Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5 FM for Medical Matters this morning.
March is Colon Cancer Awareness Month and the color is blue.
Sommer said, “For colon cancer awareness, dress in blue. You know how pink is breast cancer awareness month. So for colon cancer, dress in blue on March 7, for colon related cancers, and in honor of those who have the disease or who’ve had the disease in the past.”
Colon cancer screening recommended is now at the age of 45.
Sommer said, “Due to the higher occurrence of colon cancer in younger adults under the age of 50, the new recommendation is 45 and if you have a family history of colon cancer, they recommend speaking to your primary care physician sooner to figure out if you need one done before the age of 45. You remember years ago Chadwick Boseman, he was in Black Panther. He died of colon cancer at the age of 43 in 2020 and he was diagnosed in 2016. He had a four year battle with colon cancer, which means he was diagnosed in his late 30s.”
What are the signs of colon cancer?
Sommer said, “Persistent change in bowel habits, including diarrhea, constipation, change in the consistency of your stool. I know this is a wonderful topic to talk over breakfast and coffee, but how’s your stool today? These are things that you know you need to pay attention to, especially at any age again. While doing this, I came across a couple of young people that were Tiktok, famous for whatever reason, that died in their 30s of colon cancer. If you’re having rectal bleeding or blood in your stools, some people automatically think it’s hemorrhoids. If it’s something that doesn’t go away and it’s lasting, it’s persisting, you need to see somebody to have it checked out. Feeling like your bowel doesn’t empty completely, if you have weakness or fatigue or unexplained weight loss along with all these symptoms, you need to get that checked.”
What are the risk factors for colon cancer?
Sommer said, “African Americans are at a higher risk for colon cancer. Personal history of colon cancer or polyps. So if you’re somebody that is over the age of 50, has been getting your colonoscopy and you have polyps, and you think you’re in your 60s or your 70s, and you can stop, don’t do it. If you have quality of life, you want to make sure that none of those polyps are cancerous. So you need to follow the guidelines, whether it’s every three to five years, based on what type of polyp you have.”
Low fiber, high fat diets and a sedentary lifestyle can contribute to the risk for colon cancer.
Sommer added, “Inflammatory intestinal conditions like Crohn’s disease, ulcerative colitis, you’re a high risk for cancer. People with those diseases, they do tend to be a little bit more compliant, because they have constant, chronic problems with bowel movements, so they usually get their colonoscopies when they’re supposed to, but occasionally you get the individual that’s not compliant.”
What about Cologuard?
Sommer said, “A lot of people will choose the Cologuard, and what ends up happening is they end up coming to see us when the Cologuard is positive, and then they’re freaked out. What Cologuard is it is a test. You send a stool sample, and they check it. If it’s positive, what it can mean is that there are DNA markers in your stool associated with colon cancer. So that freaks people out, as it should, because now it’s positive and now you need to have a colonoscopy. So Cologuard can’t tell whether you have polyps or not. So if you choose the Cologuard and it’s negative, it can’t tell if you have polyps or not. So you can have a very tiny polyp that’s growing and you can’t have a Cologuard at age 50 and say, oh, I’m good. I never need to do it again. No, that doesn’t mean you don’t have polyps. There’s nothing in the polyp that’s triggering the Cologuard to be positive.”
Cologuard is not recommended for anyone with a history of polyps or a family history of colon cancer.
Sommer said, “If you’ve had a colonoscopy and you’ve had polyps and it’s time for your colonoscopy again, the Cologuard is not the option for you. You need to have the colonoscopy because you need to make sure that you don’t have any polyps, especially if you had adenomas. Those are the precancerous polyps that you want removed as soon as possible. So people that tend to have those type of polyps will have a colonoscopy every three years. Anyone with a family history of colon cancer, if there’s a strong family history of colon cancer, especially a mom, a dad, even a grandparent, you don’t want to do Cologuard, you want to have a colonoscopy. Anyone with a history, again, of inflammatory bowel disease, Crohn’s disease, ulcerative colitis, Cologuard is really not the best option for you, a colonoscopy is. If you’ve had another type of colorectal screening that was positive in the last six months, Cologuard is not the choice for you. If you have like we talked about, abdominal pain, diarrhea, constipation, rectal bleeding, you need to have a colonoscopy to see what’s going on. Cologuard is not going to be able to give you a definitive answer of why those things are occurring.”
What are the preparation steps for a colonoscopy?
Sommer said, “That is I think the biggest thing that drives people not to have a colonoscopy is the fact that they have to be on clear liquids the day before and then do the prep. We normally use a combination of MiraLAX and Dulcolax and an enema, and it’s those are available over the counter. We even sell a little happy colonoscopy prep kit in our office, and it includes those. It’s kind of mild. It’s a clear liquid of choice. It doesn’t have to be Gatorade. It’s any liquid you can see through. You drink that over a two hour period, and then when you’re done with that, two hours later, you take four little tabs of Dulcolax and you’re done for the night, taking anything or drinking any prep, and then you clean out your bowels, and the next day, you get the best sleep of your life. So it really wasn’t that terrible. Suprep is a liquid prep as well. It’s a two part liquid prep that, again, you kind of drink at the same time, 4 to 6pm in the evening, before you drink the first half and then the second half is six to eight hours before the procedure. I usually tell people just to space them four hours apart, because if you’re prepping, if you’re drinking the first half between four and six, you’re going to have to get up in the middle of the night to do the second half of the prep. So I just say before midnight, drink the second half. That way you get some rest the day before your colonoscopy. Because until the day before, you don’t know what time you’re going to have to go in the following day anyway. So there is that option, people have opted for it. I’ve heard they’ve taken it and it’s better than the alternative.”
SUTAB is another option.
Sommer said, “There are people that do not like to drink large quantities of liquid in a short amount of time. So SUTAB is also a prescription. It’s tablets. I know somebody that hates drinking lots of fluid at once, they’d rather take a pill. So you will take 24 tablets, 12 at a time, with like 16 ounces of water, followed by like another 16 ounces of water. But it’s plain water with the tablets, as opposed to something flavored or something gritty, like it’s almost like a texture issue, I think, with some people when it comes to drinking a lot of fluid with something in it, as opposed to just straight water with tablets. So that has been an option where, I won’t say people have enjoyed, they preferred.”
What about Golytely?
Sommer said, “That was like the gold standard of colonoscopy prep back when I started in nursing and it’s a 64 ounce gallon jug that everybody tells me tastes awful. You kind of have to drink eight ounces every 15 minutes until finished. When I worked in the hospital and I took care of a patient that needed a colonoscopy, I would line up cups, like shots and pour the Golytely in and they would just kind of like drink them, every 15 minutes. It was a little bit more difficult to tolerate.”
Colonoscopies are really important.
Sommer said it’s “just one day to keep the cancer away. It’s just one day that interrupts your life. That’s it.”
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