Despite remarkable advances in detection and treatment of colorectal cancer, it remains the second-largest cause of cancer mortality in the United States. This statistic looms despite the fact that colorectal cancer is one of the most treatable cancers there is because early detection, thus cure, is entirely possible.
What makes this unique among the other cancers for which we have screening tools is that prevention is also possible. This is because we can identify and remove premalignant lesions before they become cancer. So what accounts for the stark contrast between this grim statistic and our known ability to prevent, detect and cure this cancer? Lack of screening. The most common signs and symptoms of early colon cancer are — nothing at all. That’s why we so strongly recommend screening for colorectal cancer.
Current guidelines recommend colorectal cancer screening for adults between the age of 50 and 75. This may start earlier for those at higher risk (family history of colorectal cancer, chronic inflammatory bowel disease, polyposis syndromes or patients of African-American descent).
After the age of 75, we recommend screening on an individual basis. There are a variety of recommended screening tests. The gold standard is the colonoscopy, which provides both screening and prevention. Not only can it detect early stage cancers, but also precancerous lesions called polyps, can be removed to potentially prevent a cancer from developing.
As an employee of a health care institution, I consider it my professional obligation to inform you that I’ve had one, and it ain’t that bad. Want to hear more? Perhaps not, but I’ll tell you anyway.
Colonoscopies generally are recommended for people age 50 and older, since they account for more than 90 percent of colorectal cancer cases. The procedure, which involves running a thin, tubelike instrument through the colon, helps doctors spot precancerous polyps so they can be removed before they turn into cancer.
As it happens, I wasn’t quite 50 when I had mine, but I had a few minor symptoms that might fall into the “cause for concern” category. My primary care doctor and gastroenterologist weren’t particularly alarmed, but they wanted to play it safe, and they figured I was close enough to my golden years to experience this rite of passage.
In April 2010, I was diagnosed with stage 3B rectal cancer. This diagnosis came as a big surprise to me as well as my doctors, family and friends. The recommendation for colorectal cancer screening begins starting at age 50. So when I started having symptoms for this disease at age 36, the possibility that it may be colorectal cancer, at first, was at the bottom of my list.
My symptoms started in December 2009. John and I had taken a road trip down to visit my family in Florida. While I was there, I noticed that I had become constipated. I associated this with being in a car for long periods of time and not eating well while traveling. This persisted on and off even after we came back from Florida.
Somewhere between January and February 2010, I started noticing some blood in my stool. Since nine out of 10 people who are diagnosed are over the age of 50, I thought it could be anything but colorectal cancer. This concerned me, but I was still having constipation, so I assumed I had possibly done some internal damage that was causing this occasional bleeding.