Nikki Sommer, a nurse practitioner for Key West Surgical Group, joined Good Morning Keys on Keys Talk 96.9/102.5FM this morning for Medical Matters.
Colorectal cancer is a serious disease in this country – Catherine O’Hara and James Vanderbeek passed away from colorectal cancer. Vanderbeek was only 48 years old.
Testing is critical for colorectal cancer – and we have different ways to test.
Sommer said, “I bring this up because there is a difference between the two, and people who are afraid of colonoscopies, they want to do stool testing, which is the FIT testing or the Cologuard. I just wanted to bring to light the differences between the three. So we’re talking about colon cancer screening. Colorectal cancer is one of the most preventable cancers when caught early and screening now starts at age 45 and it’s amazing to me, people still don’t know that. Usually we go to the health fair every year for the city and I can’t tell you how many people are over the age of 45 and they’re like, oh, I have until 50. No, you don’t.”
Some people think they can wait until they have symptoms.
Sommer said, “They think, because they don’t have symptoms, that they’re okay, or because they don’t have a family history, they’re okay, that’s not how it works. But why is screening such a big deal? Because most colon cancers start with small growths called polyps, they are silent for years. So if you get screening regularly, we can find them early enough, remove them before they become cancer.”
It’s also about preventing cancer.
Sommer said, “That’s what makes colon cancer screening unique. We actually can stop the cancer before it starts. Those polyps don’t necessarily start as cancer. They start as benign growths. There’s two different types. There’s a hyper plastic polyp and the adenoma. And the adenoma is the one that can turn into cancer if left in there for a long time.”
A colonoscopy is what’s called the gold standard.
Sommer said, “The doctor uses a thin, flexible camera to look directly into your colon so you can see if there are any polyps, if there’s any abnormalities, if you’re bleeding. We talked about anemia. Colonoscopy is one of the tests if you have anemia, and they don’t know why there’s blood loss, they will go up with the camera and they will look to make sure nothing’s wrong. And if the polyps are there, they will remove them right then and there and send them out for pathology. That way they’re not left in there. And if they’re the bad polyp, as the adenoma, the one that can turn into cancer, it will be removed early enough, and then you’re good to go for three to five years is the recommended follow up, three years if you have adenomas, five years if you have hyperplastic polyps.”
What about stool testing?
Sommer said, “People tend to like to do these because you can do them in the comfort of your own home. You collect a stool sample, and you literally send it in the mail to the lab. I really think it’s the prep, it’s the day of prep, which is what keeps people from going for the colonoscopy. It’s not actually the colonoscopy itself. So people tend to like to do this because it’s easy. You take a sample and you send it away. So there are two types that, the two main types that look for cancer in your stool, the FIT test looks for hidden blood in the stool. So basically, that’s going to detect if you have any blood in your stool, just like it says. And if you do, then you’re going to have to have a colonoscopy. The stool DNA test, which is also known as the Cologuard, looks for blood plus abnormal DNA shed by cancer cells. So if you do that, and that comes out positive, you’re going to need a colonoscopy. Now this one brings a little bit more anxiety, because it is looking for that DNA shed of cancer cells. So people that tend to do this and have a positive, they freak out a little bit, because the FIT test just detects blood. The DNA detects cancer cells, but regardless, if you get a positive for both of them, you’re going to end up being referred for a colonoscopy. Then it is no longer a screening procedure. It is a diagnostic procedure, and depending on how your insurance covers you will have a copay. So keep that in the back of your mind.”
What are the pros and cons to stool testing versus a colonoscopy?
Sommer said, “The colonoscopy, it looks at the entire colon, removes the polyps immediately, therefore decreasing your risk of them turning into cancer. And if you do not have any polyps whatsoever, you do not need another colonoscopy for 10 years. So if you’re polyp free, you don’t need another colonoscopy for 10 years. Now, if in that 10 years you have some irregular symptoms like irregular bowel movements, constipation, diarrhea, bleeding, you may need a colonoscopy in between that time, but if you are symptom free and have no polyps, it’s 10 years. One of the things that deter people away from this route initially is because it requires a prep, and you can’t eat that day, and then you’re in the bathroom part of the day, but the sedation, you take a happy little nap. That’s probably the best part of the whole thing. It really, truly is one day, one day to do something to prevent cancer. Stool tests, obviously convenient. Can be done at home. There is no prep for them. There’s no sedation needed, but the FIT test must be done yearly, and the DNA test is every three years. So that’s something to think about, too. And if positive, you’re going to end up with a colonoscopy anyway, and you’re going to go into the colonoscopy, like I said, a little bit more nervous because now it’s positive, so the stool tests don’t detect whether you have polyps or not. So you may have a negative stool test, but all that’s looking for is blood and cancer cells. You don’t know if you have polyps.”
Screenings save lives.
Sommer said, “Colon cancer, like I said, is is often silent in the beginning, and I do tell this to people, because people are adamant about not having a colonoscopy, but they will do a FIT test or a DNA test, and that’s at least you’re choosing something, you’re doing something to try and prevent it. So I mean, whatever route you choose, I’d rather you choose one or the other, as opposed to doing nothing. So know that if you’re 45 or older or have risk factors, you need to talk to your provider, because it is time, 45 or older is the recommended age for colonoscopy, and then family history is another thing. So if you have a relative that was diagnosed fairly young with colon cancer, you probably need to be screened a little bit sooner, so make sure you talk to your provider about that. This isn’t an embarrassment. It’s about prevention and longevity. I know it’s not a fun topic.”
For more information on how Key West Surgical Group can help, click here: https://www.keywestsurgicalgroup.com/