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Geisinger highlights colon cancer awareness

KAREN VIBERT-KENNEDY/Sun-Gazette Dr. Rebecca Hoffman, general surgeon, talks about the importance of colonoscopies while standing by an inflatable colon that shows polyps and cancerous spots at Geisinger Muncy.

Visitors to Geisinger Medical Center Muncy Wednesday were greeted with an inflatable colon in the lobby, a visualization to heighten awareness about colon cancer.

Staff were on hand to answer questions about this disease that often presents without symptoms.

Colon cancer is on the rise among young patients, those less than 50 years of age, according to Dr. Rebecca Hoffman, who specializes in colon and rectal surgery at Geisinger.

“That’s the concerning thing and the reason that our recommendations for colon cancer screening have now gone to 45 instead of 50,” Hoffman said.

“Interestingly, for our older adults, our elderly adults — 70, 80, 90 — the incidence is actually decreasing. So our prior efforts at doing all the screening that we’ve done before have really paid off, that’s what that’s showing us. We’re catching polyps and we’re taking out things that could become cancer before they really do. So that’s good, but we don’t really have an idea for why our incidents in young patients are increasing,” she said.

The reason for the increase is not known, but Hoffman said that it could be a combination of factors.

“It’s multifactorial, and I hate for that to be the default answer, but it really, truly is. It’s not genetics. It’s a combination of probable inheritability, but also environmental. It’s probably what we’re eating in our diet. We don’t really know yet. We don’t know,” she said.

Although most people approach having a colonoscopy with apprehension, Hoffman stressed that it is the best way to discover the disease.

“I would say the build up is way scarier than the actual procedure. Many patients will say, you know, prep actually wasn’t that bad. What we’re finding is people that think it’s gonna be really bad are still going on the old assumption we used to give people these huge jugs of stuff to drink, and now it’s just two bottles of Gatorade,” she said.

“We try to split the preparation so that you’re not doing it all at once — you actually get a break in between and so the prep is much more tolerable than it was before. The actual procedure is quite comfortable. The medication we give you to go to sleep is very restful, and so people will wake up and they’ll say, ‘Oh, you’re done. I had no idea, that was better than I thought.’ So I would say, you know, it’s way better to have a colonoscopy than it is to be faced with a cancer diagnosis.”

I think the trade offs are quite obvious and I would say, the colonoscopy as the way to go,” Hoffman said.

Most colon cancers are asymptomatic, so having regular colonoscopies is the best way of discovering precursors of cancer, such as polyps, which are small clumps of cells that form on the lining of the colon or rectum. Most polyps are harmless, but some have the potential to develop into cancer.

“Most of the colon cancers that we have are totally asymptomatic, so that’s the importance of getting a screening colonoscopy. You’re not going to know that you have it until it’s too late,” Hoffman said.

“Some people rarely will have very vague symptoms of abdominal pain or a change in bowel habits. The reason they’re seeing me in my office or at a gastroenterologist office, the reason that we would recommend a colonoscopy are for things like bleeding, blood in your stool, change in your bowel habits, things that become very narrowed or you suddenly are faced with more constipation than you’ve had before. Those kinds of things are things that you might want to be seen for, but in general, most of the cancers that we find are in people who are completely asymptomatic,” she said.

When discovered early, the prognosis for colon cancer is very good, according to Hoffman.

“For early stage cancer, stage one — and even our later stage cancer, stage three, but have not yet spread anywhere else — have a very excellent prognosis,” Hoffman said.

“We talk in terms of five-year survival, and that means how many people are still alive after five years that have had cancer. For our earliest stages, that’s 85 to 90% or even higher. Even stage three, you’re still going to have a 75% survival rate. That’s pretty good. So I wouldn’t let it get to the cancer part if you can help it but, if you do, the prognosis is very good,” she said.

Surgery, which can be done robotically or laparoscopically, is typically the first treatment for colon cancer. If the cancer has spread to lymph nodes, then chemo is considered.

There are things that people can do to be proactive about colon cancer. A change in diet is one example, such as cutting back consumption of red and smoked meats to once or twice a week.

“It shouldn’t be an everyday kind of thing,” she said.

Eating fish, turkey and chicken more frequently as a source of protein is another change that could be beneficial. Fiber intake — eating lots of fresh fruits and vegetables or taking fiber supplements — is another move that will help your colon. Getting exercise is also very important, Hoffman said.

“I think the most important thing is not being afraid to take care of yourself. Colonoscopies and screening — that’s a really important way to take care of yourself. You can be great for 10 years and not have to go through that again, if we get to it early,” she said.

It’s also important to not be afraid to talk about your symptoms with your doctor if you’re having sickness or you have any concerns about your bowel habits, she said.

“It doesn’t always mean that something is going wrong, but it’s really helpful to be able to talk with someone,” Hoffman said.

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