Colonoscopy Critical to Prevention of Colorectal Cancer
Colorectal cancer is the second leading cause of cancer-related deaths in the United States and, excluding skin cancers, is the third most common cancer diagnosed in men and women. This year more than 50,000 people will die from colorectal cancer. In fact, someone dies from colorectal cancer every 9.3 minutes.
What is unique about colorectal cancer is not that it is common, nor that it strikes both men and women equally, nor that it strikes all races equally. What is unique is that a readily available procedure prevents colorectal cancer!
As the human genome has been unraveled it has become apparent that most colorectal cancers develop because of the presence of one or more “polyp genes”. Polyps are benign growths on the lining of the rectum and colon. These inherited genes are passed from one generation to the next. Occasionally, a mutation, or genetic defect, can occur spontaneously placing the patient at risk to develop colorectal polyps.
“Because these ‘polyp genes’ are so prevalent in our population, we are all at risk to develop colorectal cancer,” says Dr. Norman Haines, a gastroenterologist with Pensacola’s Gastroenterology Associates. “Patients with a first degree relative (parent, sibling or child) with a history of colorectal polyps or cancer have an even greater risk for this potentially lethal disease,” Dr. Haines adds.
Factors which may potentiate the expression of the gene include cigarette smoking, diets which are high in animal fats and obesity. Researchers are studying the effects of factors which may reduce the expression of the gene, including the use of aspirin and other anti-inflammatory drugs such as celecoxib (Celebrex), ibuprofen (Advil; Motrin) and naproxen (Aleve; Naprosyn), as well as calcium supplements.
Polyps rarely cause any physical signs or symptoms. The patient remains unaware that these premalignant lesions are growing within the colon or rectum. After five to ten years, there is a significant risk that as the polyp grows it will degenerate into a cancer. Left in the colon, these cancerous polyps invade the bowel wall and may spread throughout the body.
“Because we now understand the natural history of colorectal cancer, it is a relatively simple matter to prevent the disease,” according to Dr. Haines. “Colonoscopy (the inspection of the entire colorectal lining by a flexible scope) is the only procedure which both diagnoses colorectal polyps and removes them at the same time, this preventing the development of cancer,” says Dr. Haines.
Colonoscopy is an outpatient procedure, performed under sedation which renders the procedure painless. The patient cleanses the colon the day before the scheduled procedure by either drinking a liquid solution, or by taking the recently developed and more preferred series of pills with water. During the examination the entire lining of the rectum and colon are inspected for polyps. When a polyp is encountered, it is removed using an electrosurgical cautery devise which allows the polyp to be retrieved for pathologic examination, as well as destroying any cells at the base of the polyp, while closing the blood vessels to minimize bleeding. Following a brief recovery the patient may immediately eat and resume normal activity the following day.
It is recommended that average risk patients undergo screening colonoscopy at age 50. If no polyps are present, then schedule a follow-up colonoscopy every ten years. High risk patients (family history of polyps or colorectal cancer) should begin screening at age 40, and then undergo examination every five years.
“The incidence and death rate from colorectal cancer has begun to decrease over the last decade since the current screening guidelines have been universally accepted,” Says Dr. Haines. “We have within our means the ability to make colorectal cancer a rarity.”