Nilesh Vora

March is Colorectal Cancer Awareness Month, but there is one thing that makes this year different from previous Colorectal Cancer Awareness Months: COVID-19. I’ve served our community as an oncologist for nearly two decades and while I’ve always firmly believed in colonoscopy screenings for colon cancer – this year it’s more important than ever.

With the “Safer at Home” orders, the vulnerable senior population has been relegated to the confines of their own home – encouraged to only leave for essentials. This means many seniors are delaying their care in the hopes that when the pandemic subsides, they can go back to their normal everyday activities.  

I’m here to implore you, if you are due for a colonoscopy, don’t delay your care! The New England Journal of Medicine published a 2013 article that followed 88,902 health care professionals for 22 years. Those who received colonoscopies had a 68 percent lower mortality (died) from colon cancer, than others in the group. Putting it off for even one or two years, may not seem like a big deal, but it could mean the difference between a stage I diagnosis (easiest to treat and recover) and a stage III diagnosis (harder to treat, slower recovery).

In addition, older adults who are 50 years of age or older see a significant rise in the occurrence of colon cancer - making it something that shouldn’t be ignored or avoided. The American Cancer Society reports that colon cancer is the second leading cause of death in men and women in the U.S. and 90 percent of those are over 50.

From the time the first abnormal cells start to grow into polyps, it usually takes about 10 to 15 years for them to develop into colorectal cancer. With regular screenings, however, most polyps can be found and removed before they have the chance to turn into cancer.

Another misconception that should be dispelled is that older adults should stop being screened past a certain age. Colorectal screenings should occur every 10 years at least; and could be more often if a senior has developed polyps. Regular colonoscopies shouldn’t stop, even as seniors approach their 70’s or even 80’s. Seniors are just as likely to survive colon cancer as someone in their 50’s. There shouldn’t be a “one and done” philosophy when it comes to screening.

Other Screening Methods for Colon Cancer

While colonoscopies are considered the gold standard, there are a few other screening options that are perceived to be more “comfortable.” However, I warn all my patients that should one of these other screenings find an abnormality, you will most likely have to do a colonoscopy anyway to rule out cancerous polyps.

  • Sigmoidoscopy: A less invasive procedure that examines the lower portion of the colon and can remove polyps and tissue. It should be conducted every five years.
  • Fecal Occult Blood Test (FOBT): Completely noninvasive, the FOBT can identify traces of blood in the stool and can be done in the comfort of your own home. However, the test doesn’t always distinguish the source of blood resulting in a false-positive or the polyps don’t always bleed resulting in a false-negative.

Symptoms of Colon Cancer in Older Adults

The median age for colon cancer is 68 in men and 72 in women. If a senior is African American, they have a 20 percent higher likelihood of developing colon cancer.

If you’re a part of these higher risk groups, make sure to watch out for these common symptoms:

  • Rectum bleeding
  • Stool with blood in it
  • Dark color stool
  • Change in regular bowel movements, such as diarrhea or constipation
  • An urge for second bowel movement, after taking the first one
  • Stomach cramping or pain
  • Extreme fatigue or weakness
  • Unintentional weight loss

Treatments for Colon Cancer

If you do receive a colon cancer diagnosis, there is still a good chance of survival or to extend your life if it is caught in early stages. Most older adults can withstand these treatments.

  • Surgery: This is an effective treatment for stage I and II cancers, and sometimes won’t have to be paired with chemotherapy or radiation. Often colorectal surgeons remove the cancer from the colon or can remove the colon if it has spread.  
  • Chemotherapy: Drug administered intravenously to kill cancer cells.
  • Radiation Therapy: High-dose X-rays release radioactive substance to kill cancer cells.
  • Immunotherapy: These medications, called monoclonal antibodies, are used in conjunction with chemotherapy to encourage the body’s own immune system to fight cancer.

Please don’t delay your care and schedule your colonoscopy if it’s been longer than 10 years since your last one or if you are over 50 and have never received one. The time is always right to save your life.