The Bottom Line on Colon Cancer

     There's no way to dress it up, no way to paper it over. I'm scheduled for a colonoscopy next week. I've already started my preparation -- no aspirin or Advil for a week ahead, no raw fruits or vegetables for five days. But I've yet to start in on the heavy stuff.

     B and I have both had a colonoscopies. B is blessed with good genes and a clean alimentary tract, and only has to get tested once every ten years. But I always seem to have a few bits and bumps that the doctor has to remove. I'm on the five-year rotation.

     Now my time is up. (I actually have a close-up photo of my colon from my last test. But don't worry, in the interest of retaining my PG rating, I am not including that photo . . . just a picture of an innocent-looking box).

     So in other preparation for my test  -- getting ready for it emotionally, rather than physically -- 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, sinus, 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, as in many forms of 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. The procedure is done with minimal risk and usually no adverse effects.

     I have undergone four previous colonoscopies. They were always covered by my old insurance, after a $50 copay. Now I'm on Medicare. Honestly, I haven't checked. But I believe Medicare will cover most of the cost. But even if I end up getting billed for a few hundred dollars, I figure it's worth it if it, literally, saves my ass (oops, there goes my PG rating).

     I first heard of this test back when I was 50 years old 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. When he explained the procedure, I was horrified. I really couldn't believe he'd do that to me!

     I drove home in a panic and called my parents. Did they ever hear of this? Did they ever have polyps? "Oh yeah, sure," they told me offhandedly. "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."

     My parents were never very good at talking about the facts of life. These were the real facts of life.

     I managed to put this indignity off for a while, but eventually 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 ten 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 normal levels (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!