THINK ON THESE: Understanding colonoscopy

Just like that, March is over. But what most people don’t know is that every year, the country observes March as National Colorectal Cancer Awareness Month.

During a recent briefing, Dr. Robert Bandolon of the Southern Philippines Medical Center (SPMC) disclosed that more patients are now diagnosed with colon cancer cases in Davao City.

What is alarming is that most of those with colon cancer are getting younger. Most of those who were diagnosed with colon cancer in the past were 50 years old and above, there are now patients who are in their 20s to 30s having the disease.

Those who are most likely to get colon cancer are people who have family members who have had colon cancer before. Genetics, Dr. Bandolon pointed out, considerably impact the risk of the disease.

But there are other factors aside from heredity. “With all those things that surround us, they probably are the factors that you get,” said Dr. Bandolon, consultant and section head of SPMC Colon and Rectal Surgery Section, referring to fast food restaurants, eating foods with preservatives, smoking and alcohol consumption.

Colon cancer is the third leading cause of cancer-related deaths of Filipinos – after breast and lung cancers. Among those who died of colon cancer include President Corazon C. Aquino, actor Charlie Davao, and singers Susan Fuentes and Roel Cortez.

“Among cancers, colon cancer stands out as a disease that can be largely prevented, but few people believe it will happen to them,” said Dr. Jun Ruiz, a gastroenterology consultant at St. Luke’s Medical Center and a diplomate of the American Board of Internal Medicine in Gastroenterology and of the Philippine College of Physicians in Internal Medicine.

“If it is still in its early stage and localized within the colon, the cure is 100 percent,” said Dr. Ruiz. “If it had spread to lymph nodes or distant organs, the 5-year survival rate is much lower.”

Dr. Ruiz recommends that colon cancer screening among Filipinos should start at age 40. And colonoscopy is the best screening test available for colon cancer. It is an examination used to detect changes or abnormalities in the large intestine (colon) and rectum.

“In colonoscopy,” explains Dr. Aaron I. Velasco, an internist and gastroenterologist who works in various hospitals in Davao City, “we use a tube with a tiny camera to look at the whole colon and rectum. We don’t only find tumors early, but the test can also prevent colorectal cancer by removing polyps.”

I came to know Dr. Velasco because he was the person who performed a colonoscopy on me.

A colonoscopy usually takes 30 to 45 minutes, according to Dr. Velasco. However, in some instances, it may take longer, depending upon what is found and what is done during the test.

Before a colonoscopy, he advised me to clean out (empty) my colon. One day before the procedure, he told me to take general liquids all day. “You must consume 3-4 liters of fluids like water and juices,” he said. “For breakfast, you can eat porridge. Lunch is all noodles and dinner will only be just soup.”

That’s not all. I had to drink an oral laxative twice: at 8 am and then at 3 pm. At 8 in the evening, I took four tablets of Senokot. After two in the morning the following day, he advised me not to take anything.

On the day of my colonoscopy, I took two Dulcolax tablets at 5 am. An hour later, I had my anti-hypertensive medicine. Both tablets were taken with only a small sip of water.

I had my schedule at 9:30 in the morning so together with my sister, Vangie, we went to the hospital an hour earlier. There was one ahead of us at the hospital endoscopy unit. When the nurse saw me, she asked me what brought me there. I told her the reason. She then asked me to sign a consent form authorizing the procedure.

After that, she asked me to go with her and told me to wear the hospital gown. She returned to the room after I had done changing my clothes and asked me to lie down in a bed and placed a dextrose in my right hand.

It was past 10 when I was finally inside the screening room. They placed some devices all over my body, including a plastic nasal tube into my nose to provide extra oxygen during the procedure. To monitor the amount of oxygen in my blood, a small device was placed on my right fingers. My blood pressure was also monitored.

I was asked to lie on my side on the exam table with my knees drawn toward my chest. Then, Dr. Philip Valencia, the anesthesiologist, told me, “Sir, I have to let you sleep now.”

He then proceeded to give a general anesthesia through an intravenous line to induce unconsciousness in me during the whole process.

True enough, I was sleeping when the colonoscopy was done on me. After 30 minutes or so, I was awakened by Dr. Valencia. “Sir, wake up,” he told me. “It’s done.”

Aside from colonoscopy, other screening tests for colon cancer include barium enema X-rays, sigmoidoscopy, stool tests, and computed tomographic colonography. Which screening test you choose depends on your risk, your preference, and your doctor. “Be sure to talk to your doctor about what puts you at risk and what test is best for you,” Dr. Velasco says.

If you are wondering what the result of my colonoscopy was, it was negative. Thank God!

Colon cancer is deadly – but beatable if only it is discovered early. “The key here is screening patients who are already at risk for colon cancer,” Dr. Ruiz points out. “Patients may already have early cancer, even if they have no symptoms. We can also reduce the risk of colon cancer by removing pre-cancerous lesions (polyps) during a colonoscopy. In the end, colon cancer screening can just save your life or the life of a loved one.”

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