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View Full Version : Are Routine Colonoscopies After age 50 Another Money Grab?



jlroussin
6-12-12, 2:32pm
Medicine seems to have become another commercialized entity. My husband just went through a colonoscopy, and the prep is an ordeal. We both turned 50 a year ago, and recently I turned 51. I suspect that this new idea that everyone should get a colonoscopy after age 50 is motivated more by money than by true medical necessity. I mean, what percentage of people actually get colon cancer? I'm going to opt out of it. I don't want to be just a dumb sheep that does whatever our health system says I should do. I believe that our current health system is mainly motivated by greed.

Other opinions?

bae
6-12-12, 2:35pm
. I mean, what percentage of people actually get colon cancer?

About 5%.... And the survival rate is pretty high if you catch it early.

Good luck.

pinkytoe
6-12-12, 2:39pm
I am in the minority when I say I think it is somewhat of a flim flam. But I am a total conventional medicine skeptic. We each have to do what we feel is right - I choose not to get them.

creaker
6-12-12, 2:42pm
About 5%.... And the survival rate is pretty high if you catch it early.

Good luck.

A lot higher (the number that actually get it) if you have any family history of it.

jlroussin
6-12-12, 3:07pm
In my case, there is no family history of cancer, and my colon works just fine. I'm in very good health. I think it is overkill for someone like me.

bae
6-12-12, 3:09pm
The initial stages don't interfere with colon function particularly. Early detection can be a lifesaver.

CathyA
6-12-12, 3:39pm
Its really hard to know......except in retrospect!
I'm not going to have them as often as I'm "supposed" to, but I occasionally do a hemocult test, which is somewhat of an early-mid warning test.
Seems like everything is overdone in this country. yes, its a money thing, but I also think its part of our inability to lose anyone.........ever. So to save a few, they say everyone should have everything all the time.

freein05
6-12-12, 3:59pm
I agree with bae. If caught in the early stages the survival rate is very high. The cost to treat it are far higher than the cost of having your colon removed plus think how your life would be without a colon.

I had a colonoscopy this year my first one and I am 66. They found a couple of benign pulps during the colonoscopy they snip them off so if they were malignant the cancer cells would have already been removed. Because of my age and the findings I will probably not have to have another on.

I did not think the prep was that bad. I was expecting it to be a lot worse because of the horror stories I read about the prep.

rosarugosa
6-12-12, 4:06pm
Well as someone who just set the cigarettes aside after 38 years, I've hardly been a fanatic about doing what I'm supposed to do for my physical well-being. That said, I am 54 years old and had my second colonoscopy yesterday. I know a nurse who died of colon cancer at age 52, and given that it's a very slow-growing cancer and that they can actually remove potential problems during the test that could develop into cancer eventually, I see no reason not to avoid this preventable disease. The prep definitely sucks, but I suspect dying of colon cancer sucks even more. I told my DH that I was doing it for him, so that he wouldn't have to go out and find another wife at this stage of the game, and I expect him to return the favor :)
I have no doubt that it's lucrative for the health care system, but I do believe it's also a case where modern medicine actually has the knowledge and means to save us from something nasty. Just because it's profitable doesn't mean that it doesn't have medical value. Since it's unpleasant, I think that people have an easy time talking themselves out of it. I had a former employee in her sixties who chuckled in glee because her MD didn't tell her to get a colonoscopy, and she developed colon cancer shortly after retiring.
Oh and that thread about how to lose 5 lbs? I told a long hike Sun morning, then shovelled bark mulch for a few hours, then did my colonoscopy prep, and Mon morning I weighed 4 lbs less than I did Sun morning!

domestic goddess
6-12-12, 4:19pm
It all depends on whether the test finds an early stage cancer. Then it saves your life, and is totally worth it. If it finds that you are just fine, then you are more likely to think it just lined someone else's pocket.
DD has Crohn's disease, and has regular colonoscopies. A couple of years ago they removed a couple of polyps, biopsied them, and found them to be Stage I cancer. Since they had been removed, they were now not a problem. They rechecked her in a couple of months, and found 4 Stage I cancerous polyps. In one month, they found 2 Stage I cancerous polyps. In another month, they found some more. The dr. was talking about removing an 18" segment of her bowel where all these polyps were forming, which would necessitate a temporary colostomy, and then evenutally another surgery for closure of the colostomy, and dd was having colonoscopies every 2 weeks, at which there was always found at least one Stage I cancer, which was totally removed for biopsy. Shortly after the dr. started making noises about the bowel resection, they stopped finding them, and the need for surgery was averted.But every time she has a flare of her Crohn's, I feel like I am walking on eggshells until we get a negative colonoscopy. Although someone is making money off her insurance company, I feel that it is money very well spent. She is lucky, if you can call it that. Because she has Crohn's, and now has this history, she will get a colonoscopy whenever she has a flare, to see if there is anything else going on. Most people won't know until it is too late, and death from colon cancer is not a pleasant death.
Many years ago, my cousin started having some GI complaints, and when they did a colonoscopy, they found cancer. She was in her mid 20's at the time, with two young children, and her father had just been treated (successfully) for bladder cancer. Surgery was performed to remove the tumor, which was found to be an early stage and had not erupted through the wall of the intestine. They removed the turmor, and my cousin was given the choice of having chemo or not. She initially chose chemo, had one treatment, and was so sick she never had another. She is still with us nearly 20 years later. But it was found at such an early stage that it didn't matter if she had chemo or not.
I, on the other hand, have never had any GI problems. I will soon be 60, and have never had a colonoscopy. I don't plan to ever have one. At my last dr. visit, she told me I was a little anemic and I should have a colonoscopy. Well, that is not going to happen, so I have been paying more attention to my diet, since I eat little red meat, and plan to correct my mild anemia that way. DD thinks nothing of the prep or the test, but I think I'll take my chances. I may be sorry later. Any cancer may arise in any person at some time, regardless of your family history, so I don't think testing is really the wrong thing to do. It is less expensive than the treatment for cancer, and less disruptive to your life. Cancer is only curable if found early.

Tweety
6-12-12, 4:42pm
I had a colonoscopy at age 70+, and while the prep wasn't fun, the actual test was very painful for me. I could feel it but couldn't register any reaction, so could only suffer through it. Afterwards the nurse asked me "how was it?" I told her that it was excruciatingly painful and she said "No, you were out and couldn't feel a thing." Luckily the results were good because I will never have another!

ctg492
6-12-12, 4:50pm
I had mine last winter, no big deal really. I went to a place that specializes that is all they do. Kinda like an assembly line. 15 minutes. Fastest thing ever. I was actually calling my Mom at the 15 minute after point telling her how fast it was.
Having said that, I just do not know about all these tests. Goodness the mammograms I have had yearly since 33. You know why? A doctor I had once time thought a lump was found. It all turned out ok but to be sure I was told to get one once a year and on the opposite 6 months my check up. I have had a few doctors since then, BUT since one doctor said that, they all followed along. Then all the assorted lady tests. Who am I to question, I wonder. Ex-rays on teeth, another I question why so often??
Then I wonder am a better safe then sorry, I get very confused about it all.

rosarugosa
6-12-12, 5:39pm
I know I have a twisted sense of humor, but this is one of the funniest things I've ever read in my life and so relevant to the subject at hand:
http://www.miamiherald.com/2009/02/11/427603/dave-barry-a-journey-into-my-colon.html

Float On
6-12-12, 5:49pm
My husband had to have one at 45.
I'll avoid it until I think there is an issue because I have issues with medical care/tests/etc... Plus we are without health insurance right now - just flat out can't afford it anymore (self-employeed) and we just don't go to any Dr unless we're past sick.
I did have a friend this last year who felt like something was 'off' and went and had one and they did discover cancer in the colon. He survived and goes around telling everyone to get tested now.

rosarugosa
6-12-12, 5:52pm
Hey Tweety, That happened to me for my first scope, so this time around I told them about it loud and clear. The MD and nurse practitioner told me they would make sure it wouldn't happen again and they would give me a deeper level of sedation. They were true to their word. I guess the micro-anesthesia they usually use doesn't work well for everyone.

SteveinMN
6-12-12, 10:11pm
I guess the micro-anesthesia they usually use doesn't work well for everyone.
My dentist knows to give me a kind-of double-dose of novocaine because the usual amount just doesn't do it for me .

I think a colonoscopy is an insurance policy. If someone has one and no problems are found, it seems like a waste of money -- kind of like paying for insurance but not having your house burn down or your car involved in an accident. What tips me in favor of getting them on schedule is that colon cancer is fairly slow-moving, so it can be discovered and treated early. For much faster-moving cancers, an exam every ten years seems more like pocket-padding than protection. JMHO.

gail_d
6-12-12, 11:13pm
I recommend having them done. I was diagnosed with ulcerative colitis (UC) 10 years ago. Usually it shows up at a much younger age. I have had three colonoscopies to date; at the last one, 2 polyps were found, one benign, one adenomatous (the kind that could, but may not, become cancerous). Now I will have to have colonoscopies every year. The prep isn't too bad, and the zen-like state that the anesthesia causes (post-procedure) isn't too bad either. (Things to remember: make the solution and chill it ahead of time; use a straw when drinking it; there are different flavors for it; most people seem to prefer lemon-lime.) Many in my extended family have a history of inflammatory bowel disease (IBD). One of my cousins learned he had UC only after a colonoscopy; he'd had no symptoms beforehand. IBD increases the risk of colon cancer, so I'm glad to be checked out.

domestic goddess
6-12-12, 11:24pm
DD rarely has anesthesia with her colonoscopies. She doesn't want anyone with her, so she drives herself to and from, so no anesthesia. It truly doesn't bother her not to have it. I think it would be like a trip to the dentist for me; they need to sedate me before I leave the house to ever get me in there for it. She is having a Crohn's flare right now, so I imagine there will be a colonoscopy when some of the other symptoms have subsided a bit.

Weston
6-13-12, 8:44am
I hope that that what I write doesn't cause anyone not to have a colonoscopy. I think that people in the target group should have them and firmly believe that routine colonoscopies have saved tens of thousands of lives.

However, the good news is that scientists have already isolated the dna strands identifying colon cancer and I expect that it is probably going to be only a few years before an effective painless test of a stool sample will be approved by the FDA. The test itself has probably already been perfected. The question is how long the government review process will take.

peggy
6-13-12, 9:57am
I hope that that what I write doesn't cause anyone not to have a colonoscopy. I think that people in the target group should have them and firmly believe that routine colonoscopies have saved tens of thousands of lives.

However, the good news is that scientists have already isolated the dna strands identifying colon cancer and I expect that it is probably going to be only a few years before an effective painless test of a stool sample will be approved by the FDA. The test itself has probably already been perfected. The question is how long the government review process will take.

That's good news Weston!

Weston
6-13-12, 10:47am
That's good news Weston!

If you would like more info I cut and pasted an old NY times article below. Don't know if it is still on track for approval later this year but I'm certainly hoping.

http://www.nytimes.com/2010/10/29/health/29cancer.html

Mighty Frugal
6-13-12, 12:23pm
I go every 5 years and am happy to do so. Like gail I LOVE the 'zen-like' state of the drugs! The prep is unpleasant but nothing to moan about.

I am a strong believer in prevention and part of that is colonoscopies. If I recall it takes 10 years for a polyp to turn cancerous (if it is the type to become cancerous) so going every 10 years will pretty much ensure you won't get colon cancer-they stop it before it starts.

It's like PAPs-unpleasant but worth it-get the cells at the early whacky stage rather than when it becomes cervical cancer

Screening saves lives. Sadly I know this because I have a 48 year old cousin who is probably dying from colon cancer. Never had a test. Now cancer has spread to her liver, pancreas and stomach:(

also another cousin (not brother of cousin above) who fought colon cancer and it has appeared twice now in his liver and once in his lungs-he is about 60 and still fighting

AND an aunt (not mother to cousins above) who successfully survived colon cancer-she fought it about 12 years ago

So..it runs in my family. What do all my siblings and cousins and aunts/moms do? WE go for colonoscopies every 5 years. It's ur best defense.

Colon cancer can be prevented!!!

creaker
6-13-12, 1:18pm
I don't know if this will ever be an option, but it's interesting:

http://www.popsci.com/science/article/2011-02/black-lab-sniffs-out-bowel-cancer-patients-near-perfect-accuracy

oldhat
6-13-12, 7:48pm
Its really hard to know......except in retrospect!
I'm not going to have them as often as I'm "supposed" to, but I occasionally do a hemocult test, which is somewhat of an early-mid warning test.
Seems like everything is overdone in this country. yes, its a money thing, but I also think its part of our inability to lose anyone.........ever. So to save a few, they say everyone should have everything all the time.

It makes a heck of a difference to you if you're one of the few saved. I had my second colonoscopy a few weeks ago ( I just turned 57). Yes, the prep is unpleasant, but the procedure itself is nothing. My biggest hassle was finding someone to give me a ride, since my friends all work.

There are so many things about your health that you can't control, or have little control over. To me the colonoscopy is well worth it for the peace of mind. If everyone had them on schedule, colon cancer would be almost completely eliminated. It's also one of the few medical procedures that insurance companies are happy to pay for, since they know it saves them big bucks in the long run. But I'd still have mine done on schedule even if I had to pay for it out of pocket.

treehugger
6-13-12, 7:57pm
There are so many things about your health that you can't control, or have little control over. To me the colonoscopy is well worth it for the peace of mind.

This is a very good point. I feel the same about my husband's anti-rejection (kidney recipient) medication making him susceptible to melanoma and lymphoma. We can't do much (anything) about the lymphoma, so we try not to think about it, but he makes sure to wear sunscreen, a hat, and stay out of the sun as much as possible since it's a lot easier to prevent skin cancer than other kinds of cancer.

I haven't reached the age where I need a colonoscopy (although I have had a sigmoidoscopy, and, ouch!), but I will definitely get one as a present to myself for my 50th birthday. The same way I get my every-three-years pap smear and twice-yearly dental cleanings; gifts to my future self (oh, and mammograms, which I have also not had yet).

Kara

Cypress
6-14-12, 3:43pm
DD rarely has anesthesia with her colonoscopies. She doesn't want anyone with her, so she drives herself to and from, so no anesthesia. It truly doesn't bother her not to have it. I think it would be like a trip to the dentist for me; they need to sedate me before I leave the house to ever get me in there for it. She is having a Crohn's flare right now, so I imagine there will be a colonoscopy when some of the other symptoms have subsided a bit.

I did not realize this was a possibility.I am scheduled to have one done but cannot arrange for a ride after the test. Twice a year I have a colonic and don't have a problem with the procedure. Of course, only water enters the colon and poo comes out. Two women in my office had them recently and had anesthesia. Can I say no? How far up does the probe go?

herbgeek
6-14-12, 4:30pm
If you have a sigmodoscopy instead of a colonoscopy, there isn't anesthesia. I asked my doctor what was the difference between the two and he said "about 3 feet". Funny guy, that doctor.

fidgiegirl
6-14-12, 5:43pm
Thought of this thread this afternoon. Evidently there is a test in development that would be much like the pap smear. There are certain mutations of DNA that are flags for the presence of colon cancer and they are shed in the stool. So if those showed up in the stool, maybe then they could do a colonoscopy. Not sure how may years until it would be mainstream.

http://www.npr.org/blogs/health/2012/06/14/154439617/can-a-colon-cancer-test-level-the-playing-field-for-native-alaskans

Simpler at Fifty
6-14-12, 6:59pm
I agree with oldhat. I believe routine colonoscopies may be covered at 100% now thanks to Health Insurance Reform.

Gregg
6-15-12, 10:53am
The test Weston spoke of is totally a step in the right direction, but I hope people don't wait around for it to be approved and risk missing an early detection of problems. DW's dad died of colon cancer at age 67, her mom at 66*. She had her first test at 44 and they discovered multiple pre-cancerous polyps that were removed. She schedules a test annually now and more polyps are almost always found. The doc told us there is no way to be sure, but his gut feeling was that she would probably be dealing with advanced stages of cancer by now if she had not started tests early and continued them on a regular basis.

*Colon cancer was but one type present in Mom's body, but was certainly a contributing factor in premature death.

sweetana3
6-15-12, 12:11pm
I just listened to the news story on the DNA test on NPR. Very interesting. Started becaue the villagers in Alaska have a high colon cancer rate could not get colonoscopies. So a scientist is developing a test that they can use in rural areas.

Sleuthmaster
11-19-12, 3:56pm
Medicine seems to have become another commercialized entity. My husband just went through a colonoscopy, and the prep is an ordeal. We both turned 50 a year ago, and recently I turned 51. I suspect that this new idea that everyone should get a colonoscopy after age 50 is motivated more by money than by true medical necessity. I mean, what percentage of people actually get colon cancer? I'm going to opt out of it. I don't want to be just a dumb sheep that does whatever our health system says I should do. I believe that our current health system is mainly motivated by greed.

Other opinions? Colonoscopies benefit the hospital, the doctors and the pharmaceutical industry who make BILLIONS on this procedure each year. I have read that there are between 1 and 20 million done each year. At $3,000-5,000 a pop, well, you do the math!
I am currently reading a new book called "Bad Pharma" by Ben Goldacre which describes the lack of credible testing/reporting on drugs by the Pharmaceutical Industry. If you take any drug you should read this book - it should make you cautious at the very least. The drugs used during a colonoscopy are usually fentanyl and midazolam (Versed) which are both extremely powerful brain screwing drugs - very scary.

Here are my 24 questions to ask your doctor before you have this procedure:
1. How many colonoscopies have you done and what problems were encountered by the procedure/drugs afterwards?
2. What drugs do you use and who administers those drugs? Do you do a lab on the blood before administering drugs? What dosages do you give and why?
3. If you use a nurse, what certificates/qualifications does she/he have to administer these?
4. Have you personally used Fentanyl or Midozalam (Versed) or have any of your close family used them?
5. Do you allow patients to opt out of drugs altogether? How many patients have you allowed to do this?
6. Besides you, the nurse and scrub-tech, who is allowed into the surgery to watch? family of patient? hospital staff or administration? Drug reps/salesmen?
7. If there is a problem with patient’s breathing/heart, what measures are taken? Is there an anesthesiologist on duty at hospital?
8. What role/duties does the scrub-tech play, does he have hands-on duties? Should he wash his hands?
9. Does the colonoscope that you use have the ability to inject water and air into the bowel or is another instrument used for that prior to the procedure?
10. How is the colonoscope cleaned? Is it sterilized? Has this hospital had problems with staphylococcus infections?
11. Is the procedure audio taped, video taped, or photographed? If so, does patient have right to view these?
12. Can I get a copy of the papers I have just signed? all of the other reports of the procedure?
13. How much does this procedure cost – hospital, doctor and lab costs?
14. Exactly when should I expect to hear from the doctor’s office with results? Followup by nurse/hospital by phone?
15. Who will be available to call in the event of any questions or complications?
16. Are you available for consult following the procedure or is that left only to the primary care physician?
17. In what circumstances is another colonoscopy done as followup?
18. Of the 20 million colonoscopies done annually in the U.S. how many result in accidental perforations or death?
19. How many of those colonoscopies have actually prevented colon cancer?
20. How quickly can colon cancer develop and kill? How often are colonoscopies recommended for the average person?
21. What allowances are given for patients for age (60 +) or with liver compromise?
22. Following the procedure is the patient given anything to drink/eat?
23. When releasing a patient from the hospital, what tests or measures are taken to ascertain if the drugs have worn off?
24. What verbal or written suggestions/warnings are given to the patient as he/she leaves the hospital?
Ask these questions before you get to the hospital. Do not wait until you are prepped, naked and drugged with an amnesiac and an opiate before questioning any aspect of a colonoscopy. Do read everything you can find about any drugs and their after effects before subjecting yourself to them.

Gregg
11-19-12, 6:10pm
DW's dad died of colon cancer. Her mom had it, but also had multiple other cancers by the time she went to a doctor (and died shortly after diagnosis). DW herself started routine colonoscopies at age 42. Polyps were discovered with her first test and have been removed during every subsequent test. Had she simply decided to wait until age 50 there is a pretty good chance she would have been dealing with cancer or worse. Money grab or not I will drive her down for the test every spring for many years to come.

bunnys
11-19-12, 8:07pm
I think the chances of getting many cancers are to a large degree determined by the lifestyle the would-be patient lives.

I know that some diets are much more likely to keep fetid, rotting food in the colon longer that it should be than others.

I am of the school that has decided that I'm not going to spend the remainder of my life chasing one disease after another. I'm not going to worry about this month's test until I have it, wipe my brow and say "whew" and then start worrying about next month's test.

Maybe I'll miss a deadly disease early and end up minimizing my suffering with morphine and by not taking any life-extending treatments such as chemotherapy, open heart surgery or daily injections of insulin and maybe my life will end 10 years earlier than it might have. Or, maybe nothing will happen and I won't have to spend my time worrying about what could happen and I'll have a care-free, lenghty life.

After all, there's no guarantee that catching any illness early is going to keep me from dying from it. But catching it early will guarantee I'll spend endure a lot of pain and worry suffering through the treatment. I don't think so. I'm going to die some day. At this point, I've accepted it.

Mighty Frugal
11-19-12, 9:20pm
I think the chances of getting many cancers are to a large degree determined by the lifestyle the would-be patient lives.

I know that some diets are much more likely to keep fetid, rotting food in the colon longer that it should be than others.

I am of the school that has decided that I'm not going to spend the remainder of my life chasing one disease after another. I'm not going to worry about this month's test until I have it, wipe my brow and say "whew" and then start worrying about next month's test.

Maybe I'll miss a deadly disease early and end up minimizing my suffering with morphine and by not taking any life-extending treatments such as chemotherapy, open heart surgery or daily injections of insulin and maybe my life will end 10 years earlier than it might have. Or, maybe nothing will happen and I won't have to spend my time worrying about what could happen and I'll have a care-free, lenghty life.

After all, there's no guarantee that catching any illness early is going to keep me from dying from it. But catching it early will guarantee I'll spend endure a lot of pain and worry suffering through the treatment. I don't think so. I'm going to die some day. At this point, I've accepted it.

Catching colon cancer early (when it is a mere polyp) does guarantee you won't get the disease. From my understanding a polyp takes about 10 years to become cancerous (some never will) so providing you have regular frequent colonoscopies, you will never get colon cancer

Sure lifestyle has something to do with it, but some cancers are hereditary-colon cancer is one.

It runs in my family. My 49 year old female cousin is dying from this disease. It has spread to her lungs and liver and stomach. She has always had a healthy eating lifestyle. She never ate junk food, always whole foods-very little processed. She didn't drink (very rarely) or smoke. She was never even an ounce overweight-always really thin.

So while I understand that we shouldn't be getting MRIs of our entire body just to possibly catch something that may or may not kill us. I feel for some people (me included) colonoscopies are a must and they do more than extend your life with chemo-they can stop it before it starts.

bunnys
11-20-12, 6:28am
Mighty Frugal:

You make some very good points. I have read that diet and lifestyle in fact have a very big impact on one's chances of getting colon cancer.

Gregg
11-20-12, 10:25am
Heredity is the #1 flag for colon cancer, not lifestyle. That's from DW's oncologist.

sweetana3
11-20-12, 10:37am
Since all my relatives lived to late 80s and 90s with absolutely no history of cancer and very little of anything else, I am pinning my choices on that. And I will not complain if I make the "wrong" decision.