To Screen or Not To Screen...

I recently received a call from a woman whose father is dying of colon cancer. He is in his early 70’s and had never been screened. By the time his doctors found the cancer, it had spread to his liver and lungs.

This week we heard that screening for prostate cancer may do more harm than good—particularly for older men. I understand that, I suppose. Prostate cancer tends to grow slowly, and the significance of test results is not entirely clear.

I worry, though, that in a twist of logic we will generalize a very specific recommendation. That the message will shift from “Men over 75 should not be screened for prostate cancer” to “No-one should be screened for prostate cancer” to (and this is the scariest part) “I shouldn’t be screened for any cancer.”

Every day in the United States more than 100 people die of colorectal cancer because they weren’t screened when they should have been. Every day. 

Colorectal cancer is the second leading cause of cancer death in this country, yet a simple screening will reduce the risk of having this disease by 80% or more.

The debate about prostate cancer screening will go on for a long time. One thing is not debatable, though—cancer screening in general, and screening for colon cancer in particular, saves lives.

Comments

[Anne Jensen]

I am a stage IV colon cancer patient. I was diagnosed at age 49 which is earlier than the standard recommendation screening. When I was diagnosed I was already stage IV. I had no family history of this disease and I often wonder if I would have been screened earlier how much easier treatment and prognosis would have been. I had
very vaque symptoms to encourage an early screening. I'm of the belief we should lower the age of screening because early detection is the key.
I was also told that by the time a person has symptoms of colon cancer it is often advanced. Not a fun place to be.

Thank you for your efforts to keep the message going.

Sincerely,
Anne Jensen

[Carrie B]

I went to the ER two saturdays ago with a full obstruction from what was soon dx as colon cancer. The first visit to the ER, I was told I was constipated and given a laxative and sent home. I was outside the screeing age and had no familial history of this cancer. I returned that evening after vomiting. Again told I was constipated and was about to be released when someone with some sense suggested a CT scan. Within 35 hours I had my surgery and bag placed. Withine 60 hours, the stage 3 diagoses came in. The same week a 32 year old with same symptons and treatment presented at the same ER. She unfortunately had her cancer rupture and her prognosis is dire. ER attendings need to be advised that this a potential risk at a younger age than 50.

[Kam]

My sister has been battling advanced stage IV colon cancer for 18 months now, chemotherapy and several bouts of radiation. She was 38 years old when the horrible diagnosis came out of nowhere and without any symptoms. She, too, went to the ER after medicine prescribed for a bladder infection didn't do the trick. Within hours, she was admitted for exploratory surgery and then told the grim news. I have watched her suffer and literally fade away and am just dumbfounded as to how this could have happened. How on earth? If anything, the screening age should be lowered and not for just those who are "at risk".

[Kay]

I was dianosed with stage IV colorectal cancer w/4 liver lesions. I had surgery in April 2008 for a colon resection and removal of 2 liver lesions, as well as radio frequency ablation to 2 liver lesions. I am 51, and should have had a colonoscopy as soon as I turned 50. I feel the recommended age for screening should be lowered to 45-47 years. I also would like to see the insurance coverage become part of a wellness benefit. I believe that people avoid the screening because of the cost, as much as the prep.

[Lori P.E.]

I was diagnosed with colon cancer 3 weeks before my 41st birthday. I went to the doctor 3 months prior complaining of indigestion - I had stool tested & blood work done, didn't hear anything, so I thought it wasn't anything. Whenk I showed up with pain in my stomach, it was suggested that I have a CT scan, but the doctor didn't think it was cancer because I no history. CT scan showed a mass, so he admitted me to the hospital where they did a colonoscopy. I than had surgery which confirmed the cancer. They removed 1/2 of the right side of my colon along with all of my lymph nodes (7 of 9 were cancerous) My children are recommended to have screenings at age 30, I'm sure this won't be a covered expense. I strongly feel the age should be lowered to at least 40, male or female. I also believe insurances should pay for it if you have it in your family & need screenings at a younger age. If it can be prevented with early screenings, than that's what should be done.

[Vicky]

Screen! I saw a Colo-Rectal Surgery Specialist after struggling with bowel problems which included bleeding and many of the signs of cancer. I believe that because of my age, I am 42 years old, I was told it was constipation and sent home with high fiber diet instructions. No exam or any diagnostic tests were performed. I followed up with this same doctor 8 weeks (and no improvement in my symptoms) later and again there was no exam or diagnostic test performed.

I decided to obtain a second opinion from another doctor who had me undergo a colonoscopy and I was diagnosed with Stage III rectal cancer.

If I would have been screened 9 months ago instead of suffering with my symptoms until I got the second opinion I would have been over halfway through my radiation/surgery/chemo. I also wonder how much easier treatment would have been and whether the prognosis would have been different.

[dennis]

how come no one ever says where to get tested and no one ever says what to do if you dont have a doctor or insurance?

[Becky]

I applaude all who have the courage to share their experierence. It has been almost a year since my husband died of rectal cancer at age 41. Just as many of you, no family history so no "reason" to screen. He was diagnosed, treated & died in less than 18 months of this dreadful disease. Who decides the right age to be screened? MOUNTAINS of education is needed so we can be informed to make the right choices for ourselves. God Bless.

[janeen]

There are colon grants which cover the costs of the colonoscopy if you have no insurance. Check with your local hospital for details. You do not need to have a doctor's order - if you qualify (very broad requirements), you are covered.

[Michelle H]

PLEASE get screened. I am lucky - I was dx at age 31 with stage 3 colon cancer. No family history, no real symptoms. Screening is the only way we are going to prevent others from having to go through the rigors of chemo, radiation, surgery. The screening really only takes 36 hours - the benefits are so much more than that. To know that this is preventable and to not do anything about it is horrible - I would do anything if it meant that I wouldn't have to go through chemo again. We need to get the word out - it's the only way we are going to stop this awful disease....