Step Away from the Colon Cleanser!
Image © Julie Wilkinson
Unless you're scheduled for a virtual or endoscopic colonoscopy, barium enema or sigmoidoscopy, your bowels probably don't need "cleansing". Over-the-counter cleansing and detox pills, potions and supplements have become a multi-million dollar industry. Feel tired? Cleanse! Problems with weight management? Cleanse! As I see it, the problem is that many of these supplements promote fantastic claims to clean your colon with potions composed mostly of laxatives.
If you already own a "cleansing" or "natural detoxifying" product join me in reading the label. Specifically, take a look at the list of ingredients. Does your product list:
- Senna or senakot
- Aloe vera
- Methylcellulose
- Psyllium
The list of laxatives hidden under the guise of natural cleansing supplements goes on and on; these are just a few examples. Even though they may be "100 percent natural," the majority of the cleansing products have one central goal and that is to make your bowels move. Unless you have a burning desire to stare at that pink crochet doll sitting on your spare TP roll, you may not need to force your bowels to move.
Let me add to that: just because you can take it, does that mean you should? The purpose of a laxative is to facilitate movement of stool through the colon. Certain people may need a laxative following surgery, if you take pain medications or during a rare bout of constipation. The rest of us need to use the natural function of our colons to get the stool out - if you don't use it you lose it. The natural motility of your colon gets lazy when you chronically ingest unnecessary laxatives - it begins to depend on the laxative and stops doing its job.
Because it's the body's waste conduit, your colon already has a natural cleansing tool in place: healthy bacteria. These flora live in your colon and keep the bad germs (think E. Coli, yeast) in check. When you remove all of the germs, you're flushing out the good with the bad.
The next time you consider a cleansing product, remember this: you are naturally equipped with your very own filtration and cleansing system composed of your kidneys, liver and colon. I say let them do their job naturally and don't micromanage your body!
Top 5 Questions About Colon Cancer
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Not surprisingly, as the Guide to colon cancer I field many queries with questions about the disease, screening exams and prevention. Perhaps your doctor just informed you that you are due for screening or a close friend has been diagnosed with polyps. I am a firm believer that knowledge about this disease will empower you to make better healthcare decisions. The following are the top five questions I repeatedly see regarding colon cancer:
- Will my insurance pay for screening? Most insurances cover routine screening exams for the colon including the double contrast barium enema, sigmoidoscopy, colonoscopy, and stool testing. Many privatized insurances also cover the cost of a virtual colonoscopy, although Medicare and Medicaid do not at this time. Talk to your doctor to learn what tests are covered and recommended for you.
- What can I do to reduce my risk of colon cancer? Reducing personal risk factors may be as simple as altering your daily choices. We already know that you can reduce your risk through eating a healthy diet ripe with fruits and vegetables, and that excesses of red and processed meat are unhealthy for the colon. Smoking, a sedentary lifestyle and excessive alcohol consumption may also increase your risk.
- What are the symptoms of colon cancer? This question is a biggie in my colon cancer forums and throughout the Internet. Although the list of colon cancer symptoms is lengthy, it is also vague and not intended to help you diagnose an illness. Talk to your doctor if you or a loved one is experiencing any disturbing symptoms, especially if they are a source of concern or anxiety for you.
- What causes colorectal cancer? Scientific research has provided an idea what increases your risk for developing colon cancer, such as untreated colon polyps and familial hereditary syndromes. Dietary and lifestyle choices may also increase your risk of developing this disease.
- What's the best screening exam? With myriad screening exams available, the best exam for me may not be the best exam for you. Your doctor will help you choose between screening exams and make a decision based on your personal medical history, familial risk, age and any concomitant medical problems.
Taking Care of Mom
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Mother's Day is officially behind us, but that doesn't mean your obligations as a son or daughter are over. Giving gifts of a card, flowers or candy is a nice gesture, but there is an even better gift to give this year: the gift of knowledge.
As a mother myself, I appreciate gifts and the thought that accompanies them. What I would appreciate even more, much more, is knowing that my children love me enough to talk to me about colon cancer screening and awareness. It's no different than having your child come up to you and say, "Hey mom, I love you more than anything in the world and I want you to stick around for a while - so take care of yourself, please".
Based on the most recent statistics, almost 70,000 women will get diagnosed with colon cancer this year according to the Centers for Disease Control and Prevention. Now that the official day of moms is over, you can still give your mom something special - let her know how much she means to you and take the time to discuss her health.
Colon cancer risk factors are not that different amongst genders, so feel free to bring dad in the room for this discussion. Start a discussion by asking:
- Do we have a family history of cancer or genetic problems, such as Lynch Syndrome?
- When was your last colon cancer screening exam, such as a colonoscopy?
- Do you get exercise - and how often?
- Do you schedule routine check-ups with the family doctor?
Be persistent. There is a good chance that mom (or dad) won't want to talk to you about their health and screening. However, only you have the power to start these delicate conversations and possibly save a life in the process.
Don't Skip Screening
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When was your colon cancer screening exam? Chances are, if you are under 50 years of age, you may not have even had one yet. If you are over 50 years of age and have been avoiding these tests - that's a bad idea. According to the Centers for Disease Control and Prevention:
- 53,219 people still die annually from colon cancer (as of the latest statistics)
- One-third of those deaths might have been prevented with screening
- The very early stages of colon cancer have no symptoms - only screening tests can detect the presence of early cancerous and pre-cancerous lesions
If you have a family history of cancer, genetic disease or bowel diseases, or if you are over the age of 50 (45 for African Americans), I strongly encourage you to read this:
There's a downside to the myriad tests we have available today - some people don't even know where to start their screening. Your doctor will help you get started, but I have included some articles about the different methods we use for colon cancer screening exams here:
In the event that any one of these tests has suspicious findings, your doctor may encourage a colonoscopy (if you didn't have one yet) and a colon biopsy to verify the presence of cancer. If cancer is present, your doctor will need to order a few more tests, such as a computed tomography (CT) scan or a positron emission tomography (PET) scan to look for metastasis (spreading of cancer outside of your colon).
When in doubt, talk to your doctor. He or she can help you tailor a plan to keep your colon healthy!
Cancer-Fighting Heroes Unite!
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Although I've been a nurse for years, I didn't actively join the fight against colon cancer until recently. This rewarding path has allowed me to meet many incredible people who advocate for cancer awareness. Last week, I had the honor of learning about four exceptional children: Chloe Staten, Emily Brown, Abby Miller and Abigail Knight. Between the tender ages of 14 and 15, these children earned The Prudential Spirit of Community Award for their personal efforts in the fight against cancer.
As a cancer survivor herself, Chloe has become an advocate for other children fighting cancer. She has personally visited sick children and arranged fundraisers to help cover their medical expenses. She voluntarily participates in relays and radio programs to help raise awareness and money for the cause. Go Chloe!
Emily implemented a program to raise breast cancer awareness in her high school called "Sports for a Cure" - providing knowledge about proper screening and early detection at school athletic events. She has helped raise thousands of dollars for the Susan G. Komen Breast Cancer Foundation. Go Emily!
Abby uses her voice and guitar skills to raise money in public places for pediatric cancer research efforts. She can be found on YouTube, but she doesn't sing for personal gain. She uses social outlets to help raise awareness for children fighting a type of nervous tissue cancer called neuroblastoma. Go Abby!
Abigail started a project called, "Candy for the Cure" - a fundraising effort she hopes can help fund a cure for cancer. Abigail personally makes the tasty treats baking cupcakes and cookies based on orders from her community. Go Abigail!
These future cancer advocacy leaders have been named as State Honorees and hail from Oregon, West Virginia, Virginia and Alabama, respectively. They will be in Washington, D.C. on May 7th, competing for the title of "National Honoree". If you want to learn more about the Prudential Foundation Awards or our future leaders in cancer advocacy, check out the press release here.
What are Polyps?
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Recently, I've had a number of questions rolling in through email, all with the same distinct theme: polyps. The questions were from people, just like you, who wanted to learn more about how to avoid these growths in the colon, learn why they grow and who is at risk for developing them.
Because this knowledge is a vital part of reducing your personal risk for colon cancer and understanding how it starts, I've compiled a list of articles focused specifically on colon polyps.
Can They be Inherited?
Your family genes play a role in polyp development. If you don't already know, ask immediate relatives (parents, siblings) about any instances of cancer or hereditary bowel diseases, such as familial adenomatous polyposis (FAP) in the family.
How are They Found?
Typically, polyps do not have any associated symptoms, which is why routine bowel screening exams are so important. These tests can detect polyps in their earliest stages, allowing removal, if necessary, to prevent certain types from growing into colon cancer.
How Do I Prevent Them?
We already know that a number of lifestyle and dietary factors can increase or decrease your risk for developing these growths. Altering lifestyle choices may help reduce your risk of growing polyps.
What Do They Look Like?
Polyps are irregular growths - for this reason alone, they don't all look the same. The two main types are sessile, which are flat growths on the inner colon wall, and pedunculated, which look like teeny mushrooms. I've included a link to the gallery of polyps, which includes illustrations of varying sizes.
When It's Cancer
Although cancerous polyps have a distinct appearance, the only definitive way to tell if they are cancerous is through a polyp biopsy. This procedure can be completed during your colonoscopy (endoscopic, not virtual), if necessary.
Don't Leave Side Effects Unmanaged
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Excluding wine and technology, there are very few things that get better with time. Side effects are like that - you can ignore them and hope they'll go away on their own, but in the end, most of them get worse.
In regards to colon cancer treatments, side effects are defined as the adverse or unwanted byproducts paired with the desired effect (killing the cancer). These effects can be uncomfortable, mentally draining, or just a plain nuisance. The good news? Your healthcare team is trained to anticipate common side effects and has the tools to help you manage them - but first you have to report them to your doctor. Your healthcare team can't help you unless they know what you are experiencing.
Radiation, chemotherapy and even surgery for colon cancer -- there are potential side effects from each treatment modality that may include suffering:
- Fatigue
- Nausea and vomiting
- Diarrhea or constipation
- Pain
- Hair loss
- Infection
- Fear, depression or anxiety
Some side effects are more common than others and not everyone develops these complications. If you want to keep physically and emotionally well during your mental health during treatment, learn about the potential side effects and treatment before they become unmanageable monsters.
Put a Name to Your Symptoms
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Ignoring your symptoms is like turning a blind eye to that glowing "check engine" light on your car dash - it's probably not going to get better with time (and the repairs may be more expensive and difficult the longer you wait). Although your doctor doesn't want you to obsess over each symptom you feel - you do want to be aware of them and report them accurately.
Think back to your last doctor's office visit. If it was anything like mine, the first thing my doctor asked was, "What brings you in today?" This is an opening to discuss your symptoms. If they are multitudinous, consider making a list before your visit so you don't leave any important ones out.
Your colon does not always give you warning signs. Sometimes, symptoms of colon cancer are extremely vague or even absent in the early stages. Symptoms will be different for each person, but may include:
- Changes in bowel habits
- Blood in the stool
- Thin, ribbon-like stools
- Bloating and gas
- Cramping or abdominal pain
- Nausea, vomiting or weight loss
- Decreasing appetite
- Feeling tired all the time
When you report your symptoms to your doctor, try to think like a news reporter and make good use of the W's - what, when and where:
- What is the symptom?
- When do you feel it?
- Where does it occur?
Any information you provide your doctor will help him or her develop a plan of care that may include screening exams for colon cancer. Your doctor must have supporting information (provided by you) before he or she can order tests - it's not an arbitrary decision.
History Influences Our Future
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When things start to look bleak and it appears as if no advancements are being made in colon cancer studies, take a look at our history. It's beyond dazzling - where we've come from in scientific advancements and what we're looking at today.
In the 1970's, the mortality rate for colon cancer was soaring high at 28 deaths per 100,000 people diagnosed with the disease, according to the National Cancer Institute. We were still trying to figure out how best to use radiation therapy, and we basically had one chemotherapy drug of choice (5-FU). We began to discover the benefits of screening tests, such as colonoscopy and sigmoidoscopy, through published scientific proof, but lacked definitive screening guidelines.
In the 1980's, we began learning the benefits of combining chemotherapy drugs to fight colon cancer. About 35 percent of adults completed their screening tests as recommended. Soon-to-be Nobel Prize recipients were busy in laboratories, discovering cancer-causing genes and mutations specific to colon cancer. Advocacy organizations began forming, as the impact of this disease became palpable throughout the nation. The technology was present, but virtual colonoscopies were still in the context of a dream, rather than a reality.
In the following three decades, we applied our historical knowledge of colon cancer to tailor treatment plans and improve screening and outcomes. Today, we have multiple chemotherapy combinations, targeted therapies and medications used to fight the disease and ease symptoms. As of 2008, about 63 percent of adults get screened as recommended - almost twice the amount that were getting screened just decades ago according to the National Cancer Institute. Mortality rates have dropped to 17 deaths in 100,000 people and we are learning innovative new ways to use the knowledge of genetic mutations to our advantage.
Even as I sit and type this, future generations of Nobel Prize winners are beginning their careers in colon cancer research - who knows what this blog will read in 2040. Until then, let's use the knowledge we have been given and continue to improve the numbers of adults getting screened and decrease the numbers of adults dying from this disease.
Stop Avoiding Screening
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Bowel prep - no fun. Colonoscopy - don't remember it. Colon - free and clear of cancer. The problem is, many of my friends and family members don't know this. They think colon cancer screening equals a long, painful process and avoid it like the plague. Stop avoiding screening -- it may save your life.
There are a few different types of screening exams available. The least invasive are the stool tests, which require a tiny sample of your bowel movement to check for blood in the stool. The collection process is not as gross as you may think, and it's a fairly inexpensive test that can be completed annually or when needed.
Bowel preparation is not as horrific as all the hype makes it. Sure, you'll spend a lot of time in the bathroom - a necessary evil to get your large intestines cleaned out for their debut - but it shouldn't be painful.
Radiographic screening exams include the computed tomography (CT) colonoscopy (virtual colonoscopy), and a double contrast barium enema (x-ray). Both exams are minimally invasive and quick, and can locate abnormalities within the colon during the exam.
The sigmoidoscopy and colonoscopy are invasive screening exams, which can detect (and possibly allow the doctor to remove) cancer during the test. Sedation is offered for these exams, which puts you into a nice sleep while the doctor takes a look with the scope and camera.
It's human nature to be afraid (or avoid) things that we don't understand. Take the time to read and learn about each procedure. When it's your turn to get screened, it may not seem as scary now that you know what to anticipate.