Colonoscopies: the gold standard for screening
March is colorectal cancer awareness month, and Dr. Punam Parikh-Amin, Baylor Medicine colorectal surgeon, wants patients to understand that screenings are key to detecting colon cancer.
“A colonoscopy is the gold standard,” says Parikh-Amin. “With this screening, we look at the entire rectum and colon. If there are polyps and it is safe and possible to remove [them], we do so. Not all polyps are cancerous; some are pre-cancerous or completely benign, but most cancers begin as a polyp.”
Parikh-Amin says a Cologuard test is another option. “I encourage patients to have a colonoscopy, but I would rather have them screened in some form than not at all,” she says. “If a Cologuard is positive, it may mean colon cancer or polyps are present. This screening looks at certain DNA markers and blood in the stool to see if there are any risks for large polyps or colorectal cancer. If something is detected, a patient will need a colonoscopy to get a better look.”
Colon cancer is highly treatable nowadays. According to Parikh-Amin, it is not as aggressive as some other types of cancers like stomach, lung or pancreas cancer. However, it is still important to undergo screening and treatment so colon or rectal cancer can be detected and treated earlier.
The American Cancer Society recommends patients at an average risk of colorectal cancer should start regular screening at 45. If patients have a higher risk for colon cancer with factors such as family history of cancer, family or personal history of polyps or personal history of inflammatory bowel disease, they should start screenings at 40 years old.
The treatment for colon cancer is largely surgery. “Most colon cancers are amenable to complete removal with surgery,” says Parikh-Amin. “After surgery, if the pathology shows positive lymph nodes, then we tend to recommend chemotherapy. We work closely with our oncologists and radiologists to manage these patients. It’s really a multidisciplinary approach because many times, we need all those physicians involved in the management and treatment of patients.”
After treatment, a patient is monitored for five years before they are considered to be in complete remission if they are cancer-free. Follow-up tests after treatment include a colonoscopy, blood work and CT scan to ensure there is no cancer recurrence. If these tests are clear for five years, the patient is considered in remission or cured of cancer.
By Tiffany Harston, communications specialist in the Michael E. DeBakey Department of Surgery
