April 14, 2011 - Imagine being offered this deal: In exchange for undergoing some minor indignity (say, going to lunch dressed in a leopard-print leisure suit) you could drastically lower your risk of premature death. Chances are, most of us would take that deal in a heartbeat.
And yet, simple embarrassment is a big reason why many Texans avoid potentially life-saving colonoscopies and other colorectal cancer exams. Another common -- and just as poor -- excuse is the overhyped physical discomfort of these procedures.
There's a much stronger case for the pro-exam side, says the Texas Department of State Health Services (DSHS). For starters, about half of all deaths from colorectal cancer could be prevented through screening. The Cancer Prevention & Research Institute of Texas adds that, if everyone 50 and older were screened, colorectal cancer deaths might drop by as much as 60 percent.
So maybe it's time for a closer look at some of the reasons keeping about half of all Texans in the high-risk 50 and over age group from getting needed exams such as colonoscopies, rectal exams, barium enemas and fecal blood tests.
One stress-inducer is the device used in the exam: a thin, flexible endoscope that's inserted through the rectum and used to search for active cancer and pre-cancerous polyps in the colon. It sounds potentially painful but isn't. And polyp removal, included in the procedure, also is painless.
Some clinics and hospitals even offer virtual colonoscopy, a process that uses multiple X-rays or magnetic resonance imaging (MRI) to examine the colon. The technique delivers a more detailed image than regular colonoscopy and doesn't require sedatives or insertion of an endoscope.
Embarrassment? Most patients say it's a non-concern, due partly to the private setting and partly to potent sedatives administered beforehand.
Doctors also say the shudder-inducing tales of preliminary bowel cleansing with jugs of salty laxative are increasingly outdated. Many physicians now allow patients to cleanse themselves with over-the-counter laxative pills and small bottles of magnesium citrate, which many find more palatable than the liquid laxatives previously used.
Good as this news is, the bottom line is that colorectal cancer exams should be considered mandatory, even if they were as unpleasant as some say. According to American Cancer Society, about 9,000 new cases of colorectal cancer are diagnosed each year in Texas, with more than 3,200 cases leading to death.
That death rate should be much lower, the society says. When colorectal cancer is found and treated early, the five-year survival rate is about 90 percent. But, because many are tested late or not at all, only about four out of ten cases are diagnosed in time for successful treatment.
In addition to having the colorectal cancer screenings your doctor recommends, you can also look out for yourself by remembering these basic facts:
Common symptoms of colorectal cancer include blood in or on the stool, a change in bowel habits, stools that are narrower than usual, chronic stomach discomfort and unexplained weight loss.
More than 90 percent of colorectal cancer cases occur with people 50 or older. Other risk factors include a family history of colorectal polyps, rectal bleeding or chronic inflammatory bowel disease.
Colorectal cancer isn't just a guys' disease; it affects men and women equally.
Finally, remember that colorectal cancer can develop with few, if any, obvious symptoms. Don't let their absence -- or the persistent urban legends of unpleasant screening tests -- keep you from doing right by yourself and your loved ones.
From Texas Health and Human Services
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