Healthy Focus

Colon Cancer:  Don’t Be Embarrassed to Save Your Life

Up to 60 percent of deaths from colon and rectal cancers—the second biggest cause of cancer deaths—could be prevented with screening, estimates the Centers for Disease Control.

Barton Waters, MD
General Surgeon
HCMC Surgical Specialists

Yet 30 to 50 percent of people who should get screened for colorectal cancer don’t, says Dr. Barton Waters, General Surgeon at HCMC Surgical Specialists. Why? Embarrassment, fear or not being aware of what’s involved in screening “down there,” say doctors.

If you’ve been putting off your screening, it’s time to get educated about what you’re missing. The technology for colon screenings has improved in recent years, for example, and there is often much less discomfort than patients expect, say physicians. And catching a polyp (a growth on the surface of the colon) early can stop the polyp from progressing into a cancer.

Essential screenings

Screening is crucial for colorectal cancer because so many of the symptoms don’t appear until the disease has progressed. “There’s a misconception that people have, ‘Since my bowel movements are OK, I must be normal,’” says Dr. Waters.

Lack of blood in the stool can also lead people to believe that everything is healthy, but blood is generally a late stage appearance in colorectal cancer.

“People think, ‘If it’s not broke, don’t fix it,’ and they don’t get screened,” adds Dr. Waters. More common colorectal symptoms such as weight loss, fatigue and anemia can be symptoms of a number of other diseases, and thus can be harder to attribute to colorectal cancer.

Colorectal cancer tests

Fecal occult blood testing (FOBT), which looks for blood in a stool sample, is recommended by the American Cancer Society as an annual screening for colorectal cancer beginning at age 50. The non-invasive test can be done with an at-home kit so there’s no anxiety about going to a lab. The test is effective in finding blood in the stool, but “only 10 percent of polyps and 50 percent of cancers will do this and as a consequence, most would be missed,” says Dr. Waters.

For more advanced screening, the ACS recommends that one of the following tests be performed beginning at age 50:

* Flexible sigmoidoscopy. Conducted every five years, this test is used less often than it used to be because it is performed without sedation and can be uncomfortable. It uses a flexible tube inserted into the rectum to look at the left (sigmoid) colonfor polyps or cancers. If an abnormality is found, a colonoscopy is then required.

* Double-contrast barium enema. This test is also conducted every five years. It requires cleaning the colon with an enema, filling the colon with barium and then draining it, and filling the colon with air followed by an X-ray exam.

* CT colonography. This “virtual colonography” can be conducted every five years, using X-rays and CT scan images to look for large polyps and cancers. The downsides: It often is not covered by insurance, and it exposes the patient to radiation.

* Colonoscopy. All of the previous tests require colonoscopy as a follow-up for abnormalities. To prepare for a colonoscopy, you will drink clear liquids and use laxatives to cleanse the bowel beforehand, which is essential, says Dr. Waters. “You do not want to go through the whole thing and then not be able to see anything because you did not have a clean colon,” she says.

You will usually be sedated while a flexible tube is inserted into the rectum and through the colon, and generally won’t remember anything about the procedure. And if a polyp is found, it can be removed during the screening.

In general, colonoscopy is recommended every 10 years.

Reducing your risk

The causes of colorectal cancer are unknown, but you can take preventive steps to lessen your risk. Eating a diet of foods that are higher in fiber and lower in fat can help reduce the risk of colon cancer when followed over a long period of time. Exercising and quitting smoking are smart moves too, but screening is paramount,

“Although we are very effective at [colorectal] surgical treatment by way of advanced laparoscopic procedures, it still remains a tragedy that could have been prevented,” says Dr. Waters. “Most of my patients should have had a colonoscopy at an earlier date.”

5 ways to help prevent colorectal cancer

  1. Begin regular screenings at age 50 (or earlier at your doctor’s recommendation)
  2. See your doctor immediately if you experience blood in your stools.
  3. Eat a high-fiber, low-fat diet.
  4. Exercise regularly.
  5. Don’t smoke.

Living a Longer, Healthier Life

Eat right. Exercise. Don’t smoke. You’ve probably heard it all before. But can healthy living now help you live to be 100, 120 or even 140 years old?

The answer is…maybe.

Lifestyle vs. genetics

There are a lot of theories about how–or even if–people can live significantly longer than the average American life expectancy of 78.7 years. There are also plenty of myths about longevity.

Tammie Holcomb, DNP
Family Medicine
Transitions Health

“One of the biggest myths in medicine is [that because] we inherit our parent’s genes, if they died young, we’re doomed to die young,” says Tammie Holcomb, DNP, Family Medicine at Transitions Health.

While there are no specific numbers on what percentage of life expectancy is determined by genetics and what percentage by lifestyle, some actions definitely can improve both the length and quality of your life. Avoiding cigarette smoking, obesity and a sedentary lifestyle is important, but Dr. Holcomb also recommends:

  • Controlling stress.
  • Sleeping well.
  • Building supportive relationships.

Consuming foods high in omega-3 fatty acids, along with antioxidant-rich foods such as vegetables and fruits, may also help prevent some of the consequences of aging–or at least delay them.

Starving for life

Some of the most intriguing and promising research into longevity so far involves BMI (body mass index). A healthy BMI, as opposed to an extremely high or an extremely low BMI, is a significant harbinger of health and longevity, and the medical profession is beginning to be more proactive about earlier intervention.

Dr. Holcomb says American medicine has long targeted acute diseases and how to treat them. But she sees a shift in public health that focuses more on treating conditions before they become acute, particularly obesity.

“Until recently people could not quality for weight-loss surgery until they were so ill from the effects of obesity that they were looking at death’s door,” says Dr. Holcomb. “At that point, there’s only so much we can do to heal the damage that has been done. But if we can address these issues before the damage is irreversible, the possibilities for a long, healthy life are much better.”

BMI Weight status
Below 18.5 Underweight
18.5 – 24.9 Normal
25.0 – 29.9 Overweight
30.0 and above Obese


* To calculate BMI: Divide weight in pounds by height in inches squared, then multiply by 703.

Source: Centers for Disease Control

Mexican Chopped Salad

This delicious salad contains apples and tomatoes, both of which are high in antioxidants and fiber. They are also an excellent source of vitamin C, which can protect your eyesight and help prevent heart disease.


1 small head romaine lettuce, cut into 1/2-inch-wide crosswise strips
2 medium tomatoes, cored, seeded and diced
1 small red onion, chopped
1 medium green apple, peeled, cored and diced
1/2 cup frozen, thawed corn kernels
1-1/2 cups crushed, baked low-fat tortilla chips
1 small avocado, peeled, seeded and thinly sliced

1/3 cup pine nuts
1 teaspoon ground cumin
Salt to taste (optional)
Freshly ground pepper to taste
1/4 cup red wine vinegar
1/2 cup extra-virgin olive oil

Combine the lettuce, tomatoes, onion, apple, corn and tortilla chips in a large bowl. Drizzle with 3 tablespoons dressing. Toss gently but well. Top with avocado slices and serve immediately. Serves 6.