Getting to the Bottom of Colon Cancer

     There's no way to put a pretty face on it, and no way to stem the tide:  I've been scheduled for a colonoscopy.

     B and I each had a colonoscopy a little over five years ago. B is blessed with good genes and a clean alimentary tract, and was told she didn't need to get another test done for ten years. But I had a few bits and bumps that the doctor judged had to be removed. He told me I had to come back for another round in five years.

     Now my time is up. [But don't worry, in the interest of discretion, and retaining my PG rating, I am not including a photo in this post.]

     So in preparation for my test  -- no, not that preparation, but getting ready for it emotionally and psychologically -- I've done a little research into this disease, which according to my gastroenterologist is the second most common cancer killer in America today.

      Colon cancer and cancer of the rectum -- sometimes lumped together as colorectal cancer -- typically begin with the growth of a polyp, small abnormal tissue that can appear on mucus membranes. You can get polyps in your stomach, your sinuses, your uterus, bladder or vocal chords. Or in your colon. Most are benign. Some can eventually progress to cancer, but it's a slow process that usually takes five to ten years.

     The symptoms of colorectal cancer include a change in bowel habits, bleeding, anemia, bloating or unexplained fatigue. But the sneaky thing about colon cancer is that the symptoms often don't show up until it's too late. There is one test -- for fecal occult blood -- that can detect bleeding in the colon long before it becomes visible to the naked eye. But the test is not particularly accurate -- the bleeding may not show up, or it could be due to something as simple as hemorrhoids.

     If you test positive for occult blood, or for those of us over age 50, especially if there's any family history of colon cancer, doctors typically recommend going on to the next step, which is a colonoscopy. There are variations on the procedure -- for example, one option is the virtual colonoscopy, done with computer imaging -- but the usual method involves a doctor snaking a thin tube equipped with a camera and cutting instrument up the length of your colon. If there's a polyp . . . snip, snip, and it's gone, long before it turns into cancer, and the procedure is done with minimal risk and usually no adverse effects.

     I have undergone three colonoscopies in my day. Up until now they were covered by insurance, after a $50 copay. But I've found out that my plan has changed -- now it's subject to my $1000 deductible. And since I've been lucky enough not to use up my deductible this year, it's gonna cost me. But I figure it's worth it if it, literally, saves my ass (oops, there goes my PG rating). Next time  around, I'll be on Medicare. Does anyone know if Medicare covers colonoscopies?

     I first heard of this test in 1999, when I was 50 and went for my usual physical checkup. The doctor asked me if I had a family history of polyps. I didn't know. We didn't talk about such things in my family. Then, after he explained the procedure, I was horrified. I really couldn't believe he'd do that to me. I rushed home in a panic and immediately called my parents. Did they ever have polyps? Had they heard of this test? "Oh yeah, sure," they told me offhandedly. "It's no big deal. We go in every few years. The doctor usually finds something, but he takes it out, cleans us up, and we're good to go. No problem."

     So I went for the procedure, and now -- proving that human beings can get used to almost anything -- it no longer seems quite so shocking to me. It's become almost routine, like it did for my now dearly departed parents. Okay, the preparation is a little nasty. You do, after all, have to clean out your colon so the doctor can see what he's doing. But, hey, let's be mature about this.

     If you want to know more about colon cancer, the Webmd page on colorectal cancer is a good place to start.

     In the meantime, about six or eight years ago, I gave up eating red meat, in part because the consumption of red meat, especially processed meats like bacon or lunch meats, supposedly increases your risk of contracting colon cancer. I gave up smoking long ago, and I try to get a decent amount of exercise and keep my weight at close to a normal level (with limited success) -- all of which is supposed to help you avoid the perils of colon cancer, as well as any other kind of cancer.

     If I sound flip about what is really a serious disease, I just don't know how else to approach it. And beyond taking the usual precautions, I guess there's nothing else to do but hope for the best. Wish me luck!