How foolish some people are. Even when it means dying from a large bowel cancer at an early age. I`ve seen it happen many times over the years. So here are 10 points that can prevent this needless tragedy.

One – about 90% of colon cancer occurs in people over 50 years of age. This provides ample time to detect and treat this malignancy. But there is one big hurdle, and I`ve heard friends and patients react to it over and over again. They casually respond, “Yes, I`m going to have a colonoscopy one of these days.”

Ninty-nine per cent of the time this means none of these days. And I’ve seen some of these people die horrible deaths from this common preventable malignancy.

Two – colon cancer usually starts in the inner lining of the intestine. A polyp, a fleshy growth, slowly develops, often remaining non-cancerous for years. But, when polyps turn into cancer, 95% called adenocarcinomas, by this time cancerous cells have spread to the liver and other parts of the body. Now treatment is like closing the barn door after the horses have escaped.

Three – do not conclude you can wait until early symptoms appear and then consult your doctor. This is the same as trying to purchase insurance on your home after it’s been destroyed by fire. You can have an advanced malignancy without any early symptoms. This is one point you should never forget.

Four – the first warning sign (not early sign) of colon cancer and the most common one is rectal bleeding. Sometimes a small amount of blood will appear on the stool. Or blood from earlier bleeding which was not detected may give stools a tarry appearance. Or a large amount of blood will be present in the toilet bowl. And on rare occasions, an enlarging cancer will cause intestinal obstruction.

Five – the best way to diagnose a precancerous bowel polyp is by colonoscopy. A lighted flexible instrument is inserted into the rectum and gradually and slowly inched forward until it has explored the entire large bowel. If a polyp is discovered a wired loop is placed around it and the polyp removed.

Six – some patients who refuse the colonoscopy procedure can use a test to check for blood in the stool that cannot be seen by the naked eye. But if the test is positive, it’s mandatory to have a colonoscopy. Never fool yourself that it’s as accurate as this procedure.

Seven – many people refuse colonoscopy due to embarrassment and fear that it’s a painful procedure. Forget the embarrassment. If the President of the U.S. or the Queen of England can submit to one, so can you. I’ve had several colonoscopies by 8 a.m. and returned to the office by 9 a.m. without sedation. But if a few cramps bother you, sedation is available. Some people worry about possible complications. But only on rare occasion is the bowel injured or bleeding occurs during removal of polyps.

Eight – today, colon cancer is the second leading cause of death in this country. Only lung cancer is responsible for more deaths. We do not have a reliable way to diagnose precancerous lesions of the lung. But we can detect precancerous lesions of the colon. So it’s a tragedy when so many still die of this disease.

Nine – there’s no general agreement on when to have a colonoscopy. Ninty per cent of colon cancer occurs after 50 years of age. But since some begin earlier, I believe it’s prudent to have a colonoscopy in the early 30s. Moreover, since 10 to 15% of colon malignancies occur in those with a close relative who has the disease, all the more reason to arrange for an early colonoscopy. It’s a win/win situation.

Ten – if I still haven’t convinced you that colonoscopy can save your life, what should you do? I’d suggest seeing a psychiatrist. After all, isn’t it reasonable to seek an answer for why anyone would refuse a sure cure for colon cancer?

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