Health
Colorectal Cancer Screening Saves Life: What Coastal Doctors Say
Portsmouth – March is Colorectal Cancer Recognition Month. Screening is paramount because if there is one message that a doctor wants to send, if detected early, the disease can be preempted before it becomes cancer and can be prevented early in the case of cancer. Detection means that simpler and more successful treatments are very possible.
According to the US Center for Disease Control, “Almost all colorectal cancers begin as precancerous polyps (abnormal growth) of the colon or rectum. Such polyps occur in the colon for years before invasive cancer develops. May be present in. It may not cause symptoms, especially at an early stage. In screening for colorectal cancer, precancerous polyps can be found and can be removed before they become cancerous. In this way, colorectal cancer is prevented. Screening can also find colorectal cancer early when treatment is most effective. “
Dr. Michael Morton of Portsmouth Regional Hospital is a board-certified colorectal surgeon and the only fellowship-trained colorectal surgeon on the coast.
“Colorectal cancer is the third most commonly diagnosed cancer in women following lung and breast cancer, and in men following lung and prostate cancer,” Morton said. “This is the second leading cause of death after lung cancer, but we have such a good screening method and if people use it, it is very curable.”
Often, the disease can be asymptomatic, and when it progresses quietly, there are guidelines when it is necessary to screen men and women.
“We recommend screening everyone over the age of 50,” Morton said. “This includes people who are considered to be at moderate risk. They need to have a colonoscopy and then every 10 years thereafter. If the polyp is found and removed. , In some cases, the recommendation is reduced by 5, 3, and even 1 year. “
If a person is at high risk and has a genetic predisposition, it changes the recommendations. Genetics includes first-generation relatives such as colorectal cancer or suspiciously screened parents or siblings.
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It is advisable to have a colonoscopy 10 years before the person’s age. If a relative was 45 years old when he was diagnosed, he or she should have a colonoscopy at 35 years old. “
Dr. Frank McMillan, GI Section Leader and Medical Director of the Endoscopy Unit at Exeter Hospital, said the American Cancer Society recommends reducing the age of colonoscopy from 50 to 45. .. It is also expected to reduce the recommended value to 45.
There are criteria for colonoscopy screening, said Senator Tom Sherman, a core gastroenterologist at Exeter Hospital. He said patients should ask the provider about the metrics used.
“The two most important indicators are adenoma detection rate and colonoscopy rate, during which doctors visualize the cecum (cecal intubation rate) in colonoscopy screening,” Sherman said. Says. “The first value should be above 25% and the second value should be above 95%. Other important factors for the patient are proper bowel preparation, screening and if it turns out to have polyps. Follow the recommended guidelines for both monitoring and monitoring. These are the most predictive factors for a successful reduction in the incidence of colon cancer. “
Sometimes people will experience bleeding, which is the most obvious sign and always something to worry about. Other symptoms include changes in bowel habits, abdominal pain, weight loss, and night sweats.
Sherman said there are DNA tests, fecal immunochemical tests (FIT) and Cologard available. He said they are not a substitute for colonoscopy, but can be used by people who are hesitant to go to colonoscopy.
“I’ve heard that more wives are said to save their husbands’ lives by insisting on being screened,” Sherman joked. “If that works, I’m all about it. Listen to your wife.”
Finding polyps during colonoscopy means that they can be removed and tested at the same time. According to Morton, one in four people develops polyps in their lifetime and can develop cancer if they are not found and treated immediately.
“Currently, there are fewer referrals to screening,” Morton said. “I think this could be partly due to people who are afraid to come to the test for COVID-19. If there’s a big message here, it’s safe to come. Yes, delaying this screening is not the right thing to do. It is such a treatable cancer, but only if it is detected early. “
“Colon and rectal cancers are considered surgical disorders,” Morton said. “Treatment includes removal of the cancer and, if needed, chemotherapy and / or radiation therapy. Early treatment generally gives good results.”
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In stage 1, Morton stated that the 5-year survival rate was 90% if detected early. In stage 2, the cancer gets a little deeper, but it has no lymph node involvement and is still high, about 80%.
“If discovered later, it means that we have entered the lymph nodes in stage 3. The 5-year rate of benefiting from chemotherapy and radiation is 60-75%,” he said. “If you reach stage 4, your survival rate can be reduced to 5%.”
Currently, doctors are concerned that colorectal cancer is present in young people between the ages of 20 and 30 and we do not know why.
“This is a disease that primarily affects people over the age of 50,” Morton said. “We don’t know, but there can be multiple factors like obesity, cholesterol, and even environmental factors.”
McMillan said some of the reasons for lowering the recommended age were due to the younger age cases they were seeing.
Sherman said all GI doctors and the US Colorectal Cancer Multisocial Task Force are very concerned about this new statistic.
“We are seeing young cases for no known reason,” Sherman said. “Therefore, there is pressure to reduce the screening age to at least 45, and we also know that there is a high risk for people of color. This is another rationale for the younger age of screening. Treatable It is expected to catch polyps in stages. It will cost more because more tests will be done. But we need to take a step. “
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“If they are under the age of fifty, their insurance will want them to wait until they experience symptoms before they approve the screening,” McMillan said. “By that time, the cancer may have established itself. It’s much easier to prevent it than to treat it. There may be a little cancer in the removed polyps. But if you can cut it out and it doesn’t spread, it’s a cure. “
There is also a new idea of how long a person should be under medical surveillance after the polyp has been removed.
“We are currently doing 3-5 years, but we are considering up to 7 years,” says MacMillan. “Monitoring means monitoring new events.”
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