Colorectal Cancer Archive

Approaches to using laxative solutions for colon cleansing have changed since your last colonoscopy.

Preparing for a colonoscopy isn't fun. Indeed, many people dread the colonoscopy prep more than the colonoscopy itself. Traditionally, you have had to change your diet for a few days, drink quarts of laxative solutions — and then spend hours in the bathroom enduring diarrhea and discomfort as your colon empties. In the past few years, though, the approach to taking laxative solutions has evolved to become a little less unpleasant.

Lower-volume preps

Instead of downing 4 liters of medicated liquid, which was once the standard, most people now need to drink about 2 liters (a bit more than 64 ounces). The reduced volume of laxative fluid is often combined with laxative pills, to help you clear your bowels.

On call

Q. I'm 80 and no longer do colon cancer screening. However, I recently noticed some bleeding from my rectum. Does that change my need for a colonoscopy?

A. Screening for a disease means the person has no symptoms. Since you now have rectal bleeding, a colonoscopy would be considered not a screening test, but a diagnostic test. Whether you have it now or wait to see if more bleeding occurs depends upon many factors. The most important question is whether anything found on the colonoscopy will lead to treatment that improves your quality of life.

News briefs

We already know that a diet rich in red meat is linked to many health problems, such as heart disease, type 2 diabetes, and colorectal cancer. Now a Harvard-led study published online June 12, 2019, by BMJ suggests that boosting your red meat intake increases your risk for early death. Scientists analyzed questionnaire answers about health and diet provided by more than 81,000 healthy men and women between 1986 and 2010. In particular, researchers looked at whether changes in red meat consumption during an eight-year period of the study affected the risk of death eight years later. The findings: An increase of just half a serving of processed red meat per day was associated with a 13% higher risk for dying young from any cause; an additional half-serving of unprocessed red meat increased the risk by 9%. On the flip side, decreasing total red meat consumption and increasing the consumption of nuts, fish, poultry without skin, dairy, eggs, whole grains, or vegetables was tied to a lower risk of death. The takeaway: Try to curb your appetite for red and processed meats like bacon, salami, and hot dogs. Eat more poultry, fish, or plant-based proteins (like beans, lentils, nuts, and seeds), along with the other components of a healthy diet.

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According to a new guideline, testing should start at age 45, but not everyone needs to have a colonoscopy. Other tests are also available.

Colon cancer screenings for people at average risk for the disease should start at age 45 instead of 50, says a new guideline from the American Cancer Society (ACS).

The change to the screening recommendation, which was published in the May 30 issue of CA: A Cancer Journal for Clinicians, was made because the number of colon cancer cases among adults under age 55 rose 51% from 1994 to 2014, and colon cancer deaths in this age group rose 11% from 2005 to 2015.

Research we're watching

 Image: © Catherine Lane/Getty Images

March is National Colorectal Cancer Awareness month. Have you been screened? Colon cancer is the second leading cause of cancer deaths in the United States, but is also highly preventable through recommended screenings. These screenings enable doctors to spot precancerous lesions that can lead to colon cancer and remove them before they become a problem. Screenings can also find cancers early, when they are most treatable. All people ages 50 to 75 should get recommended colon cancer screenings. Some people should start getting screened earlier if they have certain risk factors for colon cancer, including a family history, a personal history of inflammatory bowel disease (such as Crohn's disease or ulcerative colitis), or a genetic condition that makes colon cancer more likely (such as familial adenomatous polyposis).

There are several tests used for colon cancer screening, including colonoscopy, which uses a device to examine the full length of the colon and rectum; stool tests; flexible sigmoidoscopy, which uses a device to examine a portion of the colon; and CT colonography, a scanning technique that produces images of the colon that are examined by the doctor.

On call

Q. I am 77 and in overall good health. My previous colonoscopies to check for colon cancer have been normal. Can I stop having them?

A. The major benefit of colon cancer screening is seen in men ages 50 to 75. After age 75, the potential benefit is smaller, and the risks and side effects of the procedure — like bleeding and perforation of the colon — are higher.

Don't be intimidated about screening tests. The latest guidelines suggest you can choose from multiple strategies.

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Colon cancer continues to be the country's second leading cause of cancer-related deaths and the third most common cancer in men, according to the CDC.

It almost always develops from precancerous polyps (abnormal growths). Screening tests, which are recommended for men ages 50 to 75, help find and sometimes aid removal of polyps before they become cancer. (Men older than 75 may still benefit, depending on their health.)

Once you've completed treatment, adjusting to a "new normal" can be challenging.

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Completing cancer therapy can feel like a graduation. You've done some hard work, it's paid off, and you may be ready to celebrate. But saying goodbye to treatment can arouse many of the emotions and uncertainties associated with beginning a new chapter in life.

Dr. Larissa Nekhlyudov is a general internist who works with cancer survivors at two Harvard affiliates, Brigham and Women's Hospital and Dana-Farber Cancer Institute. She acknowledges that cancer survivors have a lot to deal with. "Once you've had your final chemotherapy infusion or swallowed the last pill, you may find yourself facing a new set of challenges—monitoring yourself for signs of recurrence, getting recommended follow-up care, adjusting to the long-term effects of treatment, psychologically adapting to normal life, and working to stay in good health," Dr. Nekhlyudov says.