When you see your doc, be sure to bring up family history of disease

9. pathophysiology-of-colon-cancer (Photo credit: TipsTimes)

When you see your doctor, it’s hard enough to figure out what questions to ask.  Should I get screened for this, or screened for that? I have emphasized throughout this blog the importance of getting screened for prostate cancer. Guys simply don’t like to visit the doctor. But colorectal health is also vital.  With proper and timely  screening, many men and women can avoid colon cancer.  But it takes a candid conversation with the doctor to set up a colonoscopy.

According to this HealthDay.com article, a new study suggests that a family history of the disease may be important for even more distant relatives.

In many cases, colon cancer may have no symptoms. And when symptoms appear, the disease could be advanced, so it’s important to talk with your doctor as you approach age 50….much younger if you have a family history of the disease.  This article tells me that it’s important to tell your doctor if any relative (even distant) may have had colon cancer.  Just one more thing to remember when you set up your next doctor appointment.

A former peace corps volunteer starts a company that helps empower medical patients — article by Scott Keith

When did I begin taking those blood pressure pills? Is it time for a physical exam? I had a colonoscopy a few years ago and they discovered a polyp. When do I need a follow up procedure? In today’s fast-paced world, it can be hard to keep track of your medical history. But a company in the Princeton, New Jersey area, founded in 2006, is ready to help you.

John Phelan is founder and CEO of Zweena, a personal health records service that will help you take the lead in your personal health.

Phelan gradually developed an interest in health care, having volunteered in the Peace Corps in Marrakech, Morocco, working at a home for boys with polio. “I started working as a pharmaceutical salesperson in Des Moines, Iowa, of all places, selling insulin,” says Phelan, noting that after visiting doctor offices in Iowa and southern Minnesota, he started to develop an understanding of diabetes.

Frustrated that consumers were not able to navigate through the health care system, Phelan says he “decided to really do what my heart was telling me to do, which was, OK, just don’t complain, be part of the solution. Let’s sit down, and from the ground up, create a system by which the consumer is in the middle of everything.”

Phelan created a service-based consumer health record company. “You tell us who your doctors are, you give us permission to go collect the records on your behalf, we go get copies of your records. Literally we go and call the (doctor) offices and they make photo copies. It’s not sexy. They basically send those copies to us. I have a staff of medical coders and a nurse who basically reviews every single sheet of paper,” says Phelan. He says doctor notes (blood pressure readings, etc.) are digitized..

According to Phelan, “We created a company and an application around the premise that the consumer needs to be in the middle. The consumer needs to be empowered, the consumer needs to have the data, regardless of if they’re going to do anything with it.” The idea, says Phelan, is “making the consumer go from being reactive, in a health care situation, to proactive.”

Zweena can help patients who, because of an emergency, may have to visit a doctor in another city. “Zweena was really created so that the individual has the data 24/7 365…it’s online. So as long as you have an online connection, if you want to get into the application, that’s there. Anything we’ve collected and digitized for the patient is there for you to see,” says Phelan.

Your Zweena health record, says Phelan, goes from allergy down to weight. Phelan says, “It basically, very succinctly, gives you exactly what’s in the category…all your medications that you’re on or have been on, all of your different cholesterol readings, all of your blood pressure, blood glucose (readings).”

Phelan says you can share access to your Zweena health records with your partner — perhaps your wife, husband or significant other. This can be of crucial importance if you happen to collapse on a business trip and cannot communicate with your doctor. Zweena will provide emergency contact numbers, which can help a doctor in an emergency.

Zweena records are secure. Phelan says Zweena went to Microsoft Health Vault. “We basically use Microsoft’s front-end user name and password protection. If it’s good enough for Microsoft, it should be good enough for Zweena,” says Phelan.

Phelan says, “There’s no question that we, in this country, have lagged far behind in health care and health care technology for the consumer. Zweena really offers the first step to at least get a digitized copy of your medical records, so that wherever you go, wherever you travel, wherever you move to, whatever job you may take…you always have a chance to have one consistent health care platform.”

Learn more about Zweena at http://www.zweenahealth.com

Colon cancer screening: An option you might not have considered

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Throughout my blog, I’ve hammered home the importance of colorectal cancer screening. Doctors still look at the colonoscopy as the “gold standard” treatment option. But some men and women opt for the flexible “sig,” or sigmoidoscopy.  The “sig” examines a smaller portion of the colon.  Still others choose the virtual colonoscopy; there’s emerging research on this more recent screening choice.

A recent article at Reuters Health examines another option: The fecal occult blood test, or FOBT.  Amy Norton writes that a study reveals that a FOBT is an effective choice for the early detection of colon cancer.

The study in the Canadian Medical Association Journal shows a newer (FOBT) test, the immunochemical FOBT (iFOBT), has a better chance of finding colon growths. The older FOBT version, at times, would discover bleeding in the upper digestive tract.

The FOBT is designed to look for hidden blood (that can come from polyps or cancer). The price of these tests is low (under $50) compared with more expensive colonoscopies and flexible sigs.

If blood is found on a FOBT test, a colonoscopy is needed.

As I have stressed repeatedly on this blog, you need to decide on a screening regimen after close consultation with your family doctor.

Is a prostate exam really so bad? — guest post by Maria Rainier

Editor’s note: Throughout this blog, I write about the importance of getting prostate exams.  With effective and regular screenings, you have a fighting chance to catch prostate cancer in it’s earlier stages — when it’s treatable. I thought you would enjoy a guest article on prostate exams, from a woman’s perspective. As always, talk with your doctor and determine at what age you should begin prostate exams.

It’s one of the exams that men dread the most. Many have to be dragged in to see the doctor by their wives and partners. But really guys – is it so bad? It’s far less painful or traumatic than passing a kidney stone or getting a colonoscopy. And haven’t you already learned to handle awkward exams? “Turn your head and cough.” It’s time to get over those fears and do the right thing for your health.

What to Expect

A prostate exam is simply a digital rectal exam. (I know: “Simply.”) The doctor will use a gloved finger to feel inside your anus to check that there are no abnormalities on your prostate. He’ll check to make sure that it is smooth and isn’t hard or protruding into your rectum. That’s one finger. With lubrication. For a minute or two. And then it’s over! There’s no deep drilling and no sedatives involved. You won’t linger on the exam table in agony for hours. You won’t walk funny later. You won’t even feel any pain

You can handle it!

Who Needs Them

The American Cancer Society and the American Urological Association agree that all men should begin receiving annual prostate exams starting at age 50. Men who have a family history of prostate cancer are at higher risk and should begin screening at 45.  African-American men are also at higher risk of developing the disease and should start screening at 45.  Prostate cancer is 60 percent more likely to be diagnosed in African-American men than in white men of the same age. Those determined very high risk because of genetics or other factors may be encouraged to start screening at 40.

The American Urological Association also urges men to get at least one preliminary screening at age 40, and then to continue regular annual testing at 50.

Why You Need the Exam

Prostate cancer is the most common cancer in American men, and it can spread to other parts of the body, including the bones and lymph nodes.  Prostate cancer is a slow-growing disease with few symptoms, and most men are not diagnosed until they are in their 60s. Because the prostate is near the rectum, a prostate exam can detect abnormalities that can lead to early diagnosis. Though a blood test is also used to screen for prostate cancer, it is not always reliable for early detection.

Some symptoms of prostate cancer include:

        Frequent urination

        Difficulty urinating

        Weak or interrupted urination

        Pain during intercourse

        Erectile dysfunction

        Inability to urinate standing up

        Blood in urine or semen

However, many of these symptoms are not present until the cancer has spread. In the early stages, there may be no symptoms at all. Early detection can help catch the cancer before it is untreatable.

Just Do It

Yeah, so it’s uncomfortable, and it’s awkward. We ladies don’t like having our breasts smooshed on a glass plate for inspection either. But we have to do it. Because as awkward or uncomfortable as it might be, it will be far more traumatic and painful to find that you have an untreatable cancer or that you are facing months of intensive and painful medical treatments. Opt for the two minutes of embarrassment and give yourself many more years to fill with other happier, more exciting moments.

Maria Rainier is a freelance writer and blog junkie. She is currently a resident blogger at First in Education where she’s written on urban & regional planner jobs along with electrical engineering technology programs. In her spare time, she enjoys yoga, playing piano, and working with origami.

Colonoscopies: The biggest fear facing baby boomers?

As a baby boomer guy, I don’t think a colonoscopy is my greatest worry. There are scarier things to ponder as one enters his or her 50s and 60s. Among them:  oh yes, mortality! Yet, quite a few boomers are putting off this potentially life-saving procedure.  The idea behind a colonoscopy is to catch a colon cancer in its earliest stages, when it’s most treatable. Generally, age 50 is when you need to get your first colon “scope.” There are exceptions to the “age 50 rule,”  as I’ve explained in prior posts on this blog.

An article on HealthDay.com reveals that 70 percent of survey respondents (over age 50) registered fear of the procedure.

The article also points out that, of those who received a colonoscopy, the majority of survey respondents believed the bowel prep (the day before) was the worst part. I agree.

For this blog writer, the hospital procedure went well. I was either sound asleep or so sedated I  felt I was in a dream world. I can’t give you a 100 percent guarantee the procedure, itself, will be a breeze. But a good bet is you’ll get through it nicely, with your sense of humor intact. 

I didn’t like the prep the day before. I could only eat lemon gelatin…and believe me…that got tiring by nightfall. Oh yes, after drinking the laxative solution the night before, you might as well camp out in the bathroom.

Break that fear and go schedule a colonoscopy.

Harry Smith’s televised colonoscopy

For most of us who get a colonoscopy, there’s a tiny audience. The doctor who performs the procedure and a few of his or her assistants. For CBS morning host Harry Smith, there was a nation-wide audience. Recently, the star of  “The Early Show” had the procedure, where a snake-like tube is inserted into the colon in an effort to catch a colorectal cancer before it becomes life-threatening.

The Los Angeles Times has a great piece  that includes a video of Smith’s procedure. If you’re a bit sqeamish, you may want to turn away when they show the interior of the colon. If you’re brave, you’ll see how amazing the technology is. This video is a must-see for baby boomers of both ages. You’ll hear about colorectal cancer statistics. This is one cancer that can really be nipped in the bud. But screening is essential. The idea is to catch a polyp before it has a chance to become cancerous.

Comforting Smith in the procedure is CBS anchor Katie Couric, who lost her husband to the disease several years ago. This blog has discussed colorectal cancer several times, but the video you’ll see is of vital importance. I hope the video inspires more people to get screened.

Innocent polyps can lead to dangerous cancer — article by Scott Keith

It’s a detail a baby boomer must not overlook. As you approach middle age, it’s time to have a frank discussion with your primary care physician about colorectal cancer.

It’s a tricky cancer; in the early stages you may be symptom free. You could be feeling as strong as a horse, but inside your large intestine, little growths, called polyps, could be making the dangerous transition from benign to malignant.

To date, the best tool doctors have in diagnosing this disease is the colonoscopy. The very word strikes fear in the toughest men. Men and women will postpone the procedure because they don’t like the idea of a flexible tube running through their lower pipes. But screening is vital. Dr. David Lieberman, chief of the Division of Gastroenterology and Hepatology at Oregon Health and Science University in Portland, Oregon, says the exciting thing about colon cancer screening “is that, unlike other forms of screening where the goal is to detect early forms of cancer, with colon cancer we can actually prevent it because there is this pre-cancer phase of polyps.”

People of average risk should begin screening at age 50. “However, for individuals who have a close relative, a father, mother, sister or brother with colon cancer, they need to talk to their doctors earlier about colon cancer screening. Many of those patients need to begin screening at age 40,” says Lieberman. It’s good to get screened before you have any symptoms because “we know from various studies that if we wait for symptoms, often the cancers are discovered at a later stage and they’re much more difficult to treat.” Symptoms can include rectal bleeding (bleeding in stools), and changes in bowel habits.

While the colonoscopy is considered the “gold standard,” there are a couple of other screening tools. Lieberman says the fecal occult blood test “is a reasonably good test for detecting cancer, but it’s not going to detect pre-cancerous polyps.” The blood test has to be repeated every year. The sigmoidoscopy, like the colonoscopy, can detect polyps and cancers. The sigmoidoscopy can be performed in an office setting without sedation. “The problem with the sigmoidoscopy is that you’re only looking at the lower part of the colon, so if you happen to have growths further up in the colon, they can be missed.” Lieberman says use of the sigmoidoscopy has dropped off in the United States. For those with a family history of colon cancer, the colonoscopy is the recommended test.

During a colonoscopy, Lieberman says “we use a long, flexible tube with a light on the end of it and a little camera in it that we pass through the entire colon.” If you’re worried about pain or discomfort, Lieberman adds, “When we perform these procedures in the United States, everybody receives sedation. Most patients don’t remember the procedure. What they do remember is the day before the procedure…getting ready.”

The day before the colonoscopy is a day you’ll probably remember for years to come. You’ll be limited to a diet of clear liquids. You’ll also be given a solution that will cause you to visit the bathroom MANY times the evening before. The idea is to clean the colon so your doctor can easily spot and remove polyps. The important thing to remember is to follow your doctor’s prep list to the letter.

If you’re polyp-free after a colonoscopy, Lieberman says you won’t need to repeat the procedure for about ten years. If a benign polyp is found, a repeat colonoscopy is needed sooner, depending on the appearance and size of the polyp.

Does lifestyle have anything to do with developing colon cancer? Lieberman says, “There are lots of studies, and I’ve done some of them, which show that there are some risk factors that seem to be associated with a higher risk of developing colon cancer.” These include diets high in animal fat and low in fiber, diets low in calcium, obesity, smoking and low levels of physical activity. Lieberman cautions that if you start eating healthier food, including fruits, vegetables and whole grain bread, you still need to get screened.

Patients should be encouraged to get screened. Lieberman says he gives a lot of lectures to fellow doctors. “One of the things we emphasize is that it’s important to have this discussion with patients because this is one of the most preventable forms of cancer that we know of, because we can detect these polyps and take them out before there is cancer.” That, says Lieberman, is an exciting opportunity.

Check your plumbing

It’s that part of men’s (and women’s) health maintenance that we would just as soon gloss over. We all know what the large intestine is for. We just don’t want any flexible tube probing this spaghetti-looking part of our insides.

But the colonoscopy remains the key tool in detecting polyps and cancers of the colon. Katherine Hobson has a great article that touches on, among other things, fear of the procedure, the cost of a colonoscopy and how to pick a doctor:

http://www.usnews.com/health/managing-your-healthcare/cancer/articles/2009/03/04/colon-screening-5-things-you-need-to-know.html

I had my colonoscopy not long after my 50th birthday. Luckily, I was cancer free. Not even a polyp.  I was well sedated during the procedure. As I left the hospital, I realized I had spent way too much time worrying about colonoscopies.  I will admit the colon-cleansing routine the day before was anything but enjoyable.

When we think of plumbing, we think of fixing the kitchen sink or plugging a leak in the bathroom. What is critical is our own plumbing. Baby boomers of both sexes need to get a colorectal screening. Let your doctor know if your family has a history of cancer, then get checked.

Scopes and needles

There are a few medical procedures that scare the pants off most guys. I think I’ve had them all, and survived. Back in 2002 (yes, I remember the dates of my medical ordeals) my doctor discovered microscopic blood in my urine, or hematuria. This is a condition that requires an evaluation to make sure it’s not caused by a serious problem, such as cancer. So off I went to my urologist. He performed another urine test and told me to set up an appointment for a cystoscopy. This a procedure where a camera goes up through the urethra to examine the bladder. I spent the next couple of months worrying about the procedure. It has to be painful, I told myself. No man wants to endure this. I asked my doctor if I could be knocked out. He convinced me I could stay awake during the procedure because a numbing agent would be applied to the “private parts.” Luckily, no cancer was found. The whole thing lasted just a few minutes and I did not experience any discomfort. I could have kicked myself when I realized all the time I had spent worrying.

Fast forward to my colonoscopy. I decided to have this procedure as soon as I turned 50. I had read that the worst part of the experience is the day before, when you are required to consume clear foods and drinks and take a solution that makes you visit the bathroom repeatedly. I thought that’s dumb. The worst part has to be the colonoscopy itself, feeling the tube inching it’s way through the colon. As it turns out, I was so sedated that I think I was in my second or third dream before hearing my doctor tell me there was no sign of cancer. Again, I felt silly that I spent so much time worrying.

Fast forward again to my prostate biopsy. A needle is inserted through the rectum to gather some prostate tissue samples. Again, rattled nerves as I approached my biopsy appointment. But I experienced no pain or discomfort. Because of a numbing agent, I hardly knew a needle was involved. Guys, if you are scheduled for one of these tests, I’m not going to promise that you wont experience discomfort or embarrassment, but I will say that the experience will probably go better than you thought. I wouldn’t be surprised if you discover that your commute to the doctor’s office was more stressful.