Distinct cellular and genetic differences in colorectal cancer in young patients
dana-farber.org
dana-farber.org
Adenoma found and removed.
This is a type of cancer that is almost entirely preventable with screening. Get your tubes checked.
I have a condition so I have a colonoscopy every year. Once I had found out about there being a fast-acting option, I've always chosen that.
I've never done it sedated. I prefer to watch the screen and and ask questions. I've found the view quite fascinating, actually. The doctors and nurses have always been professional, focused on the colon: not the butt. There is absolutely nothing sexual about it. I've never felt pain: only some tension, and that's been because of gas (needed to get a clear view). It is perfectly safe unless your colon has some illness of some sort. The worst part has always been the prep.
Technically this will vary depending on the protocol. I have friends in this field and in some countries they effectively knock you out with sedation. Others you might get some anxiety medication and only sedate elderly or uncollaborative patients.
Regardless of that everyone should absolutely get checked but just wanted to make sure we don't set unrealistic expectations.
Starting on Friday, I followed a “low residue diet”. This primarily meant no fibrous fruits/veg or whole nuts/seeds. It was inconvenient but not hard.
Yesterday I started a “clear liquid diet”, which meant that I did not eat anything and only drank apple juice, gatorade, and the prescription prep solution. Starting at 5pm and going until about 6:45p, I drank half of the prep solution, which was like 64oz of stuff that tasted like flat Sprite. Right about the time I finished drinking, the draining out the other end began. It wasn’t a problem, and didn’t hurt, but I did visit the bathroom about 10 times over the next 2 hours with another few throughout the night.
I slept great overnight, and now I’m getting ready to start the second half of the prep solution. I’ll drink it over a 90 minute span, beginning four hours before I am scheduled to arrive at the endoscopy clinic.
(I’m also planning to have my colonoscopy without sedation. I have a very high pain tolerance, and was told that I’ll be able to watch the realtime video feed!)
The hardest part was probably convincing my doc that “yes, I’m sure I don’t want sedation.”
The procedure took under 15 minutes, with only about 2 minutes at the start being quite uncomfortable (“beesting way up my butt”). After that, it just felt like a bad case of gas rumbling through my gut. It wasn’t pleasant, but I’m not sure it is that much worse than a painful dental cleaning.
The doctor was quite good at talking through what we were seeing on the big screen. I didn’t feel anything when he used forceps to remove a few tiny polyps. I felt good that I saw the “problem spots” in realtime and could ask questions. (I’d likely have stressed out with a “we found a few tiny polyps” report after waking from sedation.)
After the procedure, I was free to leave. I put on my clothes and immediately left to walk home. No issues throughout the rest of the day.
I’m glad I skipped the propofol, and will skip sedation in the future.
A friend's girlfriend got stage3(?) recently, not 30 yet. My dad passed away ~5 years after diagnosed stage4. I had some pretty nasty IBD which, along with the mention of my family history, _finally_ got them to agree to do it. Anyways, all clean, other than h.pylori that got taken out with the first round - stomach - apparently exceedingly common here.
Watch your shit, get your stuff checked. I still had the needles set up in case perforation occurred and they had to sedate and do exploratory.
You are not going to catch the gay for having a colonoscopy, if that is your fear.
It really is not a big deal to go through it.
I've had an extended conversation about this with an ER nurse friend, in which I reminded her that although the staff go through the gamut all day every day and it's normal for them, the patient (hopefully) does not and whatever procedure(s) are new and scary.
Add in the fact that (sexualized) abuse and med students using anesthetized patients for training without explicit consent is more common in the medical field than any of us would like, and people having concerns strong enough to avoid treatment sounds pretty reasonable to me.
"we see this all the time" may settle a few concerns, but it makes others (such as the power imbalance) worse.
Same with if you get snipped. I didn't realize that "shaved" meant with a safety razor and I just trimmed with a beard trimmer. I ended up having two younger women give me a proper shave as I laid there, which was about the dumbest I ever felt in my entire life. Made for a great story for my friends though.
If it makes you feel any better, it is literally impossible to remember it. You can’t be traumatized by it even if you wanted to.
Had no symptoms, now I get one every 5 years.
I had family who was experiencing symptoms of CRC in their late 30's or early 40's, which they reported to their PCP. PCP repeatedly denied them a referral to a specialist and insisted they were too young for CRC. This goes on for about a year. Finally, with worsening symptoms, my family member 'remembered' that their 'aunt' had passed of CRC when they were very young. This got them a referral to gastroenterologist, who got them a colonoscopy. (All this trouble, even though their symptoms were textbook and got so bad they couldn't make it ten steps to the bathroom).
However! The colonoscopy came out clean, but my family member was still experiencing worsening symptoms. Finally the gastroenterologist schedules a CT or MRI, which spotted a huge tumor in their colon and they were diagnosed stage 4. The tumor was in their sigmoid (the right-angle turn your colon makes), and only the tip of the tumor was protruding from the colon wall itself, so when the doctor performed the colonoscopy and failed to fully inflate the colon, they did not see anything there. This delayed diagnosis by another few months which may have been critical to their prognosis.
They fought for eight years against cancer and the insurance company, and were scheduled to undergo a procedure earlier this year at Yale which may have eliminated the cancer in their peritoneum (often the last holdout for metastasized CRC, and with our current medicine, basically impossible to remove, I'm told), until a certain American president cut funding to basically all medical research. They passed a few months after they would have had the procedure.
Do not ignore the symptoms, and make sure to absolutely force the issue with your PCP/doctor if the symptoms persist, even if your colonoscopy comes back clear. PCP's don't want to upset insurers with useless referrals and many get their egos bruised if you think you know better. Even MD's will half-ass a colonoscopy if they get too comfortable with their judgement. You have to be your own advocate in America's medical system because nobody gives a shit if they get you killed, so long as they don't have to pay for it.
IIRC doctors wanted to lower the age for CRC screening but insurers didn't want to pay for it, so don't fall into a sense of security because you "aren't old enough".
And for those of you worried about a stranger looking up your ass, I've had a coloscopy myself and it's not that bad. These people look up stranger's assholes all day every day.
It would be interesting to see if these long non-coding RNAs show up consistently in pre cancerous polyps in younger patients or only after malignant transformation. If they are elevated early on, that could actually help solve the diagnosis problem where many late stage cancers are found, assuming we can target them specifically.