if he got regular screenings. There is no reason to die of colon cancer. All of my brothers and sister and myself would have gotten colon cancer without the screenings. So much of our personal health can be changed if we prevent acute disease before it ever happens. I know I am doing everything in my power to be around for my daughter and husband as long as possible,” said West, Naval Air Station Whidbey Island Public Affairs Specialist.
Colon cancer is the third most common cancer in the U.S. with approximately 135,000 cases expected in 2017 per the American Cancer Society. It is also the second most common cause of cancer death among men – and third among women – with 50,000 deaths anticipated in 2017.
Checking for colon cancer means getting a colonoscopy screening.
According to Cmdr. Eric Lavery, Gastroenterologist, a colonoscopy can help find colorectal cancer in patients without any symptoms.
“Colon cancer will affect almost five percent of us in our lifetime. Its prevalence can be greatly reduced by doing appropriate screening tests. Most colon cancer starts as benign growths called polyps. While most polyps do not become cancerous, some polyps over 10-15 years on average may transition to colon cancer. A colonoscopy removes any polyps seen and by doing so reduces the risk of developing colorectal cancer by up to 60-70 percent,” said Lavery.
Risk factors for colorectal cancer include a diet high in red meat, obesity, physical inactivity, smoking and heavy alcohol use. People who have a first degree relative who developed colorectal cancer before the age of 60 are at high risk, and African Americans have the highest incidence and mortality of all racial groups in the United States.
Most guidelines recommend starting a colonoscopy at age 50. Subsequent colonoscopies will occur based on what was found at the prior screening. If no polyps or cancer were found, the next colonoscopy should be in 10 years.
“If you have a first degree relative with colorectal cancer, screening starts earlier,” Lavery said.
Such has been the case with West, an active duty spouse, raised in Centerville, Utah. She remembers her dad and his siblings getting their screenings at age 40 because of her paternal grandfather’s death.
“My dad was the oldest, so he was the first to get his screening. Over the next few years, each and every one of them had precancerous polyps. We were told our generation would have to start getting our screenings at age 30. I am the fourth of six kids, and each of us has had pre-cancerous polyps. My youngest sister and brother had issues earlier and got screened before they turned age 30. They both found pre-cancerous polyps in their 20s. Our kids will get their first screening before they are age 20,” related West.
The actual procedure isn’t what inhibits people though. It’s the prep-work before that.
“The hardest part of colonoscopy for most patients is the bowel preparation, or prep – taking a bowel cleansing solution – the night before and early the morning of the procedure. On the day of the colonoscopy the patient will have an IV inserted and be given medications to make them groggy. The (entire) procedure generally takes around 20 minutes,” said Lavery.
West readily agreed that the hardest part is the bowel prep.
“No one likes it. The drink tastes awful, and spending a day in the bathroom isn’t fun. But our family history is just too strong for us to not get screenings. Anyone can be impacted by colon cancer,” West said.
Lavery explained that the reason for the bowel prep is to clean out the colon so the doctor may see the entire colon clearly and minimize the risk of missing a polyp or lesion. This involves being on a clear liquid diet the day before the procedure. That evening a patient drinks two liters of the bowel cleansing solution. Early the next morning the patient needs to drink another two liters, ensuring it’s completed at least two hours before the scheduled time of their procedure.
Lavery attests that he knows some people balk at the process because they have heard how tough the bowel preparation is, with the need to consume large amounts of salty tasting liquid. It causes nausea in some patients, and diarrhea in all to cleanse the system.
“Of course many fear the procedure itself but for the vast majority that is of minimal discomfort and in many cases due to the medication, not even recalled,” Lavery said.
A beneficiary should discuss the need for colorectal cancer screening with their primary care manager. If colonoscopy is chosen as the test of choice, they should be referred to gastroenterology.
“No one likes getting colonoscopies. They aren’t fun. But I would much rather get a colonoscopy that chemo and radiation treatment,” stated West.