Jewish World Review March 31, 2004 / 9 Nissan, 5764

Bronwyn Lance Chester

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Consumer Reports

Tell a silent killer to kiss your derriere | Americans are dying of embarrassment. Literally.

A leading cause of cancer death in the United States - colon cancer - is also one of the most preventable. But we've been conditioned since, oh, second grade to dissolve into giggles or turn puce with embarrassment whenever anyone mentions the words "colon," "large intestine" or - Heaven forbid - "rectum."

I know this probably isn't what you want to read about over your coffee and bran muffin (and congratulations on your high-fiber breakfast). But our squeamishness about certain bodily functions and reluctance to discuss colon cancer means we're sticking our heads in the proverbial sand and ignoring a merciless killer.

Stop squirming and listen.

Colon cancer is the third-most common cancer in men and women and is the second-leading cause of cancer deaths in the United States, according to the American Cancer Society. And while we're constantly bombarded with reminders to screen ourselves for breast and prostate cancers, we ignore colon cancer, which steals more lives yearly than every other cancer except that of the lungs.

More Americans die of colon cancer than from auto accidents. Yet the disease is a silent assassin, both in terms of its symptoms and the press it receives.

Nearly 146,000 Americans are diagnosed with colorectal cancer annually. Year before last, one of those was my mother. Each year, nearly 57,000 Americans die of the disease. Last year, my mother joined that group, too.

Her diagnosis was a complete surprise after a routine colonoscopy. She had no family history, didn't drink or smoke, and maintained a healthy diet and weight. I can count on two hands the times she ate red meat.

But colon cancer doesn't discriminate. Chances of developing the disease increase with age; more than 90 percent of all cases are diagnosed in patients over 50 years old. And at 64, my mother was a prime target.

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Colorectal surgeons recommend that everyone at average risk (and there's no such thing as low risk) get a colonoscopy by age 50. My mother put it off. After all, having a tiny tube with a camera snaking up your large intestine isn't everyone's notion of fun, even if you are out of your gourd on good drugs.

I wish every day that she hadn't delayed. So did she.

Let me tell you something else: Having a colonoscopy is no big deal. When compared to dying of colon cancer, a colonoscopy is a walk in the park.

March is Colon Cancer Awareness Month. And since I've become a colonoscopy scold, haranguing my colleagues about having the procedure done, I consider it a duty to inflict the same upon the reading public.

I took a poll in my office. Half of my co-workers have had colonoscopies. When I asked them what it was like, one said, "There's absolutely nothing to it. I literally didn't feel a thing."

Another waxed eloquent about being able to watch the internal action on camera. "It was like lying there watching 'Law & Order,'" she said. "But I honestly didn't feel anything. There was no discomfort at all."

Why are we so reluctant to get screened? "Bowel function is something you don't talk about in polite company. But that stigma is going away slowly," said Dr. Paul Kovalcik, a colorectal surgeon in Chesapeake, Va.

"There's a general fear of going to the doctor," he added. "People are also embarrassed, and that leads to letting a problem go until it's too late."

But Kovalcik sees a positive trend in testing. The hospital where he works performed 6,000 outpatient colonoscopies last year. "Spreading the word is a powerful thing."

"The key thing is that screening is for people who feel perfectly fine," said Dr. H. David Vargas, a Virginia colorectal surgeon. "Once you start having symptoms, it's no longer a screening test. Chances are, it's more serious and advanced. And I'd rather do a colonoscopy than surgery any day of the week."

Message: If you feel fine, get screened. Don't be a, you know, rectum and die from embarrassment.

Bronwyn Lance Chester is a columnist for The Virginian-Pilot in Norfolk. Comment by clicking here.


© 2004, The Virginian-Pilot Distributed by Knight Ridder/Tribune Information Services