A life-saving screening

Published 11:39 am Tuesday, January 30, 2024

The second leading cause of cancer deaths in America is colon cancer. But if caught early, colon cancer is very curable. The gold standard for colon cancer screening is a colonoscopy, a medical procedure looking for changes in the large intestine and rectum, which may be swollen, irritated tissues, polyps or cancer. A colonoscopy is one of the most effective means of screening for cancer and preventing a tumor from developing. Because my grandmother died from complications related to colon cancer, this has always been a topic I am passionate about. 

Colonoscopies are only effective if you have them, and 15 million Americans have colonoscopies annually. In the United States, deaths from colon cancer per 100,000 people have been declining for several decades as colon screening has increased. The US Preventive Services Task Force recommends age 45 to begin colonoscopy screenings. For patients with a family history of colorectal disease, your doctor may recommend screenings starting earlier. I had my first colonoscopy at 40 due to my family history and I have had my nifty fifties scope now as well. 

Your doctor recommends a colonoscopy to screen for colon cancer, investigate intestinal signs and symptoms, and look for polyps. All procedures have risks, but a colonoscopy poses very few. Rare complications of a colonoscopy include a reaction to the sedative, bleeding from the site of a tissue sample or polyp removal, or a tear in the colon or rectum wall.

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Preparation for the colonoscopy includes cleaning the colon in advance of the procedure. Any material left in the colon may obscure the doctor’s view during the examination.

You cannot eat solid food the day before the exam and are only permitted clear liquids.

You’ll also need to take a prescribed laxative. While this part of the process seems to be the major reason people avoid having a colonoscopy, I must tell you that the preparation process is much more tolerable than with past products used. 

A colonoscopy typically takes less than 60 minutes.

In preparation for the procedure, you’ll change into a gown and receive intravenous sedation or anesthesia to minimize discomfort. You’ll lie on your side on the exam table with your knees drawn toward your chest. Once sedated, the doctor will insert a flexible tube called a colonoscope.

The scope contains a light and a tube that allows the doctor to pump air, carbon dioxide, or water into your colon, which is long enough to reach the entire length of your colon. The air or carbon dioxide inflates the colon, providing a better view. 

The colonoscope also contains a small video camera at its tip. The camera transmits images to a monitor where the doctor can study the inside of your colon. The doctor can also insert instruments through the channel to take tissue samples or remove polyps or other abnormal tissue.

It will take you about an hour to recover enough from the sedative to go home. Expect some bloating after the exam. The anesthesia used has a short half-life, with effects resolving quickly. While you may rapidly return to normal, you’ll need a ride home. 

It is common to experience a small amount of blood in your first bowel movement after the exam. Consult your doctor if you have persistent abdominal pain, continue to pass blood or blood clots, or if you develop a fever. 

A negative result is when the doctor doesn’t find any abnormalities in the colon. If you’re at average risk of colon cancer and you have no colon cancer risk factors, you may not need another colonoscopy for ten years. I was fortunate to get the pass to my 60th birthday for my next test unless I begin to have symptoms.

A positive colonoscopy occurs when the doctor finds polyps or abnormal tissue. Most polyps aren’t cancerous but can be precancerous. All polyps removed during colonoscopy are sent to a lab for analysis to determine whether they are cancerous, precancerous, or noncancerous.

The characteristics and number of polyps will determine the scheduling of your next recommended colonoscopy. Some larger polyps may require surgical intervention. 

The good news is that colon cancer, when confined to the colon, is very curable. And because most colon cancers start as precancerous growths called polyps, you can even prevent cancer by having a regular colonoscopy to find and remove polyps before cancer develops. Please don’t delay having this life-saving test! 

Our local hospital, St Luke’s, performs colonoscopies and the process is quite simple to arrange the test. Dr. Joshua Knolhoff, General Surgeon located at Foothills Medical Associates, perform these screens. You can call his office at (828) 894-5627 to discuss colon cancer screening further. To schedule your life-saving colonoscopy, have your primary care provider send a referral electronically, through EPIC, or by fax to 828-894-5879. For additional information, you can visit StLukesNC.org/surgery.