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March is Colon Cancer Awareness Month

Let's talk about your colon. Or not. I mean who really wants to, unless you are an adolescent boy, but then the conversation is really more about what's coming out of it. Trust me, I know. I have three boys, plus a husband, so there's a lot of that talk around our household, much to my dismay. And try as I might to understand why it is a favorite topic or why it's so funny for that group, I just can't.

But that's not the point of this. March is Colon Cancer Awareness month, and we aren't talking about being aware of your colon for the purposes of the snickers and grins of boys (big or small), we are talking about being aware of your colon for the prevention of cancer. Now comes the uncomfortable part. Because we all know this involves (cue the ominous music) a colonoscopy.

Should I assume everyone knows what what a colonoscopy is? Let's go with a clinical definition from the Mayo clinic web site: "a long, flexible tube (colonoscope) with a camera on the end is inserted into the...." Yep, okay. Got it. While I like to think of myself as a mature adult, the idea of my entire colon on candid camera, my entire colon - do you know how long your colon is - five feet - is just plain unsettling. Especially when I think about the fact that I'm only five foot four, so I'm not sure how exactly that works.

According to Dr. Brett Glawe of Perham Health, he feels the procedure itself isn't what deters people, it's the prep. Drinking that gallon of goop and running to the bathroom all day.

"For the majority of people I think it's the prep that's the deterrent. It used to be the procedure, but now you come in and take a nap and don't remember a thing. You used to be awake and watched them do it—people didn't like that," he said. "Now there are some alternative preps if it's not tolerated well."

I may have to disagree. I can't say the thought of the procedure had me thinking "meh, whatever," my first time out the gate.

See, while I am not yet 50 years old, the recommended age for a first screening, I have a family history of colon cancer, so I had the pleasure of coming to the party early, age 40. Having been through childbirth three times, you would think the idea of a colonoscopy wouldn't phase me. When the doctor told me I would get to sleep through the entire procedure, I'm sure he thought that would make me feel better. Actually, it made me indignant. "What! You sleep through it?" I remember thinking. Hold the phone, why isn't this an option for all uncomfortable, invasive procedures of the nether regions?

Hisk risk groups include those with a family history, especially those with a first degree relative who had colon cancer, and those with a genetic disorder.

"There are a few inherited disorders, such as Lynch Syndrome, that put people at a higher risk, and we are seeing more of that as we learn how to look for it," Glawe said. "They will have tens to hundreds, even thousands of polyps in their colon."

He explained that if a person is found to carry one of those gene defects, instead of being screened every five years, they are screened every one to two years for the rest of their life. Also, it will be recommended that family members be tested.

I can't say why the idea of the colonoscopy produces such anxiety in me except that I am human. But, I also want to be around for my family, so I cleared my angst-riddled brain and had it done. All was clear.

While colonoscopy isn't the only test, according to Glawe, it does the best job of detecting polyps, which develop into cancer.

"Colonoscopy is the gold standard," Glawe said. "Even if you use an at-home stool test like FIT Test or Cologuard, keep in mind those may not detect polyps and if those come back positive you will still need to come in for a colonoscopy."

And let's talk about the at-home tests for those who think they are getting out of something by going that route instead of the colonoscopy. Without going into detail, (because I'm not an adolescent boy), speaking from experience, by the end, I was wishing there was a sleeping pill involved that helped me not remember the entire experience.

Catching polyps before they develop into cancer has helped decrease the rate of colon cancer since 1950, and according to the American Cancer society preventing colon cancer, and not just finding it, should be a major reason for getting tested.

Glawe said the at-home stool tests are decent at finding colon cancer, but he encourages patients to watch and listen closely to the commercials

"Colonoscopy will always be better is because it finds polyps, these tests may not. Polyps become colon cancer, in my mind if you want to help people, screening is meant to prevent a disease if you can remove the polyps and prevent the disease from ever happening then that's a win."

Screening is also important because by the time symptoms show up the cancer is usually pretty advanced, and the chances of survival are much lower.

Symptoms can include: change in bowel habits, blood in the stools, pain, feeling the need to go, but not going; feeling run down; weakness; fatigue; and weight loss.

If it's caught early enough, the five year survival is 90 percent.

"About 30 percent of polyps we remove are precancerous, which means if it hadn't been removed, it would have become cancer," Glawe said. "I tell my patients that so they know all the prep they went through was worth it, now they won't have cancer."