Colon Cancer Screening

[HarvardStudent]

As much as I advocate colon cancer screening, I think that scare tactics are a really bad thing. For instance, I have noticed how most internet websites that describe symptoms of colon cancer emphasize that the most important symptom that signals colon cancer is "narrow stool".

I experienced this symptom extensively, and the stool even got THINNER through time. I also had other hallmarks of colon cancer. I looked on the internet for alternative causes, but could not find anything. In fact, all evidence suggests a thin stool means colon cancer and a huge block. No one even mentioned IBS as a possibility.

I assumed that at age 23 it would be impossible to have colon cancer, but then I saw the posts of dozens of people who are my age who have Stage IV cancer. This frightened me and forced me to get a colonoscopy.

I recently underwent colonoscopy and the results were 100% normal: not even one polyp. This is great news for me. However, my opinion is that the literature needs to change which suggests narrow stools only indicate colon cancer. Scare tactics are not always appropriate.

[missjv]

hi,
the thing that needs to change is the age of 50 for screening. alot of young people get this disease. i don't think i would call it scare tactics i would call it signs of a cancer that there is often no symptom for. glad you went and got checked. maybe the next person who reads what you did won't be so lucky, but maybe they will be checked early enough they have a chance for a successfull treatment. alot of young people think they can't get this cancer me being one of them i assumed it was an old fart cancer but i was very wrong.

missjv

[Christine]

I don't think that listing a common symptom of a serious disease is a "scare tactic." I personally wish I would have had some of the symptoms earlier on so maybe I would have had a reason to get screened. Instead, I have never had a colonoscopy, but was diagnosed with stage IV colon cancer at the age of 28 when they saw the massive (7lb) tumor on a CT scan that was ordered because they thought that appendicitis might be causing my severe abdominal pain. The pain was actually caused by the perferation in my colon wall.

And really, we shouldn't have to "scare" anyone into getting screened. If there is a sign of a problem, it should be done. If it turns out to be nothing, be thankful that you don't have to go through all the crap that comes after the diagnosis.

My feeling is that screenings should start at 18 and if there is no family history and no polyps, they should be done at 10 year intervals. Colon cancer is the only type of cancer that can be identified and removed BEFORE it even turns to cancer. With proper screening, this disease could be completely eradicated.

I'll get off my soapbox now.

[Noonie2]

OK, Harvard......YOU scare me!! What are YOU studying?

[HarvardStudent]

Noonie and Christine:

To address you, Christine: I fully understand the pain and difficulty of what it might be like to be diagnosed with colon cancer at a young age. During the weeks waiting for my colonoscopy I was scared and constantly thought about the possibilities of chemotherapy, radiation, surgery, and the other associated issues that come with colon cancer. I am now even thinking about wearing a colon cancer bracelet to show my support for the cause! Finally, as I'm premed, I might go into gastroenterology. I believe that a colonoscopy at 18 for all Americans though would not be feasible for many reasons, particularly since on a large scale, so few people get the disease in their 20s.

That said, we SHOULD have screening beginning at 18--just not a colonoscopy because there are substantial risks involved (1 in every 1000 colonoscopies results in a colon perforation which is a REALLY serious thing because 5% of people with perforations DIE despite surgery). Plus, colon resection is painful and would be an awful complication. If everyone 18+ got colonoscopies we'd be in a situation where we'd have quite a few unnecessary colon surgeries and maybe some deaths.

An alternative would be to have all people at age 18+ begin getting yearly Hemocult tests, which are not 100% accurate but a definite right step in the direction. We have to look at this issue from a practical standpoint as well as a medical one. If the test were positive in someone 18, for instance, then the doctor could perform a barium x-ray or a sigmoidoscopy, and then move to a colonoscopy if necessary.

Noonie, what I was trying to say earlier about scare tactics is that I believe the literature for IBS SHOULD say that thin, narrow stools are a possible symptom. Instead, when I researched thin narrow stools the ONLY diagnosis that came up was colon cancer. I am thankful my test came back normal, but what I'm trying to say is that we need emphasize the MULTITUDE of possible diagnoses for people having GI distress and the importance of getting those evaluated without myopically focusing only on the most serious cause, which is undoutedly colon cancer. I am NOT advocating a careless approach to care, or that people should "dismiss" symptoms. Instead, I am proposing that people not jump to conclusions that just because they have thin stools they have colon cancer, something I did largely because the literature on IBS does not speak about thin stools.

[Noonie2]

YOU have been given a sign! This is the direction you need to go. At the age of 23, you are still young and can make a world of difference.

I wish now that I would have had a 'scare tactic' 10+ years ago. I had no idea of any of the symptoms of Colon Cancer...and if I would have, my 'narrow stools' may have helped me to recognize that I may have a problem and to get a colonoscopy then! Unfortunately, I had just turned 40 and was told that the tumor in my colon could have been growing for 10+ years. Stage IV! Mets to liver! I was scared, even more scared than if I would have been younger. I know that! The older you get, the more "I wonder how I will die" becomes! I just knew this was it. (Wife and mother of 2)

After colon surgery, to remove the (1) tumor that was blocking 75%, and thank God it was only one, I had to face....mets to the liver! I was not a candidate for liver re-section at that time due to the tumors being too close to the "life line". So, I went through 10 rounds of chemo (w/ Avastin) and the tumors became smaller. YES, I could have Liver Re-section....and MAYBE I can live a little longer now!

Liver re-section...took my whole left lobe and a portion of my right lobe...PLUS 80% of my stomach, which was not expected. Trying to Eat..............Still a problem!!!!

Ok, it will be (1) year on April 11, 2007 since my surgery! Right now, I am clear. Next CT/PET will be in April. I am nervous, scared.....and I know that the rest of my life will be this way. (just another SCARE)

I understand you were scared! But please, at your young age, you must realize that 'scare tactics' may save someone's life.

And if it saves (1) life...then it is worth it!

I do beleive you have a "Calling"! That was your sign...............GO WITH IT! Please help others...children, teens, 20-60's, know that maybe even 'narrow stools' should be addressed!

Love and Prayers, Noonie2

[Noonie2]

Just wanted to add also..................."Do NOT search the internet"!!!! You will understand soon!

[Molly]

Hey Harvard!

So glad your scope was clean! I was diagnosed on my 23rd birthday after 6 months of what most people would call "obvious" symptoms (MAJOR abdominal pain, blood in my stool, vomiting, weight loss, anemia, etc.) ...but since I was 23, my doc didn't test for (or even mention) colon cancer, and I didn't even know what colon cancer was, so I didn't ask. The weirdest thing about the narrow stools is that my doc kept asking me if I had them, but I told her everything was fine because they had gotten so thin (virtually non-existant) over time that I didn't even realize it wasn't normal.

What I want to know is, where did you find that narrow stools are THE symptom to watch out for? Most orgs that I know of list a number of symptoms. Something has to be first on the list, right? On our homepage (www.colonclub.com) , for instance, we list it first (right after the most common symptom being no symptom at all), because we didn't want to list blood in the stool first, since often times it's not visible. We don't want people thinking that if they don't have bright red blood, they're off the hook. We also indicate that if you have 2 or more of the symptoms for a few weeks...see your doc.

As for scare tactics, I hate to tell you this, but talking about thin stools isn't what I'd call a scare tactic. You should hear me rant when I know that someone has the symtoms and won't get screened. I'm a walking scare tactic and it's because I'm desperate (like most of us) to show people that it CAN and DOES happen to us youngsters. ...and I always ask myself, "At 23, what would it have taken to get me to understand?"

Stick around! We like you!

[Magnolia]

I think Harvard has a valid point. We can't scope everybody, and colon cancer symptoms can also be symptoms of many other things. Colonocscopies are invasive and not completely risk free themselves. We can't scope every otherwise low risk person that comes in with a change in bowel habits. That said, I think persistant complaints, particularly with more than one symptom, warrent some aggressive work-up. Although I am 100% convinced my IBS was really IBS at the time it was diagnosed, my doc and I didn't think I needed a scope at the time. In hindsight, I probably had the polyp then, even if it wasn't cancer yet. Scopes aren't always done in low risk people with IBS. Maybe they should be.

[northern lights]

Hello everyone, I haven't posted for awhile, but I have been keeping up on your posts.

First Happy Colon Cancer Awareness Month!!

I have been asked to sit on a Board that will be implementing Territory wide screen for Colon Cancer. The first meeting is on Thursday and I am looking forward to being the "survivor" voice in the group. There will be subject matter experts in Colon Cancer, GIs, Chemo Nurses, Epidimiologists and others.

I am going to make sure that in the advertising campagne that will follow that it is stressed that colon cancer can happen to younger people and that anyone with symptoms should be screened. The good thing with being in Canada is we don't have to worry about insurance companies.

I don't know if listing symptoms is a scare technique, but eductation and awareness is the best (if not only) way to get people in early and start putting a stop to letting this disease silently progress. I wish someone had scared me earlier!!!

Sharon

[Magnolia]

People need to know what the symptoms are. I think the information needs to be presented in such a way as not to cause panic. One of my many mantras is "Panic is only necessary when there are spiders involved." These symptoms MAY be indicitive of colon cancer, but may be something far less serious. Seeing a doctor is the first step to finding out. A lot of patients panic at the thought of cancer, decide they're going to die, and don't do anything about it. They'd rather not know. Education is not the same thing as scare tactics. Some people need to be shaken up a little, some need to be gently coaxed. Healthcare is an art. You interact with each patient differently. I work in OB/BGYN, and another mantra of mine is "Beating people up doesn't make birth control pills work better". Tough love in medicine is usually not a good idea.