“True prevention is not waiting for bad things to happen; it's preventing things from happening in the first place". Don McPherson
Housekeeping from last week...
One such cool person on Twitter I spoke of happens to be Chris Damman, MD MA, a Gastroenterologist at the University of Washington, and Former Bill and Melinda Gates Foundation Microbiome & Gut Health Lead.
Over the weekend Chris sent me a DM on Twitter asking for my thoughts and any experiences as it relates to animal protein inhibiting butyrate production, much like plant carbohydrates inhibiting ketosis.
This is an expert in the gut microbiome field asking me what I think about the production of butyrate or lack there of? Share your experiences folks. You're sitting on plenty of experience that is interesting to someone else and just might help someone.
Colorectal Cancer Awareness Month- The month of March has taken on a different meaning for me over the last few years. Normally I would be looking forward to filling out my March Madness bracket for the NCAA basketball tournament.
Now I look forward to sharing my story of how preventive screening for colon cancer is designed to work. It's also a case of how fine the line is between positive and negative outcomes.
My case had a good ending, so I'll spare you the play-by-play call on that ordeal. But some of the circumstances of the screening process might be helpful to you.
The Colonoscopy That Almost Wasn't- I have always been fascinated with the law. For the longest time I wanted to be a lawyer.
Twelve Angry Men is a favorite movie of mine.
I love the whole jury process. It took 50 trips around the sun until my name was picked for jury duty for the first time.
My two-week assignment was nearly up, and I had yet to be selected to sit on a jury. But I still had a few days. Weird? Yes, I am.
I had one eye on the calendar as my 50-yr old colonoscopy was scheduled for the last day of my jury duty tour. I recall calling the jury duty clerk and explaining my predicament to her.
She didn't hesitate to tell me "You are NOT canceling a colonoscopy for jury duty" and forthrightly relieved me of my service. No jury foreman, no sequester, no jury room drama. It was gone, all gone in one phone call!
In hindsight, I owe that woman a lot. It was the first of a few fortuitous bounces from the basketball of life. Had I canceled this appointment, who knows how long it would have taken to reschedule.
I was almost a full year late already and further delay could have bumped into the eventual Covid shutdown of most preventative procedures.
The ultimate discovery of my tumor, the ulceration, the location, and the chemo-resistant make-up of the tumor makes me more thankful than ever for that jury duty clerk.
Screening Options- If we can stipulate to the facts (wanna be lawyer talk again) that screening is recommended at the age of 45 now instead of 50, there are now competing methods for screening when you reach this window.
The gold standard is the colonoscopy. If you've had one or more, you know it can be an unpleasant process, invasive, and can be a financial hardship depending on insurance availability.
But the effectiveness of the procedure cannot be duplicated with other options.
Another popular option these days that circumvents many of the hesitations from a colonoscopy is the home stool testing kit. Cologuard is probably the most recognizable name.
Remember the fortuitous bouncing basketball?
Your turn here to get a bounce.
A home testing kit might have detected my cancer. They boast 92% detection rates for most cancers. But they are believed to only detect some 42% of large polyps.
So, if you opt to go the home route for screening, the odds of detecting a polyp that could lead to cancer is less than a 50%-coin toss. If you take nothing away from my story, remember these numbers the first, or next time, a colonoscopy decision needs to be made.
Colon Cancer Prevention- I like to think of colon cancer prevention much like cardiologists would like us to think about heart disease prevention.
Father time is not our friend when it comes to heart disease or colon cancer for that matter. Simply stated, as we age, heart disease becomes more likely. The opportunity for colon cancer rises over the same period of time.
In general, cardiologists universally agree that we need to start cardiovascular disease prevention sooner in life. Diet, exercise, stress management, and good sleep earlier in life can exponentially reduce your risk of heart disease.
These same factors are also on the grocery list for colon cancer prevention. There is no reason to wait around until the recommended 45th birthday to start thinking about colon cancer detection.
Starting earlier in life is about colon cancer prevention.
This is the challenge of our time where I sit. The early onset numbers (before age 50) of colon cancer are alarming these days.
Our young people are exposed to a much different landscape than even we were a generation ago. Our food industry has radically changed, obesity rates are much higher, kids are less active, and they deal with pressures from a social media world like we never did.
I get chills every time I hear of a young person being diagnosed with colorectal cancer. The disease is typically in a very advanced stage and outcomes are not good.
Wrap Up- Whether or not you're in a colonoscopy window, here's the challenge I'd like to give you. Get over any hang up about discussing the need for colon cancer prevention. If you have the ability to impact young people, make an impact.
We need to get past the stigma of discussing this dreaded disease. The discussion of bowel habits or changes, the hesitation to invasive procedures, and encouraging younger folks to start with prevention measures earlier in life can make a difference.
Make a difference.
Next Week- gut health and the power of walking. This very basic activity needs to be in every toolbox.
Thanks for reading!
Jeff
