Get your colonoscopy!

[Rich_by_the_Bay]

Rectal bleeding is about the only early symptom of colorectal cancer (and even then many are not localized). This can lead to anemia, another common presentation. By the time you reach mechanical symptoms like blockage, distention etc. it is usually a more advanced tumor.

Therapy has gotten more aggressive in recent years. We even remove liver metastases in selected cases, with notable improvements in survival even with that kind of metastasis. Newer techniques have reduced the number of patients who require a colostomy (draining the colon and its byproducts to an external opening). Chemo can be given before surgery with curative intent (neoadjuvant), or after apparent total surgical removeal (adjuvant) or even after metastases have occurred. While occasional major responses are seen, it is not generally considered one of the more chemo-sensitive tumors. Everything depends on the patient's individual circumstances and technical details.

You definitely do not want this disease, but if you have it your options are much better than they were even a few years ago.

I had my colonoscopy at age 51. It was easy. It was painless. It was embarrassing (the gastroenterologist and 2 of the 3 nurses and assistants were patients of mine). Versed is good.

Best wishes to the PBAT's and thanks for the opportunity to remind us to keep this important screening test up to date. Most of these tumors probably take 10 years to go from polyp to malignancy.
Do it if you haven't.

 

[Dawg52]

Best wishes to the PBAT's and thanks for the opportunity to remind us to keep this important screening test up to date. Most of these tumors probably take 10 years to go from polyp to malignancy.
Do it if you haven't.

Rich,

How often do you need to have a scope? In particular, a person that had a good first report and with no family history of colon cancer. My insurance will pay for one as a health benefit every ten years. Is that regular enough?

 

[Rich_by_the_Bay]

Rich,

How often do you need to have a scope? In particular, a person that had a good first report and with no family history of colon cancer. My insurance will pay for one as a health benefit every ten years. Is that regular enough?

10 years is recommended if the initial one was negative. 5 yrs if routine polyps are found and removed.

Interesting study some years ago which I am too lazy to retrieve looked at patients who underwent a colonoscopy and then a repeat colonoscopy the same day (brave souls or paid well). A jolting number of polyps were missed on the first study and found on the second one (like 14% or more, if I recall). Most were small and of low malignant potential, but still it gives you pause. The recommendations stick to 10 years, though.

Routine colonoscopy has still not been proven to save lives, but the cumulative observations, biologic, and common sense all favor following that guideline. The problem is that setting up such a study and controlling for all the variables such as diet, age, polyp type, and variation in care rendered is very difficult.

Virtual colonoscopy (kind of a fluoroscopic CT scan) has been disappointing and if you find something you end up with a colonoscopy anyway. Fecal blood testing alone has a 90% or higher false positive rate.

Next breakthrough in my crystal ball: molecular testing of stool samples for genetic evidence of colon cancer (then scoping only the positive patients). Probably a few years away and needs lots of mass population testing.

 

[Nords]

Interesting study some years ago which I am too lazy to retrieve looked at patients who underwent a colonoscopy and then a repeat colonoscopy the same day (brave souls or paid well). A jolting number of polyps were missed on the first study and found on the second one (like 14% or more, if I recall).

Sounds like a bunch of submarine nuclear engineers. They probably volunteered out of curiousity and hoped to apply the results to the Naval Reactors inspection programs...

 

[Achiever51]

Sounds like a bunch of submarine nuclear engineers. They probably volunteered out of curiousity and hoped to apply the results to the Naval Reactors inspection programs...

Huh?? Are you saying those Naval Reactors are full of S***?? What??!!!

 

[TromboneAl]

At the risk of discouraging people, I'll relate my colonoscopy experience of two weeks ago: it was painful.

[Warning: a little bragging coming up...]

The reason it was painful, according to the doc and anesthetist, was that I have "incredibly" strong abdominal muscles. That probably comes from splitting a lot of firewood and/or daily crunches. But apparently I would tense up and that would make things hurt.

I'm very hazy on what happened, but I have a clear memory of several times groaning and thinking, hey this hurts, and the anesthetist telling me to "breathe, breathe."

The anesthetist called me the next day to "see how I was" but I really think she just wanted to see if I remembered any of the pain.

It wasn't so bad that I'd skip the test, and it wasn't as bad as the prep, but I'm glad I don't have to do it again for 10 years. I hope that by then there's some alternative.

 

[Achiever51]

Wow! I must have had more anesthesia because I didn't feel a thing and remember nothing except that I was having a very peaceful dream when someone started calling my name to wake me up!

 

[73ss454]

Sorry Al, I've had it done 4X and didn't have one problem. The prep sucks but I need to loose a few pounds so no biggie.

 

[Alan]

I'm scheduled to have a 2nd one in 2 years which I will do even though my first one 8 years ago was a nightmare.

I was drugged but conscious, lying on my side and chatting to the very pretty nurse while the doc got ready. I heard a noise and turned to look, only to see what appeared to be the doc wrestling with a set of bagpipes and I realized that the insertion process was going to be akin to a chimney sweep pushing hinged rods up the flue. The process itself hurt like heck, particularly while he was attempting to turn the corner around the top of the horseshoe shaped colon. I could see my stomach bulging like the movie Alien just before the creature burst out. I was watching the progress also on the TV monitor and could see that all was clear as doc confirmed. When he withdrew the scope he announced that I had an exceptionaly long colon and that he would send me downstairs for a barium enema and scan, which he did. Downstairs they took an x-ray and told me that I was still full of air and needed to expell as much as possible otherwise getting the gallons of barium gung into me would hurt. Despite several trips to the toilet and letting rip blasts of air capable of capsizing a North Sea ferry, another x-ray showed plenty of air, but we proceeded and yes, it did hurt like hell.

Afterwards I went upstairs to reception to wait for my wife to come and pick me up. While waiting I got very ill and by the time she arrived I was outside with my tongue doing its best to escape from my mouth while dry vomiting. A number of folks asked if I was OK to which I replied "I was went went in for a routine test". I was sick for several days afterwards.

This all happened at age 45 because a routine proctoscope exam showed a polyp. I asked the doc as he withdrew the scope to show me the polyp that prompted the full treatment, but he said that it turned out to be a shadow cast by a natural fold in the colon.

Other than that, no problem. Can't wait for the next one

 

[megacorp-firee]

At the risk of discouraging people, I'll relate my colonoscopy experience of two weeks ago: it was painful.

[Warning: a little bragging coming up...]

The reason it was painful, according to the doc and anesthetist, was that I have "incredibly" strong abdominal muscles. That probably comes from splitting a lot of firewood and/or daily crunches. But apparently I would tense up and that would make things hurt.

I'm very hazy on what happened, but I have a clear memory of several times groaning and thinking, hey this hurts, and the anesthetist telling me to "breathe, breathe."

The anesthetist called me the next day to "see how I was" but I really think she just wanted to see if I remembered any of the pain.

It wasn't so bad that I'd skip the test, and it wasn't as bad as the prep, but I'm glad I don't have to do it again for 10 years. I hope that by then there's some alternative.

Al, I think your anesthetist was calling to see if you were going to sue him. I have had 2 of these things and each time they gave me a shot and told me to start counting ... by 2 or 3, I was being awaken by someone telling me that it was time for me to get up. I don't think you are suppose to be awake or anywhere close to it. I've had more discomfort getting my teeth cleaned.

 

[megacorp-firee]

I'm scheduled to have a 2nd one in 2 years which I will do even though my first one 8 years ago was a nightmare.

I was drugged but conscious, lying on my side and chatting to the very pretty nurse while the doc got ready. I heard a noise and turned to look, only to see what appeared to be the doc wrestling with a set of bagpipes and I realized that the insertion process was going to be akin to a chimney sweep pushing hinged rods up the flue. The process itself hurt like heck, particularly while he was attempting to turn the corner around the top of the horseshoe shaped colon. I could see my stomach bulging like the movie Alien just before the creature burst out. I was watching the progress also on the TV monitor and could see that all was clear as doc confirmed. When he withdrew the scope he announced that I had an exceptionaly long colon and that he would send me downstairs for a barium enema and scan, which he did. Downstairs they took an x-ray and told me that I was still full of air and needed to expell as much as possible otherwise getting the gallons of barium gung into me would hurt. Despite several trips to the toilet and letting rip blasts of air capable of capsizing a North Sea ferry, another x-ray showed plenty of air, but we proceeded and yes, it did hurt like hell.

Afterwards I went upstairs to reception to wait for my wife to come and pick me up. While waiting I got very ill and by the time she arrived I was outside with my tongue doing its best to escape from my mouth while dry vomiting. A number of folks asked if I was OK to which I replied "I was went went in for a routine test". I was sick for several days afterwards.

This all happened at age 45 because a routine proctoscope exam showed a polyp. I asked the doc as he withdrew the scope to show me the polyp that prompted the full treatment, but he said that it turned out to be a shadow cast by a natural fold in the colon.

Other than that, no problem. Can't wait for the next one

WOW, I knew that medical procedures, the knowledge level, and experience level vary by part of the country, the medical establishment, and just plain ole luck of the draw in getting someone that is part of the right hand side of the bell shaped curve versus the left hand side ... but man ... I am not sure you could get me to do that again after that experience. I count myself as VERY LUCKY.

 

[Alan]

WOW, I knew that medical procedures, the knowledge level, and experience level vary by part of the country, the medical establishment, and just plain ole luck of the draw in getting someone that is part of the right hand side of the bell shaped curve versus the left hand side ... but man ... I am not sure you could get me to do that again after that experience. I count myself as VERY LUCKY.

As the years go by the actual memory of the pain diminishes. At 50 DW had a colonoscopy with no complaints at all so I will almost certainly do it again.

 

[Rich_by_the_Bay]

Said hi to everyone in the room (I knew them all, though not as well as they now knew me). Went to sleep with my friend Versed, woke up, went home.

 

[Brat]

I had one Tuesday at Virginia Mason Hospital. Went to lala land via med in IV. Doc found and removed a polyp. Woke up with no memory of the procedure. Worst part was the gunk I had to put down the night before. Husband also had the procedure at VM Hospital. Same experience as I with no polyp.

Maybe 8 years ago I had one in the clinic, no med. Wouldn't do that it again unless my life depended on it.

Frankly this is a procedure where the physician should offer references. Horror stories prevent patients from using this cancer screening test.

 

[Achiever51]

...doc wrestling with a set of bagpipes and I realized that the insertion process was going to be akin to a chimney sweep pushing hinged rods up the flue.

...turn the corner around the top of the horseshoe shaped colon.

...I could see my stomach bulging like the movie Alien just before the creature burst out.

...still full of air and needed to expell as much as possible otherwise getting the gallons of barium gung into me would hurt. Despite several trips to the toilet and letting rip blasts of air capable of capsizing a North Sea ferry...

...I was outside with my tongue doing its best to escape from my mouth while dry vomiting.

...Other than that, no problem. Can't wait for the next one

First, sorry to hear that your procedure was a difficult one -- hopefully your experience will be better next time...I'm sure the process has improved over the past 8 years. (Like I've said, mine was absolutely painless.)

But I gotta tell ya, your description had me laughing so loud I woke up my DH from a sound sleep! "Capsizing a North Sea ferry"??!! Obviously your sense of humor is fully intact.

 

[citrine]

Alan....wow....I am amazed that you kept getting back on the table for the procedure....I think I would have ran out after the first hitch!

Rich_in_Tampa....do you think the procedure will be a lot less invasive and painful in the next 17 years?

 

[Martha]

Alan....wow....I am amazed that you kept getting back on the table for the procedure....I think I would have ran out after the first hitch!

Rich_in_Tampa....do you think the procedure will be a lot less invasive and painful in the next 17 years?

I am looking forward to a time where someone just waves a tricorder sensor over my hind end.

 

[Rich_by_the_Bay]

Rich_in_Tampa....do you think the procedure will be a lot less invasive and painful in the next 17 years?

Hmm, let me see: 17 years, eh? 50 - 17 = 33. So I'm guessing you're 33 yrs old.

Well my crystal ball tells me that a DNA marker for early colon cancer will be developed which would allow screening via the ever-popular stool sample. Positive results would then require a colonoscopy. The other 90% would not.

But who knows?

 

[Ronstar]

I had a massive stomach ache for about a month 3 years ago. The doctors decided to do a colonoscopy at the same time as an Endoscopy. So I was probed from two directions at once. I vaguely remember watching the video screen and wondering which end was on the screen. Ended up having a lemon sized growth surrounding my appendix constricting the wall of my colon. Took antibiotics for three months until the growth reduced in size and then had an appendectomy.

 

[RetireeRobert]

Had a sigmoidoscopy about 11 years ago,a nd it was clean. Never had a full colonoscopy. The virtual colonoscopy sounds interesting. Somewhere I think I read it is actually cheaper than pushing the scope up your insides? Plus no risk of bowl perferations from the scope.

Seems like a couple of significant advantages---especially if it turns out nothing bad spotted.

 

[happy2bretired]

I'm due for one this month, 'cept can get an appt. until next month. I have one every 5 years since my mother was diagnosed with rectal cancer many many years ago. The only problem that I've had with my past 3 tests was terrible cramping one year. I think I began eating too much and too fast afterwards. Bad cramps - went to the ER just to make sure everything was ok and it was.

 

[TromboneAl]

Plus no risk of bowl perferations from the scope.

That only happens if you have it done while eating cereal.

 

[Moemg]

That only happens if you have it done while eating cereal.

Or have incredibly strong abdominal muscles ! Oops !

 

[M Paquette]

I just ran across this thread, while chugging down HalfLytely (Now with FlavorPacks!) in prep for my second plumbing inspection, coming up tomorrow.

First one went well, with no problems. I had that one early to check on an 'anomaly'. It's been 12 years (I forgot...), so I'm past due.

 

[Gail]

I'm scheduled for my first next month.

I have a question for others about insurance coverage. It seems that my policy will pay (subject to my normal copay) if the procedure is done in a physician's office, but it will be subject to my deductible if it is done on an out-patient basis. Since I don't have any charges against my deductible this year, I'll have to pay the full amount. In my area, I don't know of any physicians who do these in their office.

Have most of you been covered by insurance or are you paying out of pocket?