March is, among other things, ColoRectal Cancer Awareness Month, so we're going to talk about your colon (if you're eating breakfast you may want to save this for later). Colorectal cancer is the second most common cancer diagnosed in the US, if you combine men and women - in women alone, it is the third most common, after breast and lung. Approximately 140,000 people will be diagnosed with colorectal cancer every year, and 52,000 will die.
Some symptoms of a possible problem with your colon are obvious, like bleeding from the rectum or suddenly thin, pencil like stools. Others are subtler, such as a change in your bowel habits, vague abdominal pain, bloating or cramping, or unexplained weight loss.
There are many risk factors, some you can control and some you can't. Colorectal cancer increases with age, with more than 90 percent of cases occurring in people over age 50. Other out-of-your-hands risk factors are a family history of colon cancer; personal history of colon polyps or inflammatory bowel disease (ulcerative colitis or Crohn's); or a genetic syndrome.
Risk factors you can control mainly involve lifestyle choices. Colon cancer is significantly higher in smokers, so don't start, or quit if that horse is already out of the barn. Being overweight or obese increases the risk, as does a lack of physical activity. Poor diets, high in fat, red meat and processed meats like bacon (yes it is yummy but it's not so good for your tummy) and low in fiber, fruits and vegetables increase the risk, as does excessive drinking. These are all things you can make a conscious choice to modify to improve your health.
Screening for colorectal cancer is important - and often overlooked. Who, after all, really wants a rectal exam or colonoscopy? Who even wants to talk about it? Well, your doctor should be talking to you about it and you should be squaring your shoulders, bucking up and having the screening - if everyone were screened as recommended, deaths from colorectal cancer could be reduced by 60 percent - that means 31,000 more people would be alive each and every year.
For those at average risk (no family history for example), screening starts at 50; for those at high risk, screening needs to start earlier - how early depends on your particular risk factors. A rectal exam and/or testing for fecal blood (FOBT or FIT) can be done at your annual exam. These tests only screen for existing cancers that are already causing bleeding. A virtual colonoscopy or sigmoidoscopy may show precancerous polyps, but they have limitations: you can't do a biopsy with a virtual colonoscopy so any abnormality seen requires a "real" colonoscopy or sigmoidoscopy in order to do a biopsy, and sigmoidoscopy misses about a third of the large intestine. Colonoscopy, which examines the entire large intestine, is the gold standard, and is recommended every 10 years.
Bottom line: chose to live a healthy lifestyle, see your doctor for regular exams and get your colonoscopy.
- Dr. Kelly Shanahan, a board certified gynecologist and owner of Emerald Bay Center for Women's Health, has been serving the women of Lake Tahoe and the Carson Valley for 19 years. This month, her practice is offering free FOBT testing with all annuals for women 40 and over. Call 530-542-4961 or 775-782-7300.