By Ask Dr. Ramo BARRY RAMO For the Journal
Days after Tony Snow, President Bush’s former press secretary, died from colon cancer, my 55-year-old patient explained to me that she felt very safe from developing the disease because she didn’t have a single family member with colon cancer.
Snow’s mother died of the disease at age 38 and my patient thought the disease only developed if it ran in the family. She was wrong.
Every year, 100,000 people develop rectal cancer and nearly 50,000 people die from the disease. Of those, the vast majority are like my patient: They have no family history of the disease.
A family history is a significant risk factor if a family member or close relative (parents, brothers, sisters or children) had colorectal cancer at a young age. The risk also goes up if you have a history of cancer of the ovary or breast or ulcerative colitis. But absent those risk factors, my patient had the most important one and that is being over age 50.
Nearly all colon cancers stem from polyps or mushroomlike growths of gland tissue that arise from the colon’s inner lining. During a colonoscopy, a precancerous polyp can usually be cut out before cancer develops and about 30 percent of cancerous polyps can be cured without further surgery.
When detected early, colon cancer is among the most treatable of all cancers and has a five-year survival rate of 90 percent. That survival rate drops to 10 percent when people are diagnosed with the most advanced stage of the disease. Early detection through screening is an extraordinarily effective way to beat colon cancer.
The American Cancer and Gastroenterology societies have developed some easyto-remember guidelines for screening, and New Mexico is one of 26 states that requires that insurance companies pay for colorectal cancer screening.
The guidelines recommend that all men and women have a screening test at age 50. There is a variety of screening tests, but the most definitive is a colonoscopy in which a scope of the entire colon is performed to look for polyps and cancer.
If you have a family member like Tony Snow, you should have a colonoscopy 10 years before the age at which that family member was diagnosed.
Why not just wait for symptoms? Some of my patients believe “if it ain’t broke, don’t fix it.” In the case of colorectal cancer, by the time you’ve learned it’s broken, it could be too late to fix. You should get in for evaluation quickly if you have symptoms.
Any blood in the stool requires immediate evaluation. The polyps can bleed intermittently, so if the bleeding stops, it doesn’t mean the problem has been solved. With the exception of blood in the stool, the other signs of colon cancer appear when the disease is advanced. Signs like alternating constipation and diarrhea, pencil- thin stools, unexplained weight loss and fatigue are late signs and require immediate attention.
One alternative screening test is called virtual colonoscopy, which visualizes your colon after a prep to clean out the colon. At this time, the interpretation takes special expertise and if something is found, then you need a regular colonoscopy anyway. My feeling is that I only want one prep, so I see no virtue in a virtual colonoscopy except in isolated situations.
The prep to clean out your colon is no fun, but neither is developing colon cancer.
I explained all this to my patient, who now has her colonoscopy appointment on her calendar.
Dr. Barry Ramo is a cardiologist with the New Mexico Heart Institute and medical editor for KOAT-TV. E-mail questions to htaylor@abqjournal. com.
(c) 2008 Albuquerque Journal. Provided by ProQuest Information and Learning. All rights Reserved.
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