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Health
Like many people, Nancy
Bierley, of Ottawa Lake, Mich., was
anxious before undergoing her first
colonoscopy to test for colon cancer nine
years ago. “I was scared of the actual test
and what they may find," she recalls.
But now Bierley, 63, sings the test’s
praises due to the peace ot mind that
followed.
And that is really what this poten
tially life-saving test is all about, says
Dr. James Lynch, a colon and rectal
surgeon at William Beaumont Hospital
in Troy, Mich. A colonoscopy allows
a doctor to examine the inside of the
colon—the large intestine —for signs
of cancer or polyps, which are abnormal
growths inside the colon. If polyps are
found, they often can be removed dur
ing the procedure, before they become
cancerous. “If we find polyps and remove
them, you don't get colorectal cancer,"
Lynch explains.
Although most polyps never become
cancerous, nearly all colon and rectal cancers start out
as these small growths. In Bierley’s case, the doctor
removed several polyps; laboratory tests showed they
weren't cancerous, but Bierley had three follow-up
colonoscopies in the five years after her first screening.
She now plans to have a follow-up every five years.
An ounce of prevention
Colorectal cancer is the third most common form
of cancer in the United States, excluding skin cancers.
The American Cancer Society estimates that the dis
ease will claim the lives of nearly 50,(XX) Americans
this year.
But there is good news: Coloreccal cancer is one of
the most preventable types of cancer, and the disease's
death rate has been declining for more than 20 years,
thanks to screening exams and better treatments.
While there are several tests that can help screen
for the disease, the colonoscopy is considered to be the
"gold standard.” The American Cancer Society recom
mends that men and women who are at average risk
for developing colorectal cancer get a colonoscopy every
10 years beginning at age 50. People with certain risk
factors, including family history of colon cancer, or
symptoms such as blood in the stool, change in bowel
habits, unexplained weight loss or abdominal pain,
may be advised to have the test at an earlier age and at
more frequent intervals.
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The procedure
Preparation for a colonoscopy, which starts the day
before the test, is designed to ensure that the stomach
and colon are empty. “We tell people to consume only
dear liquids starting the day before the procedure,”
Lynch says.
Most preparation methods involve consuming a
large volume of liquid laxative preceded by or fol
lowed by laxatives in pill form. The medication takes
from 90 minutes to four hours to begin working, and
the effects may last for several hours. “We suggest
starting to drink the liquid when you get home from
work, so it will run its course and you can get a good
night’s sleep,” Lynch says.
Most colonoscopies are performed by a gastroenter
ologist—a doctor who specializes in diseases of the
digestive system —or by a surgeon. During the test,
the doctor guides a colonoscope—a slender, flex
ible, lighted tube—into the rectum and through the
remainder of the colon. The scope is connected to a
video camera, which allows the doctor to see the inside
of the colon. Small putfs of air are inserted in the colon
to keep it open.
Typically, patients are given a mild sedative and may be
given intravenous pain medication to minimize discom
fort during the 10- to 20-minute exam.
Immediately after the exam you should be able to
discuss the findings with the physician. The doctor will
IS 1
show you photographs of any polyps that were found and
removed, and will tell you when to return for another
colonoscopy. You probably will be drowsy due to the seda
tion, so arrange ahead of time for transportation home.
A colonoscopy is considered to be a relatively sate pro
cedure. but there are risks; although unlikely, it’s pos
sible that the colonoscope could accidentally puncture
the colon. Studies have shown the risk of perforation
vary from one in 500 to less than one in 1,000. About
5 percent of such perforations are fatal.
"This is not usually a complication following a nor
mal colonoscopy," Lynch says, but the risk increases
when polyps are removed.
“Today the scopes we use are smaller and more flex
ible and che risk of not having a colonoscopy is much
greater than the risk of having one,” adds Dr. Mark
Fendrick, a professor of internal medicine at the Uni
versity of Michigan in Ann Arbor.
Bierley is glad she underwent the procedure. "Once
you get past the preparation," she says, "the test is a
breeze and it can save your life.”
A colonoscopy typically costs SBOO to about $1,500.
Some insurance plans cover the procedure, and Medi
care recipients are entitled to a colonoscopy screening
every 10 years. For more information, contact your doc
tor or the American Cancer Society at (800) 227-2345
or wuw.ianar.org. ★
Story try Da list Mann of New York City.
•www.americanprofile.com
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