This is part 2 of the Cancer preventive care series. You can read the series preamble here
This is the newest of all the screenings having been implemented less than 10 years ago.
This screening begins at age 50 and goes until the age of 74. It is recommended every 2 years as long as it’s negative.
The Fecal Occult Blood Test (FOBT) is a stool test that you get to do at home. It tests smears of your stool for hidden blood that often comes from polyps which are small growths that can develop in the lining of the colon. Because these small growths develop their own blood supply they can leak blood into the stool as it passes. The amount of blood is usually so small that it’s invisible to the naked eye.
Repeat screening every 2 years makes the test more reliable as your information is gathered and stored.
If there is a family history of colon cancer in a parent, sibling or child, these are considered first degree relatives and you should be fast-tracked to have a colonoscopy and the FOBT would not be done. There are genetic testing programs available for colon cancer where you can be tested to determine if you’re at risk for developing this disease.
Again there are few causes of colorectal cancer but there are a number of risk factors. Like breast cancer, the only thing that may cause colorectal cancer is family history. The risks, however, increase if you have a first-degree relative or have had a previous diagnosis yourself. Other risks include a lack of physical activity, obesity, alcohol use, smoking, any kind of restricted diet, irritable bowel and diabetes.
If your fecal occult blood test comes back with even one of three positive flaps you will automatically be fast-tracked for a colonoscopy.
There is little you can do yourself to monitor for colon cancer. Noticing blood in the toilet after a bowel movement can be concerning. If it’s very dark in color then it’s more concerning than bright red blood which generally indicates hemorrhoid. A few other noticeable symptoms to take note of would be diarrhea all the time, constipation and weight loss.
A colonoscopy requires the colon to be cleaned out and most people have known someone who has undertaken this process. For the actual procedure, they will give you a combination of medications to make you very sleepy and the procedure will be over before you know it. While you’re asleep the doctor will pass a tube with a light and camera into your large intestine through your rectum and will have a look at all of the walls of the colon. If there is an area of concern a biopsy (sample of tissue) will be taken and sent to the pathology lab.
Once the pathology report is received by the surgeon who did the scope you will meet with him and he will review the results and treatment plans, if necessary, will be discussed. If benign (non-cancerous) polyps were found the surgeon will advise you when your next scope should be which will be anywhere between 3 and 10 years with the average being 5 years.
If malignant, surgery will be scheduled as soon as possible followed by an appointment with an oncologist to review and discuss further treatment options with chemotherapy and radiation.
The smaller the tumor, the less likely cancer has spread to other parts of the body. This is pretty much the rule for all cancers. Unfortunately, colon cancer can be sneaky and show few symptoms, metastasize and it ends up being symptoms of the metastasis that end up found first.
The alternative to not doing this test, and yes some people think it’s disgusting enough to not do it, is running the risk of developing a tumor that completely blocks the colon resulting in becoming very ill and likely emergency surgery. The likelihood of this cancer metastasizing is very high and commonly spreads to the liver and bone.
Cancer is always scary but when it’s discovered early enough, it’s treatable and that’s the best outcome anyone can ask for.
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