Colorectal Cancer: A Candid Q&A

3/25/2021

Contributing Author: Daran J. Mason, M.D., board-certified general surgeon

Despite colorectal cancer being the third leading cause of cancer death in America, a lot of people still don’t talk to their doctors about it. Hey, I get it. It does involve a part of the body we tend to avoid for small talk and casual conversation. But the fact is, colorectal cancer deserves a frank discussion — especially because it’s a cancer that can be prevented with a screening test called a colonoscopy.

Most people should have their first colonoscopy at age 50, but if you are at higher risk, you may need to be screened sooner. As a general surgeon, part of my job is providing these potentially lifesaving screenings to men and women in our community every day, and with an increase in early onset, this is an important topic for all ages.

With that said, I’d like to share with you some of the most common questions I get when talking to my patients about this sensitive topic:

1. What is colorectal cancer?
   Colorectal cancer is cancer in your colon or rectum. Your colon is part of your large intestine, and it’s about 5 feet long. It’s followed by the rectum and anal canal, which together are 6 to 8 inches long. The anal canal ends at the anus, which is the opening to the outside of your body.
2. Something’s going on…can changes in my stool be a sign of colorectal cancer?
   Possibly. Changes in bowel habits like diarrhea or constipation that seem to be lasting longer than they should are always good reason to get with your doctor. Changes in stools – for example if they are narrower than usual, or bright red or very dark – those changes could also be cause for concern. But keep in mind that these can be signs of other conditions as well. Even with the most watchful eye, sometimes symptoms don’t appear until later in the disease, when it’s much more difficult to treat. That’s why routine screening is so important. It can find cancer in its very early stages — before you have symptoms.
3. What is a colonoscopy?
   A colonoscopy is a screening for colorectal cancer. It includes an examination of your entire colon and rectum, and is one of the best ways to prevent colon cancer. It allows doctors to find and remove hidden growths, possibly before they become cancer. These growths are called polyps, and removing them can prevent cancer altogether.
4. What’s a polyp?
   A polyp is a growth on the inside wall of your colon. Some polyps may turn into cancer. Polyps that are larger than 1 centimeter (about the size of a pea) are more likely to turn into cancer than smaller polyps. Suspicious polyps can be removed during a colonoscopy.
5. My doctor said the word “adenoma” and that sounds really scary, what is that?
   Your doctor may call a polyp an adenoma. An adenoma is just a particular kind of polyp that develops on the lining of the large intestine. This is very common, as most colorectal polyps are adenomas.
6. What happens during a colonoscopy?
   During a colonoscopy, once you are sedated the doctor will gently insert a thin, flexible tube into your rectum and guide that up through your colon. This tube has a tiny video camera on the end. The scope’s camera sends images to a video screen for your doctor to view. If the doctor sees a polyp, he or she can remove it using a little lasso-like tool on the scope. Immediately following the procedure, any such polyp is sent to a lab to check for signs of cancer.
7. Is a colonoscopy painful?
   Before the procedure, you’ll be sedated. Most people go to sleep and don’t even remember the exam later to say if it was painful or not. Some people find it mildly uncomfortable.
8. Will I have to stay in the hospital overnight?
   The procedure itself takes about 30 minutes, but with preparation and recovery, you will be in the procedure area for about two hours. You will go home the same day, just remember that you’ll be drowsy afterward from the sedation, so you’ll need someone to drive you home.
9. I’ve heard the prep before the test is AWFUL!
   During the procedure, the doctor needs to be able to see your colon clearly. This is why you have to clean out your colon starting a day or two before your colonoscopy. This might involve going on a liquid diet and avoiding certain foods and medicines. You’ll also take medicine that will make you go to the bathroom A LOT. I’d recommend planning to be at home the day and night before your test if you can. This is why many people consider the preparation for a colonoscopy the worst part of the procedure. Frankly, the prep is unpleasant. But it’s a lot better than getting colorectal cancer.
10. Is a colonoscopy the only option? What about that at-home screening kit I’ve seen on TV?
    There are other tests that screen for colorectal cancer. A DNA stool test checks the cells in your stool for signs of cancer and a fecal occult blood test uses a small sample of your stool to look for blood that can’t be seen with the naked eye. You collect the stool at home and either take it to a lab or mail it in for testing. A sigmoidoscopy is like a mini-colonoscopy. It uses a shorter scope, so the doctor can view your rectum and less than half of your colon. It usually doesn’t require sedation. If any of these tests come back positive, you may need a colonoscopy to follow up. A colonoscopy is the only one where doctors can do it all at the same time – view your entire colon, and also remove suspicious polyps. Talk with your primary care provider about what’s best for you, or give my office a call at (850) 306-2188. I’d be happy to schedule a time to chat with you.

If you need help finding a primary care provider or a specialty physician, visit www.NorthOkaloosaPhysicianGroup.com to connect with one of their qualified providers.

This information is provided by Daran J. Mason, M.D., a general surgeon at North Okaloosa Physician Group-Surgical Specialists, 550 W. Redstone Ave., Suite 410, Crestview, FL 32536. Dr. Mason's office can be reached at (850) 306-2188. Learn more about Dr. Mason here.

Back