colonoscopy

Is colorectal cancer getting its butt kicked?

Among those over 50, the number of people with colon or rectal cancer plummeted 30 percent from 2001 to 2010, due to screening and removal of precancerous polyps, according to data published this week.

For those 65 and older, the decline in new colon cancer incidents was even more dramatic, dropping 7 percent a year during the three-year period from 2008 to 2010. 

A national coalition of cancer groups, organized by the National Colorectal Cancer Roundtable, now hopes to eliminate colorectal cancer as a major public health problem through an “80 percent by 2018” campaign, launched this week. The goal is to screen 80 percent of people over 50 by 2018.

“It is realistic for us to achieve this goal at UC San Diego,” said Samir Gupta, MD, an associate professor of clinical medicine and gastroenterologist at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System. “We are in the midst of a coordinated effort between primary care physicians and gastroenterologists to optimize screening rates.

“To increase screening rates, we are reminding patients, who are not up to date, to get screened. This effort includes mailing patients invitations. Our main challenges are awareness and making sure patients are talking to their doctors about screening and when to get screened. The ‘ick factor’ is also probably significant.”

Colonoscopies are the primary means for detecting precancerous tumors early. For those who prefer non-invasive options, patients may request the fecal immunochemical test (FIT) or guaiac fecal occult blood test, both of which have the endorsement of the U.S. Preventive Services Task Force.

Virtual colonoscopy or CT colonoscopy has been endorsed by the American Cancer Society, but not all insurers cover the procedure and it still requires a bowel preparation.

anonymous asked:

What do you do when no one is taking your health concerns seriously because of your age? I say this because I have had every symptom of colorectal cancer for over 8 months now along with a VERY strong family history of it and cancer in general, but none of the doctors are taking it seriously because I'm still a teenager. Its getting to the point where I can barely walk sometimes and have to take a lot of time of school and I just can't live like this anymore but I don't know what to do...

Ok, so you have two options.  Number one: the next time you’re having pain so strong you can barely walk, bring yourself to the emergency room.  Now, be prepared to settle in, because you’ll likely be there waiting all day since you’re not missing a limb, but this is probably your next step.  

Or, make an appointment with a Gastroenterologist. It’s possible that it will take a while to get an appointment, so if you’re still waiting for your appointment and you have pain so strong it makes it difficult to walk, go to the emergency room anyway.

Be very clear with the doctors you speak with.  Say:

  • I’m having the following symptoms: X, Y, Z, in addition to the pain in my abdomen that is currently making me unable to walk.
  • This began happening X number of months ago.
  • The pain lasts for X number of hours.
  • _______ makes it better, and ________ makes it worse.
  • My family has a strong history of colorectal cancer.
  • I understand that colorectal cancer usually occurs in older people, but because of my family history I need to be certain that I don’t have it.  Additionally, this pain is insufferable.  If it’s not colorectal cancer, I’d like to figure out the cause so it can be treated.
  • Will you be able to preform a colonoscopy today, or should I come back next week?

With clear presentation of facts, any provider that you speak to cannot brush you off since the pain you’re experiencing is a significant red flag.  Even if they’re certain it’s not cancer, it could be a number of other things and they can’t just send you home without identifying it.

This technique can be used for any health concern.  Lay out the situation clearly and accurately, and tell the providers that you would like to have testing done to clarify the situation.  If they say no, ask why.  If their explanation is that you’re low risk for a certain condition, ask them how they can explain your pain/bleeding/discomfort/etc without doing testing.

Only in medicine
  • SC:Medicine is the strangest job in the world. I can walk in a room, say, "I'm Dr. C. Take off all your clothes and I'll come back and stick my finger up your butt," and people obey without question!
  • EP:Yeah, and in 2 weeks I'm actually going to pay a guy I never met to starve me and then shove a 5 foot hose up my @$$.
Black Mamba
  • While working through a case study.
  • T:...So the DRE was positive for blood, so what would be the next investigation you would like to do?
  • H:Release the black mamba.
  • P:Did you just refer to a colonoscopy as the black mamba?
  • T:That is seriously disturbing.
  • P:And it has a wicked bite.
  • H:Well we take bites of tissue for biopsy purposes on colonoscopy so it is close.
  • P:No. No, they are not even remotely close to being the same.
  • T:Oh man, I cannot get that image out of my head! Ah!
My colonoscopy prep tips

1. Put on cosy clothes and have a breakfast full of energy.
2. Make yourself a bottle of your favourite tea.
3. Prepare yourself with films or books beneath your bed.
4. Start as soon as possible with the prep (it’s nicer if you don’t have to go to the bathroom the whole night).
5. Buy the best toilet paper and enough baby wipes or baby oil.
6. Drink enough other fluids with your prep, even when you get nauseous. Then you have to slow down.
7. Prepare your family: choose a bathroom and say “it’s mine today!”.
8. Let it flow.
9. And don’t forget to put a sanitary pad in your slip :)

The colonoscopy is over. They removed some things. There will be biopsies…which is a great Paul Thomas Anderson film. The nurse kept telling me I looked like her son and then right before they put me under she showed me a picture of him. I said, “I’d fuck him.” Don’t know why I felt the need to make everyone in an operating room uncomfortable before they shoved things up my ass but that’s what I do. I’m a giver.