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Old 12-22-2013, 09:58 PM   #21
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I know, yet another thread on colonoscopies

They found 2 small sessile polyps in me (3mm and 5mm), and 3 in DW. (the FOBT was a false positive, as the Doc had predicted)

He recommended that we have another colonoscopy in 3 years, which was not music to my ears. Since I hate the procedure I went onto the NICE site in the UK to see their recommendations. (NICE is the National Institute of Clinical Excellence and provides guidelines to the NHS in the UK).

Their recommendation is for another screening in 5 years, not 3. I've copied out the relevant sections from pages 8 and 9 of the document. For "adenoma", read colon polyp.

Thoughts?

http://www.nice.org.uk/nicemedia/liv...3641/53641.pdf
Actually, not all polyps are adenomas. The recommendation for adenomas and hyperplastic polyps are different since adenomas are considered to be potentially cancerous and hyoerplastic polyps are like skin tags. Without risk factors follow up screening for hyperplastic polyps is generally 10 years. (Diverticulosis does not require routine screening.) I recommend having a talk with your PCP.

Colon polyps: Causes - MayoClinic.com
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Old 12-22-2013, 10:04 PM   #22
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Eh? You mean take responsibility for yourself and do the research....because you are the one who REALLY should make the decisions?
I don't see why I shouldn't take responsibility for the decision. I have had 2 colonoscopies with 2 different specialists and 2 identical results. However, the 2nd specialist has given me a different, more frequent and costly, recommendation. I can see no reason why I shouldn't seek a 3rd opinion, even if that comes from research done by myself looking into respected organizations such as the ACS and NICE. I will make my final decision in 3 years when the time comes, after further advice from my PCP here, and also possibly in the UK (I should be dual resident then).
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Old 12-22-2013, 10:13 PM   #23
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Actually, not all polyps are adenomas. The recommendation for adenomas and hyperplastic polyps are different since adenomas are considered to be potentially cancerous and hyoerplastic polyps are like skin tags. Without risk factors follow up screening for hyperplastic polyps is generally 10 years. (Diverticulosis does not require routine screening.) I recommend having a talk with your PCP.

Colon polyps: Causes - MayoClinic.com

Thanks, I am jumping the gun as I don't have the test results yet, but neither does the specialist who is already recommending a return visit in 3 years, "for surveillance".
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Old 12-22-2013, 10:40 PM   #24
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Had my third colonoscopy at five year intervals in 2010. This time Doc discovered a couple of polyps (which were removed) and diverticulosis. I was told to come back in 2015.

So, in 2011 I had a heart scare. This time the ER doc ordered a C-T scan because I was experiencing pain in my mid-section (Turned out to be a pulled muscle). The C-T scan showed the diverticulosis and would have shown the polyps if they had not been removed.

My question is. Why do a colonoscopy if a C-T scan will show the same things? It appears to me the C-T scan is less invasive.
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Old 12-22-2013, 10:52 PM   #25
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Had my third colonoscopy at five year intervals in 2010. This time Doc discovered a couple of polyps (which were removed) and diverticulosis. I was told to come back in 2015.

So, in 2011 I had a heart scare. This time the ER doc ordered a C-T scan because I was experiencing pain in my mid-section (Turned out to be a pulled muscle). The C-T scan showed the diverticulosis and would have shown the polyps if they had not been removed.

My question is. Why do a colonoscopy if a C-T scan will show the same things? It appears to me the C-T scan is less invasive.
I was told the colonscopy was more accurate. It had to be done according to the specialist. CT had revealed what may have been an issue. I'd had food poisoning for 3 days before the colonoscopy. I wish I'd had a picture when the doc told me I needed this procedure, along with the prep. I'm done with that hospital.
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Old 12-22-2013, 11:29 PM   #26
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My question is. Why do a colonoscopy if a C-T scan will show the same things? It appears to me the C-T scan is less invasive.

The colonoscopy is a far more sensitive test, and if polyps are found they can be removed.
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Old 12-22-2013, 11:51 PM   #27
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Some years back I was researching this stuff in my own quest for a colonoscopy. The new thing they were talking about was a "virtual colonoscopy" which was essentially a refined CT scan. Some studies showed it as accurate as a colonoscopy others said it was not so good. The downsides were 1) You still had to purge which for many people seems to be the worst part anyway, and there was some concern about the repeated radiation exposure.

As far as having to do a real colonoscopy anyway if they find polyps, not really. Most polyps are better left there. If they start getting bigger (1 cm was the cutoff) then remove them. As expected the radiological community was all hyped about the new procedure. The surgeon types were against it.

My own experience on trying to get one of these things done is that it is largely a scam like cholesterol to bilk people. When I said something like "They recommend one every 10 yrs", one Dr told me "No, we now recommend one every 3 to 5 yrs, even if they find nothing."

With all the hoopla the American Cancer Society considers colon cancer a "rare" form of cancer according to their head man a few yrs ago. (Dr Roberts or Robertson I think his name was) So we need to all get screened and be afraid to die over a rare form of cancer.

My personal experience every time I scheduled one was to get a shockingly incomplete briefing. Always a wham-bam-thank-you ma'am/ get 'em in and get e'm out deal. I canceled every one.
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Old 12-22-2013, 11:53 PM   #28
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... That said, in my own case, it was less than a year between a medical ok, and the diagnosis of cancer in the sigmoid colon.

...Today my across the street neighbor and best friend is dealing with unsuccessful radiation and chemo for advanced colon cancer. Not that there was a delay in diagnosis or any procrastination on his part, but a rapid onset (1 year) case that will not have a good ending...
In some rare cases, a tumor can grow rapidly. Consider thyroid cancer, which has been called the "best cancer" one would choose if one had a choice because it is slow growing and quite treatable. Yet, I knew someone who died within a few months of diagnosis because his was of the very aggressive type.

So, back on colonoscopy, what's one to do?

It should be noted that only some cancer types have screening, such as breast, colorectal, and prostate cancers. A full-body CT scan is not as useful as one would hope, I have read. It often leads to false positives, which would require more invasive procedures for biopsies. How would you like multiple organs of yours poked to check out every little lesion or nodule?

Health risk is something we cannot do much about or control. So, we spend all our time thinking about tweaking WR, or shuffling money around to save a bit of taxes. None of those financial worries matters that much when compared to one's health.

Thinking about all this makes me depressed. How about an asteroid hitting us and put us all out of human misery?
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Old 12-23-2013, 12:13 AM   #29
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Speaking strictly about colon cancer, how rare is it? What is the risk? I do not know what to compare it to, but according to CDC, a man at 50 years of age now and expecting to live another 30 years has a risk of 1 in 28 of getting colon cancer. If he expects to live till 90, the risk goes up to 1 in 23.

Is the above higher or lower than the risk of diabetes, heart attacks, strokes, other forms of cancer, etc...? I have not checked, but heck, when you make it to your 80s or 90s, or even 60s or 70s, your days are numbered. Something is going to get you. Well, we are all going to die of one thing or another.

Just today, my mother told me about an acquaintance we knew. This 50-ish man had total kidney failure and has been on dialysis for a year or so. He had a systemic infection (though his port apparently), got a fever and came down in a coma within a few hours. There's no hope of revival.

PS. Sorry, but the above puts me in a somber mood. I will get over it tomorrow.
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Old 12-23-2013, 12:26 AM   #30
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If I were in your situation, I'd go with the Dr's suggestion of doing it 3 years. It'd give me a peace of mind.
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Old 12-23-2013, 01:03 AM   #31
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Here's some more statistics I've found from CDC and various cancer institutes.

Top death causes in 2010:
  • Heart disease: 597,689
  • Cancer: 574,743
  • Chronic lower respiratory diseases: 138,080
  • Stroke (cerebrovascular diseases): 129,476
  • Accidents (unintentional injuries): 120,859
  • Alzheimer's disease: 83,494
  • Diabetes: 69,071

Regarding cancer, approximately 40.8 percent of men and women will be diagnosed with some kind of cancer at some point during their lifetime. Here are the top 5 cancer death rates in one year.
  • Lung and Bronchus Cancer 159,480
  • Colorectal Cancer 50,830
  • Breast Cancer 39,620
  • Prostate Cancer 29,720
  • Non-Hodgkin Lymphoma 19,020

PS. Note that the most common cancer type for men is prostate at 238,590 cases/yr. The most common type for women is breast cancer at 232,240. Yet, the death rates for these two are not as high as for lung and colorectal cancers as shown above. Lung cancer is the most deadly, followed by colorectal.
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Old 12-23-2013, 07:13 AM   #32
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My forst two were five years apart but now they switched me to ten years. I wish they had a better alternative. I don't care about the procedure itself -- I just hate drinking the anti-freeze.
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Old 12-23-2013, 08:25 AM   #33
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Thinking about all this makes me depressed. How about an asteroid hitting us and put us all out of human misery?
I'd rather have the colonoscopy instead.

It wasn't bad at all.

I was more scared of the IV needle than anything else,and I didn't feel that. I had a great team of nurses and a good doctor, and I will not hesitate to go back to her and that facility.
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Old 12-23-2013, 09:12 AM   #34
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I'd rather have the colonoscopy instead.

It wasn't bad at all.

I was more scared of the IV needle than anything else,and I didn't feel that. I had a great team of nurses and a good doctor, and I will not hesitate to go back to her and that facility.
The needle is just used to insert the catheter into the vein, then removed. Yes they might pinch a little, but it's plastic. Really nothing to fear.

I passed out at every Dr. appointment till I was about 25. This big chicken removed the IV himself at the last hospital visit, nothing to it. I'll do it again if they can't get a Dr. to sign a piece of paper in over four hours.

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Old 12-23-2013, 09:32 AM   #35
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I'd rather have the colonoscopy instead.

It wasn't bad at all.

I was more scared of the IV needle than anything else,and I didn't feel that. I had a great team of nurses and a good doctor, and I will not hesitate to go back to her and that facility.
Colonoscopies are the least of my worries; I have had two. Piece of cake!

I have had major surgeries recently, and been through some procedures that you would not want to know about. But eventually, most of y'all will have a taste of some of that.

What I meant was that despite all these procedures, we will all die of one thing or another. We are all just buying time.
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Old 12-23-2013, 09:45 AM   #36
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Interesting discussion. My GI doc wants me back after only 1 year. Why? The tubular adenoma was large (> 10mm), very flat, and in a bad location. He sent me home with the pictures for the proof.

The procedure was easy, and I didn't even think the purge was that bad since you don't feel sick like you do when you purge naturally due to something like Norovirus. The IV is nothing, I give blood regularly, and that needle is a fire hose. The IV needle is a thread. Finally, propofol is a wonder drug. No wonder Michael Jackson was hooked on it.

We'll see what happens next year. DW had one through the same doc and he recommended she return in 10 years, so I know he isn't necessarily just a money making machine. Still 1 yr gives me some pause, and I'll reevaluate next year.

A sibling has many polyps and a first cousin (1/8 gene sharing) had actual colon cancer. I think I need to be cautious.
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Old 12-23-2013, 10:15 AM   #37
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Originally Posted by NW-Bound View Post
Here's some more statistics I've found from CDC and various cancer institutes.

Top death causes in 2010:
  • Heart disease: 597,689
  • Cancer: 574,743
  • Chronic lower respiratory diseases: 138,080
  • Stroke (cerebrovascular diseases): 129,476
  • Accidents (unintentional injuries): 120,859
  • Alzheimer's disease: 83,494
  • Diabetes: 69,071

Regarding cancer, approximately 40.8 percent of men and women will be diagnosed with some kind of cancer at some point during their lifetime. Here are the top 5 cancer death rates in one year.
  • Lung and Bronchus Cancer 159,480
  • Colorectal Cancer 50,830
  • Breast Cancer 39,620
  • Prostate Cancer 29,720
  • Non-Hodgkin Lymphoma 19,020

PS. Note that the most common cancer type for men is prostate at 238,590 cases/yr. The most common type for women is breast cancer at 232,240. Yet, the death rates for these two are not as high as for lung and colorectal cancers as shown above. Lung cancer is the most deadly, followed by colorectal.
Where's the stat for dying of old age?
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Old 12-23-2013, 10:28 AM   #38
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Watching the colonoscopy on the TV screen is a fascinating experience... A little like the movie 2001... or like being in a big white cave with some red and blue lines on the wall and ceiling. The end of the endoscope has a camera bright light that shows the twists and turns, and if there is a polyp, you can see it being snipped off.

BTW... we're talking about colonoscopies... A sigmoidoscopy is considerably less invasive, and may be a good choice, if there are no obvious problems.
Before making the choice... if a choice is involved, it might be a good idea to check out the differences online. A sigmoidoscope is smaller and is used to explore the more likely polyp locations. Anaesthesia may or may not be required...
Sigmoidoscopies do not necessarily require a gastroenterologist, so the overall expense may be less.
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Old 12-23-2013, 10:55 AM   #39
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Thinking about all this makes me depressed. How about an asteroid hitting us and put us all out of human misery?
I'd rather be hit by a hemorrhoid.

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Where's the stat for dying of old age?
0%

No American has died of old age since 1951 when it was made illegal to die of old age

(Death Certificate has to give a reason other than "old age")
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Old 12-23-2013, 12:08 PM   #40
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I also got an invitation to come back in 5 years after my recent colonoscopy results.

My focus now is on diet as something positive I can do. I'm been eating a lot more dietary fiber starting with raisin bran cereal or maybe oatmeal in the morning. Also eating things likes figs. The stuff I'm cutting and the stuff I'm adding is in general easy for me. We already have a Mediterranean type diet.

I'm cutting out a lot of processed meats, see thread Processed versus unprocessed meats

I still eat a bit of processed meats like the 2 pieces of pepperoni pizza last night.
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