Are You Too Old for Colon Cancer Screening?

Eighty" is the "new" fifty. Why? Many are in good health as natural and unnatural aging occurs.  This may be attributed to ongoing healthy lifestyle habits, good genes, as well as preventive screening.  In addition, early intervention and treatment of conditions found from preventive screening add additional healthy years.  Should preventive screening tests like colonoscopy be abandoned after 80 years of age?

Scientific studies report that one is more likely to die of something other than colon cancer after 80 years of life.  This may be interpreted to mean that at age 80, your last screening colonoscopy if positive for colon cancer, will really be a diagnosis you can live with until you die. In fact, the colonoscopy itself gets riskier with more complications as one gets older especially after 65.  Chronic conditions can potentially increase complications as well. Life expectancy is expected to decrease anyway in spite of the risk that cancer increases with age.

Though current guidelines are without an age limits, there is much controversy over whether colonoscopy after 80 is beneficial.  The risk of complications from colonoscopy as well as the prep and sedation get much higher after 65.  There is up to 75% higher risk of gastrointestinal bleeding and perforation of the gut after 80.  Add more risk if chronic conditions like stroke or heart attack are part of the past medical history.

Much medical success and good health depend on you.  Individual assessment based on your medical history, physical exam and tests is key to obtaining the best outcome for you, regardless of "one size fits all" guidelines.  These guidelines are just that, a guide to help you and your doctor decide if you are too old for colon cancer screening via colonoscopy. 

Here's to making 100 the "new" fifty!

Best health!

Men's Health Month Memorandum: Check-up Time!

"If I had known I was going to live this long, I would have taken better care of myself." — Mickey Mantle

Statistics show that men are less likely than women to get routine health checkups and physical exams. Men are more likely to seek medical attention when there is an acute problem, and once that has resolved not until another acute problem. Part of the reason for this is lack of health education. Men are also more prone to the "this can't be happening to me" syndrome. Is ignorance truly bliss? Short term, maybe. Long term, no.

So what is a fella to do? Make a yearly checkup routine. Do it around your birthday or holiday like Father's Day or Christmas as a gift to yourself (your most important asset!). In addition to a complete medical history (be sure to take your notes and questions http://bit.ly/122ZEeF) and physical exam, there are other things your doctor should do. This includes:

• complete blood panel including a PSA (prostate specific antigen) if over 40 or have a history of prostate cancer in your family - please note that PSA screening is very controversial as to if it should be done and should be discussed at length with your doctor as this test does save lives
• EKG, baseline at first physical then every 2-3 years - yearly if over 50, have risk factors such as smoking, obesity, hypertension, diabetes, increased cholesterol, family history of heart disease
• cardiac screening by a cardiologist if any signs or symptoms of heart disease especially if there is a family history of heart attack, angina
• colon cancer screening with stool guaiac cards - stool samples are placed on these and returned to your doctor who checks for blood (this should be done when a rectal exam is performed, but if for some reason it is not, be sure to get these cards)
• colonoscopy, baseline at 50, sooner if stool positive for occult blood or gross rectal bleeding, weight loss, stomach symptoms

Be sure to include regular visits to the dentist, and optometrist or ophthalmologist (eye doctor).

Best health, guys!

by J.L. Richardson, M.D., family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide.