Colorectal cancer is preventable, treatable with early screening

Twan Phanijphand, D.O., a gastroenterology specialist at St. Anthony's Medical Center

“No! No! Please Don’t Tell Me I Need A Colonoscopy!”

Colonoscopy may be the most dreaded, feared and misunderstood screening in the entire arsenal of the medical community’s weapons to fight cancer, said Twan Phanijphand, D.O., a gastroenterology specialist at St. Anthony’s Medical Center.

“Colorectal cancer is a disease in which cells in the colon or rectum become abnormal and divide without control, forming a tumor,” Dr. Phanijphand said. “The cells also may break away and form tumors in other parts of the body.”

Symptoms of colorectal cancer may include blood in the stool, change in bowel habits, unexplained weight loss or gain, anemia, fatigue, frequent gas pains and stomach discomfort that may include vomiting, diarrhea, constipation, bloating and/or cramps. Unfortunately, by the time symptoms appear, 50 percent of patients already have had cancer for a couple of years and do not survive, Dr. Phanijphand said.

Colorectal cancer is the third most common cancer and the second most common cause of cancer death among men and women in the U.S. The American Cancer Society estimates some 141,210 new cases of colorectal cancer were diagnosed in 2011, resulting in nearly 50,000 deaths.

According to the National Cancer Institute, most people who develop colorectal cancer are over the age of 50. Unless there is a family history of the disease, (which would warrant earlier screening), a screening colonoscopy is recommended at age 50 and every 10 years thereafter (more often if polyps are discovered during screening).

“The good news is that, in most cases, regular colonoscopy screening can prevent colorectal cancer through early removal of polyps,” Dr. Phanijphand said. “A colonoscopy allows the doctor to examine the entire colon by inserting a long, thin, flexible instrument with a lighted lens at its end, through the rectum and colon. Instruments can be introduced through the scope to remove polyps or to take samples of tissues for biopsies.

“The bad news is that people are so terrified of the idea of undergoing a colonoscopy that they decline to have this lifesaving screening,” he said. “Their perception of a colonoscopy is akin to being placed on a torture wrack. The reality of it is a quick, painless procedure, with few, if any, after-effects and very little down time.”

Dr. Phanijphand offers a simple, straightforward primer on what to expect when you have a colonoscopy:

THE DREADED PREP

The “prep” – cleaning out your colon the day before your colonoscopy – is definitely the worst part of the screening. Here are the steps your doctor will have you take:

No solid food, milk or dairy products the day before the test. You can drink any hot or cold liquid, including clear broth and gelatin, but nothing with red dye in it.

Some time in the afternoon on the day before the test, you will be required to drink a large volume of a liquid preparation that will produce a lot of watery diarrhea. Your doctor may recommend one of the following:
- Polyethylene glycol solution (up to four liters of fluid) drunk in eight-ounce portions every 10 minutes;
- Miralax®, a powder mixed with two quarts of Gatorade;
- MoviPrep®, a lemon-flavored liquid prep that comes in two pouches that are mixed with one liter of water;
- LoSoPrep™, a liquid based on magnesium citrate;
- Prescription pills to be taken with clear liquids over a period of time.

Within one to two hours after taking the liquid prep, you will have frequent episodes of watery diarrhea, as the entire colon area is cleaned out. Unlike the diarrhea you may experience when you have the stomach flu, it is rarely accompanied by pain, cramping or nausea. This usually ends within three to four hours.

Tips: Drink LOTS of liquids throughout the process to keep from getting dehydrated. Plan your prep early enough in the day (usually early afternoon) so you get a good night’s sleep, without having to get up and make a trip to the bathroom.

THE COLONOSCOPY ITSELF – WHAT TO EXPECT

You must have someone to drive you to and from the hospital.

You may not eat or drink anything until after the procedure is complete.

Arrive at the hospital an hour before the scheduled procedure.

You will fill out some forms and give a health history – probably more than once – and signs some forms. Staff members will answer any questions you may have.

You will don a hospital gown and the nurse will insert an IV into your hand or arm, so that sedatives and other medications can be administered.

You will be connected to equipment to monitor your heart rate, blood pressure and oxygen levels.

The procedure takes about 20 minutes – longer if there are many polyps to remove – and you will be sedated the entire time.

You will awaken feeling rested and relatively alert, but you will need to remain in the endoscopy area for about an hour to be sure you fully recovered from the anesthesia.

Because your doctor used air to inflate the colon during the procedure, you might experience mild cramping or bloating. This should disappear once you start passing gas.

If any polyps are removed, they are examined for cancer cells. You may experience a few drops of blood due to their removal.

Unless your doctor indicates otherwise, upon release from the hospital you can resume your normal diet.

If you experience severe abdominal pain, fever, bloody bowel movements, dizziness or weakness after your colonoscopy, contact your doctor immediately.

Voila! Your colonoscopy is complete! If everything is normal, you won’t need to be screened again for another 10 years.

To make an appointment with a gastroenterologist or to schedule a colorectal cancer screening at St. Anthony’s, call 314-ANTHONY (268-4669) or 1-800-554-9550.

For information, please call our Health Access Line at 314-ANTHONY (268-4669) or 800-554-9550 or visit find a physician online.

At St. Anthony's, our vision is to be the area's premier health care organization
— and your first choice for health care services.

Media Center

For the Media

Colorectal cancer is preventable, treatable with early screening