Isn't it kind of incredible that you can prevent your older self from getting cancer? Here's my own recent adventure in fucking future cancer in the ass (literally), and why you should say "Fuck Future Cancer" too:
I'm 42. I recently developed some weird 💩-related symptoms that definitely had my doctor-brain worried that I might have an early colorectal cancer (more on that later). I talked to a few colleagues, and off I went early Wednesday to have a flexible sigmoidoscopy.*
A "flex sig" is a small, VERY-lubricated camera that goes up your butt and can look for bleeding, cancers, hemorrhoids, or anything else in the last parts of your colon, called the sigmoid & rectum. It's about the diameter of your pinky.
You have taken much bigger dumps.💩
Since normally there's poop in those parts of your colon: yes, you have do a clean out so the GI doctor can see things clearly. It's about 2 medium Gatorade bottles-worth of liquid, some stool softeners, and some Gas-X. And then a bunch of stomach rumbling and pooping.
It's not painful at all. There's no cramping or burning. It's just frequent and annoying, because normally your rectum—amazing organ than it is—just lets you sleep and holds onto your poop for you until morning. So I was up every hour or so. Annoying. 🤷♂️
The flex sig is a 5-10 minute procedure for many patients, and I chose to do it without any sedation, because I had shit to do later that day. (Pun intended.) There was maybe 30 seconds or so of pressure, like I needed to poop? But really not that bad.
And since I'm a doctor and honestly the human body is just really incredible and amazing, I watched the screen and marveled at my large intestine while my doctor painlessly removed a small polyp and found a few hemorrhoids. Nothing more, phew.
The reason I bring up this overly personal story? I know 3 men in their 30s with colorectal cancer, and one of them is dead, and left behind a 6 month-old baby.
Colorectal cancer rates are rising in young people AND being diagnosed LATE.
You may have heard that the GI and cancer specialists recently lowered the screening age to 45, and it's because of more cancers in younger people now. Rates AND deaths are going down in people over 50, and going UP in younger people:
AND younger people are presenting with more advanced cancer (probably bc they're not being screened AND they/their doctor don't necessary know the symptoms). Look at this: 90% of people under 50 had symptoms at diagnosis, and had symptoms for 8 MONTHS before diagnosis!
So what are the symptoms? Often for young people they're not very specific — which is why they can be missed:
—Change in bowel habits (new long-lasting constipation, sometimes diarrhea)
—Fatigue (often due to anemia)
—Rectal bleeding
—Cramping/abdominal pain
Later symptoms can be things like unexplained weight loss, or a change in the size of your poop.
NB about the first one: UNEXPLAINED WEIGHT LOSS (more than 5-10 pounds) IS NEVER NORMAL, IS OFTEN CANCER, AND YOU NEED TO SEE A DOCTOR. PLEASE *PLEASE* TAKE THIS SERIOUSLY.
Now, we don't exactly know why younger people are getting cancers. It's probably some combination of low-fiber diet, sedentary lifestyle, obesity, and increased alcohol intake.
But there's really great news:
Often colorectal cancers can be PREVENTED and/or caught early with screening!
Almost all colorectal cancers start as colon polyps, and if a GI doctor removes the polyp, they prevent it from turning into cancer (which often takes 5-10 years).
There are lots of different screening tests with various pros and cons. This is a nice graphic of 3 common types of tests, colonoscopy (a procedure) and two types of non-invasive tests where you actually send in your poop and check it for blood, since cancers tend to bleed.
Remember, screening begins at age 45, and the type of screening really depends on your medical history and your preferences. Your doctor can help you decide. (People with certain family history or other diseases probably need a colonoscopy, and may need it younger than 45.)
(The other thing to consider is that if you have a positive non-invasive poop test, like FIT or @Cologuard which must be done yearly, then you need to have a colonoscopy anyway, which is why many people opt to just get a colonoscopy every 10 years in the first place.)
And just a point of clarification: if you have symptoms regardless of your age, a) you need to see your doctor and
b) you're no longer being "screened" for cancer.
Screening is something we do for people *WITHOUT* symptoms of a disease.
Well if you're made it this far into this boring thread, you deserve an award. And that award is: a photo of my polyp! Ain't it precious? cc the OG @katiecouric
*Just to be clear, I had a flexible sigmoidoscopy after discussion with my doctors and my very specific symptoms—and if my polyp was a pre-cancerous one, I would have needed to get a colonoscopy. Luckily I think I'm all good.
Thanks for reading; get screened and get your partner or parents screened if they've been avoiding their colonoscopy—and any GI doctors with corrections or comments, please comment below!
Finally, for all the sufferers and survivors: FUCK. CANCER.
Thanks to my wonderful doctors who didn't make me feel embarrassed for talking about butt issues with them and research and images from my friend @mohammad and @AmerGastroAssn @AmericanCancer @CDC_Cancer @theNCI
PS: I wrote this thread with @typefully. typefully.com