Colonoscopy isn't the only option for colorectal screening, though it's still the best

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Tuesday, January 24, 2023
Colonoscopy is best, but not the only option for colorectal screening
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Experts are stepping up their message of the importance of regular screening and early detection.

FOX CHASE, Pa. (WPVI) -- The death of actress Kirstie Alley has put a spotlight on colon cancer, the third most common cancer among American adults.

Alley apparently didn't learn of her cancer until it was advanced.

For that reason, experts are stepping up their message of the importance of regular screening and early detection.

Tanyalee Wise wishes her dad could see her young daughters grow.

But at age 63, he lost his life to a colon cancer that wasn't caught early enough for a cure.

"He was hoping like he would get better. So he wasn't doing what he's supposed to do," says Tanyalee of Northeast Philadelphia.

The CDC says screenings should begin at age 45, earlier if you have:

  • 1. a family history of colon cancer
  • 2. an Inflammatory bowel disease such as Crohn's disease or ulcerative colitis
  • 3. a genetic syndrome that raises your risk, such as Lynch syndrome

When Tanyalee's doctor learned about her dad's death to colon cancer, and that she was 48 years old, she urged her to get a colonoscopy.

"I was very very scared," recalls Tanyalee.

Dr. Malorie Simons, an interventional gastroenterologist at Fox Chase Cancer Center, hears those worries daily and says there are multiple options for screening tests.

"The best test is the one that gets done and the one that gets done as soon as possible," says Dr. Simon.

"In the early stages, people may have no symptoms at all," she says. "What I tell my patients is to stay in tune with your body," so that subtle signs aren't missed.

And if something seems unusual, check with your primary care practice.

Colonoscopies use a small camera to look inside the colon for polyps - small growths that may become cancerous.

"Some studies have said that at 50 years old, 50% of people can have a polyp," she notes.

A sigmoidoscopy is similar, but only checks the sigmoid colon, which is the lower part of your or large intestine.

Virtual colonoscopies use a CT scan to look inside the large bowel from outside the body.

The third major type of screening is at-home tests which look for DNA and blood linked to colon cancer in the stool.

If there are negative results on the virtual or the at-home tests, a colonoscopy will be needed as a follow-up.

Dr. Simons says both forms of colonoscopy require prep to empty the colon but don't let that stop you.

"There are so many options that we can cater someone's bowel prep to him or her," she says.

Tanyalee said the colonoscopy team was comforting and reassuring.

"I wake up back and they call my name - Tanya, Tanyalee. I woke and said am I finished already?" she recalls.

"A lot of my patients say - 'Well, that was the best nap I ever had,'" says Dr. Simons.

Tanyalee says she won't have any reservations when she's due for her next colonoscopy.

And she says no one should say they're too busy working to get screened.

"You have to have good health for you to work. So you have to put yourself first," she says emphatically.

Dr. Simons says it's especially important for those 50 and younger to get screened.

Colon cancer is rising in those born in the 1980s and 90s, though no one knows why yet.

Dr. Simons urges patients to follow the Three B's:

  • 1. Bowel habits. What is your normal? Has anything changed over the past month or so?
  • 2. Bleeding.

"Any bleeding is not normal," says Dr. Simons, adding, "It deserves an explanation."

  • 3. Blood levels

"What we have found in early stages of cancer is that people can be anemic or have low blood levels. What that means is that people may feel more tired, more out of breath," says Dr. Simons.