AdventHealth House Calls: Colon Cancer Awareness Month
Dr. Charlene LePane, a gastroenterologist at AdventHealth Medical Group, answered all of your questions on colon cancer.
QUESTIONS:
What other options/test can be done other then a colonoscopy? And do you have to go under to have them done?
- FOBT (fecal occult blood test) is a stool test yearly (falling out of favor)
- FIT (fecal immunochemical test) stool test yearly
- DNA stool (Cologuard) every 3 years
- CT colonography every 5 years (insurance issues and not as common as above)
Keep in mind all of these positive tests will require a colonoscopy to follow
I have Lynch Syndrome and had stage 2 colon cancer resulting in removal of my ascending colon in October 2019. My sister tested negative (saliva test) for the MSH2 gene. She is 30 years old. Does this mean that she does not need to have early screening or should she since there is now a family history?
I would absolutely treat her early. She should have a colonoscopy at least every 5 years starting 10 years before you were diagnosed with colon cancer.
I hope you are doing well. Thank you for the question.
What are the differences between Colon cancer vs. colorectal cancer and what similarities are there between the two diagnoses? Do both have the same high risk once diagnosed?
The rectum is the last 6 inches of the colon and they do act similar and therefore we group them together.
The biggest difference is when it comes to surgery. Most rectal cancers will result in a colostomy (a bag).
The risk will depend on the extent of disease (how far into the wall it invades). If caught early, the prognosis is excellent for both (>91% 5 yr survival)
Can I decrease my risk? Any foods recommended or vitamins?
Wonderful question. And thank you so much for taking your health seriously.
Eat a diet low in red meat/processed meats
Eat more veggies and fruits
Exercise
Watch your mid-abdomen size
Avoid getting type 2 diabetes (watching your weight)
Don't smoke
Don't drink excessively (>2/day in men and >1/day in women)
Most vitamins and minerals have unfortunately demonstrated inconclusive or conflicting data
How accurate are the at home tests I see advertised everywhre?
91% sensitive is the FOBT if done 3 times (only one test is ~30% sensitive)
FIT test is ~ 80% sensitive
FIT+DNA test (ie. Cologuard) can be ~93% sensitive
What are treatment/success rates?
If the cancer is caught early and localized the 5 yr survival rate is 91%. If, however, the cancer has spread outside the colon wall, the 5 yr survival rate is <10%. Unfortunately, only 37% of the early cancers are detected. The other 63% of patients present when the cancer has spread outside the colon wall.
Bottom line...success rate is EXCELLENT if caught before or early
Do I need to ask for test or does doc automatically recommend at certain age?
Excellent Question!!! And thank you for being proactive.
You should be asked about colonoscopy when you begin approaching the age of 50, and thereafter. However, if by chance you are not asked, you should ask the question.
My sister was diagnosted with adeno (?) polyps at age 45, what are signs I need to look for and get tested?
I would recommend a colonoscopy at 45, however, if your sister had any question of cancer in that polyps, I would recommend beginning at 35 years old (10 years before hers).
What are signs and symptoms one should look for?
Great question!
Narrowing in caliber of stool, blood in stool, weight loss and abdominal pain are some of the elements we look at.
What is the recommended age for screening?
It is suggested to start at 50 years old, however, 5 years earlier in blacks (they have an increased risk of polyps) in average risk individuals. Recently, the ACS (American Cancer Society) recommends we begin at 45 years old (this comes from analysis of data which demonstrates an increasing incidence of colon cancer in young individuals).
With family history, we begin at 40 or 10 years prior to the youngest relative (primary relative).
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