There's no doubt: Time to scope it out

While the thought of having a colonoscopy might be daunting for many patients, there is another thought to keep in mind.

"Colon cancer is a preventable disease," said Dr. Gary Griglione, a gastroenterologist at Carle Clinic.

For most cancers, including lung, breast or skin, a screening often confirms a problem that already exists. But doctors can use a screening toward actual prevention of colon cancer, he said.

A colonoscopy done as recommended at age 50 will allow doctors to see if there any polyps or growths that could develop into cancer.

"If you remove a polyp at an early stage, you can prevent it from becoming a cancer," Griglione said. "If you let that polyp grow, it may turn into cancer."

Most polyps take from five to 10 years to become malignant, but not all polyps become cancerous.

Nationally, doctors are getting only about 40 percent of patients older than 50 to come in for colon screening, he said. That means 60 percent are not getting checked.

"About 30 to 35 percent (of those patients over age 50) already have polyps," he said.

Griglione said when people wait until age 60 to 65 to have their first screening, they run the risk of already having a polyp.

A person having a colonoscopy might find that preparation might be more unpleasant than the colonscopy itself.

According to Joan Plunk, a nurse manager of special procedures at Carle Foundation Hospital, patients have to watch their food intake for five days before a scheduled colonoscopy.

Patients then go on a clear liquid diet, including such foods as chicken broth or soft drinks, for 24 hours before the procedure.

The evening before the procedure, they begin drinking a laxative, mixed with a clear liquid of choice, she said.

The purpose is to clean out the colon so the doctor can get the best view, according to Griglione.

When patients come in for the procedure, they are given doses of medication to control discomfort.

The medicine has an additional effect of short-term memory loss, so most people don't remember the procedure, he said.

"It's not an unpleasant experience," Griglione said.

The colonoscopy takes less than 30 minutes, Plunk said, followed by a recovery period that varies by patient but usually takes about 30 minutes. Most patients can expect to be at the medical facility for about two hours, she said.

Patients must have someone drive them home beause driving after having the sedation is not permitted.

Carle Clinic and Carle Foundation Hospital have plans for a proposed Carle Digestive Health Center that would include state-of-the-art technology for diagnosis and therapy for gastrointestinal procedures.

Among the improvements would be endoscopic ultrasonography technology and expertise.

The ultrasonography probe is on the end of the endoscope. This provides doctors a more precise view than if done through a conventional external manner, such as through a patient's skin.

According to Griglione, the center also would give patients and their families more privacy and comfort.

The Carle Digestive Health Center also will involve more research opportunities for doctors and patients.

FACTS AND FIGURES ABOUT COLON CANCER

Definition

Cancer that forms in the tissues of the colon (the longest part of the large intestine).

Most colon cancers are classed as adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).

Data

— In 2007, there were an estimated 112,340 U.S. residents with colon cancer and 41,420 with rectal cancer; there were an estimated 52,180 estimated combined total deaths of U.S. residents from both colon and rectal cancer.

— Not counting skin cancers, colorectal cancer is the third most common cancer in the U.S. with 153,760 new cases for men and women in 2007, behind lung cancer with 213,380 cases. For men, the leading cause of new cancer was prostrate cancer with 218,890 cases and for women it was breast cancer with 178,480.

— The death rate from colorectal cancer has declined for 15 years due to more frequent screening, improved treatments.

— An estimated $8.4 billion is spent each year on treatment of colorectal cancer in the U.S.

Average-risk group

— People with no family history of colon cancer and no symptoms (such as rectal bleeding, abnormal bowel movements, abdominal pains or constipation).

— People in this group should have colon screenings beginning at age 50 and then every 10 years afterward.

High-risk group

Colon cancer is more frequent in people over age 50 and the risk increases with age.

Risks also increase for people:

— who previously had colon cancer or polyps or people with a "first-degree" family relationship, such as parent or sibling who has had cancer or polyps;

— with chronic inflammation of the colon, such as Crohn's disease or ulcerative colitis;

— with a "second-degree" family relationship, such as aunt or uncle, who has had other cancers, like lung or breast cancer; or

— who have a diet high in fat.

People in this group should have screenings even earlier than age 50 and then have checkups every five years.

SOURCES: Carle Foundation Hospital, U.S. National Institutes of Cancer, www.cancer.gov; American Cancer Society, www.cancer.org

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