7 ms·

Just taking the opportunity to chime in on this thread: Do not hesitate to press for a colonoscopy or sigmoidoscopy if you are worried about your colon health.

Just taking the opportunity to chime in on this thread: Do not hesitate to press for a colonoscopy or sigmoidoscopy if you are worried about your colon health. Something is going on now where demographically much younger patients are getting polyps and colon cancer: https://www.cancer.gov/news-events/cancer-currents-blog/2020/colorectal-cancer-rising-younger-adults https://www.cancer.gov/news-events/cancer-currents-blog/2020... Doctors are still mostly operating under the old wisdom that it is not a problem for those under 60 or so. I had blood in my stool at 36, and after convincing my doctor that I wanted it checked even if it was 'probably a hemorrhoid', a sigmoidoscopy found 3 polyps. I was lucky that the big one was right at the 'front door' so to speak, otherwise the sigmoidoscopy would have not been deep enough to find them, and I might not be writing this comment today.

CyanBird 6y ago
Absolutely, when TotalBiscuits (John Bain) was still fighting cancer he couple times unabashedly said while doing his live starcraft 2 esports casting to everyone listening to be mindful of colon cancer, to not play dumb with it if you consistently find blood in your stool and go get yourself checked, insist on it if the doctors seem not particularly concerned He was saying that to save lives Might he rest in peace
- dstick 6y ago
  Thanks for reiterating this. In the end, what we leave behind is the love we gave others and the wisdom we bestow. Hoping they learn sooner than us, and benefit.
- ekianjo 6y ago
  > In late April 2014, Bain announced he had a precancerous mass in his colon, the first indications of bowel cancer, a condition with which two of his grandparents had also been diagnosed. (wikipedia) It's good to promote diagnosis, but let's also put this in perspective: he had family history of this kind of cancer. This kind of changes everything when it comes to your personal risk, just like your grand parents having Alzheimer indicate a major risk that you will get it as you age as well. This is why (good?) doctors also ask for conditions running in families.
greesil 6y ago
It still seems pretty rare, even if it's more common. I have had some similar symptoms, and similar interactions with doctors in the past. No, I don't think I have cancer. But, what I want to know is what is the probability of having this condition given the symptoms. In other words, use Bayes' rule. Most doctors seem incapable of thinking this way! If it's a 1% chance that I have a life-threatening condition because there's blood in my stool, then it makes sense to get diagnostic that would test for that. I know these datasets exist, but why can't my doctor make use of this, or me for that matter?
- greedo 6y ago
  Rare doesn't really help when there are almost 8B people on the planet. I was 41 when I was diagnosed with colorectal cancer. I had blood in my stool and my GP misdiagnosed me due to my age. If I hadn't pushed the issue, I wouldn't be here now. If you ever have blood in your stool, get an exam. Preferably by a gastroenterologist.
  - Geezus_42 6y ago
    I had a friend who died of colon cancer in his late teens. We weren't super close so I don't know the details like what variety it was.
  - mpfundstein 6y ago
    Hi, mind sharing how the blood in your stool looked like? What was the color etc? Was it there always? Was it occassionally? Was it ON the stool or mixed through it? And when you finally got diagnosed. What stage were you in? Are you healed now? And how long did you put it off? Sry for asking so much.
    - greedo 6y ago
      I noticed bright red blood on my toilet paper periodically. I would ignore it a bit, then worry more when it re-occurred. After a month or so, I went to see my GP (I was 40 at the time). He thought it was just hemorrhoids. A year later my wife convinced me to go back and see what was up. I was referred a week later to my gastroenterologist who diagnosed me with a 5cm tumor. The path report showed that it was T2N0M0. I'm fully healed now, though I have a permanent colostomy.
elihu 6y ago
Same here; had a large tubulovilous adenoma removed a couple years ago, at just about the same age. It wasn't cancerous, but it probably would have been soon if left to its own devices. In my case it's probably genetic. My grandmother survived cancer by having part of her colon removed. She had a bunch of siblings who all died of cancer or undetermined causes; the difference is that she went to the doctor and they didn't.
epmaybe 6y ago
This concept behind earlier screening is a whole thing amongst medical professionals, and a point of controversy in a number of specialties. As with most things, procedures have risks and benefits. Colonoscopies have risks too, right? Bowel perforation (bad news), bleeding, infection, etc. So, balancing that with the obvious benefit of catching cancers early, the USPSTF (United States Preventive Services Taskforce) made some recommendations on when patients should undergo screening for colon cancer. As of right now, per their highest level of evidence recommendations, you should get a colonoscopy starting age 50, and every 10 years thereafter. Note, I said colonoscopy. Not sigmoidoscopy, not stool testing, etc. Those have different guidelines and intervals (but do still start age 50). If you have family history of colon cancer, or certain diseases that put you at higher risk for colon cancer, the recommendations are significantly earlier. In the case of a positive family history, you get a colonoscopy age 40 or 10 years before the earliest colon cancer diagnosis in the family, whichever comes first. The reason I bring all this up is to point out that if you go to the USPSTF web site, you'll see an evidence level B recommendation to start screening age 45 as well. You'll also find the American Cancer Society has colonoscopies starting age 45. The evidence and safety for colonoscopies at earlier and earlier ages is getting better and better. Doctors should absolutely be screening well before age 60. If your doctor isn't following uspstf guidelines due to practicing outdated medicine (some variation due to personal preference/evidence based practice I guess is acceptable), in my not so professional opinion you should probably find a new doctor.
- vimy 6y ago
  No risk with a camera pill. Less risk with a virtual colonoscopy. https://www.mayoclinic.org/tests-procedures/capsule-endoscopy/about/pac-20393366 https://www.mayoclinic.org/tests-procedures/capsule-endoscop... https://www.hopkinsmedicine.org/health/conditions-and-diseases/colon-cancer/virtual-colonoscopy-for-cancer-screening https://www.hopkinsmedicine.org/health/conditions-and-diseas...
  - epmaybe 6y ago
    Sure but both modalities don’t have large randomized trials comparing long term efficacy. Here’s some food for thought regarding pill cam endoscopy: https://www.nejm.org/doi/full/10.1056/nejmoa0806347 https://www.nejm.org/doi/full/10.1056/nejmoa0806347 “ The use of capsule endoscopy of the colon allows visualization of the colonic mucosa in most patients, but its sensitivity for detecting colonic lesions is low as compared with the use of optical colonoscopy.”
raylad 6y ago
There are at-home screening tests you can get that are inexpensive and as accurate as colonoscopies in screening for cancer (according to some ways of measuring). https://www.healthline.com/health-news/dreading-colonoscopy-other-effective-tests-for-colon-cancer-032015 https://www.healthline.com/health-news/dreading-colonoscopy-... Some of these can be ordered without a prescription online. So if you want to get screened and can't justify or afford a colonscopy, these are worth checking out.
01100011 6y ago
Be sure to have a dialogue with your parents and siblings regarding your family history. My dad has a history of polyps, starting around 40. It's not something I would have known about without talking to him as it's just a regular part of his life to get them removed every few years. I had my first colonoscopy last year at 45 and had a polyp removed. If I didn't know my family history, I might have waited until the normal age of 50 and it might have been too late.

CyanBird 6y ago

Absolutely, when TotalBiscuits (John Bain) was still fighting cancer he couple times unabashedly said while doing his live starcraft 2 esports casting to everyone listening to be mindful of colon cancer, to not play dumb with it if you consistently find blood in your stool and go get yourself checked, insist on it if the doctors seem not particularly concerned He was saying that to save lives Might he rest in peace

dstick 6y ago
Thanks for reiterating this. In the end, what we leave behind is the love we gave others and the wisdom we bestow. Hoping they learn sooner than us, and benefit.
ekianjo 6y ago
> In late April 2014, Bain announced he had a precancerous mass in his colon, the first indications of bowel cancer, a condition with which two of his grandparents had also been diagnosed. (wikipedia) It's good to promote diagnosis, but let's also put this in perspective: he had family history of this kind of cancer. This kind of changes everything when it comes to your personal risk, just like your grand parents having Alzheimer indicate a major risk that you will get it as you age as well. This is why (good?) doctors also ask for conditions running in families.

greesil 6y ago

It still seems pretty rare, even if it's more common. I have had some similar symptoms, and similar interactions with doctors in the past. No, I don't think I have cancer. But, what I want to know is what is the probability of having this condition given the symptoms. In other words, use Bayes' rule. Most doctors seem incapable of thinking this way! If it's a 1% chance that I have a life-threatening condition because there's blood in my stool, then it makes sense to get diagnostic that would test for that. I know these datasets exist, but why can't my doctor make use of this, or me for that matter?

greedo 6y ago
Rare doesn't really help when there are almost 8B people on the planet. I was 41 when I was diagnosed with colorectal cancer. I had blood in my stool and my GP misdiagnosed me due to my age. If I hadn't pushed the issue, I wouldn't be here now. If you ever have blood in your stool, get an exam. Preferably by a gastroenterologist.
- Geezus_42 6y ago
  I had a friend who died of colon cancer in his late teens. We weren't super close so I don't know the details like what variety it was.
- mpfundstein 6y ago
  Hi, mind sharing how the blood in your stool looked like? What was the color etc? Was it there always? Was it occassionally? Was it ON the stool or mixed through it? And when you finally got diagnosed. What stage were you in? Are you healed now? And how long did you put it off? Sry for asking so much.
  - greedo 6y ago
    I noticed bright red blood on my toilet paper periodically. I would ignore it a bit, then worry more when it re-occurred. After a month or so, I went to see my GP (I was 40 at the time). He thought it was just hemorrhoids. A year later my wife convinced me to go back and see what was up. I was referred a week later to my gastroenterologist who diagnosed me with a 5cm tumor. The path report showed that it was T2N0M0. I'm fully healed now, though I have a permanent colostomy.

elihu 6y ago

Same here; had a large tubulovilous adenoma removed a couple years ago, at just about the same age. It wasn't cancerous, but it probably would have been soon if left to its own devices. In my case it's probably genetic. My grandmother survived cancer by having part of her colon removed. She had a bunch of siblings who all died of cancer or undetermined causes; the difference is that she went to the doctor and they didn't.

epmaybe 6y ago

This concept behind earlier screening is a whole thing amongst medical professionals, and a point of controversy in a number of specialties. As with most things, procedures have risks and benefits. Colonoscopies have risks too, right? Bowel perforation (bad news), bleeding, infection, etc. So, balancing that with the obvious benefit of catching cancers early, the USPSTF (United States Preventive Services Taskforce) made some recommendations on when patients should undergo screening for colon cancer. As of right now, per their highest level of evidence recommendations, you should get a colonoscopy starting age 50, and every 10 years thereafter. Note, I said colonoscopy. Not sigmoidoscopy, not stool testing, etc. Those have different guidelines and intervals (but do still start age 50). If you have family history of colon cancer, or certain diseases that put you at higher risk for colon cancer, the recommendations are significantly earlier. In the case of a positive family history, you get a colonoscopy age 40 or 10 years before the earliest colon cancer diagnosis in the family, whichever comes first. The reason I bring all this up is to point out that if you go to the USPSTF web site, you'll see an evidence level B recommendation to start screening age 45 as well. You'll also find the American Cancer Society has colonoscopies starting age 45. The evidence and safety for colonoscopies at earlier and earlier ages is getting better and better. Doctors should absolutely be screening well before age 60. If your doctor isn't following uspstf guidelines due to practicing outdated medicine (some variation due to personal preference/evidence based practice I guess is acceptable), in my not so professional opinion you should probably find a new doctor.

vimy 6y ago
No risk with a camera pill. Less risk with a virtual colonoscopy. https://www.mayoclinic.org/tests-procedures/capsule-endoscopy/about/pac-20393366 https://www.mayoclinic.org/tests-procedures/capsule-endoscop... https://www.hopkinsmedicine.org/health/conditions-and-diseases/colon-cancer/virtual-colonoscopy-for-cancer-screening https://www.hopkinsmedicine.org/health/conditions-and-diseas...
- epmaybe 6y ago
  Sure but both modalities don’t have large randomized trials comparing long term efficacy. Here’s some food for thought regarding pill cam endoscopy: https://www.nejm.org/doi/full/10.1056/nejmoa0806347 https://www.nejm.org/doi/full/10.1056/nejmoa0806347 “ The use of capsule endoscopy of the colon allows visualization of the colonic mucosa in most patients, but its sensitivity for detecting colonic lesions is low as compared with the use of optical colonoscopy.”

raylad 6y ago

There are at-home screening tests you can get that are inexpensive and as accurate as colonoscopies in screening for cancer (according to some ways of measuring). https://www.healthline.com/health-news/dreading-colonoscopy-other-effective-tests-for-colon-cancer-032015 https://www.healthline.com/health-news/dreading-colonoscopy-... Some of these can be ordered without a prescription online. So if you want to get screened and can't justify or afford a colonscopy, these are worth checking out.

01100011 6y ago

Be sure to have a dialogue with your parents and siblings regarding your family history. My dad has a history of polyps, starting around 40. It's not something I would have known about without talking to him as it's just a regular part of his life to get them removed every few years. I had my first colonoscopy last year at 45 and had a polyp removed. If I didn't know my family history, I might have waited until the normal age of 50 and it might have been too late.