for COLON CANCER
SCREENING & DIAGNOSTIC
Cancer of the colon and rectum is now the second most serious cancer among adults. Screening and diagnostic tests will take the guesswork out of your health problems. They will tell you if you are in a disease state or at risk for colon cancer.
A CONSUMER'S GUIDE TO COLON CANCER SCREENING
The following information is offered as educational information only. It is your responsibility to consult your physician regarding your health.
COLON CANCER PREVENTION
- It is most important to reduce the risk of colon cancer by changing the diet – increasing fiber; and decreasing bad fat, refined foods, additives and chemicals.
- It is beneficial to cleanse the colon of toxic bacteria and poisons with cleansing herbs, enemas, rectal implants or Colonic Irrigation Hydrotherapy.
- It is important to determine if you are actually at risk. Physicians recommend early detection through the use of several tests. Screening tests are used periodically for people who are experiencing gastrointestinal disturbances. Diagnostic tests are used to follow up positive screening test findings for people with symptoms of high risk.
Although there appears to be some evidence of hereditary disposition, the vast majority of these cancers appear to be related more to diet, environment, and lifestyle.
OCCULT (hidden) BLOOD in the STOOL
This is the most widely used screening test for colon cancer. Colorectal cancers often develop slowly without any signs or symptoms. These cancers tend to bleed easily, but the amount of blood may be so small that it cannot be seen. Fortunately there is a simple chemical test called Hematest or Hemoccult-II that can make this hidden (occult) blood visible. A stool sample is placed on a slide and a developer is added. Any trace of blue color, not grey or green that appears within 30 seconds after adding the developer shows a positive result. However, this does not mean that you have colon cancer. The blood could come from hemorrhoids, an ulcer, an anal fissure, an inflamed colon, a polyp, bleeding gums, or colon cancer. About two percent without symptoms who perform this test obtain positive results. Ten percent of those people will be diagnosed with colon cancer, so early detection may be a lifesaver. Discuss any positive results with your physician.
It is also important to determine whether parasites or bacteria are present in the feces, if they are suspected as a cause of disease. To perform this examination, a fresh stool is collected in a clear container. It is immediately examined under a microscope in order to see whether bacteria, worms, or eggs (ova) are present. Amoeba and other parasites are readily discovered by this means also.
FINGER (digital) RECTAL EXAM
About twelve percent of colorectal cancers are located within a few inches of the anus and can be detected by the physician who inserts a finger to feel for lumps. This exam should be a routine part of physical exams for people over 40. It can be a bit uncomfortable and is generally not as sensitive for cancer detection as other screening tests.
About half of all colorectal cancers occur in the lower bowel within a foot of the anus. These cancers can be detected by visual examination of the lining of the rectum and lower (sigmoid) colon with an instrument called a sigmoidoscope, a rigid, hollow tube with a light on the end. The metal tube is about one foot long and a half inch in diameter. If a mass or polyp is found, a small segment of the growth may be removed by a special forceps. This segment is examined microscopically to determine whether malignant cells are present, as well as any polyps, ulcerations, or inflammation.
Proctosigmoidoscopy has been shown to detect one to three new cancers per 1,000 exams. Another five to ten percent of those examined will be diagnosed as having adenomatous polyps, internal growths that should be removed to prevent possible transformation into cancer. Doctors recommend proctosigmoidoscopy every 3-5 years after age 45 for people with average cancer risk. The procedure takes about 15 minutes; however, an enema is necessary beforehand. The only risk from this test is perforation of the bowel, which is extremely rare. The drawbacks are that it covers only a limited section of the colon. It is expensive and time consuming, and it requires considerable experience to perform well. Further, many people find the exam uncomfortable and somewhat embarrassing. A new, longer but flexible fiberoptic sigmoidscope promises to make the exam much more comfortable and effective, but this new instrument is expensive and many doctors lack training in its use. Consult a Gastrointestinal Specialist.
A considerable research effort is being devoted to development of laboratory tests to detect substances in blood and other bodily fluids related to cancer. One of the early blood tests involved measurement of carcinoembryonic antigen (CEA), but this test proved inaccurate. CEA was found in many people who did not have cancer. At present the CEA test is used to follow pwoplw qith known cancers to check for reoccurances. Other promising tumour marker tests are being developed.
This test involves pouring barium, a contrast solution, into the colon via the anus, and then taking x-rays which outline the entire colon lining. The xrays can show polyps, diverticula or cancers. In “air contrast” or “double contrast” barium enemas air is added through the rectum to improve the quality of the pictures. The physician will require the taking of a laxative prep such as mineral oil, magnesium or citric acid the day before the x-ray in an attempt to cleanse the colon. It may be considered to have a Colonic Irrigation Hydrotherapy done by a Certified Colon Therapist to remove the remaining barium from the colon. All of the barium does not expel into the toilet after the x-ray is completed. Barium enemas are uncomfortable but fortunately pose little health risk.
This procedure involves insertion of a long, flexible fiberoptic tube into the colon via the anus for direct viewing of the entire colon lining. Specimens and biopsies can be takenwith the colonscope. It takes considerable technical skill on the part of the doctor to perform a safe, adequate exam. This test is decidedly uncomfortable, but it is safe; the major risk, perforation of the colon is extremely rare. Furthermore, the risk from colonoscopy is considerably less than the risk from an abdominal operation, which is sometimes the only alternative.
Its purpose is the same as the proctosigmoidoscopy except that it provides a greater depth of view into the colon.
ASSESSING YOUR CANCER RISK
- Do you have any of these symptoms?
- Rectal bleeding or blood in the stool
- Recent change in bowel habits
- Narrow pencil-thin stool
- Unexplained weight loss
- Anemia (low blood count)
These might be signs of colon cancer. If you have any, consult a physician.
- Are you 45 or older? Colon cancer risk increases with age beginning at about 45, and doubles each decade thereafter, peaking at 75 to 80. Those over 45 should consider regular screening checks for colon cancer.
- Do you have a history of previous colorectal cancer? A history of colon cancer means a five to ten percent chance of reoccurance.
- Do you have a history of colonic polyps? Most of these small growths on the inside lining of the bowel are benign (noncancerous) but some can develop into cancer.
- Do you have a family history of colon cancer of familial polyposis? Having a blood relative with colon cancer increases your risk slightly. Some families have an inherited tendency to develop extensive polyps throughout the colon, a condition who do not treat it have nearly a 100 percent chance of developing colon cancer. Symptoms of these polyps usually develop during childhood.
- Do you have ulcerative colitis? People with inflammatory bowel disease (not to be confused with “spastic colon” or “functional bowel disease”) have an increased risk of developing colon cancer.
If you answer “yes” to any of the above questions, be sure to discuss it with your physician.
A colostomy is a surgically created opening in the colon, to be an artificial anus in the wall of the abdomen. A colostomy may be temporary, to divert intestinal contents where a portion of the colon is healing; or it may be permanent, as is usually the case if a large section of the bowel must be removed due to disease. A colostomy bag is a plastic pouch that covers the artificial opening and receives the excretions, which then have to be emptied from the bag.