You’re putting what–where?!

Forty percent of FOFs still aren’t getting colonoscopies. Dr. Michael Kreines thinks he knows why…

Colorectal cancer is the most preventable and curable type of cancer. In fact, when it’s caught early, the five year survival rate is over 90 percent. And here’s more good news: colonoscopy, the most effective means of prevention, is fully covered under the new Affordable Care Act–you don’t even need a copay!

Yet 30-40% of adults over 50 still don’t get screened. What’s up, FOFs?

We spoke to Dr. Michael Kreines, a gastroenterologist and medical advisor for the Colon Cancer Alliance, about why women aren’t getting screened and what you can do about it. (Hint: It’s no big whoop. Just do it.)

  • Okay, why aren’t women getting colonoscopies?
    • They have to go somewhere and do something that they think is going to be uncomfortable, embarrassing and may result in bad news.
  • They’re afraid of the results.
    • Yes. They think, ‘gosh, if I’ve got cancer, I don’t want to know about it. I’m gonna die anyway.’ They associate getting a colonoscopy with finding cancer. But that’s not really what it’s about. Colonoscopies prevent cancer. We find polyps–which are little growths that can become cancer. And we remove them before they become cancerous.
  • So it’s like a pap smear? Or removing a mole?
    • Yes! That’s the analogy I use all the time. You’re detecting precancers.
  • Who should get a colonoscopy and and when?
    • If you’re 50 or older and you’ve never had a colonosopy, get one now. Your first one should be at age 50. If someone in your immediate family had colon cancer, then get your first one at age 40. If your immediate family member had colon cancer at a young age–for example, if your sister had it at 40–then have your first colonoscopy at 30. Just subtract 10 years from the age of your relative when he or she was diagnosed.
  • What if you have an aunt, uncle or grandparent who had colon cancer?
    • The data shows that your risk is a little elevated, but not as high at it would be with a first-degree relative. Still, if your aunt was young–for example, she was 40 when she was diagnosed–then we would start you a little bit younger. And if you have several second-tier relatives who’ve had it, then we would probably start you at 40.
  • How often should you get a colonoscopy?
    • Every 10 years. If you have a family history, have it done every 5 years. If we find polyps, then we encourage you to come back in 3 years.
  • If it’s been less than 10 years since your last colonoscopy, what sort of symptoms should send you back to the doctor early?
    • The most common symptom of colon cancer is no symptom at all, and that’s why colonoscopy is so important. You can’t wait for symptoms to be screened! But you can watch out for bleeding or blood mixed with your stool, abdominal pain that you haven’t had before, or a change in your bowel movements, such as unusual bouts of diarrhea or constipation.
  • What exactly happens when you get a colonoscopy? Does it hurt?
    • No–it really doesn’t. The night before, the patient drinks a bowel cleanser. Many people describe that as the worst part of the whole procedure because it basically gives you diarrhea. The day of the colonoscopy, you come in, put on a gown and are sedated.
  • Some people are nervous about being sedated. What kind of sedation do you use?
    • It’s called twilight sleep. You’re sedated, but you can still respond to questions and commands…you just don’t remember anything afterwards. While you’re sedated, we insert a flexible fiber optic scope into your rectum and up through your colon to look for polyps. If we find anything, we remove it right then.
  • Are there any alternatives to colonoscopy?
    • One alternative test checks your stool for evidence of microscopic blood. It’s based on the theory that any lesion or cancer will bleed. The problem with that test is that it’s not very accurate. There are a lot of tumors that don’t bleed, or they bleed intermittently, so you might be falsely reassured that you’re okay, when you’re not. There’s also a CAT scan, which is called virtual colonoscopy. It uses a fancy computer program to digitally make a picture of the colon. The problem with that test is that it’s very expensive, most insurance companies don’t pay for it, and it exposes you to a lot of radiation. Also, if polyps are found during the virtual colonoscopy, the patient will still need a regular colonoscopy to remove them.
  • Which test do you recommend?
    • The colonoscopy. It’s just the best test.
  • What else do you think would encourage women to just get screened?
    • It would be nice if the colonoscopy gown was more attractive. In fact, if you have any members who would like to design a more appealing gown, I’d love to talk to them.

Here’s something else that might inspire you. Right now, Olympus is donating $1 to The Colon Cancer Alliance for every woman over 50 years old who makes the commitment to get screened. Visit www.FinditFirst.com to commit right now!

Author
Dr. Michael Kreines
GastroenterologistDr. Michael Kreines is a gastroenterologist with the Ohio Gastroenterology and Liver Institute in Cincinnati, Ohio, and a Member of the Medical Science Advisory Committee for the Colon Cancer Alliance

16 Responses to “You’re putting what–where?!”

  1. RLSKLS says:

    Bravo to you, courageous and bold …
    I know what a struggle it was to follow through with all the fear and anxiety…but you did it! And congrats to your daughter for being such a super support. Great going!

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  2. JacqueS says:

    I actually went thru with it! OMG I did it! I had a Dr appointment Monday. They were able to convince me and got my RX reordered in time for the cleanse Tues. and the Colonoscopy Wed. I was not able to get anything but the GoLytely Prep. My daughter came up to nudge me along and to keep the prep solution coming in a timely way. Probably a good thing, cuz wasn’t always finished enough to get it myself. Don’t think I woulda/coulda done it without all her help and support. I panicked at first before I started the prep, as she handed me the first glassful. I just couldn’t make myself drink it…However, I composed myself and though a half hour delay, I managed to get all the prep down, except for a small amount I accidently spilled. Then I was worried after all that I wouldn’t be clean!
    Anyway, I am happy to report it is all done and over. Though I am slow to bounce back due to some of my other issues, and am still having noticable memory issues and having a nightmare with my veins, and crying from time to time from before the prep to laying there waiting saying “I can’t do this”… I DID! I am clean and no polyps at all so I am good for 10 years!
    I never thought I could actually go thru with this. I am so darn PROUD of myself and relieved too, I guess…which was a surprise I didn’t expect.

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  3. RLSKLS says:

    Jacque, Did you ever get your questions answered?
    If I don’t respond in a timely fashion please understand…I am having computer problems.

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  4. JacqueS says:

    Thanks for the reply. No I haven’t gotten my questions answered yet. I have a call in to one of them now and waiting. I tore up my RX and the prep/procedure info. As of right now I am not planning to go thru with it. I just can’t do it, for so many reasons… thanks again, Jacque

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  5. RLSKLS says:

    The prep worked well. I would never do the GOLightly again cause the taste to me is ‘not so great’…

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  6. RLSKLS says:

    did you get your questions answered?
    I prefer the Miralax powder cleanse to the Go Lightly. The Miralax has NO TASTE. It takes on the flavor of the liquid you dissolve it in. I did not follow the directions exactly for the cleanse. I started at 9 am instead of 12 noon. I spaced the drinks out longer…about 30-45 mins or so rather than 15.

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  7. CamiO says:

    My maternal grandmother passed away age 41 with rectal cancer. My older sister just passed away age 40 this January after only 9 month battle with small cell rectal cancer (on sphincter). I am currently having rectal bleeding so I went in to GI doctor who did ANOTHER colonoscopy on the 17th of October this year. I have had 3 colonoscopies in 3 years (because of gastroparesis) and each time I have had polyps (2-3 at a time/ about 3mm in size) removed each year. I don’t recall ever hearing about the “type” they are. I seem to be more concerned about “preventing” ME getting colon cancer because I feel that I am high risk. My last GI doc told me that I should have a follow up every 5 years but my PCP says yearly…..Do I really need to be “FREAKING OUT” or just taking precausionary measures? Does that fact that I have gastroparesis and do not eat a lot of fiber make me more at risk? What questions should I be asking the doctors as I seem to be fresh out and still feel like my questions are not being answered.
    Thank you for your help!

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  8. JacqueS says:

    No I was fully sedated during the cone biopsy. It was in the recovery room, while I was coming out of it, or waking up, when I couldn’t breathe, swallow, yell for help, move to grab them, etc. It was like I was drowning and has always had a profound effect on me…
    I am just concerned about the type of sedation after reading so many comments. It was to my understanding it was a “conscious sedation”. I have read comments and had people I know say lately that you are “knocked out” for this procedure. I just don’t know if I can do this if that is the case. As for the prep the day before, mine RX is for the GoLytely Bowel Prep and I don’t possibly think I can drink 8 oz if this stuff every 10 minutes until the whole gallon is gone. Thank you for the reply, I will call and ask questions until I feel assured and well informed…

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  9. RLSKLS says:

    JacqueS….Do I understand your concern? It sounds like you were awake when you were supposed to be sedated during your cone biopsy? That does sound awful. You have had a bad experience and are transferring the fear to this minimally invasive procedure.
    Please call your doctor’s office and tell them all about this. Make an appointment just to talk about this if necessary and bring all your concerns out in the open. They must know your fear and desire to cancel so they can give you the information you need.
    I am guessing that we are talking about 2 different procedures as far as pain is concerned. A cone biopsy sounds really painful. A colonoscopy is simply a small tube going through the colon which views the inside of the colon, looking for small growths. If they are removed when they are small the problem is resolved.
    To begin with, some folks do not take any sedation meds for a colonoscopy at all. It can be uncomfortable but I know it is not horribly painful. Katie Couric had a colonoscopy on national tv and chatted away with the doctor during the procedure. I saw this program myself. She seemed fine. She was fully awake.
    The sedation they give you is fairly minimal for a colonoscopy…(but I do not know the name of it). I am guessing that it is totally different than the sedation for a cone biopsy.
    I am guessing that you think the same thing will happen to you. You need information…and need assurance that all will be right and comfortable. IF need be, please talk to the anesthesiologist who will be doing the procedure. They are very knowledgeable. Ask good questions and get the answers you need. Don’t let fear win this one…you need information and assurance. Don’t let fear turn you into a statistic…please write back and let us all assure you. Call your doctor’s office asap…and start on the road to an education about this procedure…ok? peace be with you… RLSKLS

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  10. JacqueS says:

    I have to say, I have a colonoscopy scheduled and am quite frightened. In the 2 prep sheets the Dr.’s office sent me home with I thought I might might be able to do this. However, the one I was sent w/the RX attached isn’t like either one of those!
    In, 1995 I had a cone biopsy and had one of the most frightening experiences! I was in recovery, and I was aware of 2 nurses, techs, whoever they were, beside me. I couldn’t breathe, swallow, move, talk, or anything to let them know! I thought I was gonna pass right then and there!
    Anyway, I really need to know if it us consious sedation or not! They scheduled it so far out, I think I have read too much and have had too much time to think about it! As of right now, I am planning to cancel due to my fear, not of the test(though the day before sounds brutal) but how that last experience went…

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  11. RLSKLS says:

    Over the past (almost) 20 years I have had 7 colonoscopies.
    The prep has varied tremendously and certainly CHANGED for the BETTER over the years. ( A gastroenterologist should be informed as to the latest preps used in this procedure.) Last September I had my 7th colonoscopy and I used laxative pills to ‘get started’ and then switched to Miralax powder, dissolved in liquid for the rest of the cleanse. It was so gentle that I was convinced that I could not have the procedure in the morning because I was not fully ‘ready’.
    Surprisingly enough, I was ready and they proceeded to find another polyp that was ‘moderately aggessive’ and precancerous. I had had a colonoscopy 3 years previous and was convinced that they would find nothing…it was a
    surprise to me that the prep was so gentle…no cramping…nothing horrible at all.
    It is just time consuming and you need to be as rested as possible in case you stay up later than usual to finish the cleanse. I have found that it is not a picnic and not awful…and certainly BEATS CHEMO and major surgery for a colon cancer.
    I would encourage anyone who is afraid to talk it over with your doctor to find out the newer methods of doing the prep.
    FEAR often prevents us from doing the right thing for ourselves.
    We can OVERCOME this with information sharing and support.
    JUST DO IT ladies..and encourage your family to do the same.
    Colon cancer is preventable! See my sister’s story below in my first comment and please, please don’t let the prep stop you from doing what you need in order to be around for your families and live a full, productive life…FREE of colon cancer.

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  12. Teri Newman says:

    The prep is AWFUL which is why I haven’t done it. You get to drink 2-4 bottles of magnesium citrate which is nasty to drink and then spend the night in the bathroom straining and cramping–every 15 minutes. The test is a breeze–it’s the prep that’s HORRIBLE!

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  13. nanbon44 says:

    Please, Please take the advice of the doctors and have this test done. My Mom had one at 40 and it was clear.. so she thought she was fine. Her rule was if it ain’t broken, don’t fix it. She rarely went to a doctor and other then a cold here and there she never got sick… jump ahead almost 40 years, she thinks she has a hernia, goes to doctor which is something she dosen’t do often… Test is scheduled, and they find a tumor… which is the size of a football… surgery to remove tumor, chemo for 18 months and she loses her battle… something that could have been preventive with follow ups on her tests. So please call your doctor and schedule this test, I did and they removed pre cancerous polyps.

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  14. linaperl says:

    Great comments LeslieJean and RLSKS. stories like your make this real and hopefully get women to go get screened!

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  15. LeslieJean says:

    For your own sake and all those you love and who care about you, please schedule your colonoscopy today! I had one several years ago and had two polops removed, one was on its way to bigger and more awful things.
    P.S. It is a piece of cake – you don’t feel a thing! Truly, please schedule yours now.

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  16. RLSKLS says:

    My sister died at 52 of colon cancer. Her polyps started growing at approx. age 38. (Turns out we had an uncle who died at age 42 of colon cancer around 1952. )
    Breast cancer can be a ‘cousin’ to colon cancer and we were really watching for that cancer …(my mother had it so we were ‘on guard’ ; she lived to age 81 …a survivor!). Some cancers are ‘related.’
    Colon, breast and ovarian are ‘cousins’ . They jump around in a family. And if all 3 are in your family..or 2 of them are..etc..WATCH for the third cancer like crazy. (Men in your family also need to watch for prostate cancer as well, it is related to these 3 cancers).
    My younger sister had bilateral breast cancer at age 50. Both my younger sister and I had precancerous polps removed at age 48…and since then ‘ moderately aggressive precancerous polyps’ removed. The word REMOVED is the magic word! (I have had 7 colonoscopies by age 66.
    I have read that 80 % of those who get cancer have no history of it..so the lesson dear ladies is “PLEASE get a colonoscopy.”
    The prep takes time and energy. Buy a tube of Desitin to protect your bottom during the cleanse. The cleanse is tiring…but so is chemotherapy.
    The procedure is a lovely nap and no pain afterwards.
    You are not even sore afterwards.
    You enter the procedure room, they place you on your side,,,say good night to you and you wake up tired …but it is DONE! no more worries.
    It is not embarrassing..they do one procedure after another..just routine for the staff. They do not care what size you are or if your bottom is the perfect shape. You are draped nicely.
    Their goal is to save your life!
    Just do it!!!! Write me back and I will encourage you..and hold your hand over the internet.
    Do it today…get your appointment. My sister’s death taught us all an awful lesson ..we learned it well.
    We are now crusaders, fighting for the lives of anyone we can talk to about this!
    PLEASE learn from her and honor my sister’s life by saving yours.

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