I recently underwent a colonoscopy screening that I had put off for quite some time. I decided it was important to share my personal journey because of the recent rise in cancer occurrences in people under 50. Additionally, the rates become even more dire when we take a closer look at certain marginalized populations such as African American men.
We all recall the high profile and sadly untimely death of actor Chadwick Boseman due to colon cancer. This was a wake-up call for some, however, far too many are operating in the darkness of realizing how deadly this disease can be, and the steps needed to avoid a late diagnosis. Additionally, many are unaware of how to advocate for early screening if they are not 45 but are exhibiting concerning symptoms.
The Facts
Colorectal cancer ranks as the fourth most common and fourth leading cause of cancer-related deaths in the United States (CDC, 2020). In 2020, there were 126,249 new cases of colon and rectum cancer reported, with over 50,000 fatalities (CDC, 2020). The American Cancer Society (2020) reports that Black adults face a 20% higher incidence rate of colorectal cancer and a 40% higher death rate compared to other racial groups. This disparity underscores the necessity of early detection, particularly as this form of cancer can be treatable if caught in its early stages.
Despite the shift in recommended screening age from 50 to 45, awareness remains low. Having a primary care physician or access to a gastrointestinal specialist who emphasizes the importance of early detection is vital. Knowing your body and communicating concerns to a medical professional can lead to timely screening and potentially save your life. Primary physicians that I have seen have all pushed for this important screening to take place some more than others. Unfortunately, not having a doctor or medical professional that highlights this or not having one at all can lead to adverse consequences of not knowing the importance of early detection. It's not a very comfortable topic to discuss bowel habits, however, it is a much-needed life-saving one.
The Process
The process of the colonoscopy is dreaded by most. The actual procedure is quick and painless. I prolonged doing the procedure, however, I did not stop speaking with various healthcare professionals until I found the right fit. I also did not stop researching the process, the preparation used, and tips for the proper way to prepare. The result was a relatively smooth journey from start to finish and a trusted relationship with both the process and the medical team involved.
The idea of forcefully giving yourself diarrhea is unpleasant. However, when you break down that concept and practice discipline it can go a bit easier. Asking the doctor performing the procedure as many questions upfront and leading up to the day before is extremely useful. The fact that two medical professionals I saw weren't readily available to answer my questions or had assistants who gave out incorrect information weighed heavily on my decision to delay the procedure and look for a better-qualified doctor.
The type of preparation solution used to clean out your bowels is important. Knowing the potential side effects of each can assist you in determining with your doctor which preparation is better suited or can be better tolerated by you. Additionally, knowing and understanding the instructions are key. You should have access to a nurse or doctor the day before to ask any questions. I found this to be extremely helpful in knowing when to start certain steps of the prep and when the target end should be.
Modifying your diet is something that some doctors do not highlight enough. The stress is always on the day before, however, depending on your diet, it is recommended to start as soon as three to five days before. Everyone's system is different so this is something you should always consult with a medical professional on always. Many are intimidated by a liquid diet, yet I was pleasantly surprised by how far broth, tea, homemade, and watered-down clear juice pops, and clear hard candies can go!
On your preparation day you should be as relaxed as possible. Plan ahead what your liquid menu will be and also plan your menu for a few days before. This will help to allow the process to be less overwhelming. This is also where you want to be sure to ask your doctor all specific questions about your preparation including but not limited to when to start, how fast or how it works, when to finish, how you know it's working, and any potential side effects.
Once your procedure day arrives, make sure you have a trusted person with you who can ask questions for you and also escort you home. Additionally, make sure you are clear on the type of sedation that will be used and what you can expect to experience before and after the procedure. A good provider will have a member of their staff contact you several hours after the procedure to make sure you are ok. The doctor should speak with you immediately after the colonoscopy to discuss the results and the next follow-up. If someone is experiencing grogginess from the anesthesia, ask beforehand if your escort can be present to take notes on the doctor's feedback.
It is crucial to remember that this disease when caught early can be treatable. Yet, it is important to recognize that there may be barriers in place that keep certain groups from retrieving access to high-quality testing. These barriers can range from ineffective communication by medical professionals to patients on the importance of the screening, fear of the preparation for the test, or even costs if insurance is an issue. The important things to remember are that it is necessary to know what your options are and to pay attention to your body. Once it is established that you meet the requirements for screening, complete the test.
Be sure to talk to your relatives to see if this type of cancer runs in your family so that you can in turn share this with your medical provider. Do not be embarrassed to talk about your body and its digestive health, and do not let fear of preparation or the actual test deter you. A colonoscopy can be a life-saving tool and well worth learning more about and talking to a trusted medical provider about the process!
Talking about colon cancer and its screening should not be taboo. Understanding the significance of early detection and overcoming the fear associated with the preparation and procedure are steps toward safeguarding our health. As someone who has navigated this journey, I can attest to the colonoscopy's life-saving potential. It's a call to action for everyone, especially those at higher risk, to prioritize their digestive health and seek early screening.
Sources
Center for Disease Control and Prevention (2020) - US Cancer Statistics: Data Visualizations
American Cancer Society (2020) “Colorectal Cancer Rates Higher in African Americans, Rising in Younger People”