Break the Silence
Talk and Take Action Against Colorectal Cancer
By Caperton Gillett
Speaking up could save your life from a silent disease. By talking to your doctor about a colonoscopy, you could protect yourself against colorectal cancer, which can appear without symptoms; it's almost entirely preventable with proper screening and early treatment. "In the vast majority of cases, cancer can be prevented if a polyp is found and removed," says J. Pablo Arnoletti, M.D.
Dr. Arnoletti, a surgical oncologist, is part of a team of UAB cancer specialists who continually study the latest, most advanced, and most precise methods of early detection and diagnosis. One of those new options is a virtual colonoscopy, says Dr. Arnoletti. "The study is done with radiologic imaging, and it seems to be comparable to other tests," he explains. After the screening, if you need a biopsy or polyp removal, your doctor will likely recommend a traditional colonoscopy as well.
The classic colonoscopy, considered the gold standard of screening tests, enables doctors to examine the entire length of the colon and remove any polyps found during the exam. Alternatives include a flexible sigmoidoscopy coupled with fecal occult blood testing, and a double contrast barium enema.
When should you get a colonoscopy? Dr. Arnoletti and other UAB specialists advise that if you have no specific risk factors, you need to start screening at age 50-even if you enjoy a healthy lifestyle. "Patients should not wait for the development of symptoms," he says. "By the time colorectal cancer develops symptoms, the tumor is often advanced."
If your mother, father, brother, or sister developed colon cancer, polyps, or certain other types of cancer before age 50, you should consider earlier screenings. "We generally recommend that these patients have a colonoscopy at least 10 years before the age of diagnosis in the family member," Dr. Arnoletti says. "So if you have a relative who was diagnosed at age 40, you should have a colonoscopy by age 30, regardless of the presence of symptoms." He adds that earlier screenings also may be advisable if you have a history of inflammatory bowel disease such as ulcerative colitis or Crohn's disease, which increase the risk of developing colorectal cancer.
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A True Visionary
Colonoscopies wouldn't exist if it weren't for a pioneering UAB physician. Fifty years ago, gastroenterologist Basil Hirschowitz, M.D., invented the flexible endoscope and improved fiber optics, providing physicians with the tools to clearly see inside the stomach and colon for the first time. Hirschowitz's first endoscope, now recognized worldwide for revolutionizing the diagnosis of many kinds of cancer, is now in the Smithsonian Institution.