question

Hi all, I am new here. I have been having some bowel problems for a few months (and have a family history of colon cancer) and had a CT scan last week that was fine but the GI still wants to do a colonoscopy. wouldn't he be able to see if there are any tumors in the colon via the CT scan?

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Do the colonoscopy for sure! Colon cancer runs in my family also and I was recently diagnosed with Stage 2/3 rectal cancer at age 48. Went through 6 weeks of radiation and chemo and waiting for my surgery date. The procedure is really not a big deal and finding it early is soooo important!

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Thanks so much. I guess I was hoping that if the CT was fine then I would not have to go thru the colonoscopy. I am dreading the prep b/c I have such bowel problems already.
Did your family members have CC at a young age? It seems more high risk when they get it younger. My family members have all been over 60 when they got it (mother and two grandparents). Leslie, did you have symptoms or was yours found during routine colonoscopy?

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The CT will not pick up anything inside the colon, have the colonoscopy, it will be the best sleep you have had in years, the worst part is the prep, but they do have pills you can take instead of drinking the gallon of ? My twin sister is now at end stage Colon cancer and if at all possible you want to catch it early, she was Stage IV when diagnosed in March 2010, this is has been a long and horrible journey so catch it early, it is curable if caught at an early stage.... Good luck and you have time on your side so go get that colonoscopy!

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CT colonography (virtual colonoscopy) only detects polyps larger than 1 cm. Compared to traditional colonoscopy, it would miss ninety percent of polyps removed (to prevent developing into cancer). Talk to your doctor about prep options, but do proceed with colonoscopy.

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Bowel problems mean a colonoscopy!!

A CT scan won't find polyps or cancer inside the colon, and it can't find other conditions like ulcerative colitis or Crohn's disease that might be causing your problems.

There is a special CT scan called CT colonography or virtual colonoscopy that can see polyps and cancers inside the colon, but it requires the prep, just as regular colonoscopy does. It isn't right for people who already have bowel problems that might be a symptom of colorectal cancer. It is used only in people who don't have symptoms as a screening tool.

There are lots of reasons for bowel problems (diarrhea, constipation, gas, pain, even bleeding) that are NOT cancer. But any symptom in any person, no matter their age, needs to be evaluated thoroughly, including a colonoscopy.

The prep can be yucky. No doubt about that. But the procedure itself is easy with sedation and pain medicines.

It is important to do it, especially with the added concern of a family history.

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Thanks so much everyone. Mine colonoscopy is scheduled for the 26th so I will go ahead with it and get it over with. I really do appreciate the input!
And jmarkov, so sorry to hear about your twin sister. I cannot imagine what this is like for you but you all are in my thoughts and prayers.

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My mother had colon cancer when she was about my age but they found it early so she just had surgery alone and lived another 23 years until different cancers finally took her. I was having blood in my stools, i wish i had done it sooner but i was terrified of the procedure which really wasn't bad at all. Even the stuff that i had to drink was tolerable...just hide yourself in a room and watch good movies (and go to the bathroom alot). Good luck to you and hopefully everything turns out good!

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I was diagnosed with a stage 3 or 4 colon cancer .... 12 years ago. The Dr.s didn't give me much hope for survival as the cancer cells were found throughout my lymph system. I was 46 and had 3 young teens....so went for all treatment. I had surgery, chemo...which my body rejected violently and had to be stopped and then boosted radiation. I have been cancer free ever since. I've had yearly colonoscopies ever since. My GI Dr. finally said I can now go 5 years between tests. That doesn't sit well with me so I'm hoping to convince her that every other year would be better. I absolutely hate the prep...as I suffer from horrible late side effects of my radiation. But, I don't want to ever go through that again. Please do follow through with your colonoscopy...it is a life saver.
Good luck and please let us know how you make out.
Kathie

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Kathy (and everyone else too!),
I appreciate so much all of your input. I promise to follow through with the colonoscopy. I will dread the prep but I will do it. My Mom had colon cancer and by the time she sought treatment she had been having diarrhea with blood for almost a year but was too embarrassed to tell anyone. My symptoms are not that severe but I certainly do not want to go through what she did. She is cancer free right now but has terrible problems with constant diarrhea that has changed her life - she does not want to go far for fear of an accident. Her cancer was in the sigmoid part of the colon and she lost a very large segment of it so things don't work like they used to. Her mother had colon and breast cancer and my Dad's father died from colon cancer. I will let you all know the outcome of my procedure after I get the results.
Knitty

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Hi Knitty,
One suggestion. I watched my husband do his bowel prep before his colonoscopy and it didn't look too fun so I did some asking and found out that if you don't eat before you need to do the prep, it is much easier. I have no problems with fasting so I didn't eat solid food for two days before doing the prep and it really wasn't too bad. Only had to drink two quarts of the prep to get cleaned out. Good luck!

Lauretta

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Kitty, I have stage IV colon cancer with mets to liver. The prep is the worst of the procedure, but
necessary. I had to do it twice within a week in 2009. I had my last colonostomy in 2011. I had a
little trouble drinking all of the prep and mentioned that to the nurse before my colonostomy.
She said she struggles also and there is pills you can take and you only have to drink plain
water. Even though it's alot of water it is easier than drinking the flavored water with the prep. I
intend to ask for that next time. I think I can get pills and plain water down easier than I can
the flavored prep. The smell and taste starts to make me sick towards the end of drinking
all of it. I hope you do well. We are strong and can get through it, I know you can do it.

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Guidelines for colonoscopy surveillance after a diagnosis of colon cancer are:

Colonoscopy one year after surgery if a colonoscopy was done before surgery and reached the full colon.
Next colonoscopy in 3 years.
If no polyps are found, colonoscopy every 5 years.

These guidelines were decided on by the American Cancer Society and the US Multi-Society Task Force on Colorectal Cancer who also say:

"Following the examination at 1 year, the intervals before subsequent examinations may be shortened if there is evidence of hereditary nonpolyposis colorectal cancer or if adenoma findings warrant earlier colonoscopy."

You can read the full set here: http://www.guideline.gov/content.aspx?id=11879

While all of us get nervous about a possible cancer recurrence or new polyps or even cancer in the colon after surgery, the guidelines are sensible and based on good evidence for how colon and rectal cancer develop.

Colon cancer develops very slowly from tiny polyps (adenomas) to larger, more advanced adenomas and finally to cancer. Only a small fraction of adenomas (less than 1 out of 10) will ever progress to cancer.

On the other hand, colonoscopy is NOT a simple or completely safe procedure. When it needs to be done, the benefits outweigh the risks, but doing it more often than necessary means the risks are bigger than the benefits.

It is possible to poke a hole (perforate) the colon or cause serious bleeding during a colonoscopy. In addition, sedation has risks and dehydration from the prep can be serious, especially in older people or people with heart or kidney conditions.

So, even if you are worried, accept the advice of your doctor and wait those five years.

Unless you have rectal bleeding, pain, or other symptom of colorectal cancer. Then a colonoscopy might be necessary to evaluate the problem. But if it is just for screening . . . wait!

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Hello Kate;
Thank you so very, very much. Your response was incredibly pertinent to me. I'm going to read through the info at the link you sent. You were absolutely correct in saying my colonoscopies are only for screening. I think because I've had them so often I've come to feel they are critical to my health. I wasn't considering the serious complications that can arise. I will talk to my Dr. again and make sure that we are definitely on the same page regarding timing of these tests. The statement you made about dehydration really struck home as it is a constant threat to me. I'm on TPN due to intestinal failure from my boosted radiation treatments. I am encouraged to eat small (very small) meals throughout the day to help protect my liver from the lipids in my TPN. Food just zooms through my digestive system leaving no calories or nutrients behind. I love food but certainly being tied to the bathroom is miserable. I'm 13 years cancer free! Not bad for someone told they would unlikely live 2 years!
So, I repeat, thank you for the excellent advice...and I will look into it. Your answer actually made more sense than my Dr.s. She is incredibly busy and just tossed off...'You won't need another colonoscopy for 5 years' as she left the office.
Sincerely
A grateful Kathie

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Hello to all,

First of all, I highly recommend colonoscopy screening - I have no doubt that it saved my life. Yes the prep can be a hassle, but isn't so bad these days; my most recent experience had me drinking 2qts of any sport drink (that wasn't red or purple), and taking some tasteless laxative dissolved in it. Not so bad, & actually tasted good. An evening's discomfort is well worth the early detection or the assurance that you're clear!

I also wanted to reinforce something mentioned by FightCRC-Kate, above: hereditary nonpolyposis colorectal cancer, also known as Lynch Syndrome. My first CRC was found in my mid 40's, and I did the colonoscopy screening pretty much as Kate described it. At the end of my first five year wait between colonoscopies, another CRC was found. My surgeon looked at my history and my family history, and diagnosed me with Lynch Syndrome, recommending that the remainder of my colon be removed as I would have a 60% chance of another CRC if any was left in. I agreed to this, and in analyzing the colon after surgery, another very small, but fully formed cancer was found in a section of the colon that would have been left behind.

The recommendation for any with Lynch Syndrome is to have colonoscopies every year. Had I been doing this, my current fight with CRC may have been as simple as having a polyp removed a year ago. In retrospect, what surprised me is that none of the many doctors I've seen over the last 12 years since my first cancer mentioned the possibility that I may have Lynch Syndrome, even though one of the primary indicators is CRC before age 50. Had they known of Lynch Syndrome and advised me appropriately, I think I might have been able to avoid some of the mess I'm in now.

My recommendation to all of you that first discover CRC in your 40's, is to discuss the possibility of Lynch Syndrome with your doctor - you may very well be teaching them a thing or two. Diagnosis is based on a full family history as well as your own personal experience, and genetic tests are now able to pin point the genes involved in 60% of those with the syndrome. In women, Lynch Syndrome also causes endometrial cancer.

Knowing about Lynch Syndrome (hereditary nonpolyposis colorectal cancer), can make a huge difference for your siblings and children. I am ever so thankful to my surgeon, he not only saved my life with this diagnosis, but may well have saved the lives of many of my family members.

Best of Luck to you all.

Bruce

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PS

I almost forgot to post a resource for learning more about Lynch Syndrome. This site from the Mayo Clinic is the clearest and most thorough I've found.

http://www.mayoclinic.com/health/lynch-syndrome/DS00669

Cheers,

Bruce

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Bruce, thanks so much for the great information! I appreciate you all so very much and will let you know what happens on the 26th.

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Just wanted to let you guys know that my doctor moved the colonoscopy up to the 21st - tomorrow! I will start the prep later today. I am really nervous and cannot sleep. Here's hoping that there is nothing there and all is good.

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Thinking of you, Knitty.

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Hey there Knitty. After reading your post and all of the replies, just wondering how your colon scan turned out? Hopefully you are fully rested and will be given some good news when the results come in. Colon cancer runs in my family too, FAP from my father's side and lost him and my younger brother.....my brother was only 30 years old! Screenings are crutial to outrun and stay a step ahead of family-born colon cancers like hereditary colon cancer! So glad you decided to go through with the colonoscopy and that the docs saw enough importance to even bump it up a week! Hugs to you and your family and hope to hear from you soon.

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Hoping you're doing alright.

Bruce

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