Doctor Vito Cirigliano with Lebauer
Gastro Enterology is back answering our
questions when it comes to colon cancer.
Alright one of the things that people
talk about all the time are all those
commercials that we see about stool
testing versus the colonoscopy.
So is it the same? Is it different?
Yeah, that's a great question because
there's definitely been increasing
awareness about the commercially
available products of stool testing.
Specifically, there's a lot of
commercials about Cologuard and and these
noninvasive tests have really come a
long way of increasing the sensitivity
for picking up on colon cancers.
And also sometimes colon polyps that
Cologuard that will detect colon cancer in
92% of patients and advanced polyps in 42%.
Which unfortunately means that Mrs.
Colon cancer in 8% or it misses
those large polyps of 58%,
and you converse that with colonoscopy.
That will pick up on those large polyps
greater than 95% of the time, but.
We also can find them in remove those
polyps which again reduces those
risks of progression to colon cancer.
Another another worry or concern
I get from patients is well gosh,
they get a positive one of those stool tests.
And now there's a lot of worry that
goes along with that while they
wait to get their colonoscopy done.
And there could be these false
positives in in 12% or so of patients,
meaning it was positive and there wasn't
anything there to have caused alarm.
But certainly it caused a lot of worry.
Yeah, whereas the colonoscopy is
kind of 1 and done because they get
to see everything and take Ken can
take care of some of those polyps
instead of you having to wait.
For another procedure at another time,
OK, alright, so let's just get to it.
We hear the prep is terrible.
We hear the horror stories.
So how can you make that better for us?
You can't get around it, right?
There's the prep is absolutely the
most dreaded part of colonoscopy.
With that said though,
the the days of drinking the the
large gallons of prep are gone.
Thankfully we now have low volume
preps which are just, you know,
it can be as little as 6 ounces of prep,
which then you drink with us.
A bunch of your own fluids,
whether that's Gatorade,
Pedialyte, water, whatever.
The case may be,
we can now flavor preps at home.
You can add some flavoring to it,
so it's not as as terrible,
and there's actually even some
tablet preparation formulas now.
So yes, that is still the most dreaded part,
but it is absolutely come along way.
Thank goodness we do like to hear
that it's come a long way, alright,
and we can ask for those smaller.
Yes, absolutely yes yes.
Alright so colonoscopies.
Some folks are worried that
they can be dangerous.
Can you explain where they're
getting that idea and what we
should be thinking of? Yeah,
I mean, you know colonoscopy is a procedure
and every procedure carries risks to it.
The biggest that we think about
is perforation. That's putting
a small hole in the colon wall,
but thankfully it's it's actually quite rare.
It's well under one in 1000 patients.
If that would happen with.
Bleeding abnormal bleeding is also
another complication that we think about,
but again, it's it's equally rare.
Well, under 100,000,
that's even when we are removing polyps,
so overall we consider
colonoscopy to be re quite safe,
and for that reason we considered the gold
standard for colon cancer screening, right?
It's a very effective,
but also safe and available tool.
Alright, so we've gone through a
bunch of like true and false things.
What do you think the final
take away message that you
want folks to hear about this?
Yeah, I really appreciate you allowing
me this time to talk about this.
'cause it is.
It's a really important topic.
Colon cancer again is unfortunately
very common in the United States,
but it is preventable and it is
treatable when we find it early.
And colonoscopy allows us to to find
these colon cancers early or find
these pulps before they have a chance
to to morph into colon cancer and
remove them and thereby reduce the
risk of progression to colon cancer.
But patients are still worried
about colonoscopy and I get.
Set up and I would encourage
a couple of things.
One would be scheduling an
appointment with to talk about
these these options for screening,
'cause at the end of the day,
the best screening study is just
simply the one that gets done.
So again,
if you're concerned about colon cancer,
or certainly if you're concerned
that you're having symptoms that
might suggest colon cancer,
then I absolutely urge you to schedule
an appointment and talk about this.
It is a very important topic,
and are there are just a few
symptoms that you can pass along
so that people would know.
So I didn't even know
that that was a symptom.
Yeah, so blood in the stool is one
that certainly highly concerning
to patients when they see it and
certainly want to get that evaluated
change in stool where it would be
like thin or ribbon like stools.
Domino pain that tends to persist or
any of these symptoms were talking
about that just aren't going away.
Some of the other big ones we talked
about our unexplained weight loss
or maybe even night sweats again,
would be reason to say, hey,
let's go in and get an appointment and
talk about your options of screening.
This is one of those ones where
you don't want to put it off.
I know in the last two years we've
been putting off lots of preventative
things and so this is definitely
one that we want you to do.
This is one that Julie Luck
wants you to do as well for sure.
Alright, let's take a look.
If you have missed any of this
this all this information is going
to be in the two your well-being
section so that you can go back
and listen for these questions
and also get resources as well.