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Don’t count on at-home colon cancer tests

- James E. Causey James E. Causey is an Ideas Lab reporter at the Milwaukee Journal Sentinel, where this column first published. Email him at jcausey@jrn.com. Follow him on X: @jecausey

I’m 54, and I just got my first colonoscop­y. I’m glad I did.

My doctor removed four polyps during a 25-minute procedure. Two of the four were the type that, if left alone, could have the potential to turn into colon cancer.

Last year, I did an at-home test that came back negative and was told I didn’t need to do it again for three years.

My wife got a colonoscop­y last year and doctors discovered a non-cancerous polyp. She had been on me for quite some time and kept telling me to get a real colonoscop­y.

I finally decided to schedule an appointmen­t after the American Cancer Society reported a rise in colorectal cancer cases in younger adults.

March is Colorectal Cancer Awareness Month. The profile of this deadly form of cancer ebbs and flows.

Most recently, the death of Chadwick Boseman, the star of “Black Panther,” in 2020 following a four-year battle with colon cancer boosted awareness. Bosman, who also starred as baseball legend Jackie Robinson in “42,” was not yet 40 years old when he received a stage 3 cancer diagnosis in 2016.

Having a procedure like this is not fun, and it’s not something people like to talk about. The funny thing is that when you do talk about it, everyone has a story about themselves, a friend or a loved one.

Nothing I share here is intended to replace medical guidance from a trained profession­al. Each case is unique along with family histories. And that’s precisely why I’m sharing my experience.

Request the informatio­n. Schedule an appointmen­t. Get this test done.

It can save your life.

Stigma, anxiety and misinforma­tion

One of those people with a story is Gaulien Smith, 53, owner of Gee’s Clippers barbershop in Milwaukee. He knows all too well the importance of a colonoscop­y. His father, Gaulien Smith Sr., died of colon cancer in 2006 when he was just 62.

“He never got a colonoscop­y. He didn’t have any health problems until he started experienci­ng abdominal pains,” Smith said.

When Smith’s father went to the hospital, he was already at stage 4, which is considered the most serious case. He said misinforma­tion, stigma, anxiety or fear are some of the reasons why men don’t get checked.

“They heard the prep is difficult and the procedure will be painful,” he said. “And to be honest with you, some men are uncomforta­ble in their own skin. They fear something going inside of them.”

He is hosting a panel discussion March 30 with a doctor and those impacted by colon cancer at the barbershop, 2200 N. Dr. Martin Luther King Jr. Dr. in Milwaukee, from 11 a.m. to 1 p.m. The event is free and open to the public.

“Colorectal cancer is the second most common cause of cancer-related death in men and women, so we need to talk about it,” said Smith, who gets tested every three years because of his family history.

I’ve done the at-home colon cancer screening test

Like Smith, I have my own family experience. My first cousin, Marshel Lewis, who is the spitting image of my mother, was diagnosed with stage 3 colon cancer in 2018. She underwent surgery and had a foot of her colon removed. Today, she’s cancer-free, but at the time of the diagnosis, things did not look good.

While colon cancer runs in my family, I was hesitant to get a colonoscop­y because I didn’t want to drink a gallon of the polymer-based laxative, so my physician told me about a do-it-yourself home kit called Cologuard six years ago.

He said the kit could determine if there was blood in my stool – a common sign of colon cancer or the precancero­us polyps. It seemed easy enough, so I told him to order the test.

The kit was shipped to my home in a week. I placed this cup-like device over my toilet to collect a stool sample. Then, once the sample was in the cup, I followed the instructio­ns in the patient guide and sent the collection back to a lab. Two weeks later, I received my “negative” result.

At the time I received my results, my cousin discovered she had cancer. Colorectal cancer arises from the inner lining of the large intestine. It usually begins as an abnormal growth, or polyp, in the colon or rectum.

I took another Cologuard test last March and received another “negative” cancer screening and was told I wouldn’t need to test again for three years.

While colon cancer screenings for Black Americans were recommende­d to begin at age 45 even before this became the recommenda­tion for all adults with average risk, the American College of Physicians now advises Black men and women to undergo their first screening at age 40.

African Americans are not only at greater risk of colon cancer than other races, they also have higher death rates from colorectal cancer when compared with other races.

The most challengin­g part: How to prep for a colonoscop­y

The prep is worse than the procedure itself. You’re advised not to eat solid foods a day and a half before. You can have Jell-O and juices as long as they’re not red. You can also have broth, which helped me out a lot. They advised me to take a stool softener first, and then I started the strong laxatives to clear my digestive tract. Take care of everything before you start the laxatives because you will not be leaving the house.

You’ll drink a half-gallon of the liquid laxative in the evening and finish the other half about six hours before your appointmen­t. I went to the bathroom nearly two dozen times, but honestly, I felt pretty good.

Schedule your appointmen­t as early as possible because you can’t have anything – not even water – three to four hours before your procedure.

My appointmen­t was at 9:30 a.m. When they got me to my room, I changed into a gown.

Again, a personal experience intervened. My nurse shared the story of her brother-in-law, who discovered he had colon cancer when he was at stage 3. She said he had no prior health issues before that, and he was 45. By the time he started cancer treatments, she said, it was too late. He died shortly after that.

Colonoscop­y is ‘gold standard’ for cancer screening

Before my bed was rolled into the procedure area, the nurse connected me to an IV. I was administer­ed fluids and would receive anesthesia. She asked if I wanted the drug where I would be in a “twilight state” or if I wanted to be completely “knocked out.”

I chose to be knocked out.

The procedure area was larger than a bedroom. The light was dim, and Dr. Amir Patel from Froedtert & the Medical College of Wisconsin assured me I would not feel a thing.

The anesthesio­logist placed me on oxygen before telling me to turn on my left side. When he started to give me the anesthesia, I could feel my hand burn a bit.

The last thing I remember is asking how long my hand would burn. He told me I would not feel anything in 30 seconds. When I woke up, I was in the recovery room with my wife.

Dr. Patel did his best to assuage my fear and said that even if the polyps were precancero­us because he removed them during the colonoscop­y, there was no further cause for alarm. I would need to return in five years to be rechecked because the colonoscop­y is the gold standard for colon cancer screening.

When I checked the MyChart patient portal online, I discovered that two of the polyps could have turned cancerous if left alone.

Seeing those results shook me a bit, but I’m glad I got screened when I did. And I didn’t allow feeling inconvenie­nced for 48 hours stop me from getting a procedure that could save my life.

You shouldn’t, either.

 ?? DAN MACMEDAN/USA TODAY NETWORK ?? Actor Chadwick Boseman, at the Academy Awards in 2019, died of colon cancer in 2020, at the age of 43.
DAN MACMEDAN/USA TODAY NETWORK Actor Chadwick Boseman, at the Academy Awards in 2019, died of colon cancer in 2020, at the age of 43.
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