Moderator (Moderator) - 12:57 PM:
Welcome! Today’s chat: Colon Screening can be a Lifesaver. Please start submitting your questions and Dr. Jonathan Williams will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit our
Cancer Screening Pages to obtain more information.
Dr. Jonathan Williams (NorthShore) - 1:04 PM:
Hi. I am Dr. Jonathan Williams. I am a Gastroenterologist at Glenbrook Hospital.
I am excited to participate in this event and help with colon cancer awareness month.
Jim (Glenview) - 1:05 PM:
I'm a little apprehensive about the prep process involved with a colonoscopy. What exactly is this liquid I need to drink and why do I have to drink 3 liters of it?
Dr. Jonathan Williams (NorthShore)
Great question. The prep is the often thought of as the worst part. It's not great, but it is not as bad as people make it. The preparation entails - the day before being on a clear liquid diet and drinking the preparation the night before. The liquid preparation is called GoLytely/Trilytely or half-lytely. It is a 4 L bottle that most people drink 3 L to ensure that their colon is clean.
I (and some others) actually use something called Half-Lytely - which is 2L. The new recommendations favor splitting up the prep - half the night before and half the morning of. Studies show that this is better tolerated and the preparation is better.
Hope this helps.
Mike S. (Chicago) - 1:10 PM:
When factoring in family history of colon cancer, how far in the family do I have to go to consider a colonoscopy for myself? I'm not 50 but cancer runs in my family.
Dr. Jonathan Williams (NorthShore)
Generally first or second degree relatives. The closer and the young they were when they had colon cancer determines when you should start.
In general, if a family member (up to 2nd degree- i.e. uncle) had colon cancer OR colon polyps, screening should begin at age 40 (instead of 50 for the general population).
Staci (Glenview, IL) - 1:12 PM:
What are symptoms of colon cancer?
Dr. Jonathan Williams (NorthShore)
Great question. Often there are no symptoms. But if you were to have the symptoms it could be anemia, blood in the stool, abdominal pain, change in stool frequency or stool contistency.
Bill S. (Riverwoods, Illinois) - 1:18 PM:
Can certain foods increase your risk of colon cancer? If so, what should I stay away from? Does having a high-fiber diet help minimize the risk of colon cancer?
Dr. Jonathan Williams (NorthShore)
Another great questions...you guys are good!
There are no certain foods that specifically increase your risk of colon cancer. In general, high fat foods, smoking and alcohol can increase your overall risk of developing cancer. A high-fiber diet may decrease your risk of colon cancer. Additionally, calcium and vitamin D may help decrease your risk of colon cancer.
The best way to prevent colon cancer is to get screened.
Staci (Glenview, IL) - 1:23 PM:
What are common risk factors of colon cancer?
Dr. Jonathan Williams (NorthShore)
Risk factors for colon cancer include: family history, high fat diet, alcohol intake (more than moderation), smoking/tobacco use and obesity.
John (Wilmette) - 1:24 PM:
What causes polyps in the colon to form in the first place?
Dr. Jonathan Williams (NorthShore)
No one knows for sure. Likely a combination between genetic and environmental factors.
Nathan (Chicago) - 1:24 PM:
How curable is colon cancer?
Dr. Jonathan Williams (NorthShore)
It depends on when it is detected.
The first step is trying to prevent colon cancer. 90% of colon cancers are preventable by screening colonoscopies, that is doing the colonoscopy before symptoms develop, finding pre-cancerous polyps and removing them before they can develop into cancer.
If colon cancer is detected, it depends on what stage it is - meaning if it has spread anywhere else.
If it is caught early and is contained in the colon, a surgical resection of the cancer can often be a cure and may not require chemotherapy.
David (Evanston, Illinois) - 1:31 PM:
I've heard the screening colonoscopy described as the "gold standard" of care. What makes this procedure better than some of the others that essentially do the same thing or do they?
Dr. Jonathan Williams (NorthShore)
Yes, colonoscopy is the 'gold standard' compared to other available tests. Some other tests are:
-sigmoidoscopy - this only examines half of the colon
-Barium enema - x-ray of the colon. Not very sensitive and if somethiing is detected a colonoscopy would then have to be performed.
-Testing stool for blood - this often detects colon cancer, thus it is not a preventative test. Also, not very specific.
-CT Colonography- a CT scan looking at the colon. This test is good for largerpolyps, but still requires a preparation, insertion of a rectal tube, no sedation is given and if any abnormalities are found a colonoscopy would have to be done.
So, I guess the colonoscopy is gold standard, because it is not only provides a diagnostic examination of the entire colon, but polyps can be removed or biopsied at the same time.
Robert (Mount Prospect, Ill) - 1:36 PM:
How sedated would I be during the actual procedure? Am I able to watch the procedure and will I feel pain or pressure?
Dr. Jonathan Williams (NorthShore)
In general we use conscious sedation or twilight. The sedation is tailored to the individual and is given in small increments until the desired response is achieved. In most cases, patients sleep through the entire procedure and wake up when we are done.
I have done many cases in which people request to have little or no sedation so that they can watch the colonoscopy on the screen. There is often some mild bloating or discomfort from the air that is inserted during the colonoscopy (the colon is normally collapsed, so we insert air to expand the colon and we can view the walls - looking for polyps).
Staci (Glenview, IL) - 1:40 PM:
Is colon cancer more predominant in males or females?
Dr. Jonathan Williams (NorthShore)
It is pretty much equal.
Brent (Chicago, IL) - 1:44 PM:
Are there changes that I could make to my diet to help prevent colon cancer?
Dr. Jonathan Williams (NorthShore)
The best thing you can do as far as diet is to have a healthy diet with lots of fruits and vegetables. Fiber is great. Avoid high fat foods, smoking, alcohol consumptiion and obesity.
The best way to prevent colon cancer is with a colonoscopy.
Moderator (Moderator) - 1:45 PM:
Thank you everyone for your great participation, the chat will be ending in approximately 10 minutes. Please submit any final questions you have.
Staci (Glenview, IL) - 1:49 PM:
How does colon cancer develop and get worse?
Dr. Jonathan Williams (NorthShore)
Most colon cancers develop from pre-cancerous polyps and over they can grow into colon cancer.
We don't know specifically what causes these polyps, but it is a combination of genetic and environmental influences.
Colon cancer will get worse, i.e. spread, the longer it goes undetected and untreated. Smoking can make it worse.
Dr. Jonathan Williams (NorthShore) - 1:57 PM:
I want to thank you all for participating in this discussion. Your questions were very thoughtful and important.
In my practice, I often (if desired or if any special circumstances) meet with patients before their colonoscopy and answer all questions and explain the procedure. I think it is helpful and reassuring for the patient to know the physican and feel comfortable with them prior to the procedure.
I perform all my procedures at Glenbrook Hospital's GI lab as outpatients. I do colonoscopies Monday through Friday.
I always call my patients with results of any biopsies and then will see them in the office a week or two later to discuss the findings, the treatment plan and answer all questions.
My office is conviently located in the Glenbrook Hospital Professional Building. 2050 Pfingsten Road, Suite 105.
Please call my office fif you have any questions or would like to schedule an appointment.
847-998-8530.
Thank you.
Moderator (Moderator) - 1:58 PM:
Thank you again for participating in our chat today. For more information please visit our
Cancer Screening Pages
Also, a transcript of this chat will be available shortly.