By Michelle Brusio, MSN, RN, CCM
Did you know that colon cancer is the leading cause of cancer death for men under 50, and the second leading cause of cancer death for women under 50? There can be a lot of shame and fear that goes along with testing, including the prep, the colonoscopy itself, and the biopsy results. If your screening test and/or biopsy come back negative, you only need to repeat them every 10 years.
Screening
Regular colorectal cancer screenings are recommended starting at age 45 for most people, but only 20% of those aged 45–49 get screened. Colon cancer is on the rise, so screening is imperative for early diagnosis. Colonoscopies remain the preferred screening method, but home-based stool kits are also available. Even with home-based stool kits, the patient may still undergo a colonoscopy after a positive test.
Your past medical history, including a history of cancer as well as that of your family, is important to know your risk factors. One in ten cancers is caused by a genetic mutation inherited from a family member. Ask family about their past medical history and any positive cancer screenings. You’ll usually need medical clearance from your primary care provider before the colonoscopy.
The Colonoscopy and the Prep
Some people do not follow the prep instructions completely. Making sure your colon is clean is essential so that doctors can clearly see tissues and identify any polyps or areas that may need a biopsy. If your colon is not clean, the provider will stop the test and reschedule for another day. Follow the directions given to you by your provider, especially if you have a chronic condition like diabetes.
Once you complete your prep of fasting, clear fluids, and a laxative to clean your colon, you are on your way to the test. I emphasize clear fluids, no purple, blue, or red drinks. Because you may be sedated for your test, bring someone with you. The test takes about 15–30 minutes and uses a camera tube inserted into your rectum to examine the lining of your rectum and large intestine. Biopsies may be performed to assess polyps, tumors, or to help diagnose inflammatory bowel disease. Recovery takes 15-30 minutes before you can head home to rest. You are usually back to normal activities the next day. Risk factors for colonoscopy include bleeding, infection, or a colon tear, especially after a biopsy. Whenever anesthesia is administered, there are potential risks, which will be discussed with you before your procedure.
Home Screening Tests
Several colon cancer screening tests can be done at home. These tests efficiently detect blood and abnormal DNA in the stool without being invasive. Usually, providers order kits that are shipped directly to patients' homes. Once used, patients return the kits to the lab for analysis. These tests for an average-risk person are repeated annually or every 3 years, depending on the test. These tests can be a good option for people who cannot or are not interested in a colonoscopy. If any of these home tests turn out positive, the person should still consider undergoing a colonoscopy after speaking with their provider.
Symptoms of Colorectal Cancer
Colorectal cancers usually cause bleeding; however, it may not be noticeable at first. Stools could be darker, but bleeding may not be noticeable until later in the disease process. However, when you notice a change in your body or bowel habits, it is time to seek medical attention. Bowel changes may include diarrhea, constipation, or persistent narrow, ribbon-like stools. One may have a bowel movement and still feel the need to go. Blood in the stool can appear dark brown or even black, or bright red rectal bleeding can occur. Abdominal cramping or belly pain, weakness and fatigue, and unintended weight loss are common symptoms and often symptoms of other diseases as well. Discussing all symptoms with your provider aids screening and diagnosis.
The “Bottom” Line (Ha ha)
Colon screening is crucial; if you have a personal or family history of cancer, promptly report symptoms to your provider for early detection and treatment. Colonoscopies are the gold standard for screening, but you should speak with your provider about what test is best for you. Educating people about colorectal cancer and screenings is imperative to lower the number of people who develop colorectal cancer and reduce deaths from the disease. If you have not had your colorectal screening and are due, this is your reminder to care for yourself.
Managing complex, high-cost cases requires more than just standard procedures—it requires Integrated Case Management.
CMSA’s ICM Training gives you the tools to move patients toward health stabilization by engaging clients, stratifying risk, and developing comprehensive care plans to achieve improved health and well-being.
What’s included:
-5 Online training sessions & quizzes
-Emotional Intelligence Survey
-3 Days of interactive Zoom sessions with peers
-28.5 CE Credits!
Pricing: $995 for Members | $1,150 for Non-Members
Hurry! Registration closes April 3.
Register here: cmsa.org/integrated-case-management/
Bio: Michelle Brusio, MSN, RN, CCM, has been an RN for twenty-six years and in case management for twenty. She is currently the Clinical Manager for Population Health, Care Transformation Organization and Primary Care at University of Maryland Upper Chesapeake Health. Michelle has experience in acute care, payer, primary care, and outpatient case management. Michelle serves on several local committees in Harford County, Maryland. Michelle also serves on several CMSA national committees. On a personal note, Michelle is a fierce allergy mom and advocate, and volunteers with her certified pet therapy dog, Gunnar Henderson.