As the famous saying goes: An ounce of prevention is worth a pound of cure. In the next few paragraphs, I would like to discuss what I believe is one of the most important and underutilized preventative and potentially lifesaving tools available to our community: screening colonoscopy!
Colon Cancer
Colorectal (large bowel) cancer is a disease in which malignant (cancer) cells form in the inner lining of the colon or rectum. Most colon and rectal cancers originate from benign wart-like growths on the inner lining of the colon or rectum called polyps.
Colorectal cancer is the second most common cause of cancer-related death in the United States in both males and females. There are approximately 153,000 new cases and 52,000 deaths from this disease each year. Whats more amazing is that this terrible disease can be prevented by removing precancerous polyps (abnormal growths), which can be present in the colon for as many as 10 years before invasive cancer develops. Reducing the number of deaths from colorectal cancer depends on detecting and removing precancerous colorectal polyps, as well as finding and treating the cancer in its early stages. In fact, when colorectal cancer is identified early and treated, the 5-year relative survival rate is 90%. Because screening rates are low, less than 40% of colorectal cancers are found early! As many as 60% of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly!
I witness the tragic ramifications of these numbers frequently. However, I must admit that the most rewarding part of my work is that I also prevent such disasters on a daily basis. The routine colonoscopy is perhaps one of the most poorly understood and even feared procedures by the general population. Myths about the preparation, the procedure itself and complications leave patients frightened and anxious to the point that they put off going for the test. The reality is that a colonoscopy is a very simple, safe and effective procedure. Historically, the worst part of the test was the preparation on the day before the test. Now, many doctors use sports drink based preparations which significantly improve the taste and quality of this step. The procedure itself is absolutely painless and is usually quite comfortable and takes approximately 30 minutes. A short acting intravenous anesthetic is administered to the patient immediately before the procedure.
The true benefit of a colonoscopy is that it is not only a diagnostic tool, but more importantly it is therapeutic. This means that if a polyp is identified, it may be removed at the same time, thus preventing and even curing a potential cancer from ever developing.
Some men think that because theyre in good shape they dont need the test. Theyre wrong. Polyps are usually asymptomatic and can affect anyone, especially people over 50. In fact, colonoscopy is so important because it can find and remove the most polyps in asymptomatic individuals.
Its always a pleasure to be asked, when a patient wakes up, when are you going to start the procedure? or Thats it?
Everyone over 50 and those who have parents or siblings that have been diagnosed with colon cancer should be tested immediately. Remember, colon cancer is completely preventable, yet it is one of the most common causes of cancer death in the United States. Please consider the infinite merit of speaking to your doctor and referring loved ones for a colonoscopy.
________________
Dr. Rabin Rahmani is the director of medical education and research at Maimonides Medical Center and staff physician at Greater NY Endoscopy and Surgical Center. He has been recognized nationally for his clinical research in various aspects of gastroenterology. In addition to the management of liver, pancreatic and gastrointestinal disease, Dr. Rahmani specializes in advanced endoscopy.
