colonscopy with breast cancer history?
 

I was just wondering if others have done a colonscopy due to cancer history even when you are younger? Thanks, my MD recommended this as an option for cancer screening even though no one in my immediate family has had colon cancer.

I wondered if I would have to do this, but so far, it hasn't been recommended. Maybe when I turn 40?

I was and did so in April, 2006. It was recommended a year earlier but I procrastinated but I was clean (no pun intended:))

Hi Becky, I'm glad you were clean. How was the procedure? Was it as uncomfortable as it sounds, and do you know if there are any potentially adverse side effects, common or rare, such colon tearing or perforation? Thanks for the help...smile.

I have been reccomended to have this test just because of my age (53). Would have done so last year, but bc kind of pushed it off the stage. I expect to get to it this summer. My local imaging place does virtual colonoscopy, which has the value of not requiring anesthesia, as it is non-invasive. I asked my gyn (who is ordering the test) if that would be ok with her, and she said sure. I will have to pay for it myself, but would prefer this to the standard procedure, so I don't mind.

Hopeful

I had one recently and it was relatively easy; hardest part is drinking the liquid the night before. And today you can take a pill and drink water. All invasive procedures can have problems, but it's rare. My husband had two very miserable days after his, done in New York, because of the anesthesia. He had one in Italy (no anesthesia) and had no after effects. I don't think I'd consider doing it if not knocked out, but it is safer. If you have no polpys,you can usually wait another five years for the next; and if you have benign polyps then you are told to return in two years.

It was recommended that I have one , and I am glad that I did. They found 6 polyps but they turned out to benign.

Drinking the liquid stuff was yucky but tolerable. I was put under a local to have mine done and had no problems.

Since I had 6 polyps it now recommened that I have this once a year.
Unfortunately colon cancer and BC can go hand in hand, and thought well isn't that just great.

age and CA history and colonoscopy
 

If no family history of colon CA, then at age 50 colonoscopy is recommended, but it IS really important for everyone to complete the simpler tests (as well as to have any evidence at all of rectal bleeding checked out, even if you think it is only hemorrhoids):

fecal occult blood test annually (the cards for samples from 3 different times you poop)

digital rectal exam

It was a challenge to drink all the necessary fluid, but if you do not clean out your bowel adequately they cannot see the walls of the bowel very well and in that case you will have put yourself through the experience without getting the best possible look at the bowel, and then evidence of problems can easily be missed. So.... do thoroughly flush your innards.

Colonoscopy was uncomfortable for me even with twilight anesthesia. It might have been less so if I would have had it at a cancer center.

A good doctor will tell you what the limitations are with virtual colonoscopy compared to physical colonoscopy.

I know I haven't specifically answered your question about those under 50 with a history of bc but I will see if I can get some general recommendation for that, RobinP.

AlaskaAngel

I had my first colonoscopy when I turned 50...before breast cancer(it was OK...the colonoscopy!). It was no picnic but after all I have been through now...!!!Maybe it WAS a picnic (in disguise!) I got a migraine from the prep stuff...but I understand that folks that are prone to migraines sometimes get them from the colon prep. Anyway...since cancer, now my oncologist feels I should have one every 5 years instead of the 10 years that the first doc. said.

I had one because I turned 50.

Karen

I had one last year (pre-cancer dx) at age 45 for some abdominal pain I was having.

My sister dxed with breast cancer last year as well has her first colonoscopy in a few weeks - it was suggested because of her age rather than the BC as she just turned 50.

Kathy

The procedure was fine. I had a twilight anesthesia and was out and up in a flash. The drinking one gallon of trilyte was NO picnic. When I have to get another one in 4 years, I am getting the pills.

My doc has said that I can and probably should... but while on certain chemos that knock down my WBC, he has asked me to do it only at a certain point in the 3 week chemo cycle. I have asked him if we would see any other types of cancer (colon or ovarian) on any of my multitude of regular scans and he said
we would see ovarian, but not colon polyps.... so he would like me to follow thru on that. I, too, have been a procrastinator, but I intend to.

Robin,

Hello, I cannot speak about having it younger than 50, however, my paternal grandmother had colon cancer, in addition to my maternal great aunt. I had a colonoscopy 4 years ago at age 49, and (the chicken that I am-translated.. I do not like unecessary pain) strongly requested (actually demanded-because my gastroenterologist said I didn't need an anesthesiologist, and that insurance probably wouldn't pay, but ins paid) to have an anesthesiologist to be with my airway (asthma), and so I could have the maximum sedation that was safe. I had no problems with the anesthesia-most are very short acting anyway. For those medically oriented, I believe what I had was Versed, Propofol, and Fentanyl as that is what the anesthesiologist said he would give me after we discussed my desires. It does help to speak up, that is the only way we will get what we want, and helps us feel some control over our lives.
Sorry to ramble on, but hope my point of view is helpful
Dinogirl

I had one because of being over 50 and was out the whole time. The prep was no problem for me as I started drinking in the morning and was scheduled at 4:00 p.m. and home by 5:30. Went to a meeting at 6:30 after the procedure! So had a good night's sleep and spend most of the day in the bathroom-then the procedure. I think my primary physican may have requested an afternoon appointment so I wouldn't be up all night. You need to make sure you drink the necessary fluids the day before so you do not get dehydrated which happened to one of my friends. She was very ill from dehydration. I would not be nervous to do it again however, I was told 10 years as nothing was found. hugs, Sandy

This is something I just brought up to my husband. I haven't had one nor has my GP ever told me to get one. But now after bc....I want it done. My husband had one last year and he said the worse part of the whole thing was the prep the night before. Other then that...he said he was completely out and didn't feel a thing. He just got a notice to come back in for another one since they found a benign polyp last year. I will be the big 50 this June so I am calling my primary to get one scheduled. I am dreading doing this...but after what I've been through this last year..this should be a peace of cake.

Chelee

Thanks for the responses. It sounds like the test isn't that bad from what most of you thought. I think it is a good idea to screen for colon problems with my cancer history. Hopefully, my experience wtih the colonscopy will be as tolerable as everyone's here. Smile.

Robin,

Believe me it is not what we think the test will be. I think our perception
of the test just turns us off from having it. I had the test done and the
dr. found three benign polyups which he removed. I am relieved I went.

A little hint: about two to three days piror to test and starting to prepare
for the test...eat very small light meals this way the prep will not be such
a major burden. I found this helped - also when eating light do not eat bulk
fiber foods - I had jello, ice - cream - plain veggie soup broth. It went
a heck of a lot easier during the prep time.

Keep us posted and wishing you a good test!

Regards,
jean

I have had three starting at age 45, 1st time was routine screening due to family history (brother was 55 when DX w colon ca.) and two years later had a precancerous polyp removed. Last years procedure was CLEAN...woo hoo!
Prep is not fun, but procedure is a BREEZE! If they find something they deal with it then and there and you wake up no worse for the wear. (That is unless they find an invasive ca. which requires more extensive treatment and evaluation.)

Best wishes!
MARCIA

Robin,

Also wanted to share with you that the procedure is not difficult. You
are asleep, so as I posted earlier it is more our own minds that the test
may be a turn off. I have had more discomfort with some mammograms.

Best of luck with test!
Jean

virtual colonoscopy as an alternative
 

CT Colonography May be Most Cost-Effective for Colon Cancer Screening

Laurie Barclay, MD

April 23, 2007 — Computed tomography colonography (CTC) with nonreporting of diminutive lesions, which have a low malignancy rate, was more cost-effective than optical colonoscopy for colon cancer screening, according to the results of a study published online in the April 23 Early View of the June 1 print issue of Cancer.

"Prior cost-effectiveness models analyzing...CTC screening have assumed that patients with diminutive lesions (?5 mm) will be referred to optical colonoscopy (OC) for polypectomy," write Perry J. Pickhardt, MD, from the University of Wisconsin, in Madison, and colleagues. "However, consensus guidelines for CTC recommend reporting only polyps measuring ?6 mm. The purpose of the current study was to assess the potential harms, benefits, and cost-effectiveness of CTC screening without the reporting of diminutive lesions compared with other screening strategies."

Despite the availability of effective screening tests for colon cancer, screening rates remain low and deaths remain high; colorectal cancer is the third leading cause of cancer death in both men and women. OC and flexible sigmoidscopy, which have been the primary screening tools for the past few decades, can give rise to complications ranging from abdominal pain to bowel perforation and bleeding.

CTC, also known as virtual colonoscopy, uses x-rays and imaging software to create 2- and 3-dimensional images of the gastrointestinal tract, with higher tolerability and fewer adverse effects than OC and flexible sigmoidscopy.

Using a Markov model applied to a hypothetical cohort of 100,000 people aged 50 years, the investigators determined the cost-effectiveness of screening with CTC (with and without a 6-mm reporting threshold), OC, and flexible sigmoidoscopy.

Compared with no screening, the model predicted an overall cost per life-year gained of $4361, $7138, $7407, and $9180, respectively, for CTC with a 6-mm reporting threshold, CTC with no threshold, flexible sigmoidscopy, and OC. Although the additional costs associated with the reporting of diminutive lesions at the time of CTC amounted to $118,440 per additional life-year gained, the incidence of colorectal cancer was reduced by only 1.3% (from 36.5% to 37.8%).

CTC with a 6-mm threshold yielded a 77.6% reduction in invasive endoscopic procedures (39,374 vs. 175,911) and 1112 fewer reported OC-related complications from perforation or bleeding than with primary OC screening.

"CTC with nonreporting of diminutive lesions was found to be the most cost-effective and safest screening option evaluated, thereby providing further support for this approach," the authors write. "Overall, the removal of diminutive lesions appears to carry an unjustified burden of costs and complications relative to the minimal gain in clinical efficacy."

Study limitations include failure to consider the need for recovery time after OC, the need for a second person to drive the patient home after OC, pathology costs related to the histologic evaluation of polyps, and costs of additional workups related to extracolonic abnormalities detected with CTC.

"These results provide further support for the practice of a 6-mm polyp size reporting threshold at CTC screening," the authors conclude. "The use of primary CTC screening as a selective filter for OC polypectomy for lesions measuring ?6 mm represents a potentially powerful new approach to CRC screening."

Cancer. Published online April 23, 2007.

Thanks, everybody, I'm going to copy your posts for encouragement to do the procedure.