degree relative before age 60, begin screening
sooner (typically at age 40)
• Continue getting a colonoscopy every 5-10 years,
and a fecal occult blood test every year
• If you have had a polyp detected and
removed, get screening colonoscopy more
frequently as recommended by your doctor
• Adopt a mostly plant-based diet, stay physically
active, don’t smoke tobacco, maintain a healthy
weight, and limit processed grains and alcohol (no
more than 2 drinks per day)
COLON PREPARATIONS
• One to two days before a colonoscopy, you will
stop eating solid foods and drink only clear fluids,
such as water, tea, coffee, clear juices, clear broths,
flavored ice pops, and gelatin (such as Jell-O). Do
not drink anything red or purple, such as grape
juice or fruit punch. And do not eat red or purple
foods, such as grape ice pops or cherry gelatin.
• Your doctor will recommend a prescription laxative
tablet and/or a laxative solution that you drink
before your colonoscopy. This solution may taste
very salty and may make you feel sick to your
stomach.
• You will want to stay home while doing the colon
prep, because the colon prep will make you use
the bathroom often. The colon prep causes loose,
frequent stools and diarrhea so that your colon will
be empty for the test.
• Drink plenty of clear fluids during the prep so you
will not get dehydrated. This will also help clean
out your colon completely after you finish the colon
prep.
• Do not eat any solid foods after doing the colon
prep.
• Stop drinking clear liquids 6 to 8 hours before the
colonoscopy.
Unfortunately, only about half of people eligible for
colorectal cancer screening, get the tests that they
should. This may be due to lack of public and health
professional awareness of screening options. Screening
colonoscopy can be arranged at various hospitals and
health institutions in Trinidad &Tobago.
The cost for a screening can range from $3,000 -
$6,000 TTD. For more information, you may contact
Centramed at 290-1265, 290-1266 or
email
8
9
I
f you are age 50 or over, you should give yourself a
Christmas Present of a screening colonoscopy.
Regular colorectal cancer screening or testing is one of
the most powerful weapons for preventing colorectal
cancer, since it can find polyps, which can be removed
before they can develop into cancers.
Excluding skin cancers, colorectal cancer is the third
most common cancer diagnosed in both men and
women, Overall, the lifetime risk for developing
colorectal cancer is about 1 in 20 persons.
Colonoscopy is a test that allows your doctor to look
at the inner lining of your large intestine (rectum and
colon). He or she uses a thin, flexible tube called a
colonoscope to look at the colon. A colonoscopy
helps find ulcers, colon polyps, tumors, and areas
of inflammation or bleeding. During a colonoscopy,
tissue samples can be collected (biopsy) and abnormal
growths can be taken out. Colonoscopy can also
be used as a screening test to check for cancer or
precancerous growths in the colon or rectum (polyps).
The colonoscope is a thin, flexible tube that ranges
from 48 in. (125 cm)to 72 in. (183 cm) long. A small
video camera is attached to the colonoscope so that
your doctor can take pictures or video of the large
intestine (colon). The colonoscope can be used to look
at the whole colon and the lower part of the small
intestine
Colonoscopy can visualize the whole length of the
large intestines and is able to look up, across and
down the length of the colon. This procedure however
requires preparation, sedation and carries small risks
such as perforation and bleeding.
Bowel preparation techniques vary but the goal is
the same, to rid the colon of any stool so that there
is nothing obstructing the doctor’s view. Bowel prep
begins a few days before progressing to a liquid-
only diet, and is followed by a bowel prep solution
or strong laxative enema the night before the test.
An improperly prepared colon can block polyps and
other abnormalities, so following the prep directions
carefully is critical. You will be awake, but sedated
enough to be comfortable. You may experience
cramping when the doctor manipulates the scope and
instills air into the colon to better navigate the twists
and turns.
Colonoscopy may be done in a doctor’s office, clinic,
or a hospital. The test is most often done by a doctor
who works with problems of the digestive system
(Gastroenterologists and Colorectal surgeons) During
the test, you may get a pain medicine and a sedative
put in a vein in your arm (IV). These medicines help
you relax and feel sleepy during the test. You may not
remember much about the test.
Again, if a polyp or abnormal looking tissue is found, it
is removed or biopsied during the procedure and later
analyzed by a pathologist who will generate a report to
give to your doctor.
The large intestine is the last organ in the
gastrointestinal system picking up where the small
intestine leaves off. It is charged with removing water
from the leftover solids of digestion and eliminating it
as stool. Cancer can form anywhere inside the 5-foot
tube that squares the abdominal cavity.
The large intestine extends up on the right side
(ascending colon), making a left turn past the liver and
across (transverse colon), bending down at the spleen
on the left (descending colon), looping to the middle
(sigmoid colon) before passing through the rectum and
out the anus. (The cecum and appendix balloon off the
ascending colon just below the juncture between the
colon and small intestine.)
The cells lining the colon are constantly growing and
dying in a natural process of cell turnover. If the cells’
growth message system fails from faulty or unstable
genes, the cells can grow unchecked into a mass of
tissue called a polyp. As the cells continue to divide
and grow, they can become more and more abnormal.
You probably won’t feel them growing or have any
noticeable symptoms that let you know they are there.
Mostly these changes are benign polyps (adenomas),
a seemingly harmless bump or tag. But these polyps
can also take a turn for the worse and transform into
an advanced adenoma or cancerous mass that can not
only narrow or block the opening of the tube, but also
breakthrough the wall to invade nearby lymph nodes
and travel to metastasize elsewhere in the body. Since
you won’t know if and when they will become a threat,
you need to get them removed.
Finding and removing benign polyps can reduce the
risk of colon cancer substantially and finding and
removing cancer early, at a more curable stage, can
save lives. Nearly, 25% of 50 year olds develop polyps
and 5% of these are cancerous.
Who is at Risk for Colorectal Cancer?
To put it simply, all adults are at risk for colorectal
cancer, even those that live healthily.
Some people are at very high risk – those who have
a particular gene mutation that predisposes them to
developing multiple polyps, those with a diagnosed
first-degree relative (mother, father, sister, brother,
child), especially if the relative was diagnosed before
the age of 50. Ulcerative colitis and Crohn’s disease,
types of inflammatory bowel diseases, also up the risk.
Other Lifestyle risk factors for colorectal cancer are:-
• Diets high in fat or low in fiber, calcium, or both
• Obesity
• Physical inactivity
• Tobacco smoking
• High alcohol intake
ADVICE
• If you are experiencing bleeding, a change in
the frequency and characteristics of your bowel
movements, (including constipation and diarrhea)
abdominal pain or unexplained fatigue,
cramping or weight loss, go to the doctor as soon as
possible
• If you are 50, undergo an endoscopic procedure,
preferably a screening colonoscopy
• If you have personal risk factors such as colorectal
cancer or adenomatous polyps detected in a first-
The Importance of a Screening
FACT : The majority of deaths
from colorectal cancer could
be prevented if every adult 50
years or older got tested !
Dr. Alan De Freitas
