Generation Health

Probing your inner self for colon cancer is a must.

  by Kate Nolan

I have news for the poet who named April the cruelest month: March is no slouch. It happens to be National Colon Cancer Awareness Month, and therefore time to turn our attention to that most audacious of medical tests, the colonoscopy. 


That’s the procedure where a physician looks up inside you through a metal tube to examine your large intestine for polyps, common precursors of colon cancer, the second leading cause of cancer death for adults.

When polyps are found, they’re zapped on the spot and you’re good for another five years. If early cancer is found, surgery and chemotherapy follow, and most likely you will recover nicely. If nothing is found, your next appointment is in 10 years.

Colonoscopy’s brash intrusion (which experts agree should commence once one turns 50) pays big dividends. Yet several factors keep too many people from the life-saving technology. The number one reason people blow off this medical test is plain old squeamishness. My brother’s wife was so unnerved by the idea of colonoscopy, she didn’t have one until it was too late. Sadly, she died of advanced colon cancer in 2009. Overall, among Americans, the fear factor has declined somewhat as word spread that colonoscopy isn’t as bad as it sounds. The American Cancer Society says only 44 percent of qualified people had colonoscopies in 1999. Nowadays, 62 percent do. Health experts think the figure should be higher for a procedure that thwarts the disease and provides a 90 percent survival rate for patients whose cancers are diagnosed early.

“Eighty percent of women over age 50 get mammograms, which detect breast cancer. The number who get colonoscopies is lower—but colonoscopy actually prevents cancer,” says Dr. Russell Heigh, a gastroenterologist at Mayo Clinic of Arizona, who studies ways to prevent colon cancer. “Colonoscopy identifies and removes polyps before they become cancerous.”

The second most popular reason for ignoring colonoscopy is health insurance coverage. In Arizona, most insurance companies and Medicare cover screenings for patients 50 and older with average risk for the disease. Which technology they cover may differ, according to Heigh, but people with elevated risk factors—a family history; previous polyps—may need to be screened earlier. Insurers sometimes only cover less extensive screenings, such as sigmoidoscopy, which only probes part of the intestine. It can be a less effective screening method for high-risk patients.

Finally, there’s the age thing. Colon cancer risk increases with age, but that can lead to confusion about screenings. In 2008, cancer was the last thing Michelle Hastings, a young mother who lives in Surprise, was thinking about when a specialist recommended she have a colonoscopy.

“I said, ‘Are you crazy?’” Hastings recalls. “I told the doctor, ‘I’m 31 years old and I have 19 years before I have to do that.’” But Hastings had noticed persistent blood in her stool, and her gastroenterologist recommended a colon screening. Hastings was young, but bleeding is a trademark symptom of colon cancer. Her husband told her not to take chances, so she got the screening and was diagnosed with late Stage 3 cancer. Hastings had surgery in May 2008 and remains cancer-free.

At the other end of the bell curve are the elderly, whose risk is the highest, but whose screening indications are confusing. One grandmother had a hard time finding a doctor who would do a colonoscopy, and later who would operate after her cancer diagnosis. Following successful colon surgery, the grandmother survived. The only mystery: why was it so hard to get her diagnosed and treated?

Confusion surrounds screenings for older people. A federal panel that develops guidelines for preventive services says everyone should be tested until age 75; after 85, only those with symptoms should be tested. But from 75 to 85, the decision is an individual one. “Biological and chronological ages differ,” Heigh explains. But screening guidelines are intended for the healthy; anyone with symptoms should be tested.

If there’s good news surrounding colon cancer, it’s that rates for the disease are dropping, as rates for colonoscopy are rising. Colonoscopy works. Removing polyps before they become cancerous is beating cancer. Still, Heigh says there’s one thing he doesn’t understand: people who have insurance, know about screenings, and yet don’t get them.

Hastings understands, but she’s lost her patience.

“What’s the big deal?” says this young cancer survivor. “You’re talking about an orifice in your body you poop out of every day. It’s a forbidden topic. People don’t get tested because we can’t talk about this orifice? Look what talking about breast cancer has done. We need to do that with colon cancer!”

Senior Writer Kate Nolan is willing to discuss her bottom.

Cancer Awareness Activities in March

The Arizona chapter of the Colon Cancer Alliance raises money for the disease year-round. Their big-deal event is a November “Undy Run” that has raised as much as $100,000. March events, focused on raising public awareness, are listed below. For more information, visit ccalliance.org/centralaz.

March 5: Dress in Blue Day 
Participants dress in blue (for colon cancer awareness), donate money, and wear stickers that prompt others to “Ask me why I’m wearing blue.” To get a starter kit, visit the CCA website.

March 6: Colon All Angels Motorcycle Run
The event’s slogan says it all: “Ride a Bike, Save a Butt.” Registration takes place at 10 a.m. at Joeta’s Leathers, 433 West Main Street in Mesa; kickstands go up at noon. A party follows at the American Legion Post #2, 2125 South Industrial Park Avenue in Tempe. Wear blue.

March 21: Suns Game:
The Phoenix Suns play the Portland Trailblazers at U.S. Airways Center; one dollar from each ticket sold will be donated to the CCA.

Fit and Fifty HealthCheck Program

The Arizona Department of Health Services runs this colorectal cancer-screening program for underinsured, low-income residents age 50 or older. Details can be had by calling 602-542-2808 or visiting azcancercontrol.gov.

Caring for Your Colon

“We need to talk about colon cancer in order to avoid it,” says Jamie Sellar, Phoenix program director for the Wellness Community, a national group that helps patients and families and educates the public about cancer.

“People tell doctors about their hearts, lungs and headaches but are afraid to talk about their colon. If they have blood in their stool, it’s ‘just hemorrhoids.’ But changes in the bowels can be symptoms of cancer and should be discussed with a doctor,” said Sellar, a licensed professional counselor.

Sellar suggests some other hard and fast rules to avoid colon cancer:

Eat healthy foods. Fatty foods and lack of dietary fiber promote cancer. Therefore, eat a balanced diet, avoiding fat and cholesterol, especially from meat. In fact, the crispy parts of grilled meat are carcinogenic and tend to lodge in the intestines. Instead, load up on high-fiber fruit and vegetables.

Maintain a healthy weight. Obesity increases colon cancer risk, especially in men.

Exercise. “This may be easier than it sounds,” says Sellar. Activity needn’t mean an hour in a gym five days a week. If you can’t climb a mountain, you don’t have to be sedentary. A walk around the block helps. Twice around the block is better, but once is better than zero.

Don’t use tobacco. Chewing tobacco is worse, but smoking is closely associated with colon cancer.

Get screened. Colon cancer starts as polyps that may take years to develop into cancer. Regular screenings let you catch them before they have time to become cancerous. Most people need a colonoscopy every 10 years after 50. If you have a family history of colon cancer or polyps, check with your doctor about genetic risk. A doctor can tell you when to start getting screened.

For more information, contact the Wellness Community: 602-712-1006 or visit twccaz.org.