The Colon Checkup

By Christine Gorman

Few details have been released about Supreme Court Justice Ruth Bader Ginsburg's recent surgery for colon cancer. And other than wishing Ginsburg a speedy recovery, I'd rather not delve into her personal business. But there are a couple of important facts--and potentially lifesaving guidelines--that everyone should know about colon cancer. Ginsburg's illness prompts me to offer a mini review.

First the facts: This year, 130,000 Americans will learn that they have developed a tumor somewhere in the inner lining of their colon or rectum. For those whose cancer is discovered at the earliest stages, the odds of living at least five more years are greater than 90%. Unfortunately, fewer than 40% of colorectal cancers are discovered that soon. In the same period, about 56,000 people in the U.S. will die of the disease, making it the second greatest cancer killer, after lung cancer.

Now the guidelines: Although colon cancer can strike at almost any age, it becomes more common after 50. Symptoms include a change in bowel habits, fatigue, gas pains and anemia. Yet the disease produces few, if any, signs of trouble at its earliest, most curable stages. That's why experts recommend that everyone undergo annual screening, beginning at age 50. If there's a strong family history of the disease (particularly if one or more of your parents, sisters or brothers have had it), you may need to start sooner. A good rule of thumb is to begin getting tested 10 years before the age at which the youngest person in your family was found to have colon cancer.

There are a variety of screening tests, but the most common checks for the presence of blood in a stool sample. Let's be frank: no one likes chasing poop in the potty with a stick. But I've done it, and it's not hard. You need only the barest sample to smear on the card. Yes, it's disgusting, but think of the reward. Doctors estimate that the mortality rate of colon cancer would drop 30% if everyone would overcome his or her squeamishness about providing a stool sample.

Fifty is also a good age to have a sigmoidoscopy, in which a doctor inserts a flexible tube into the lower third of the colon to look for polyps or tumors. If the lining is clear, you won't have to undergo the procedure again for five years.

But if there's blood in the stool or the sigmoidoscopy reveals a problem, a more thorough exam is required. (A positive stool test indicates cancer less than 10% of the time.) In a procedure called a colonoscopy, a gastroenterologist uses a light-tipped fiber-optic instrument to examine the entire length of the large intestine. Since you're sedated, the hardest part is often drinking the salty liquid needed to evacuate your bowels the night before.

There are a few things you can do to help lower your risk of developing colorectal cancer. Eat at least five servings of fruits and vegetables a day (a serving is half a cup for solid vegetables, a full cup for raw lettuce, or a medium-size banana, apple or orange). Do something physical--walk, dance, garden--at least three hours a week. Taking aspirin or estrogen may help, but check with your doctor first to find out if it's right for you. Often it's the little things we do for ourselves that make all the difference.

For more on colorectal cancer, visit healthfinder.gov or time.com/personal You can e-mail Christine at [email protected]