Getting a Colonoscopy: What to Expect
- A 39-year-old woman who was experiencing abdominal pain (and also had a family history of colon cancer) was diagnosed with stage 4 disease after she was denied a colonoscopy.
- When you have a colonoscopy for colon cancer screening, the gastroenterologist performing the procedure is looking at the inside of your colon to detect polyps.
- Many people hold off on getting a colonoscopy because of the perceived discomfort or embarrassment of the situation. That’s why it’s helpful to know that it’s a painless procedure.
“She was told no,” Gibson said. “I don’t know the specifics of what her doc said — whether the doc felt she was too young, even despite her heightened risk — but insurance wouldn’t pay for it. She tried to advocate for herself. She was denied.”
“She never got that colonoscopy,” Gibson continued. “Instead, just before her 39th birthday, 8 months ago, after docs told her that the abdominal pain she’d been experiencing for a few weeks was probably just gallbladder-related, she was diagnosed with stage 4 colon cancer.”
The series of tweets, posted Monday, has since gone viral, with thousands of retweets, likes and replies.
A friend of mine died of colon cancer this week. She was 39.
Two years ago, after marrying her incredible wife, she asked her doc for a colonoscopy. Her father had died young of colon cancer, putting my friend at higher risk, and it was on her mind. She wanted a screening. 1/x
— Caitlin Gibson (@CaitJGibson) June 6, 2022
“This system is so deeply broken,” Gibson wrote about her friend’s story. “Especially for women, whose intuition and pain is not taken seriously. Especially for people without the right kind of access or money or privilege. And it’s unforgivable that so many like my friend pay for that brokenness with their lives.”
Gibson’s friend died from stage 4 colon cancer a few days prior to her series of tweets, which she posted to raise awareness for this deadly cancer.
Getting a Colonoscopy: What to Expect
When you have a colonoscopy for colon cancer screening, the gastroenterologist performing the procedure is looking at the inside of your colon to detect polyps.
Polyps are small growths in the colon that aren’t yet cancerous, but have the potential to develop into cancer. A polyp that’s found during a colonoscopy is removed, which can actually prevent the development of cancer. A pathologist determines if it’s a benign polyp or if it’s colon cancer. Most polyps (about 95%) that are removed are precancerous, meaning that they haven’t yet progressed into cancer.
Many people hold off on getting a colonoscopy because of the perceived discomfort or embarrassment of the situation. That’s why it’s helpful to know that it’s a painless procedure.
“When we see a polyp, we actually physically take the polyp out through the colonoscope,” Dr. Zuri Murrell, a colorectal surgeon at Cedars-Sinai Medical Center, previously told SurvivorNet. “That means we basically put a wire through with a little bit of a little 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.”
When doctors take the polyp out, they send it to a lab.
“A pathologist basically cuts up the little polyp and looks under a microscope,” Dr. Murrell explained. “And underneath the microscope, they can decide whether or not it is early cancer or whether it is just a precancerous polyp.”
“But it would have been a cancer ultimately if you just let it grow and grow and grow,” he continued. “Well, guess what? Now that it’s out of your body, there is no more risk for that polyp to become a cancer.”
The American Cancer Society, as well as SurvivorNet experts, recommend that people at average risk of developing colon cancer start regular screenings at age 45. (Gibson’s friend was only 39 years old, which is most likely the reason why he insurance wouldn’t cover her getting a colonoscopy.)
People are considered to be at average risk if they DO NOT have:
- A personal history of colon cancer or certain types of polyps
- A family history of colon cancer
- A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
- A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
- A personal history of getting radiation to the abdomen or pelvic area to treat a prior cancer
Understanding Colon Cancer
Colorectal cancer affects your large intestine (colon) or the end of your intestine (rectum).
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. If you don’t have these polyps removed, they can sometimes turn into cancer. It takes up to 10 years for a colon polyp to become full-blown cancer, so if you get the recommended screenings, then your doctor will have time to remove any polyps that form before they can cause problems.
Stages one through three colon cancers are cancers that haven’t spread far from the colon. Because of this, there’s the potential for a cure with surgical resection.
Generally, surgery is recommended for anyone with stage 1, 2 or 3 colon cancer, though people with stage 2 and 3 cancers may need both surgery and chemotherapy. Even if surgery is successful at removing your cancer, there are always risks. That can mean anything from an infection that is treated with antibiotics, to a problem with the surgery itself that requires another procedure to correct.
The risk of complications is higher for older people and those who have other medical problems (like heart and lung disease). In these situations, your surgeon can help you decide whether surgery is the right option for you, and what other choices you might have to prolong your life while also maintaining your quality of life.
While early stage colorectal cancer has good survival rates, in the later stages of the disease, treatment can get a little more complex. It’s important for you and your doctor to understand as much as possible about your cancer, so that you can make the right decisions about your care.
Contributing: SurvivorNet staff reports