Advice from the Trenches: Screening

Dear C,

My brother Kenny and I are having a disagreement. He’s been having digestive problems off and on, but refuses to get checked out. He is of the opinion that if you don’t look for trouble, you won’t find it. He reels out story after story of people he knew who were okay until they went to the doctor. Then as soon as they were diagnosed with a problem, things went downhill.

I’d like to think I’m worrying for nothing, and I gotta admit he has a point — our father had low grade symptoms for years, but it didn’t keep him from working … or fishing.Then, my mom forced him to go to the doctor and they said he had colon cancer. Almost immediately after, his health went south and before we knew it, he was gone. Kenny says he would have lived a lot longer if they’d just left him alone.

Some people do seem to be okay until a doctor tells them they are sick. Then suddenly, they are SICK. Is it better to just wait and see?

Worry Wart

Dear Worry,

Normally, I might agree with you, but not in this case. Your brother is an idiot, and you are an idiot if you don’t get him to a GI specialist, NOW. But let me tell you why.

The statistics are in — the number of Americans dying of colon cancer has decreased by 30% in recent years. Is this because fewer people are at risk for colon cancer? No. It is because there has been an increase in screening for colon cancer. The industry standard is a colonoscopy and during these admittedly invasive exams not only is it possible to detect the polyps that are the forerunner to colon cancer, but doctors can also get rid of the buggers right then and there. Those polyps would almost certainly develop into cancer if they were left untreated. Because of timely screening, they are nipped in the bud.

If colon cancer runs in your family, there is a much greater chance that your brother will develop it at some point in his life. Before this happens, there are often low grade, easily ignorable symptoms, but sometimes there are no symptoms at all. Let’s say Kenny’s lucky and there’s nothing amiss, just random cramps and bloating. In that case, the colonoscopy will do nothing but give him peace of mind. But if those symptoms are from polyps, a colonoscopy could save him a boatload of pain, agony and regret later on. I’m not one for invasive medical tests, but this is one screening that I think everyone with a family history of cancer should have.

I’ve heard a lot of people trot that out that “if you don’t look, it isn’t there” rationalization because they were afraid to go to the doctor. If you’re looking for excuses, this is a good one, because it really can seem like that’s what happens. Someone is going along in their daily routine, having occasional symptoms that can easily be explained away. They don’t feel great, but they aren’t sick enough to slow down. Often they start self-medicating with one socially accepted vice or another, and the symptoms ease. “It’s all in my mind!” they say, and crack open another beer. After all, it’s the rare person who feels great all the time.

But in those cases where everything seems okay until the fateful doctor’s exam, here’s what has actually happened: The person in question let their symptoms go on for too long and by the time they are diagnosed, their condition has progressed from low-grade to final stage; and sometimes there sometimes isn’t much that anyone can do for them at this point. This is especially true in the case of colon cancer.

Your mom probably let your father cow her into silence until his symptoms became so pronounced even he couldn’t ignore them. If you care about your brother, don’t back down like mom did. I’ve had three friends die before their time with colon cancer. They had symptoms, but they were stubborn, just like your brother, and wouldn’t listen to anyone, so I backed off. If I’d known then what I know now, I would have held a gun to their freakin’ heads if I had to, all the way to the hospital.

Scare the crap out of Kenny if you have to, but get him in there. This is not a decision that either of you will regret.