CHESAPEAKE, Va. — Colorectal cancer is highly preventable and highly treatable, yet it is the second deadliest cancer in this country. I spent some time with a local colorectal surgeon to talk about why and the importance of screening.
Dr. Reena Tahilramani with Chesapeake Regional Surgical Specialists explained, “When you have your screening colonoscopies, the goal really is for us to find something that we can take care of at that time, so it does not progress any further.”
During the procedure, using a colonoscope, doctors can snip off polyps if they are relatively small.
A polyp is a clump of cells that forms along the lining of the colon. Most are harmless, but over time some can become cancerous and even though the recommended screening age has dropped to 45, the rate of colon cancer continues to increase.
Dr. Tahilramani offered up a few possible reasons for that: “If you think about it, at 45 years, you know, we are in the midst of our career, we are family planning, we want to travel the world and so it’s easy to lose making yourself a priority and putting it sort of on the back burner," she said.
Often there are no symptoms with colon cancer, at least not early on.
However, possible indications include a change in bowel habits, bleeding, discomfort and weight loss.
I asked Dr. Tahilramani about risk factors and who should be on higher alert.
“One of our main risk factors is obesity. Yes, of course, you must be aware of family history, but I think it’s really a lot of social stuff, such as a lack of physical activity, and we have so many options of eating processed food at this point,” she told me.
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The Centers for Disease Control and Prevention also lists inflammatory bowel disease as a risk factor, along with alcohol and tobacco use.
Screenings, however, can reduce risk. So, why is compliance such an issue?
Well, one reason is the prep, but they’re not as bad as they used to be.
“Bowel preps have evolved. You don’t have to drink four liters how we used to before. You have the options of having a smaller volume of prep, you have options of taking tablets," said Dr. Tahilramani.
Yes, tablets. Two 12-pill doses of Sutab can be used for colon cleansing. So can a lower volume liquid called Moviprep, as well as over-the-counter products like Miralax and Dulcolax.
Those are just a few of the prep options now available.
Talk with your doctor about the best method for you, but the bottom line is colonoscopy prep has become much more convenient and palatable.
As for the actual procedure, Dr. Tahilramani explained, “You essentially fall asleep, and you have a lot of people monitoring you carefully. So, it’s not a dangerous situation by any means. Colonoscopies, if they are straightforward, don’t take more than 15 to 20 minutes.”
How often you get one depends on the findings of the screening. Dr. Tahilramani recommends every 10 years if the colonoscopy is normal, and three to five if polyps turn up.
Before wrapping up, I asked about one more thing.
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What about Cologuard, the at-home colon cancer screening kit?
“It is not the standard plus, I think the way I look at it personally is that, you know, a Cologuard could be negative if the polyps are not that big," Dr. Tahilramani said.
"I feel like there is a place for Cologuard. I don’t think it’s my first choice," she said. "You could miss something.”
Cologuard is not recommended for anyone with high-risk factors or a family history of colon cancer. Colonoscopies are considered the gold standard for screening.
The takeaway: stop putting it off. The day before prep and diet is not nearly as bad as you think, and neither is the procedure. A missed or delayed screening gives cancer a chance to grow.
March just happens to be Colorectal Cancer Awareness Month so if you’re 45 or older and haven’t had a colonoscopy, make your appointment today.
Chesapeake Regional Healthcare is posting a colon cancer awareness event on Wednesday, March 12. They'll have colon health resources on hand, free blood pressure screenings, and more. It's completely free to attend!
Event details are as follows:
