Colonoscopies: What can you expect?

It's March - Colon Cancer Awareness Month - so we have been sharing information about colon cancer in this space, on Facebook and Twitter, and in our monthly e-newsletter. We've emphasized the need for awareness of the risks and symptoms, and provided information on recommended prevention methods. But we know that one of the most important things an individual can do to prevent colon cancer is also one of the least likely things an individual will do, simply because the thought of having it done makes most people uncomfortable.

Many of the misconceptions and fears regarding a colonoscopy stem from a basic ignorance of what the procedure entails, and how it's performed. To help ease some of those fears, we thought it might help to share a briefing on how to prepare for, and what to expect from a colonoscopy from the U.S. Department of Health & Human Services website:

How to Prepare for Colonoscopy

The doctor usually provides written instructions about how to prepare for colonoscopy. The process is called a bowel prep. Generally, all solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before the procedure. Patients should not drink beverages containing red or purple dye. Acceptable liquids include:

• fat-free bouillon or broth
• strained fruit juice
• water
• plain coffee
• plain tea
• sports drinks, such as Gatorade
• gelatin

A laxative or an enema may be required the night before colonoscopy. A laxative is medicine that loosens stool and increases bowel movements. Laxatives are usually swallowed in pill form or as a powder dissolved in water. An enema is performed by flushing water, or sometimes a mild soap solution, into the anus using a special wash bottle.

Patients should inform the doctor of all medical conditions and any medications, vitamins, or supplements taken regularly, including:

• aspirin
• arthritis medications
• blood thinners
• diabetes medications
• vitamins that contain iron

Driving is not permitted for 24 hours after colonoscopy to allow the sedative time to wear off. Before the appointment, patients should make plans for a ride home.

How is colonoscopy performed?

Examination of the Large Intestine

During colonoscopy, patients lie on their left side on an examination table. In most cases, a light sedative, and possibly pain medication, helps keep patients relaxed. Deeper sedation may be required in some cases (Tip: don't hesitate to ask your doctor about this option if you are interested). The doctor and medical staff will monitor vital signs and attempt to make patients as comfortable as possible.

The doctor inserts a long, flexible, lighted tube called a colonoscope, or scope, into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctor to carefully examine the intestinal lining. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing.

Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again. Bleeding and puncture of the large intestine are possible but uncommon complications of colonoscopy.

Removal of Polyps and Biopsy

A doctor can remove growths, called polyps, during colonoscopy and later test them in a laboratory for signs of cancer. Polyps are common in adults and are usually harmless. However, most colorectal cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer.

The doctor can also take samples from abnormal-looking tissues during colonoscopy. The procedure, called a biopsy, allows the doctor to later look at the tissue with a microscope for signs of disease.

The doctor removes polyps and takes biopsy tissue using tiny tools passed through the scope. If bleeding occurs, the doctor can usually stop it with an electrical probe or special medications passed through the scope. Tissue removal and the treatments to stop bleeding are usually painless.

Recovery

Colonoscopy usually takes 30 to 60 minutes. Cramping or bloating may occur during the first hour after the procedure. (This is due to the carbon dioxide used to inflate the colon.) The sedative takes time to completely wear off. Patients may need to remain at the clinic for 1 to 2 hours after the procedure. Full recovery is expected by the next day. Discharge instructions should be carefully read and followed.

Patients who develop any of these rare side effects should contact their doctor immediately:

• severe abdominal pain
• fever
• bloody bowel movements
• dizziness
• weakness

There are many stories in the news this month about the value of getting a colonoscopy, and some, like this one, that detail personal experiences with the screening test. Across the board, the most common complaint patients share about the procedure is the colon prep that requires patients to drink a gallon of less-than-delightful liquid to clean out the colon. Colon cancer is the 2nd most deadly form of cancer, and the 3rd most diagnosed form of cancer in men and women in the United States. Surely a day of unpleasant preparation is worth the effort when compared to the alternative - a diagnosis of colon cancer.

For information about our Save-A-Life program that assists patients with the costs of colonoscopies and other cancer screening tests, contact Christina Bostian at 479-361-5847 or by email.

March Colon Cancer Awareness

For many years, we have been spreading the word about colon cancer screenings and their potential to save lives. Recently, our claims were backed up in the New England Journal of Medicine. According to an article printed in the New York Times, the results of a research study show a correlation between colonoscopies with polyp removal and a 53% reduction in deaths from the disease. The five-year survival rate for colon cancer found in an early, localized stage is 90%. Now, we just have to convince more people to get screened.

Colon cancer (also called colorectal cancer) is the third most common cancer in both men and women as well as the third most deadly. While incidence rates have been decreasing for most of the past twenty years (colon cancer used to be the number two cancer killer), increased awareness and prevention education is still vital because early stages of the disease do not typically show any symptoms. And, while the number of total diagnoses has been declining, the number of younger adults being diagnosed has been on the rise. Knowing your risks, the symptoms, and how to get screened in a timely manner is potentially life-saving knowledge.

"What are my risks?"
The biggest risk of colon cancer is associated with age. According to the American Cancer Society, 91% of cases are diagnosed in people 50 years of age and older. Other medical or hereditary factors that increase your risk include a family history of the disease, a personal history of other colon-related diseases such as chronic inflammatory bowel disease, and certain inherited genetic conditions. Studies have also found that people with type-2 diabetes are at higher risk.

Non-medical, and easily modifiable risks include obesity, physical inactivity, a diet high in red or processed meats, alcohol consumption, long-term smoking, and possibly very low intake of fruits and vegetables. Consumption of milk and calcium and higher blood levels of vitamin D appear to decrease colorectal cancer risk in research studies.

"What are the symptoms?"
As we mentioned before, early stages of colon cancer typically do not show any symptoms, which is why screenings are so important. More advanced stages of the disease may cause rectal bleeding, blood in the stool, a change in bowel habits, and cramping pain in the lower abdomen. In some cases, anemia can result from blood loss within the bowel, which would cause symptoms such as weakness and excessive fatigue.

Recommendations:
Beginning at age 50, your doctor should start encouraging you to get a colonoscopy. If the results show no polyps or areas of interest, you should plan to schedule another screening in ten years unless you have risk factors that would suggest more frequent follow up screenings. Discuss your personal follow up plans with your physician.

Another screening option is the Fecal Occult Blood Test (FOBT) that can be done at home in the privacy of your own bathroom. Throughout the month of March we have FOBT kits available at no cost. Simply stop by our office at 5835 W. Sunset in Springdale to pick one up, and follow the directions on the package.

If you experience any of the symptoms listed above in yourself or your loved ones, you should pursue evaluation by a medical professional as soon as possible. If your doctor prescribes a screening test and you are unable to pay for one, contact our Save-A-Life program coordinator, Christina Bostian, for information on how to apply for assistance from Hope Cancer Resources. We're here for Northwest Arkansas with support for the journey and education for life. 

Prevention and Early Detection Save Lives!!

We've been talking a lot lately about prevention and early detection being important keys to reducing your risk for cancers of any type, but this month we're backing up that talk with action! We are providing free colon cancer screening kits to anyone in Northwest Arkansas who asks for one, so come by to pick one up! In fact, be a true friend and get one for everyone you know. Sure, that sounds a little weird, if not downright awkward... handing out colon screening kits isn't something you usually do after a great session of Zumba with the girls or a couple of rounds of golf with the guys. But we're talking about a cancer that kills approximately 50,000 Americans each year. 

Here are a few myths from the American Cancer Society about colorectal cancer that might make it easier to consider a screening:

Myth: Colorectal cancer is a man's disease. 

Truth: Colorectal cancer is just as common among women as men. In fact, according to the Centers for Disease Control, it is one of the most commonly diagnosed cancers in the U.S. - number 3 on the lists for both men and women.

Myth: Colorectal cancer cannot be prevented.

Truth: In many cases colorectal cancer can be prevented. Colorectal cancer almost always starts with a small growth called a polyp. If the polyp is found early, doctors can remove it and stop colorectal cancer before it starts. These tests find polyps: double contrast barium enema, flexible sigmoidoscopy, colonoscopy, or CT colonography (virtual colonoscopy).

To help lower your chances of getting colorectal cancer:

• Get to and stay at a healthy weight.
• Be physically active.
• Limit the amount of alcohol you drink.
• Eat a diet with a lot of fruits and vegetables, whole grains, and less red or processed meat.

Myth: African Americans are not at risk for colorectal cancer.

Truth: African-American men and women are diagnosed with and die from colorectal cancer at higher rates than men and women of any other U.S. racial or ethnic group. The reason for this is not yet understood.

Myth: It's better not to get tested for colorectal cancer because it's deadly anyway.

Truth: Colorectal cancer is often highly treatable. If it is found and treated early (while it is small and before it has spread), the 5-year survival rate is about 90%. But because many people are not getting tested, only about 4 out of 10 are diagnosed at this early stage when treatment is most likely to be successful.

The screening kits we have available are easy to use, and did we mention they're FREE??

And just as a reminder, here's where we talk about signs and symptoms of colon cancer. No matter your age, if you are experiencing any of these please talk to your doctor and get screened. Younger people are often diagnosed in later stages of the disease just because their symptoms were mis-diagnosed. You owe it to yourself and the people who love you to do what you can to prevent cancer.

Just Around the Corner!

We are busy this week making last minute plans for the Heather Ridley Fleeman Battle for Hope scheduled for this Saturday, May 1st at Old Tiger Stadium in Bentonville. Banners to pick up, prizes to get sorted and assigned, volunteers to train... it's a little crazy, but it's going to be a great event!

If you don't know already, the Battle for Hope is named in honor of a young woman from Bentonville who lost her battle with colon cancer at the young age of 28. She had struggled with bowel issues for several years before she was finally diagnosed with Stage IV Colorectal Cancer. It wasn't suspected due to her young age and the absence of a family history of the disease. The race was created to raise awareness of this deadly cancer - the 2nd deadliest form cancer affecting men and women in the U.S. (lung cancer is #1) and one of the most preventable and detectable.

Hope Cancer Resources offers free colon cancer screening packets annually during Colon Cancer Awareness Month in March, but throughout the year we also have a program to assist the uninsured and underinsured to receive colon cancer screenings. Too often, insurance companies will not pay for a colonoscopy if the patient is under the age of 50, placing the burden of payment - which can amount to around $1,000.00 - upon the patient. How many of us have that kind of cash lying around? Our Save-A-Life program tries to alleviate some of that stress.

There are, of course, outward signs of colon cancer. They include blood in the stool, unusual weight loss, and extreme fatigue. But by the time the patient encounters these symptoms, it can be too late for complete recovery. That's why we are so committed to helping people get screened early, and often. The kits we offer are discreet and can be taken to a lab by the patient themselves.

So, what are you doing this weekend? We have a slight chance of getting a little rain on Saturday, but nothing like we had last Saturday. We will be there, rain or shine. Please join us to support our assistance and educational programs, and to bring attention to the need for early colon cancer detection! See you there!

What are you doing May 1st? 

Now that you've read our post about March being Colorectal Cancer Awareness Month, you've probably gotten your free screening kit and taken care of the immediate need of being aware of your own risk and current situation... but we know you've been thinking "Gee, I wish I could do something that will help others with their battles..." Fortunately, we have the perfect opportunity for you!

The 6th annual Heather Ridley-Fleeman Battle for Hope is set for May 1st this year, and we are going to have a great turnout of runners and walkers all raising awareness of colon cancer in our community and supporting the screening, assistance and education programs available free-of-charge through Hope Cancer Resources. There will be 10k & 5k races, a 5k walk, a 1-mile family fun walk, and kids' races. Something for everyone!

You can find more information about the event on the race website - including the story of Heather Ridley-Fleeman, the young woman for whom the race is named. She died at age 28 after several years of colon issues, doctor visits, and finally a diagnosis of Stage IV colon cancer. She wasn't in the highest risk group for the disease since she was in her 20's, which led to her diagnosis being delayed. We don't want anyone else to suffer what Heather suffered, but that's going to mean getting the word out about early detection and frequent screenings. Don't wait until you're 50! Don't wait until you are experiencing symptoms of the disease! Early detection can happen before you have any symptoms, and it can save your life.

You can register for the race online on the event website. If you can't join us, but would still like to support our efforts, feel free to make an online donation. You can even start your own fundraising page! Every dime raised will stay in Northwest Arkansas and be used to help your friends, neighbors and possibly your loved ones. If you have any questions about the event, please contact us at 479-361-5847. 

See you there!!

March is Colorectal Cancer Awareness Month!

Colon cancer is probably not the most popular lunchtime topic for you and your co-workers. Nor is it likely that you'll be chatting about fecal blood tests with your neighbor as you trim your lilac bushes. It's an uncomfortable subject due in part to the manner in which it's detected. Subjects involving bodily functions are uncomfortable to discuss with medical professionals - let alone people you see more than once a year while wearing more than a couple of yards of cotton fabric.

Perhaps it's the reluctance we have about discussing it that makes colon cancer the #2 cancer killer in the United States - second only to lung cancer. In fact, there are approximately 150,000 new cases diagnosed every year in this country, with over 50,000 deaths resulting. 


Do we have your attention yet? 

Here are a few more facts we've collected. Feel free to throw them around while chatting with your friends... they may look at you funny, but if it helps even one of them catch colorectal cancer early - it will be worth the risk of being talked about behind your back or uninvited to happy-hour for a couple of weeks, we promise.

• The lifetime risk for an American to get CRC is 1 in 19 for both men and women.
• Annual screening with a proven Fecal Occult Blood Test (FOBT) can lead to the detection and removal of polyps and reduce the risk of getting CRC by 20%.
• Annual screeting by FOBT can help reduce the number of deaths from CRC by 15-33%.
• The five-year survival rate from CRC is about 90% when the disease is detected early, compared to only 11% when it is detected in a later stage.
• Annual screening with a proven FOBT can detect 90% of CRC cases in average risk individuals; i.e., those who are age 50 and older and have no symptoms.  

To highlight the preventable nature of this disease, we are giving away free screening kits at Hope Cancer Resources throughout the month of March. You can come by our office in Springdale, Arkansas, or you can contact Rebekah Billingsley, our Community Cancer Education Coordinator, to request a kit to be mailed to you. Rebekah can also provide more information about screenings we provide through our Community Outreach Programs. 

Additional information about colorectal cancer can be found at one of these websites: 
The Colon Cancer Alliance
American College of Gastroenterology
Johns Hopkins Colon Cancer Information
The Colon Club