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Still, less than 40 percent of Americans with health insurance are getting screened, Carlson said.
The procedure vs. the prep
The details of the examination are well known: Doctors send a tube with a camera into the colon to detect and remove potentially pre-cancerous growths called polyps.
“With colon cancer, we know how to screen for it, we know exactly how to find it and we know how to treat it,” Carlson said. “And it’s the only cancer that basically waves at you with the polyps and says, ‘Hey, I’m about to turn into cancer, but if you pluck me out that won’t happen.’ Polyps are your friends.”
Oftentimes, the procedure isn’t the most worrisome part. It’s what comes before. When he sees a patient on examination day, Brosam tells them “they’ve been through the worst part.”
The preparation involves a day or more of consuming nothing but water and a liquid laxative. Minnesota Gastroenterology’s Lisa Belak said that most patients prefer a Gatorade-type sports drink, “but it is not universal. Many still use the ‘big jug’ or packet preps.”
There also are noninvasive alternatives to the traditional procedure. A new test called Cologuard, developed by a Wisconsin company, examines stool samples for DNA anomalies. The new screening method awaits FDA approval.
Another test, called a colonography, is basically a virtual colonoscopy. This procedure uses X-rays and computers to produce two- and three-dimensional images of the colon. But even with this alternative, Carlson noted, “you still have to do the prep, and if they find a polyp, they still have to go in there.”
Beyond the alternatives, Brosam said it’s simply easier these days to assure patients that getting one is a good idea. He cited publicity, including Katie Couric’s live colonoscopy on “The Today Show,” and word-of-mouth.
“More people have done it, so it’s not as much a taboo as it used to be,” Brosam said. “They know somebody who’s had it before. And we have more data now saying that it does good things for you. So people are more eager.”
Some people get their motivation from experience.
“My brother and I are diligent,” said Jean Peterson of Shoreview, “because we saw our grandfather die from colon cancer, avoiding the doc until it was too late. It’s a sneaky bugger.”
Peterson, by the way, is not one of those patients who had a major food craving after her two colonoscopies. “I really hated to eat a thing, even though I was famished,” she said. “it just felt good to be so whistle-clean. That said, a glass or two of my favorite white wine was in order.”
For Brosam, even more common than the cravings is the potty humor that comes along with getting a colonoscopy. Most of these risqué quips are, of course, not suited for a family newspaper, but Brosam said that perhaps the most oft-heard jape comes from men:
“You can tell my wife that you didn’t find my head in there.”
Bill Ward • 612-673-7643