Home' Trinidad and Tobago Guardian : March 29th 2017 Contents A39
Wednesday, March 29, 2017 guardian.co.tt
IS COLORECTAL CANCER A PROBLEM IN T&T?
Yes it is. It affects both men and
women. It has also been rising in
all age groups, most noticeably in
people less than 50. This is a wor-
What are the symptoms of col-
Rectal bleeding, unexplained di-
arrhoea, a change in bowel habit
or stool, abdominal discomfort,
anaemia and weight loss are all
important symptoms. Any one of
these by themselves merit proper
Early stage, curable colorectal
cancer is painless. Don't wait for
There may be no symptoms at all
for a long time. This is why screen-
ing for the disease in persons over
the age of 50 is recommended. It
is now a recognized duty of care.
The large bowel has lots of room
to grow. By the time someone has
multiple symptoms (e.g. rectal
bleeding with a change in bowel
habit and weight loss), the tumour
would be more advanced.
Can colorectal cancer be pre-
Yes it can!
Removal of polyps at the time
of colonoscopy can prevent the
development of cancer.
Frequently Asked Questions:
1. How important is diet?
A healthy diet with healthy life-
style choices is certainly recom-
mended, but in today's world that
is not enough. Prevention in better
than cure, and getting screened for
colorectal cancer makes a differ-
ence. This is proven.
2. What about colon cleansing?
Someone whom is constipated
is no less healthy than someone
whom has a daily bowel motion.
The colon is actually self-cleaning.
It is durable and built to do what it
does. The quality of food eaten is
important; not how long it takes
to get out.
The danger of colon cleansing is
that people whom have a medical
problem, will get no better and their
diagnosis will be delayed. The truth
will be denied for which there may
be a mortal risk. Beware of herbal
3. I want to get screened but
there seems to be so many op-
tions? Which is best?
Colonoscopy is the best test for
screening. In skilled hands it pro-
vides the best opportunity to ex-
amine the colon, find and remove
polyps, and prevent a cancer. If the
test is normal, screening may not be
necessary for another ten years.
People are usually skeptical of hav-
ing this test. Understood, but many are
actually pleasantly surprised when it
is over. Really isn't that bad! Like an-
ything else in life, there are cases which
can be painful, present difficulty and
Most will agree that the bowel prepa-
ration is the most challenging part of
the procedure, and with this in mind,
you would want to get the most out of
that purge. Abnormalities detected
on any of the other test will require a
4. What other screening tests are
Virtual CT colonography: Many
people may prefer to do this. It is
non-invasive, which is an advantage,
but it can only reliably detect large pol-
yps (> 1cm). Retained stool is often a
source of confusion, which may then
require a colonoscopy to investigate.
Barium enema: This traditional
workhorse should now be a relic of 20th
century medicine. It is a low resource
item and does not adequately examine
the rectum which is an important site
Capsule Endoscopy colon: Intui-
tively, nothing could be better than tak-
ing a purge, popping a pill and having
your colon examined! We were a part
of a multicenter trial that studied this
and compared it to colonoscopy. From
the results, five (5) cancers were missed!
The technology is improving, but not
considered a high quality screening
Flexible Sigmoidoscopy: This test
is a bit of a cheat. It really only examines
one third to half of the colon. Yet still,
it has proven its worth in the United
Kingdom where it is an important part
of their National Bowel Cancer Screen-
ing Program. Cancers of the rectum and
left colon account for perhaps 60-70%
of cancers. Thus there is a known miss
rate. Locally we do not have the hard
data regarding the site of our cancers,
and I would be reluctant to recommend
this as a high quality screening test.
5. What about stool tests?
Testing the stool for blood that can-
not be seen (occult) is a very important
test. T here is no good reason, why in
the 21st Century, in our prosperous
Nation that everyone of screening age
should not be offered this test. The
FIT, which is an immune testing agent
is readily and widely available and needs
no preparation at all. This should be
done yearly, and can be done at home.
It should also be ordered at the local
health centres as part of the primary
health care programme
Dr. Feisal Daniel
Specialist Surgeon Endoscopist
17 King Street
Haemorrhoids a problem?
human condition. You may experience burning,
itch, wetness, swelling or rectal bleeding. For
these an over the counter (OTC) treatment rec-
ommended by your Doctor should be OK.
However there are things that you need know:
RECTAL BLEEDING is always an important
symptom. Haemorrhoids are the most common
cause of bleeding, but the least important.
COLORECTAL CANCERS bleed. In fact they
may not bleed too much at a time to get your
RECTAL BLEEDING demands a diagnosis.
Do not be reassured that the "bleeding has
A Public Service Message courtesy,
ENDOSCOPY TRINIDAD & Tobago Ltd.
For more information call 223-3636
This test can save your life.
According to the medical textbooks, colon
cancer is an easy diagnosis. The symptoms are:
rectal bleeding, a change in bowel habit, unex-
plained diarrhoea or constipation, weight loss or
low blood counts (anaemia).
Unfortunately, for many with these symp-
toms they never got the test they needed
most, early enough: A COLONOSCOPY.
COLONOSCOPY is an endoscopic examination
of the inner lining of the colon, rectum and anus.
This layer, the mucosa is where most large bow-
el diseases originate (piles, cancer, infammatory
bowel disease and polyps).
This test will make the diagnosis and can pro-
vide treatment for haemorrhoids without surgery.
It can also PREVENT COLON CANCER by
removing polyps (polypectomy).
BE CERTAIN! Get Scoped!
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