Once we hit 45, one common refrain we can expect to hear at the doctor’s office is, “You need to get a colonoscopy.” The thought of getting a colonoscopy often makes people cringe—it seems painful, embarrassing and, yes, even gross. And yet, a colonoscopy is one of the most important things that you can do for your long-term health.

Colorectal cancer is common

Cancer is the second-leading cause of death in the United States, accounting for roughly 25% of all deaths nationally, and colorectal cancer is one of the most common cancers in the United States. According to the Centers for Disease Control and Prevention (CDC), colorectal cancer “is the third most common cancer in men and women, [and] the third-leading cause of cancer-related deaths in the United States.”

Risk factors

There are several factors that can increase your risk of being diagnosed with colorectal cancer. Of course, the most common is age. The average age for a colon cancer diagnosis is 68 for men and 72 for women, while the average age for a rectal cancer diagnosis is 63 for both men and women.

Other risk factors include:

• Genetics: colorectal cancer runs in families. If someone has a family history of colorectal cancer diagnoses, his or her chances of receiving that same diagnosis doubles.
• Inflammatory bowel disease: diseases like Crohn’s disease and ulcerative colitis increase the risk of developing colorectal cancer
• Gender: men are more likely to receive a colorectal cancer diagnosis than women

Lifestyle risk factors include:

• Sedentary lifestyle and obesity
• Eating red or processed meat
• Smoking and drinking alcohol

Colorectal cancer is preventable

Colorectal cancer could be thought of as a “silent” cancer—in other words, someone can have it for years before showing any symptoms. The good news is that, unlike many cancers that occur without warning, colorectal cancer can be prevented through screenings like a colonoscopy. In fact, if detected early—at stage I or II—colorectal cancer has a 5-year survival rate of 90%. However, that statistic drops to 71% if detected at stage III, and drops precipitously to 14% at stage IV—clearly showing the need for regular screening and early detection.

Getting a colonoscopy doesn’t have to be scary, embarrassing or inconvenient. At Door County Medical Center we work with you from beginning to end to make your experience as easy and convenient as possible. Earlier this summer, Phil went through the process of getting a colorectal cancer screening and relayed his story to us—and we thought we’d relay it to you.

Phil’s Story—Part I

This past June, I arrived at DCMC in order to have a colonoscopy. In my case this was a routine procedure. I had no specific symptoms. Because I have had previous colonoscopies, the hospital contacted me to let me know I was due for another. I am on the 5-year plan and I didn't even need to keep track of when I needed to have another one done. The hospital reached out to me—I was impressed!

As soon as I made the phone call about scheduling the colonoscopy, it was smooth sailing all the way. I was put in touch with the great DCMC General Surgery team who had me come in to set up the appointment for the procedure as well as to go over what I could expect and what I should do to prepare.

Not only did the RN explain everything in easy to understand language but I was also given printed copies of everything that was covered. She was so nice and attentive to all my questions. I felt entirely comfortable.

Additionally, I was given a list of recommendations about what to eat and what foods/drinks to avoid starting four days before the procedure, as well as how to tweak those suggestions on the day before. Because I love to eat, it was fun to plan the menu! And now I had an extra excuse to buy those frozen lemon bars I was craving. 

I was also informed about the liquid drug prep—called Clenpiq—that I would take the night before the procedure. I was so relieved when I found out the prep consisted of only two small bottles of pleasant-tasting liquid, each taken five hours apart (followed by several glasses of water, which were spaced out over the five interim hours). Easy!

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What is a colonoscopy?

The colon and the rectum are both parts of the large intestine—the colon is (approximately) the last 5 feet of the large intestine, while the rectum is the final 5 or 6 inches of the colon, which then connects to the anus. Colorectal cancer almost always develops from abnormal precancerous growths in the colon and rectum called polyps.

According to the American College of Gastroenterology, polyps grow on the inner lining of the large intestine, often have a raised appearance, and “may be scattered throughout the colon and vary in size from a few millimeters to several centimeters.” When a doctor performs a colonoscopy, they are primarily looking for polyps.

During a colonoscopy, the patient lies on their left side and a flexible tube with a tiny video camera at its tip—called a colonoscope—is inserted into the rectum. This allows the doctor to view the inside of the colon and look for abnormalities and polyps. In addition to the video camera, the colonoscope is equipped to remove polyps or abnormal tissue that is found, as well as take biopsies (tissue samples), which can be sent to a lab for analysis.

The typical colonoscopy lasts between 30 – 60 minutes. Patients generally opt for moderate sedation, which reduces pain and usually means there is no memory of the procedure. Alternately, a patient may choose to receive no sedative at all.

Preparing for a colonoscopy

In order for a colonoscopy to be successful, the colon must be as empty as possible. While most medical centers follow slightly different procedures for clearing the bowel, two parts of the bowel prep are generally the same: diet and drinking bowel-cleaning liquid. The general procedure is as follows

• 4 days before the colonoscopy—start a low-fiber diet. No whole grains, nuts, fruit, seeds, etc.
• The day before the colonoscopy—avoid solid foods. Drink clear liquids like broth, black coffee, tea, clear juice (like apple juice), and water.
• The night before the colonoscopy—drink the bowel-cleaning liquid (in Phil’s case it was Clenpiq)
• The day of the colonoscopy—no food or liquid 4 hours prior to the procedure.

Phil’s Story—Part II

On the day of the actual procedure, I was up early, showered and brushed my teeth. No food or any liquids—including water—were allowed four hours before my arrival time. That was no problem because those were hours I was still asleep. When I got to the hospital of course I was hungry so I laughed when one of the first questions I got from the nurse who took my vitals was "What kind of snacks would you like following the procedure?" (I opted for the chocolate chip granola bar, a banana, and a big cup of coffee!)

Everyone I came in contact with that morning was so friendly, helpful and focused on making sure I was comfortable. I was. In fact, they were all so calm and encouraging that I wasn't nervous at all.

The surgeon, Dr. Michael St. Jean, and the anesthesiologist, Brian Matysiak, met with me prior to the procedure. They put my mind at ease. I really admire these guys.

I did choose to have a sedative—just an IV in my arm—and it worked so well, and so quickly, that I don't even remember much more than being wheeled into the operating room and then waking up in the recovery room—absolutely no pain or discomfort!

And yes, my snacks were there when I opened my eyes!

Besides the attentive, friendly care I was given throughout this entire experience, one thing I particularly appreciated was the printed material that were shared with me both pre- and post-operation. Before being discharged, the nurse went over final instructions and it was so helpful to be able to reference those comments and recommendations once I returned home.

My entire time at the hospital was under three hours.

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While it is true that colorectal cancer runs in families, it is just as true that the vast majority of colorectal cancer cases are diagnosed in those with no family history of the disease at all. If you are 45 or older, it is time to consider scheduling a colorectal screening. As Phil’s story shows, a colorectal screening doesn’t need to be an embarrassing and time-consuming ordeal. Indeed, a small amount of discomfort and a few hours of your day can save your life.

To schedule a colorectal screening at Door County Medical Center today call 920-743-5566.