Tuesday, February 20, 2018

Get that colon checked

HEALTH INSTRUMENT: Dr Alan De Freitas holds a a colonscope (a long flexible instrument about inch in diameter) which is used to examined inside the large during a colonoscopy.

Have you checked your colon lately?
It’s awkward saying this out loud, but once you get past the awkwardness, it can spark a conversation that may not only save your life but tsomeone else’s as well.
March is Colorectal Cancer Awareness Month. For some people cancer represents the dreaded ‘c’ but it doesn’t have to be, says Dr Alan De Freitas.
Knowledge is power, and by understanding all the facts about this disease makes colon cancer preventable, treatable and beatable. While there are many reports, documentaries and articles about breast cancer and its severity, the colon is one organ in the human body that is not often highlighted.
Hoping to raise awareness of colon cancer and the importance of having a colonoscopy, Dr De Freitas and his team at CentraMed Surgical and Endoscopy Centre in Chaguanas are on a mission to make citizens more proactive rather than reactive about their health.
He said: “Colon cancer is cancer of the large bowel. It is an uncontrolled growth of tissue in the body which eventually overwhelms the body. Compared to breast and prostate cancer, which are the top two cancers globally, colon cancer is ranked at number three. Colon cancer is the third most common cancer in both sexes but it is the number two killer; in terms of number of people dying from it.”
Dr De Freitas noted that what causes colon cancer is still somewhat of a mystery for medical practitioners, however doctors know that most colon cancers originate from small non-cancerous (benign) tumours called polyps that form on the inner walls of the large intestine. It is also believed that there is a genetic link that can increase the risk of colon cancer.
During a recent interview with the Express, Dr De Freitas gave a general overview about colon cancer and sought to displace any misconceptions about colonoscopies.
How do I know if I
have colon cancer?

You will know if you have colon cancer for sure once you have had a colonoscopy. A colonoscopy is an outpatient procedure in which the inside of the large intestine (colon and rectum) is examined. Though there are other tests to check for colon cancer, a colonoscopy is actually the only confirmatory test, Dr De Freitas said.
Colon cancer should not to be taken lightly. It can present almost like two different diseases in that the early presentation is almost always curable (90 per cent five-year survival), and the late presentation is almost incurable with 5 per cent survival. It is in your best interest to do something about your health since colorectal cancer might not show symptoms right away. If left untreated some of these polyps may grow into malignant colon cancers over time. These cancer cells will then invade and damage healthy tissue that is near the tumor causing many complications. Once malignant tumors form, these cancerous cells can spread to other parts of the body. This process is called metastasis, and the result is a more serious condition that is very difficult to treat, he said.
In an online article written by Maya Rhodan from Time magazine dated January 25th, 2016, people under the age of 50 aren’t usually screened for colon cancer but they’re still at risk, according to a new study.
The article further states, the study which was published recently in the journal Cancer, finds that one in seven patients with colon cancer is under the age of 50, and younger patients tend to be in more advanced stages.
Dr De Freitas noted while the recommended age for colon screenings in Trinidad and Tobago is age 45, you can start colon screenings at any age, especially if there is a family history of the disease.
Though some people might mistake colon cancer for haemorrhoids, it is important to check your physician, Dr De Freitas said, if you have any of the following symptoms:

Symptoms of colorectal cancer include:
• Diarrhoea or constipation
• A feeling that your bowel does not empty completely
• Blood (either bright red or very dark) in your stool
• Stools that are narrower than usual
• Frequent gas pains or cramps, or feeling full or bloated
• Weight loss with no known reason
• Fatigue
• Nausea or vomiting

What is a colonoscopy?

A colonoscopy is a relatively simple procedure which allows the doctor to see inside your colon. The doctor uses a colonscope (a long flexible instrument about inch in diameter) which is inserted into the rectum and advanced through the large intestine. If necessary during a colonoscopy, small amounts of tissue can be removed for analysis (a biopsy) and polyps can be identified and entirely removed. In many cases, a colonoscopy allows accurate diagnosis and treatment of colorectal problems without the need for a major operation.
Dr De Freitas admits that having to convince patients to have the procedure done is an uphill battle but one he is not about to give up.
“Many people are reluctant to have the procedure done because of how intrusive the examination is. Having any sort of medical device going up your anus can be off-putting for most people. For some the fear of the unknown, pain and embarrassment is too much so they avoid the procedure that can actually save their life. I say to all my patients ‘you should be more afraid of death than doctors’,” he said.
Facilitator manager at CentraMed, Elizabeth Kelly recently had a colonoscopy at the centre and says the procedure is nothing to be afraid of. The pain on a scale of one to ten is about four, and if your pain tolerance is low you can receive medication for the pain.
She said, “It can be a bit uncomfortable but for me the preparation is the worst. For the doctor to see inside of you; you have to be clear. In order to be clear you have to have a preparation. The preparation cleans the entire digestive tract so as you can imagine, it is not a pretty thing in the bathroom. This prep has to take place almost 24hrs before and you also have to fast on top of that. Once that is done, it is a flexible tube that is just wider than a straw that is attached with a camera. It goes through the tract and the doctor manoeuvres it; it is uncomfortable and some people require a sedative; others do not. The procedure takes about 30-40 minutes.”

How is colon cancer treated?

Treatment for colon cancer is based largely on the stage (extent) of the cancer, but other factors are also important. It usually involves surgery, chemo and radiation therapy. Screening tests help prevent colorectal cancer by finding precancerous polyps (abnormal growths) through a colonoscopy so they can be removed. Screening also finds this cancer early, when treatment can be most effective, Dr De Freitas said.
Centra Med Surgical and Endoscopy Centre is a same-day surgical centre that started under the Health Net Group of Companies. The centre has been in existence for the past two years and offers several services including same-day surgery, hernia repair, gall bladder removal, wound care management, diabetic feet care management and access to a wide range of specialists.
Kelly said, “When you go to your general practitioner (GP), there is always need for a specialist. We have found that there is more need for guidance than just general knowledge, and that’s what CentraMed does.
“It is important to take control of your own health. We provide a link to specialists; in addition to preventative care and wellness. Looking at the economic environment that we are in now, we have seen a niche to find a way to bring healthcare to the ‘average joe’ that cannot afford private healthcare,” she said.
“We have been told once you are sexually active you should have a pap-smear. Just as we are told, once you are over 40 you should have a mammogram. Just as we have been told as men you should have a prostate exam — once you are over 45 you should have a colonoscopy,” Kelly added.
For more information e-mail info@centramed.co.tt