March was designated as Colorectal Cancer Awareness Month back in 2000 as a way to remind people to get screened for the disease. The Center for Disease Control reports that cancer of the colon or rectum is the second leading cause of cancer-related deaths in the United States. But it doesn’t have to be. The truth is colorectal cancer is a very curable illness. It can be detected and treated long before it becomes a major problem, and getting a colonoscopy every 10 years starting at age 50 is the best way to do that.
We know the colonoscopy works. For the past 20 years, the medical profession has been collecting data from screening colonoscopies and during that time the number of deaths has gone down by about three percent. When you consider 141,000 people were diagnosed with colorectal cancer in 2011, we’re talking about more than 4,000 people living a normal, healthy lifestyle who otherwise would not have been.
Everyone should get a colonoscopy no matter how you choose to live. Only about 20 percent of colorectal cancer cases are genetic, and there is no medical consensus that eating habits can prevent it. It’s true we do see more cases in a society like ours that consumes a lot of processed foods and beef. But I’ve seen cases of colorectal cancer in people who live all kinds of lifestyles from red meat-eaters to vegans.
The overwhelming majority of patients have no abnormalities on a colonoscopy. About 25 or 30 percent of patients will have a benign polyp, which puts them at higher risk for colorectal cancer. The colonoscopy procedure allows the doctor to remove or biopsy a polyp at the same time. If the abnormality is pre-malignant or malignant, it can be removed with a follow-up colonoscopy or a minor surgical intervention that won’t alter a person’s lifestyle.
Even if the polyp is cancerous, the chance for a positive outcome is very good. The surgical procedure for removing the affected area has been around for the better part of a century. The whole operation takes about 90 minutes and most patients are able to leave the hospital after four or five days, with full recuperation taking two to three weeks. Some patients may need radiation therapy or chemotherapy if the cancerous tumors have advanced to the lymph nodes or other areas. These post-operative treatments advance the cure rate significantly for people who had malignant tumors.
Most of the patients I see who have an invasive cancer have never had their routine screening. Unfortunately, a 2010 survey found that about 35 percent of the men and women of eligible age for a colonoscopy do not get one. Some people put it off because they’re scared they won’t be able to live a normal life following surgery. But that kind of outcome occurs in a very small minority of patients. Of course, those who get their colonoscopy screening on time stand a very good chance of avoiding major surgery altogether.
Here in Windham County, we’re seeing less colorectal cancer than we were five years ago, and I think that’s directly attributable to the amount of screenings that are done. If you’re over 50 years old, talk to your primary care provider and set up a routine colonoscopy with a gastroenterologist. If there is an abnormality that needs a surgical intervention, my colleagues and I at Brattleboro General Surgery can take care of almost every situation right here in the local community, which makes it easier for your family and friends to visit and lift your spirits while you recuperate.
Dr. Thomas H. Lewis is a board-certified surgeon and a Fellow in the American College of Surgeons. He practices jointly with Dr. Gregory Gadowski and Dr. Joseph Rosen at Brattleboro General Surgery, a member of BMH Physician Group. He can be reached at 802-254-5510.