Talk To Me About Colon Cancer (don't need answer fast)

My understanding is that by the time the patient experiences symptoms of colon cancer, it’s too late, and that’s why the American Cancer Society is so keen on early colonoscopies. Is this the case? Also, does the colon cancer patient feel just fine until they don’t, and then some time later they die?

I’ve got a colonoscopy scheduled, and after reading the instructions I’m this close to telling the gastroenterologist, and the American Cancer Society, to go fuck themselves. I’m having a hard time convincing myself that this is anything more than a racket to drive business to gastroenterology clinics.

Ummm…actually, my old PCP (who has retired) kind of agreed with your point of view. He pointed out that statistically, while there were people whose lives were saved by colonoscopies, the actual benefit did not compare favorably with the cost of the procedure.

He cited some study showing that if everyone followed the guidelines, the actual benefit averaged out to just a tiny increase in life expectancy.

But then again the guy was kind of a dick. I’m interested in hearing informed replies to the OP.

My favourite colon cancer story is about Walter Breuning. Born in 1896 he had surgery for colon cancer in 1960 at the age of 64, removing as he described it, his “mudmaker”. He died…in 2011, 5th longest living man ever.

Diagnosed with stage 3 in April 2017. Had my power port installed second week of April so I could start infusion the next week Thursday [my infusions started Thursdays 0700, were more or less done Sunday 0900 - I was plugged into a monster IV machine for 4 hours and then it was replaced with a ‘pod of death’ as my goddaughters named it. It stayed hooked up til Sunday morning. The Thursday between infusions was bloodwork, so it was a fast in and out, didn’t need to see anybody - bp, 3 vials of blood, hop on a scale, temperature. 6 infusions then a chemo vacation with a CT scan, then 6 more infusions.

And another 2 week chemo vacation with a CT scan and consult down in radiation therapy. 2 more weeks, then 28 daily radiation sessions with an oral chemo med - about 1 week before the end I ended up in the hospital for a week, the treatment had caused an increase in diarrhea that had me pretty much turning into one of those self mummified monks, it was not responding to 12 doses of immodium washed down with a shot of kaopectate or the atropine boosted immodium because it wasn’t intense peristalsis, it was that my guts had turned into a 36 foot long road rash that never clotted so no matter how much I drank, it was pouring my interstitial fluids out as well as my gut contents. [I made hospital record - 17 minutes mouth to toilet bowl as measured by timing an undigestied wholeish piece of watermelon from that morning’s fruit salad snack.]

They had me on 2 IVs running full bore 24 hours a day for that week and I told them to just wheel me down every day for the final week of treatment. Once done, was on chemo vacation for a month, with the same bloodwork schedule. Finally seemed to finish clotting off and diarrhea stopping, they PET scanned me and nothing lit up. FOr the next 20 months I had a quarterly sigmoidoscopy with biopsy [experimental, to see if they needed to rearrange my guts or not] It came back, so 6 more chemo sessions, CT scan showed it grew this time.

Surgery scheduled for Feb 14th 2021 [our 30th wedding anniversary, yay?] where they removed my anus, rectum - basically the end 20 cm of my guts. Rerouted it out into a classic stoma, and sewed my ass shut. Effectively, check out field dressing a deer, they cored me out and sewed me back shut. Healing took effectively 3 months. Had a vaginoplasty to repair the slice they took out, have to use dialators to keep it to a usable size [well, if I want to get laid that is] and had a check up at the 3, 6, 9 and 12 month point with bloodwork to check for certain proteins. Last May I was doing a breast self check, found a lump, had it biopsied and it was cancerous [11 mm] had it and the powerport removed, radiation and oral only chemo. The tumor was not related to my ass at all, which was a relief. I am now on oral chemo [letrozole] for 5 years, and an annual colonoscopy, annual mammogram and quarterly bloodwork as I am considered very high risk.

Ask me anything, my stoma is named P’tit Joey after Le Petomane because the week post op I spent in hospital and for another few weeks after that I was on tons of antibiotics and it made me fart a whole lot. I was also on a blood thinner injectible for a month post op so I had to avoid leafy greens and injuring myself [boy did I bruise if I even lightly hit something!] I have a visual of the tumor pre-op, we named it Lil Donny Trumpkin because as my roomie pointed out it looked like a goblin and was a pain in my ass. [if asked, can provide non-obscene pix of my power port, my stoma and Lil Donnie if asked and someone tells me how to put in the click through deal.]

Which they do through the stoma, I assume? Same prep? Wide awake or sedated?

My wife was diagnosed because she was anemic. In her case it was not too late for successful treatment, although I believe that she (like many other humans) will probably die “some time later”.

I was diagnosed when I shit half a litre of blood. I was lucky, I have met people who was diagnosed only when the tumour grew so big that it closed the colon.
I only felt ill after the operation.

Through the stoma, though because I hyper react to the normal whacked chemicals by having a week of diarrhea, I get to go on a liquid/ultra low residue diet [also no purple red or blue foodcolored stuff, no beets] for the final 3 days, and 24 hours before I do 64 oz of miralax doped gatorade or equivalent. Then I get to do an enema through the stoma [it is easier than a regular one, there is a tube sort of thing I can sit on the toilet and poo directly in instead of into my bag.

I was being diagnosed for what we thought was perhaps gallbladder issues and what I originally thought was external thrombosed haemmheroids. It was actually the tumor going through all the layers of the gut [but not out into the rest of me] and full diameter [like a pipe clogged with glop?] that was causing the gastroparesis and vomiting because the food simply wasn’t leaving my guts out the bottom [the opening by that time had been narrowed to about little finger in diameter] so it was being vomited upwards.

I got to tell some asshat who told me that it was the chemo killing me, and that the hospital and doctors were faking it so they would get all that money. Yup. So I told him exactly how I would probably die if I didn’t get it cut out - my gut would close so I couldn’t poop, making my colon back up and swell until it burst, giving me peritonitis and gangreen, with tumors spreading out into all of my body until cascading organ failure happened. Grossed him right out =)

You can be diagnosed fairly early in the stage of actual cancer, if you are vigilant about potential danger signals. Most people aren’t.

If you are concerned about discomfort in your colonoscopy, I would say it is relatively minor. The prep (as you will read in all the threads about them) is annoying. The actual procedure is only annoying in that it can take a big chunk out of your day, and you have to have someone drive you home. Physical discomfort is minimal to nonexistent, most of the time.

If you are concerned about dollar cost, it should be covered by your medical insurance, with some co-pays on your part (and depending on all the little snickety factors that the insurance companies use to ding you). If you take one at 50 and are clean (no polyps) you can wait 10 years for the next one. If you have polyps, it may be 3 or 5 years, until you are clean, and then 7 or 10 years again.

Speaking for myself, it’s worth the peace of mind. I don’t want to live forever, but I don’t want to go out that way either.

It wasn’t that long ago that Maggie the Ocelot died of colon cancer. Please be vigilant.

StG

A lady I never met. She’s the real reason I’m doing this. My first appointment’s in April.

Lots of people have done the prep and had the procedure (including many Dopers), and seriously, it’s totally doable. The prep is not a barrel of laughs, but it’s not painful (just tedious), and it’s one day out of your life. Two days, including the procedure. I’ve had two colonoscopies, and they were simpler and less time-consuming than the breast cancer I also had. Suggest you don’t dwell on the subject-- just git 'er done.

However, if you’re convinced it’s nuttin’ but a doctors’ scam/racket, then by all means, stick to your principles.

My mother refused to ever have a colonoscopy because she didn’t want anyone “messing with my bottom.” <shrug> She died at age 93 of “natural causes,” i.e., no particular diagnosis.

Not to mention, some of the danger signals might be utterly benign in some people (pencil poos, etc.) and thus easily ignored.

As far as the prognosis once symptoms are experienced: I’m sure there are people who’ve lived for quite some time, but your chances are definitely reduced (and quality of life will suck for a bit).

I think I once read an article arguing that the ultimate cost for colon cancer screening, weighed against the work-years saved, tilts in favor of doing less screening - but can’t find the article at the moment.

However, as one of those who would likely not be here without such routine screening, I personally am a big fan. @HeyHomie, GET THE DAMN THING DONE.

Found a couple of articles.

From [this one] (which predates ColoGard, for what it’s worth) (Cost-effectiveness of colorectal cancer screening – an overview - PMC), " All CRC screening strategies are cost-effective compared to no screening

There is no consensus on what is the preferred CRC strategy for a given willingness to pay

Generalization of cost-effectiveness analyses from one country to another cannot be done, because screening costs, resource capacity and population preferences differ

CT colonography, stool DNA and capsule endoscopy are not (yet) cost-effective compared to FOBT and endoscopy screening

Rising CRC treatment costs will make CRC screening even more cost-effective and possibly cost-saving

Test-specific adherence may be the key determinant of the (cost-)effectiveness of a CRC screening strategy"

For those who are invested in this, I got it done, although I was quite salty about it. The prep wasn’t nearly the Baroque horror I was led to believe it was going to be. But I was still conflicted about submitting to something that went against my morals. But my PCP wouldn’t shut the hell up about it so to get her off my back I went through with it.

What’s the moral angle?

@HeyHomie bravo for getting it done. :+1:t4:

Yeah, what’s up with this?

I didn’t want to be a part of what I see is a scam (viz, American Cancer Society recommends unnecessary colonoscopies to drive business to its member gastroenterologists).

Remember your PCP is working for you. If you aren’t thrilled with their care, shop around!

That’s maybe fine for deciding on public health policy, and maybe also fine for individuals who measure the value of their own life by economic productivity alone. Individuals who value their own life for reasons beyond just economic productivity will want to take those other factors into consideration when deciding whether and how often to test.