colorectal cancer

Preventing colorectal cancer with free screenings

Texas A&M Health Community Clinic offers free colorectal cancer screenings
March 8, 2019

Colorectal cancer, or cancer of the large intestine or rectal area, is the second-leading cause of cancer-related deaths for both men and women in the United States. It is also considered one of the most preventable cancers. With routine screening, polyps—unwanted growths in the colon that can develop into cancer—can be detected and removed. So why are more than 50,000 people dying from colorectal cancer every year? The answer is simple: people aren’t getting screened.

Jason McKnight, MD, MS, clinical assistant professor at the Texas A&M College of Medicine and faculty physician at the Texas A&M Family Medicine Residency program discusses the basics of colorectal screening and prevention.

Signs and symptoms

During screening tests such as a colonoscopy, health care providers look for polyps or other abnormalities. Once these potentially pre-cancerous polyps are removed, the likelihood of developing colorectal cancer is reduced. However, even if you receive regular screenings, it’s important to be familiar with common cancer symptoms and warning signs as these symptoms can also be signs of other benign medical conditions.

  • Change in bowel habits, such as diarrhea, constipation or narrowing of stool that lasts for more than a few days
  • A feeling that you need to have a bowel movement that is not relieved by doing so
  • Rectal bleeding
  • Bloody stool, which may make it look dark
  • Cramping or abdominal pain
  • Weakness and fatigue
  • Unintended weight loss

“During the early stages of colorectal cancer, you may not notice any symptoms,” McKnight said. “However, it is important to quickly catch the cancer, so timely screenings are important.”

Who should be screened?

Often, the idea of having a colonoscopy fills people with an understandable amount of apprehension. However, the American Cancer Society recommends everyone over the age of 45 to get regularly screened.

McKnight urges anyone with an average risk for colorectal cancer to have a colonoscopy every 10 years. For those with a family history of colorectal cancer, McKnight says to talk with your physician about starting screenings even earlier than 45, usually 10 years before the youngest case of polyps or colorectal cancer occurred in your family. Also, if you have had a previous colonoscopy where polyps were removed, you may need another colonoscopy in less than 10 years.

There may be available resources in your community if cost is a barrier for getting screened. “Thanks to a grant from the Cancer Prevention and Research Institute of Texas (CPRIT), we offer free colonoscopies and FIT testing for people without insurance or people in the Brazos Valley who cannot afford their deductible for the procedure,” McKnight said.

Colonoscopy preparation

A colonoscopy is usually done in a clinic or hospital setting by a physician with specialized training in the procedure. The afternoon or evening before the procedure, patients will ingest a prep drink, similar to a laxative. The drinks are designed to clear out your digestive tract to empty the colon.

A clean digestive tract allows the physician to get a better view of the entire colon, so even the smallest polyp can be detected. After all, it only takes one polyp to develop cancer. Additionally, patients will be asked to avoid eating solid foods a day before the procedure.

What to expect during a colonoscopy

The colonoscopy itself should take less than an hour. Beforehand, the physician will sedate the patient. Depending upon the facility where the procedure is done, the patient may be completely sedated or undergo a conscious sedation.

A colonoscope—a thin, flexible tool with a camera and light attached at the tip—will be inserted through the anus and move slowly through the rectum and colon to look for polyps and cancer.

During the colonoscopy, the patient may feel the need to have a bowel movement or some cramping, but it is important to breathe deeply and relax stomach muscles. If a polyp is found, it will be removed during the procedure.

After the colonoscopy, patients may need to remain at the clinic before they are released for monitoring and to ensure there are no immediate complications. Because the physician adds air into the intestine during the procedure, patients may experience gas and cramping afterwards.

If a polyp was removed during the procedure, the individual may find blood in their stool for a few days. The physician will explain when regular diet and activities can be resumed.

Alternatives to the colonoscopy

While colonoscopies are the most thorough way to detect cancer, some alternatives methods exist for those who prefer less invasive methods. These screenings often require more frequent testing than a colonoscopy.

Some alternative screening tests:

  • CT colonography (also known as a virtual colonoscopy)also uses x-rays to detect polyps or cancer. It should be done every five years.
  • Fecal occult blood test (FOBT)tests stool samples for hidden traces of blood. In contrast with other alternatives, FOBT should be done annually.
  • Stool DNA test examines DNA in a stool sample for certain gene changes that are present in colon cancer cells. This method of screening should occur every three years.

Lifestyle changes to reduce your risk

Other than regular screenings, you can make additional changes to help reduce your risk of developing colorectal cancer. McKnight recommends you exercise for at least 30 minutes, five days a week to help you maintain a healthy weight, which lowers your risk. He also recommends you try to consume more fiber through vegetables, fruit and whole grains, while limiting your intake of processed meats and alcohol.

“Colorectal cancer can largely be prevented by maintaining a healthy lifestyle and having preventive screenings,” McKnight said. “In fact, the Centers for Disease Control and Prevention reports that deaths from colorectal cancer could be reduced by 60 percent if everyone age 50 and over had regular screening tests.”

That’s why efforts like the Texas C-STEP, run by Texas A&M Health Science Center, are so integral. The program, supported by CPRIT, provides financial assistance for colonoscopies to uninsured or underinsured residents in 17 central Texas counties. For more information, visit the Texas C-STEP website.

— Mary Leigh Meyer

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