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PST wrote:

chunkyfrog wrote:I read somewhere the cure rate for cancers found by colonoscopy is nearly 100%!
Nice odds, very nice.
Pretty much can't afford NOT to do it!

Alas, I wish that were the case. I think what you must have read, chunkyfrog, is that when pre-cancerous polyps are found through colonoscopy, their removal is nearly 100% effective in preventing them from developing into malignant tumors. That's way better than treating it once it's already present, and the polyps are usually removed during the colonoscopy itself using a wire loop attached to the scope with no muss, no fuss. That is also the case when cancerous cells are found on the polyp (carcinoma in situ), but no invasive tumor has developed.

I understand your skepticism, but it's my understanding that finding polyps that could become cancerous before they get to that stage, and removing them, reduces the risk of developing difficult-to-treat colon cancer. I don't like these procedures but must admit that I've had several polyps removed that were of the type that could become cancer. My main question is how many screening tests do we endure to avoid a single cancer.

Mindy

A colonoscopy can lead to the detection and removal of polyps that can lead to cancer, but colonoscopies are not 100% in the detection of polyps. Even in expert hands, there is a 25% miss rate of tiny polyps/lesions. However, having a colonoscopy does significantly reduce the risk of developing colon cancer and has been shown to decrease mortality from colon cancer.

My understanding is that if polyps are found, the recheck is much sooner.
The polyp development and cancer formation is said to generally be a slow process, but there are probably exceptions.
Also, the better a patient is 'cleansed' beforehand, the more likely the exam will be reliable.
Knowing that, I started the clear liquid diet a day earlier.
I was a little cleaner by the beginning of the 'night of a thousand waterfalls'.

chunkyfrog wrote:My understanding is that if polyps are found, the recheck is much sooner.
The polyp development and cancer formation is said to generally be a slow process, but there are probably exceptions.
Also, the better a patient is 'cleansed' beforehand, the more likely the exam will be reliable.

True.

chunkyfrog wrote:My understanding is that if polyps are found, the recheck is much sooner.

Wife's family has a history of polyps and cancer both, so she is checked every 5 yrs. I'm clean, every 10 years.

Also, the better a patient is 'cleansed' beforehand, the more likely the exam will be reliable. Knowing that, I started the clear liquid diet a day earlier. I was a little cleaner by the beginning of the 'night of a thousand waterfalls'.

My doc/hospital gave me an instruction sheet that started the week before, first with cessation of aspirin and other blood thinners, foods, mandatory water drinking rates, fiber reductions, clear liquid diet for 2 days, dulcolax/happy-jug, fasting, etc. It was quite extensive. I read that thing about 4000 times as I went through the process. They said if patients screw up, the appointment is cancelled (on the spot if need be) and you have to start all over again. I did not error!

mindy wrote:

PST wrote:

chunkyfrog wrote:I read somewhere the cure rate for cancers found by colonoscopy is nearly 100%!
Nice odds, very nice.
Pretty much can't afford NOT to do it!

Alas, I wish that were the case. I think what you must have read, chunkyfrog, is that when pre-cancerous polyps are found through colonoscopy, their removal is nearly 100% effective in preventing them from developing into malignant tumors. That's way better than treating it once it's already present, and the polyps are usually removed during the colonoscopy itself using a wire loop attached to the scope with no muss, no fuss. That is also the case when cancerous cells are found on the polyp (carcinoma in situ), but no invasive tumor has developed.

I understand your skepticism, but it's my understanding that finding polyps that could become cancerous before they get to that stage, and removing them, reduces the risk of developing difficult-to-treat colon cancer. I don't like these procedures but must admit that I've had several polyps removed that were of the type that could become cancer. My main question is how many screening tests do we endure to avoid a single cancer.

I absolutely agree with your statement, Mindy. If you find the polyp before cancer develops, you're good to go. That potential cancer doesn't get the chance to develop. What I was disagreeing with was that the cure rate for actual cancers found by colonoscopy is nearly 100%. I went through that process a number of years ago, having been diagnosed via colonoscopy, and while everything turned out just fine for me, it motivated me to read everything I could on the prognosis for patients with tumors of various stages, and I had to discuss cure rates very frankly with my doctor in the course of making treatment decisions.

RoboLobo wrote:I am going to have my first colonoscopy on Friday, the day before I start treating my Apnea with a CPAP machine. I was wondering if anyone here has recently (fairly recently?) had a colonoscopy (and specifically a colonoscopy) and how they handled your Obstructive Sleep Apnea issue. Whilst I was walking the dog tonight I brewed up some ugly imagery of me dying on the outpatient operating table, and although ridiculous it got me thinking. I do plan on calling the hospital tomorrow (and mentioning it again on Friday), but I was wondering if anyone has a personal experience they would like to share with the group

Thanks!

I had my third colonoscopy in 2yrs last week. There was no issue whatsoever with my OSA, however my surgeon will not go ahead with the procedure unless my CPAP machine is with me under the table if needed - it hasn't been, or even been close to being needed.

I've heard that not all doctors are like this, however I'm glad mine is. I have my procedure at a G.I. clinic, where that's all they do.

Honestly - it's a piece of cake and the prep is way worse than the actual procedure - but don't try and cheat on the prep - do it exactly as they tell you - you don't wanna go back for a second one soon after.

Good luck!
Cheers,
xena

BasementDwellingGeek wrote:Rather sick South Park humor regarding Lemmiwinks: http://www.youtube.com/watch?feature=pl ... Q8_nAeeXaE

I got scoped for the first time about 8 years ago. They didn't put me out, just got me to where I didn't worry about stuff - almost like a mega-version of the dentist using nitrous. I was even able to watch the video, and wanted to know what was going on - but all they talked about was football. I had to wait a week to find out how it went.

Anyway, as I was being wheeled into the room, I said "Hi Doctor Lemmiwinks!"

Pretty much just confusion throughout the room, except for one nurse getting the gear ready. She snorted so hard she blew snot all over the inside of her mask and had to go change and re-scrub.

Should be due for another in a couple years. We'll see if there's more South Park fans in the crew...

I had my first one last week. I made very sure at every step of the process that everyone involved knew I had sleep apnea.

I was put under a full anesthetic, instead of the don't care drug, with an anesthetist present. I also have pretty severe claustrophobia which they also knew about. They put me under using propofol. I wasn't told to bring my mask, but the anesthetist asked about it when she visited me just before the procedure. I had it in the car but not on me. I'll specifically ask about it next time. Later in the day my jaw felt a bit sore, so perhaps they propped it open with something after they put me out.

When they took me in, they put some oxygen tubes in my nostrils and stuck a simple mask on my nose (not a PAP mask) and asked me to roll onto my left shoulder. That's my standard sleeping position, so I was very comfortable and happy to doze off. The propofol probably helped. Before the procedure I was most worried about my sleep apnea and claustrophobia being issues, but they were total non-issues. They said they have a lot of experience with sleep apnea patients.

Regarding the preparation, because I was going to be put completely under, I had to finish mine at least 6 hours beforehand, instead of 3. I didn't find the prep particularly bad. I just drank an 8 oz glass of the stuff very quickly every 10 minutes or so, in two batches. A bit of a bad aftertaste but not a big deal. My wife basically sipped hers continuously, and dragged out the whole thing and looked really miserable.

Early stage colon cancer is very treatable if found early. It's often really nasty if not. Where I had my colonoscopy they also do a pathology test on the removed polyps and want to see you back after just 3 years if you have whatever they'r looking for. My wife is due back in 5 years. I don't know my results yet.

If you do have any concerns I would insist on full anaesthesia and an attending anaesthetist; you will have a pre-procedure interview at which time you can advise on your OSA and get input. If your OSA is bad enough they will allow you to bring your CPAP machine and mask with you and will likely infuse some oxygen.

I wouldn't sweat it too much. The procedure is relative short. At the very least I would insist on being in lala land. I had only ONE where I was not in lala land and will NOT do that again as the cramping was so bad that they could not get the garden hose all the way up as I was in pain. All of the others I have had have been a breeze and when done you have that lovely feeling of knowing that you have had 'the Presidential' examination and have no polyps or cancers. Any plops that are found are removed on the spot if possible, whereas, with CT scan/MRI based 'pseudo-colonoscopy' procedures, if a plop is found, they have to reschedule you to come in and have it/them removed.

I have had to friends succumb to colon cancer. It is not a pleasant way to go. What bothers me the most is that it was almost entirely preventable/curable if they had been having regular colonoscopies.

Now, when they come at your from the other end, you want to be well and truly in lala land. I bought myself a pair of $300 running shoes and told them the next time they try to do that they are going to have to catch me first.

I just went through the process several days ago. OSA wasn't a concern at all since I was on my side and sedated, not knocked out. The doc had my med record at hand. Told the doc it was my understanding after the day of clear liquid diet and laxatives, and the sedation, that after it was all said and done more than likely I wouldn't give a s**t!

I mentioned to some folks a day later I endured a clear liquid diet on Sunday and had the internal inspection associated with the diet on Monday. The doc gave me a clean bill of health!

JointPain wrote:They put me under using propofol.

Propofol is one of the meds that cause 'conscious sedation' with some nice amnesia qualities. Because of a combination of a genetic disease and current polyp growth, I have routine scopes of my short (< 10 inches) colon and my stomach at least once a year. The place where my doc does both scopes switched from versed to propofol a couple of years ago - serious happy for me since propofol has much shorter activity than versed so I am awake and able to drink sooner.

Yep, MUCH happier w/propofol. Considerably more expensive for insurances. More lucrative for facilities and anesthesiologists. Since there is NO REVERSAL AGENT for propofol most states REQUIRE administration by an anesthesiologist rather than a CRNA.

PST wrote:

Slartybartfast wrote:The actual procedure is anti-climatic. I don't know why people make such a fuss over it.

I have always thought that people make a fuss because they are afraid of the diagnosis.

What scares me is I know more than one person who had problems with the procedure. One person was in intensive care for some time and almost died. The Dr. removed what he "thought" was a polyp and it was not.

If there's a medical reason for the test, then fine, but to just do it because one is a certain age, I don't agree with.

MsBea wrote:What scares me is I know more than one person who had problems with the procedure. One person was in intensive care for some time and almost died. The Dr. removed what he "thought" was a polyp and it was not.

Do you know how rare that is?

If there's a medical reason for the test, then fine, but to just do it because one is a certain age, I don't agree with.

Well, then your risk of colon cancer just went up.