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Colorectal Cancer is Treatable - Early Detection Is the Key

Routine screenings can help protect against this deadly disease early - while it's more than 90 percent curable, says Dr. Hughes.

"No one wants to talk about this disease, and that's a major problem," notes Dr. Hughes. "Our goal is to empower patients and family physicians to take control of this very treatable disease."

Four Commonly Used Screening Tests

There are four widely used screening tests for colorectal cancer:

  • Fecal Occult Blood Test. This test involves checking stool samples for the presence of blood, which can be a symptom of colorectal cancer and other digestive diseases. It's an easy, early screening test that can be done right at home with an over-the-counter, inexpensive screening kit.
  • Flexible Sigmoidoscopy. This procedure uses a flexible scope to examine the lining of the rectum and the lower part of the colon. People preparing for this procedure need to take a laxative or enema to clean out their bowel before the test to provide a clean view of the colon. This outpatient procedure is often performed in the doctor's office. A sigmoidoscopy is not as thorough as a colonoscopy since it scans only part of the colon, but it costs less.
  • Colonoscopy. A colonoscopy examines the entire colon and detects more than 90 percent of cancerous growths in the colon. It is the most effective screening device for colorectal cancer, but it is also the most expensive, since the procedure involves day surgery under sedation. People preparing for this procedure need to take a laxative or enema to clean out their bowel before the test to provide a clean view of the colon.
  • Barium Enema. This procedure is offered as an alternative to either sigmoidoscopy or colonoscopy. Rather than using a scope to detect polyps, a contrast enema and X-ray of the colon is used to screen for polyps.

Talk to Your Doctor

"If you are 50 years or older, you should have a fecal occult blood test every year and a digital rectal exam," says Dr. Hughes. "And you should talk to your doctor about what other colorectal screenings might be right ​for you." Testing should start earlier and be more frequent for patients with a family history of colorectal cancer or colorectal polyps, other cancers, or inflammatory bowel disease. Also, women who have a family history of ovarian, endometrial or breast cancer may need to be screened before age 50.

Colorectal cancer is the second leading cancer killer in the United States, despite the fact that up to two-thirds of those deaths are preventable with simple screening and prevention methods. Most cases of colorectal cancer begin as non-cancerous polyps - small growths on the lining of the colon and rectum. Not all polyps become cancerous, and those that do, become deadly over time - anywhere from five years up to 15 years.

"That's why early screening is so important," stresses Dr. Hughes. "Removing these pre-cancerous polyps can help prevent the disease from ever occurring."

Nearly an equal number of men and women get colorectal cancer each year. All men and women 50 years and older are at risk. The older you get, the higher the risk. But colorectal cancer is not an "old person's disease." Up to 130,000 new cases of colorectal cancer will be diagnosed in people under 50 this year.

Dr. Hughes Helped Draft National Guidelines

Dr. Hughes served on a national committee for the American College of Gastroenterology, which helped to draft the current guidelines for screening and prevention of colorectal cancer. He has been an advocate and supporter of colorectal cancer awareness ever since.

One of the reasons people at risk don't get tested is that the definitive test - colonoscopy - is "icky and costly," says one 49-year-old woman whose father died of colorectal cancer and whose mother is a colon cancer survivor. "The recommended guidelines say you need to be 50 years or older, and that even with a family history of colorectal cancer, the screening tool of choice is a flexible sigmoidoscopy, which only looks at part of your colon," she noted.

In the decade since Dr. Hughes helped the American College of Gastroenterology draft the original screening guidelines, there has been new research about colorectal cancer and genetics and long-term studies on who should get tested and when. "As a result, those guidelines are being reevaluated right now," notes Dr. Hughes who frequently works with insurance companies to reimburse a procedure he thinks is necessary.

Testing Is Critical

"I can't stress enough that the most important thing about colorectal cancer is to get tested," says Dr. Hughes. "Know your risk factors and know what you can do to prevent colorectal cancer. Early screening is one preventive tool. Lifestyle and dietary modifications are another."

In 1998, the Centers for Medicare & Medicaid Services (formerly known as HCFA) expanded coverage to include colorectal cancer screens and began tracking a controlled group of Medicare patients for 10 years. "Among that control group, there was a 70 percent reduction in colorectal cancer," notes Dr. Hughes. "Early screenings prevent deaths, and we have the proof." On July 1, 2001, Medicare & Medicaid expanded coverage again to include colonoscopies.

Fear, embarrassment and confusion about insurance benefits are among the reasons people do not get screened for colorectal cancer at its earliest, most treatable stage. The most perplexing barrier to early detection is the lack of symptoms. The primary symptom - rectal bleeding or blood in the stool - might be attributed to hemorrhoids, ulcerative colitis, or inflammatory bowel disease. Other symptoms include a change in bowel habits, persistent abdominal cramping, chronic diarrhea or constipation and/or unusual fatigue.

Colorectal Cancer Is Most Curable at Early Stages

"No one wants to believe they have colorectal cancer," says Dr. Hughes. "By the time there is blood in the stool, cancerous polyps could have been developing with no symptoms for 10 years or more. Colorectal cancer is most curable when it is found before it causes symptoms."

That leads the doctor right back to his passion and #1 cause: colorectal cancer awareness and prevention. "We can treat this disease. We can prevent this disease," says Dr. Hughes. "Schedule an appointment with your personal physician to talk about which colorectal cancer screenings tests are appropriate for you. Routine screenings often detect this disease when it is most curable."

Schedule An Appointment with Your Personal Physician Today

To schedule an appointment with a Kelsey-Seybold doctor, call 713-442-0427. Same-day or next-day appointments are available with Kelsey-Seybold internists and family physicians at locations throughout Houston.