by Jeffry Potash, MD
- Why is there so much talk about colon cancer?
Colon cancer is the third most common cancer. In Vermont, there are about 330 new cases per year and 24 of them are from Windham County. Many people know someone affected by this disease.
- Can colon cancer be prevented?
Yes, to a certain degree. All major health authorities recommend colon cancer screening for people beginning at age 50. Screening is testing people for the disease, even if they have no symptoms. Individuals should not wait for a symptom, such as rectal bleeding, to have their colons checked. People presenting with symptoms typically have advanced cancer. Those with cancer found by screening have earlier stages of the disease.
- Should I have testing to look for colon cancer?
Yes, if you are 50 years or older. People with family members who have a history of colon cancer or polyps should begin testing by age 40, at the latest.
- What is a polyp?
A polyp is a benign growth that can turn into cancer. By removing polyps, we may be preventing cancer and the need for an operation.
- What kind of tests are there to detect polpys or cancer?
The vast majority of patients have a colonoscopy to look for growths. There are other alternatives such as X-ray tests, sigmoidoscopy, and stool collections which look for blood.
- If there are multiple options, what should I do?
As mentioned, the vast majority of people protect themselves from colon cancer by having a colonoscopy. It is the most complete, most comfortable, and most accurate type of exam. It is also the only test that can deal with abnormalities definitively, by removing growths. It is also done once every 10 years if no abnormalities are found.
- I’ve heard the preparation for colonoscopy is awful! Is that true?
Some people do have a hard time as they need to drink a gallon of salty water over a period of four hours to cleanse the colon. There are alternative “clean outs” and almost everyone can get through the process.
- Once I’ve gotten through the prep, what will happen?
You will come to the hospital for about three and a half hours to receive intravenous fluids, go under sedation, have the colonoscopy, and recover for an hour. Someone will have to drive you home afterwards.
- How dangerous is a colonoscopy?
Generally quite safe. But, there can be serious complications like bowel perforation or over sedation. Even taking into account the chance of something going wrong, the potential benefit of finding a problem is felt to outweigh the risk in almost all patients under age 76. According to guidelines released last year, patients age 76-85 should carefully weigh the risk-benefit ratio. Patients over age 85 should not have colonoscopy screening.
- How much will this cost?
This answer varies upon several factors such as whether or not you are insured, your insurance’s deductible and co-payment policies, and whether or not you are a Medicare or Medicaid patient. What is found during a colonoscopy, like a polyp, can also affect your out-of-pocket costs. However, colonoscopy is often covered by health insurances provided you meet the coverage criteria and according to Vermont law, preventative tests (like colonoscopy) should be covered. Contact your insurance for their coverage policy.
- Is the United States making progress getting rid of colon cancer?
Yes, the incidence of new discoveries of colon cancer is decreasing. However, no test is perfect and about four in ten Vermonters have not been tested.
- I’ve never been advised to have a colonoscopy. What should I do?
There could be many reasons for that. You should be proactive with your health and ask your doctor about getting tested for colon cancer.
- Are there better places than Brattleboro Memorial Hospital to have colonoscopy?
No. BMH has all the equipment, expertise, and facilities to do excellent colonoscopies. Nationally recommended guidelines of “scope withdrawal time” and “polyp detection rate” are being met. I believe the personalized nursing care at BMH is outstanding.
- What’s with this virtual colonoscopy people talk about?
A virtual colonoscopy is a CAT scan-generated image of the colon lining. It is not generally approved by Medicare and other insurances because, while it may find abnormalities, a colonoscopy would still be needed for further assessment. A colonoscopy is still the best and most efficient way to test.
Dr. Potash is a gastroenterologist on the Medical Staff at Brattleboro Memorial Hospital.