March of each year has been declared Colon Cancer Awareness Month. I have committed to do whatever I can to increase awareness for this killer disease.
My fervor to help prevent colon cancer goes beyond my expected zeal as a physician. I lost two of my dear elder brothers to colon cancer, both in the prime of their lives.
Manoy, our eldest brother, succumbed to this disease three years and three months after diagnosis. He underwent extensive surgeries both here and in the United States, and for a while, he was in remission.
We thought the cancer had been licked for good. But after over a year of remission, it came back, with a vengeance. It would not respond even to potent anticancer therapies. He breathed his last at age 59.
My other brother, Francis, also died of colon cancer at age 57, less than six months after diagnosis and even after 11th-hour efforts to save his life.
Third most common
It’s understandable then that I’m waging a personal crusade against this third most common cancer worldwide, and also a leading cause of cancer deaths in the country.
Early detection is important in the early treatment and likely cure of many ailments, and this is more paramount when it comes to the early diagnosis of colon cancer. We can nip colon cancer in the bud through the early detection of precancerous polyps which may be detected through colonoscopy.
This is a procedure in which a hose-like instrument with a camera at the tip is inserted through the anus and gradually pushed to visualize the entire length of the colon.
In expert hands, a colonoscopy is a relatively simple but life-saving procedure done by gastroenterologists (specialists in liver and intestinal diseases). When polyps are seen, they can be excised during the procedure by clippers or a snare at the tip of the instrument (colonoscope).
Polyps are benign, bud-like small tumors of the inner intestinal wall which can later turn into cancerous tumors. So, literally and figuratively, colon cancer can be licked if the polyps are detected early by colonoscopy.
I have been a beneficiary of this modern technology when I first underwent the procedure five years ago at Manila Doctor’s Hospital. Noted gastroenterologist Choy Nolasco performed it on me, with Mon Pesigan giving the intravenous sedation. Choy expertly removed three polyps from my colon, one of which was quite big already and almost ripe to become cancerous tissue in a few years.
It was a life-changing moment. Still drowsy from the mild sedation Mon had given me, I cried like a small boy when Choy told me about the polyps she had removed.
I was overcome by gratitude that the polyps were discovered early enough, and sadness, remembering my two brothers whose lives were cut short by colon cancer.
Dreamlike state
Perhaps it was the effect of the anesthetic putting me in a dreamlike state, but I seemed to have seen my two dead brothers a short distance from me, smiling, happy that I had a colonoscopy to save my life.
I wish I had prodded my brothers to undergo the procedure much earlier. To this day, that remains my biggest frustration as a physician. I’ve sworn that no one else in my family will ever become a victim of colon cancer.
It is unfortunate that only about half of people who have strong indications for a colonoscopy have it done, because of misconceptions, like the belief that it is embarrassing, uncomfortable and risky. In expert hands like those of Dr. Nolasco, the risk of complications is extremely low.
Colonoscopy usually takes less than an hour, and is usually done as an out-patient procedure. No need for confinement. Except for some cramping or bloating, one wakes up from the procedure feeling rested and relaxed from the short-acting sedative one is given for anesthesia.
In places where colonoscopy is not available, there are other simple screening tests to detect the possibility of colon cancer. The most simple and affordable of these screening tests is the fecal occult blood determination. A small amount of stool is sent to the laboratory to detect if there’s any evidence of occult bleeding—microscopic bleeding unseen by the naked eye.
If the test turns out to be positive, then the person should be referred to a gastroenterologist for colonoscopy.
Everyone 50 years and above should be screened for colorectal cancer. It should be done earlier if one is considered at risk—with a family history of colorectal cancer, a prior history of adenomatous polyps, previous history of inflammatory bowel diseases, changes in bowel movement (alternating diarrhea and constipation) especially if there is loss of weight, presence of blood in the stools, smoking, increased alcohol intake, obesity and unhealthy diet (high in fat and meat, and low in fiber, fruit and vegetables).
Colorectal cancer is always bad news, but the good news is that it can be curable, if detected early. Even in those with Stage 2-3 cancers, survival can be extended with surgery plus modern anticancer therapies.
Pass the word to your friends and loved ones. Let’s get ourselves screened for colorectal cancer! Better early than late.