The Importance of Screening For Colon Cancer
- Steve Hollington, was 58 years old when he took the fecal immunochemical test (FIT), an at-home colorectal cancer screening test kit, something he credits to saving his life as it led to his stage three bowel cancer diagnosis.
- Although the FIT screening ultimately led Hollington to his cancer diagnosis, colonoscopies are the most effective way to screen for colon cancer, according to our experts.
- The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.
- The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
- Colon cancer, or colorectal cancer, affects your large intestine (colon) or the end of your intestine (rectum).
Now 59, Hollington is sharing his story to inspire others to screen for bowel cancer at home if they are eligible.
Read MoreThousands more people in the North West will be sent a home-testing kit to help detect signs of bowel cancer, as the NHS expands the lifesaving NHS Bowel Screening Programme to people aged 54 in England.
Read more➡️https://t.co/CcXYL35PDj pic.twitter.com/Rr5dnWNkD3
— NHS North West (@NHSNW) January 10, 2024
Hollington explained, “The first thing was after my 58th birthday, which was at late August 2022, this box appeared, which was the bowel screening infamous poo on a stick thing which I didn’t know what it was at first. And I looked at it.”
He admitted it was the first of its kind that he’s ever done, and he at first didn’t think of taking it as he was asymptomatic.
“I didn’t do the test straight away, in hind sight I wish I had. However, it sat there for probably a couple of weeks in its box on the table before I did the actual test,” he added, noting that about a week after completing the test he got a letter informing him further investigation was needed.
He was diagnosed with stage three bowel cancer in November 2022.
Hollington recounted feeling worried after the MRI and CT scan, before learning whether his cancer was operable or not, but he insists, “taking the bowel screening kit has saved my life, and potentially given me 20 more years to live it.”
According to MedlinePlus, “if the FIT results come back positive for blood in the stool, your provider will want to perform other tests, usually including a colonoscopy.
“The FIT test does not diagnose cancer. Screening tests such as a sigmoidoscopy or colonoscopy can also help detect cancer. Both the FIT test and other screenings can catch colon cancer early, when it is easier to treat.”
Speaking to Bowel Cancer UK, Hollington explained he had some tumors and 18 lymph nodes, 10 which tested positive for cancer, surgically removed on Dec. 9, 2022, and a course of chemo was recommended after surgery.
He continued, “I was also given an ileostomy during this operation. I then had chemotherapy for 12 weeks from February until April in 2023, and two months later, I had a stoma reversal on 22 June 2023.
“My treatment is now complete. However, I’ll have annual scans for the next few years, my first one being 12 months post-surgery, which is due December 2023. I believe I’ll have both a colonoscopy and MRI scan at this 12 month mark.”
Hollington concluded, “Naturally, I do have some anxiety about whether the cancer could’ve spread but again, I try to think positively and put any negative thoughts to the back of my mind. I cannot fault the support and care I received from the medical team who took care of me. They were all, and continue to be, absolutely fantastic. My family and friends have also been very supportive and I consider myself very fortunate and blessed in that regard.
“The main message from my perspective is to return your FIT test, irrespective of whether you have any symptoms because it could save your life, as it did mine. I won the lottery when that FIT test fell through my door because without it, doesn’t bear thinking about.”
What is Bowel Cancer?
Bowel cancer is a general term for cancer that begins in the large bowel, but generally we use the term colorectal cancer or colon cancer or rectal cancer depending on the location the United States.
Bowel cancer, like all cancers, presents its own unique challenges for patients on the road to recovery. But Dr. Heather Yeo, a surgical oncologist and colorectal surgeon at New York Presbyterian Weill Cornell Medical Center, wants to remind people how far the treatment of this disease has come.
Expert Colon Cancer Resources
- Colon Cancer Screening Options And Genetics: Myth Busting With Dr. Heather Yeo
- Colon Cancer Screening is Extremely Important; Guidelines Now Say to Start at Age 45 if There Is No Family History
- Colorectal Cancer Screening: a New Study Questions the Effectiveness of Colonoscopies But Specialists Reinforce its Importance
- Colorectal Cancer Is On The Rise in Young Adults — Here’s What We Know
- Considering Anal Rejuvenation After Colorectal Cancer Treatment
- Clinical Trials for Colorectal Cancer Can Offer Cutting-Edge Treatment
“One of the most exciting things about my job is that we’ve made a lot of progress on treatment options,” Dr. Yeo says in a previous interview with SurvivorNet.
“However, patients are still while they’re living longer, they are still living with colon cancer, and so I think it’s really important that we talk about how some of the things in your life affect you.”
Dr. Yeo also reminds people of the importance of colorectal screenings such as colonoscopies because most colorectal cancers can be prevented early with screening.
“In the United States, on a national level, colorectal cancer has been decreasing for the last 20 years,” Dr. Yeo says. “And much of that is thought to be directly due to screening for colon cancer.”
Are Colonoscopy Alternatives Better? Many Experts Say “No”
Most colon cancers can be prevented if people are regularly screened. SurvivorNet experts recommend getting a colonoscopy rather than relying on an at-home test for the most accurate results. The screening usually involves a colonoscopy, in which a long, thin tube attached to a camera is used to examine the colon and rectum. The advantage of colonoscopy is that your doctor can remove any polyps found during the test. If no polyps are discovered, the following screening won’t be needed for about ten years.
At-home stool tests are also available to screen for colon cancer. However, our experts warn that they are not as effective as colonoscopies. Even though the at-home colon cancer test Cologuard is 93% effective, that’s still 7% of people who will have their cancers missed.
Colon cancers begin as polyps 95% of the time. A study published in 2014 in the New England Journal of Medicine found that the Cologuard test, for example, missed more than 30% of polyps that will soon become cancer and 57% of polyps that may become cancer. That’s a significant discrepancy. Especially since when polyps are found during a colonoscopy, doctors can essentially stop cancer from growing before it even starts.
“We know that colon cancers can be prevented when polyps are found early,” Dr. Heather Yeo, who is board-certified in general surgery, colon and rectal surgery and complex general surgical oncology, previously told SurvivorNet. “Lowering the screening age helps somewhat with this, but access to care is a real problem,” Yeo added.
Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, previously explained the colonoscopy procedure to SurvivorNet.
“When we see a polyp, we actually physically take the polyp out through the colonoscope,” he explained.
“What does that mean? That means we basically put a wire through with a little bit of a flange at the end, and we pull the polyp out. Now, note there is no pain with that. Inside the colon, there are no pain fibers. So, there’s no pain,” Dr. Murrell added.
The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.
RELATED: Myth Busting: Let’s Talk About Colon Cancer Screening
When to Screen for Colon Cancer?
The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
The U.S. Preventive Services Task Force recommends guidelines that state colon cancer screenings should begin at 45 years old. This is in response to the increase we see in colon cancer diagnoses in younger adults. However, many insurance companies still do not cover the cost of screenings for those under 50. In the past, the disease had predominantly been found in adults 50 years or older, but for those predisposed to getting it at a younger age, these new guidelines could help catch it earlier.
The best and most complete way of screening is a colonoscopy every ten years. You should get your first colonoscopy at age 45, but the guidelines differ depending on your risk category.
If you have a close relative who has colon cancer, a rule of thumb is to get screened ten years before their age of diagnosis to make sure any growths or cancers are caught early.
If you have several family members who had colon cancer or family members who got it at a young age (less than 50 years old), it may be necessary to undergo genetic screening. If you have a lot of polyps on your colonoscopy or if you have had colon cancer previously, you will need a colonoscopy every 3 to 5 years.
Symptoms of Colon Cancer
Colon cancer might not immediately cause symptoms, but there are signs to look out for.
Below are possible symptoms of colon cancer:
- A change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days
- A feeling that you need to have a bowel movement that’s not relieved by having one
- Rectal bleeding with bright red blood
- Blood in the stool, which might make the stool look dark brown or black
- Cramping or abdominal (belly) pain
- Weakness and fatigue
- Unintended weight loss
It is important to note, however, that displaying some of these symptoms does not mean you have colorectal cancer. You could also have colon cancer and not display any of these symptoms.
Regardless, it is important to bring up any symptoms to your doctor should they arise.
Leading Experts Urge Us to Be Proactive
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told SurvivorNet in a previous interview, “because finding a doctor who is up to the latest of information is important.”
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options.
Also, in some instances the specific course of treatment is not clear-cut. That’s even more reason why understanding the potential approaches to your disease is crucial.
At the National Cancer Institute, there is a patient referral service that will “guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments,” Rosenberg says.
Cancer Research Legend Urges Patients to Get Multiple Opinions
Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers.
“So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, told SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn’t listening to you, or isn’t giving you good advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn’t improving on your current treatment
Be Pushy, Be Your Own Advocate- Don’t Settle
Just remember, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.
Contributing: SurvivorNet Staff
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