Colon Cancer –– What to look for and how to prevent it

By Dr. Michael S. Morelli, Indianapolis Gastroenterology and Hepatology, Indianapolis South LIVING WELL Magazine

Colon cancer is the third most common cancer and accounts for the second most cancer related deaths in the U.S., despite being preventable and curable if found in its earliest state. Roughly 3 – 5% of people will develop colon cancer in their lifetime but many Americans never get appropriate screening for colon cancer. There are many reasons for this, likely related to fear of screening, lack of understanding for the need for screening, or lack of guidance on when and how to get screening by physicians.

Symptoms of colon cancer can include blood in the stool, unexplained loss of weight, iron deficiency anemia (low blood count due to low iron total body stores), and sometimes abdominal pain and diarrhea. However, colon cancer can be without any symptoms whatsoever which highlights the needs for patients to have screening colonoscopy exams to look for colon cancer or pre cancerous growths of the colon called colon polyps. The risk of colon cancer is higher in those with a significant family history of colon cancer, in smokers, and those who are overweight.

In the absence of symptoms, all people, male or female, should have a colonoscopy for colon cancer screening starting at the age of 50. If there is a significant family history of colon cancer or advanced polyps, defined as a first degree relative (parents, siblings, children) or two second degree relatives (grandparents, aunts, uncles) with a colon cancer history, patients should be screened earlier, either at age 40 or 10 years younger than the age at which their first degree family member was diagnosed. Patients that have chronic diarrhea, blood in the stool, or iron deficiency anemia regardless of age should talk to their family doctors about having a diagnostic colonoscopy done.

While there are several available methods for colon cancer screening, colonoscopy is considered the gold standard screening exam for colon cancer and is covered by almost all insurance carriers. This procedure involves the insertion of a long, thin, flexible tube with a camera on the tip into the rectum and the gentle pushing of the scope to the end of the colon. The procedure is done with intravenous sedation with continuous monitoring of patient vital signs so that the procedure is both comfortable and safe. The risks of the procedure are minimal with only a 1 in 1,000 chance of a serious complication. The overwhelming majority of patients state that the day before the procedure, during which patients need to be on a clear liquid diet and ingest a fluid that will lead to bowel cleansing, is the worst part of the process and that the exam itself is quite easy and relatively painless. This is an outpatient procedure typically lasting 30 minutes with a usual arrival time of one hour before the procedure and including a 45-minute post procedure recovery time. Patients cannot drive themselves, work that day, or make important decisions due to the sedation given for the exam. The bowel preparation usually can be started around 5 p.m. or so the day before the procedure and thus does not require the day off of work on that day.  Colonoscopies are typically done by gastroenterologists, physician specialists in diseases of the esophagus, stomach, small and large bowel, liver, and the pancreas with extensive skill and experience at performing colonoscopy exams.

Indianapolis Gastroenterology has over 30 years of experience in performing low risk and high quality colonoscopy exams on their patients. This group has published multiple articles on screening colonoscopy in several peer review journals including “The New England Journal of Medicine” and administers a colonoscopy screening program for the local employees of Eli Lilly, Marathon Oil, and Caterpillar.

Please contact your physician to discuss having a colonoscopy or contact us directly at 317-865-2955, ext. 123 to schedule a visit to our office or visit us at www.indygastro.com to learn more about our clinical capabilities as one of the leading gastroenterology programs in the state. 

Be sure to mention when you call that you read about our organization in LIVING WELL Magazine.

About the author: Michael S. Morelli MD, CPE, is vice president of Indianapolis Gastroenterology and Hepatology and medical director of Colorectal Cancer Center of Excellence at St. Francis