By Durado Brooks, MD, MPH
Embarrassing! Painful! Disgusting!!
These are some of the words that come to mind for lots of folks when they think about getting tested for colorectal cancer. Let's face it - this involves a part of the body and bodily functions that people don't talk about in polite conversation. Hopefully I can convince you that they (and you) need to get past this attitude and get on with testing.
Cancers of the colon and the rectum (the last sections of the digestive system) are extremely common. In fact, they're the third most common cancer in US men and women. The good news is the rates of this disease have been falling steadily over the past 20 years, and a big part of the decrease is directly related to testing for colorectal cancer. You see, not only can testing help find the disease early, when it's highly treatable, but testing can actually help to prevent the disease! That's because most colorectal cancers start as a small, non-cancerous growth called a polyp. Finding and removing these polyps stops cancer before it starts.
You'd think that with these proven benefits people would be lining up to get tested - yet 4 out of every 10 adults who should get tested are missing out on this possibly life-saving opportunity. Why? There are a lot of myths about colorectal cancer that people use as excuses to avoid getting tested. The following are some of the myths about testing, as well as the facts people need to know.
Myth/Excuse: "No one in my family had colorectal cancer, so I don't need to get tested."
Fact: Most people who get colorectal cancer DO NOT have a family history of the disease. The most common reason for getting colorectal cancer is simply getting older. Risk starts to go up around age 50 and continues to rise for the rest of your life. If you have a family history of the disease your risk is even higher, but, family history or not, everyone 50 and older should get tested.
Myth/Excuse: "I'm not having any symptoms so I don't need to worry."
Fact: Many people who are diagnosed with colorectal cancer have no symptoms, and people with polyps rarely have symptoms. If you wait to get tested after symptoms develop you might miss the chance to prevent the disease or to find it before it grows and spreads.
Myth/Excuse: "If I have cancer there is nothing they can do about it, so why bother getting tested?"
Fact: Colorectal cancer is one of the most treatable forms of cancer. When the disease is found at an early stage (before it spreads outside of the colon) most people can be treated very successfully and go on to live long, full lives. Regular testing increases the chance that the disease will be found at this early, most treatable stage.
Myth/Excuse: "The tests are embarrassing and painful!"
Fact: There are actually a number of different tests for colorectal cancer. The most common tests are stool tests and the colonoscopy. Stool tests are used to look for small, invisible amounts of blood passed in a bowel movement that might indicate a polyp or cancer. These simple tests are performed in the privacy of your home. A colonoscopy is done by a specialist in a hospital or outpatient center. The test is done in a private room with no other patients around. A thin lighted tube is inserted into the rectum and allows the doctor to view the inner lining of your colon. Many people fear that this test will be painful. In fact, people who are having a colonoscopy are given medicine to help them relax; many people sleep through the exam.
Most of the complaints about colonoscopy actually are not about the test, but instead are about preparing for the test. In order for the doctor to get a good look at the colon lining the colon has to be cleaned out with strong laxatives, so people spend a lot of time in the bathroom during the evening before the test. This is not convenient and it's not comfortable, but it's a small price to pay for a test that may save your life.
March is National Colorectal Cancer Awareness month. Take this opportunity to talk about it! If you haven't been tested, talk to your doctor. If you've been tested, talk to your family and friends. Make sure they know the facts and encourage them to get tested. Accept No Excuses!
Dr. Brooks is director of prostate and colorectal cancers for the American Cancer Society.