Benched from playing basketball by stage-3 colon cancer four years ago, David Stark, 42, wants everyone to know that colonoscopy saved his life.
Your Local Health | Written by BJ Towe
Most of the time, colorectal cancer has no symptoms in its earliest stages. It begins silently as one or more small noncancerous polyps in the colon or rectum, which — if not detected and removed during a colonoscopy — can slowly develop into cancer. That's what happened to David Stark, an otherwise healthy individual who prides himself in staying in shape.
“I like to play basketball with friends. I began noticing that I couldn't catch my breath after just one or two times up and down the court,” Stark says. “I also became addicted to chewing on ice; I'd get cups full of ice and chew all day long, which I now know is an indicator of iron deficiency caused by blood loss.”
Although Stark suspected something was wrong, he never suspected colon cancer. And for good reason: Stark was one of those rare cases where colon cancer developed without his having any known risk factors, such as having a family history of the disease, inflammatory bowel disease, or obesity. Additionally, more than 90 percent of colorectal cancer cases occur in people who are over age 50. Stark was only 38.
Fortunately, Stark paid attention to his body and, realizing his fatigue wasn't normal, made an appointment with his primary care physician. Blood tests revealed that Stark had severe anemia, prompting his doctor to order an immediate colonoscopy.
Justin Rice, M.D., a Gastroenterologist with The Iowa Clinic, performed the colonoscopy. “We saw a large, ulcerated mass, which almost certainly was the cause of the blood loss. David was diagnosed with colon cancer.” That was on a Tuesday.
On Wednesday, Stark was in the operating room with Colorectal Surgeon Kyle Rogers, M.D., also of The Iowa Clinic. Dr. Rogers was able to remove the large mass in its entirety. Biopsies showed that Stark had stage-3 colon cancer, and Stark was prescribed a six-month regimen of chemotherapy.
Dr. Rogers explains, “Colon cancer, if detected in stage 1, 2, or even 3, has a good chance of being cured with either surgery alone or, for stage-3 cancers, with a combination of surgery and chemotherapy, and sometimes radiation. At stage 4, colon cancer has spread to other areas, typically the liver or lungs. Disease at this stage is more advanced and much harder to cure.”
“I'm doing great now,” says Stark, who is obviously grateful that colonoscopy detected his cancer before it reached that point. “I get to have frequent follow-up appointments and colonoscopies now. So far everything is clear. My energy is what it used to be and I'm back playing ball on Monday nights.”
Colonoscopy: The Best Way to Detect and Prevent Colorectal Cancer
“Approximately one-third of all adults have polyps,” says Dr. Rice. “Those are the people we are trying to find. But without colonoscopy, we don't know who they are. It's much easier for people to come in, get screened, and — if they do have polyps — have them removed than it is to go through chemo- or radiation therapy.”
Just before the colonoscopy procedure, patients gown up, visit with the physician, and are lightly sedated to keep them relaxed and comfortable throughout the exam. Most will remember nothing. However, some patients choose to receive a “light” anesthetic, which allows them to watch the procedure on the monitor while still being comfortable.
In the exam room, physicians use a flexible tube to view the interior walls of the rectum and colon. Any polyps are removed and other tissue may also be collected for closer examination. In most cases, the procedure itself lasts just 20 to 30 minutes. Because of the anesthetic, patients must have someone else drive them home after the procedure, and most are fine by evening.
“Piece of Cake”
As a colon cancer survivor, Stark now gets a colonoscopy so often that he affectionately calls it his “annual recreational colonoscopy.” He says, “The colonoscopy itself is a piece of cake. It's very efficient and painless. And it's definitely worth doing to avoid a cancer diagnosis.”
Rice adds, “After patients have their first colonoscopy, they know how easy it really is. The vast majority of people have a good experience.”
Healthcare reform encourages disease prevention through regular check-ups and screenings. For most patients, this makes colonoscopy screening more affordable.
The only way to know if certain symptoms are due to colorectal cancer is to have a colonoscopy. But it's best not to wait for symptoms to occur — get your screening colonoscopy according to the recommendations, below.
When to Get Your First Colonoscopy
In recent years, the incidence of colon cancer has declined among individuals over age 50 who have no family history of the disease, says Dr. Rice. “That's because more individuals are getting a colonoscopy when they reach 50. However, colon cancer has been increasing among individuals just under 50 who have a family history.”
Therefore, every adult should get their first screening colonoscopy based on the following:
If you do not have a family history of colorectal cancer, schedule your first colonoscopy at age 50. If no polyps are found, repeat every 10 years.
If you have a family history of colorectal cancer: If a first-degree family member (parent, sibling, child) or two second-degree relatives (grandparent, aunt/uncle, cousin, niece/nephew) have had colon cancer, schedule your first colonoscopy at age 40, or when you are 10 years younger than the age at which your youngest relative was diagnosed.
A “silent disease”
Kyle Rogers, M.D., a Colorectal Surgeon with The Iowa Clinic, says, “Most colorectal cancers have no symptoms at all, especially in their earliest stages. That's why getting a screening colonoscopy is so important.”
When symptoms do appear, they may include:
- Blood in the stool
- Black, tar-like stools
- Stomach pain, aches, or cramps that don't go away
- Unexplained weight loss
140,000 Americans are diagnosed with colorectal cancer each year.
50,000 deaths are caused by colorectal cancer each year in the U.S.
1 in 20 people will develop colon cancer during their lifetimes.
Sources: National Institutes of Health; American Cancer Society.