Ignoring the doctor
can cost you your life

Kids Stuff
By William Feldman

Welcome to Kids Stuff. Today’s column wants you to be aware of National Colorectal Cancer Awareness Month, which just happens to be the entire month of March. Now you are probably wondering why Kids Stuff is writing about colon cancer.
Well, here is the answer: I received a request from a reader, my dad, to submit to my editor for a reporter to cover the importance of colon screenings at a primary care level and he would supply them with a name of a gastroenterologist. Anyway, my editor knew my dad, Robert, is an internal medicine specialist with Abington Hospital and suggested that I interview him for this column.
Right now about 58 organizations that are focused on colorectal cancer join forces to bring attention to this disease. I am trying to put this column together as if it was a story with sequence of events that anyone of any age could understand.
The colon and rectum are part of the large bowel that is sometimes called the large intestine. They are part of the digestive system.
The digestive system is the group of organs that work together to give us the ability to eat. However, sometimes bad things can develop, like colorectal cancer. This can often happen with no symptoms. This is why screening for the disease is important.
According to my dad, "You do not wait for a problem to happen to have your first screening. Your first line of defense is seeing your primary care physician regularly, where they will inform you about various health screenings like getting a colonoscopy. Colon cancer is fairly unique in that it can be detected in a pre-malignant (non-cancer) stage when polyps are found during a colonoscopy. Most other medical tests or screenings can hope, at best, to find a cancer at an earlier stage before it has spread, but not in a pre-malignant stage," he continued.
The other issue he discussed was that people need to be aware of two misconceptions: They will have a symptom if they have a polyp, and if they feel "fine" they can’t have a problem.
Once a person understands the importance of having a colonoscopy, the next question is when should he begin the screening.
"Like most things in medicine, there is not one simple answer," the doctor said. "A main determining factor is family history or genetics of the individual patient. The important point is that people should start screening at age fifty when there is no family history, which is the age that is generally recommended to start the process.
"If one close relative of an individual has had colon cancer at a relatively young age, the patient should start the screening process sooner," he continued. "A general rule of thumb is that the individual should start the screening process at least ten years prior to the age that the family member was diagnosed."
For example, if a parent was diagnosed at age 45, his children should begin the screening process by age 35. In addition, some families have an even higher risk for colon cancer, where multiple members can have colon polyps and colon cancer in their 20s, he said.
"These family members should begin screening by their twenties," the doctor emphasized.
What about symptoms and signs for people to watch out for that may indicate the need to see their doctor and inquire about the need for a colonoscopy?
• Change in bowel habits — Watch for either a change in the frequency of bowel movements or the size and consistency of the stools.
• Rectal bleeding — Any unexplained bleeding needs to be explained.
• Unexplained weight loss — An adult who notices weight loss that is not intentional needs to find out why it’s happening.
• Abdominal pain — While many things can cause this, pain associated with any of the above symptoms needs to be explained.
The doctor cautioned that just because someone has these symptoms does not automatically mean the person has cancer. It is important for the person to see their doctor and ask the right questions.
I found more details on various Web sites that stressed the points that were already mentioned. A risk factor is something that increases your likelihood of developing cancer.
Some risk factors can be changed (like diet) but others cannot (like having inflammatory bowel disease). Some people who are at high risk for cancer may never have it, and on the other hand, some people who are at low risk may develop cancer in their lifetime. Doctors can’t always explain why this happens. Even so, it is important to focus on the risk factors that can be changed to help reduce the risk of colon cancer.
Some risk factors for colon cancer are:
1. Age: Older people, specifically over the age of 50, are more likely to get colon cancer, but it can occur in younger people, too.
2. Diet: Studies have shown that a diet high in fat and calories and low in fiber can contribute to colon cancer.
3. Polyps: A polyp is a benign growth on the wall of the colon or rectum. Certain types of polyps can increase the risk of colon cancer. A condition called familial polyposis (which is inherited), results in hundreds of polyps to develop in the rectum and colon. This condition is almost certain to lead to colorectal cancer unless it is treated.
4. Medical history: Women who have had cancer of the breast, uterus or ovary are at an increased risk for colon cancer. Additionally, people who have had colon cancer in the past may develop it again.
5. Family history: A person whose parent, sibling, or child has had colon cancer is at an increased risk, particularly if the person had cancer at a young age.
6. Ulcerative colitis: People with longstanding ulcerative colitis are at an increased risk.

Glossary of words

Abdomen: (AB-do-men) The part of the body that contains organs including the pancreas, stomach, intestines, liver and gallbladder.
Benign: (beh-NINE) Not cancerous; does not invade nearby tissue or spread to other parts of the body.
Biopsy: (BY-ahp-see) The removal of cells or tissues for examination under a microscope. When only a sample of tissue is removed, the procedure is called an incisional biopsy or core biopsy. When an entire tumor or lesion is removed, the procedure is called an excisional biopsy. When a sample of tissue or fluid is removed with a needle, the procedure is called a needle biopsy or fine-needle aspiration.
Cancer: A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread through the bloodstream and lymphatic system to other parts of the body.
Colon: (KO-lun) The long, coiled, tubelike organ, also called the large bowel or large intestine, that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. The colon has four sections: the ascending colon, the transverse colon, the descending colon and the sigmoid colon.
Colonoscope: (ko-LAHN-o-skope) A thin, lighted tube used to examine the inside of the colon.
Colonoscopy: (ko-lun-AHS-ko-pee) An examination of the inside of the entire colon using a thin, lighted tube (called a colonoscope) inserted into the rectum. If abnormal areas are seen, tissue can be removed and examined under a microscope to determine whether disease is present.
Intestine: The long, tubelike organ in the abdomen that completes the process of digestion; the intestine is comprised of the small intestine and the large intestine, which consists of the colon and rectum.
Intravenous (IV): (in-tra-VEE-nus) Injected into a blood vessel.
Polyp: A grape-like growth that protrudes from a mucous membrane. Precancerous polyps in the colon can be removed during a colonoscopy to prevent them from developing into colon cancer.
Polypectomy: (pol-ee-PEC-toe-mee) Removal of a polyp during a colonoscopy.
I hope this column will influence at least one more person to have a colonoscopy. ••
Columnist William Feldman can be contacted by e-mail at wmkidscolumn@aol.com