The doctor wished me a good sleep. Then I blacked out. I awoke a half-hour later, but it felt as if only seconds had passed. I couldn’t open my eyes. It was if they were squeezed shut. But I could hear women chatting about cooking and a heart monitor beeping.
Slowly, as the anesthesia wore off, I was able to pry open my eyelids, and I awoke to the sight of the gurney’s shiny aluminum bars. I turned to lie flat on my back. A nurse passed and inquired how I was as she went. “I’m fine,” I replied. “Thank you.” She returned and gave me apple juice and graham crackers, which tasted divine.
It was over. The test that I had feared for years was done.
I’m speaking of the colonoscopy. There is perhaps no exam that induces greater worry than this one. After all, you’re asked to gulp an oversized cup of awful-tasting clear liquid that, soon after, rids your colon of its contents so a doctor can insert a half-inch-wide tube with a camera up and through your large intestine. The doctor is searching for polyps (precancerous growths) and tumors (cancerous growths).
To help clear your digestive tract, you can’t eat the day before, so more than 24 hours later you’re feeling a little weak and woozy. In the final four hours, you can drink nothing, so you’re also thirsty.
The actual test is easy. The “prep” is the hard part.
Throughout the preparation phase, I kept thinking, is all of this necessary? The lifetime risk of developing colon cancer is 1 in 23, or 4.4 percent, for men, and 1 in 25, or 4.1 percent, for women, according to the American Cancer Society. Ergo, I thought, there’s a 95 percent chance that I will never develop colon cancer. The median age of a colon cancer diagnosis is 68. I’m 52. So the odds were in my favor that I wouldn’t have colon cancer, so why get the test?
Colon cancer, as I learned through research, is relatively slow-growing. It takes roughly a decade for a polyp to mutate into cancer, according to the Cleveland Clinic. Here’s how the clinic describes the process on its website:
“A colorectal polyp begins with a gene mutation in one of the stem cells that are constantly dividing to produce the cells that line our colon.
“Each of the stem cell’s ‘daughter cells’ inherits that gene mutation, which makes them grow faster and live longer than nearby cells. Only a few mutations cause cancer.
“Colon cells grow and divide so rapidly that we replace the entire lining of our colons once a week. Each time these cells divide, they pick up more and more mutations, and the risk of cancer rises.
“As cells with the mutation build up on the surface of the colon, they form a small cluster that appears as a polyp. They continue to divide, picking up even more mutations — some in the genes controlling cell growth. So the cells start growing faster, and the polyp enlarges.”
Pick up enough gene mutations, and the polyp morphs into cancer, and cell growth becomes uncontrollable without medical treatment. If, however, a polyp is caught early, before it turns cancerous, then a doctor can remove it during a colonoscopy — and with it, the risk of developing cancer. Thus, with regular colonoscopies, you can reduce the chance of developing this deadly cancer to virtually zero.
The survival rate for Stage 4 colon cancer is 7 percent — that is, if you are diagnosed at this stage, there’s a 93 percent chance that you’ll die. Why take this risk unnecessarily if we have the medical technology to prevent such a horrible death? I concluded.
So, I determined, I was going to have this test, as seemingly unpleasant as it was. Having now been through it, I have to say, it wasn’t as bad as I thought. I would be lying if I were to say it was somehow enjoyable, but it was more than bearable.
The Centers for Disease Control and Prevention recommends that people have their first colonoscopy at age 50, and then in five- or 10-year intervals thereafter. If you have polyps, you must come back in five years; no polyps, 10 years.
If you have a close relative with polyps or colon cancer, or if you have an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis, or a genetic syndrome such as familial adenomatous polyposis, then you should be checked earlier than 50, the CDC says.
I put off the test two years longer than I should have. That was a mistake that I chalk up to fear of the test. I’m thankful that I had no polyps or tumors. What the colonoscopy gave me was peace of mind, which was worth the 24 hours of discomfort that I experienced.
Scott Brinton is the Herald Community Newspapers’ executive editor and an adjunct professor at the Hofstra University Herbert School of Communication. Comments about this column? SBrinton@liherald.com.