Sticking your head in the sand

By Richard P. Holm MD

People like to joke about colonoscopies. One guy asked me after his test if I could see his head through the scope, since his wife was always telling him it must be up there.
But it’s no laughing matter that 90 percent of colon cancer deaths could be prevented, and still 70 percent of people who should have a colonoscopy are not having it done.
So why would that be? I hear all sorts of excuses: “It’s an invasion of my privacy,” “I don’t want to think about it,” “I had a bad experience 10 years ago,” “It’s humiliating,” and worst of all, “I’m afraid you may find something.” Unfortunately, these excuses have been way too effective.
Let me tell you a true story: One day, years ago, my dad called and said that there had been blood in the commode for a while, and asked what to do. My worst fears became a reality as first the colonoscopy discovered cancer, and then the surgery found that it had spread to the lymph nodes.
What followed was chemotherapy and medicine, which, I’m sure, gave him at least an extra year until the malignancy reared its ugly head again.
In the end he developed pneumonia, appropriately called “the old man’s friend,” his pain went away, and he slipped from us gently, and with dignity. What’s done is done, but I wish his cancer had been caught earlier.
So what about the plusses and minuses of the colonoscopy?
First the disadvantages: it’s expensive; the cleaning out before the test is not fun; and there is a small risk that you may go on to need surgery. But there are advantages: using new sedative analgesics, the patient experiences, with rare exception, merely a pleasant nap. The expense is generally and appropriately covered by insurance and is nothing compared to what it would cost if cancer were not discovered early. And the biggest advantage of all: the whole thing just may save your life.
Remember, 90 percent of colon cancer deaths can be prevented. Please, if you see blood in your stool, notice a change in your bowel habits, or even if it is just time for that every 10-year screening colonoscopy, don’t stick your head in the sand, or for that matter, your bottom either.
To hear more from Dr. Holm, watch his TV show, On Call with the Prairie Doc, every Thursday at 7 p.m. CT on South Dakota Public Broadcasting and his Web site, On Call with the Prairie Doc is produced by the Healing Words Foundation in association with the South Dakota State University journalism department and airs Thursdays on South Dakota Public Broadcasting Television at 7 p.m. Central, 6 p.m. Mountain, and streams live at

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