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Dr. Oz, Colon Cancer Screening, Colon Polyp, and Colonoscopy - What Can We Learn

Posted Sep 07 2010 11:40pm
I'm a big fan of Dr. Oz . What is there not to like about the guy?  He's incredibly smart, a graduate of my alma mater, the Wharton School, energetic, pretty good looking, and charismatic.  Though as a doctor I don't always agree with him, as I practicing primary care doctor I have great respect for his mission of getting all Americans healthier. (I wished he could have given me a testimonial for my book , though he sent a nice email wishing me luck. Perhaps my next book?). Though I have a busy day job, the season premier for his second season was one I could not miss. He turned fifty in June and had a colonoscopy in August to screen for colon cancer.  As a result he saved his own life.

Dr. Oz had a colon polyp.  The polyp which was removed was found at the distal sigmoid and identified as an adenomatous polyp.  These types of polyps have the potential to become cancerous over time.  Had it been left in the colon undetected, it could have become cancerous over a period of years.  Had he had delayed his colonoscopy until age 60 it could have developed into a full blown cancer.  Like most of us, Dr. Oz admitted that life is busy and we often delay important screening tests because we don't have time.  Fortunately, the polyp was removed and the likelihood of developing cancer from that growth is essentially zero.  Nevertheless to make sure, he will be repeating a colonoscopy again in a few months.

Understandably, Dr. Oz was shocked and humbled by the experience and the colonoscopy finding.  No one likes to be a patient, particularly cardiothoracic surgeons, who are often in complete control.  Like many patients and particularly even more doctors, he had a bit of arrogance going into the procedure because he works hard on staying healthy.  The colon cancer screening test was simply a thing to check off on his to do list.  A formality, but nothing that was taken seriously.

Instead, the procedure saved his life.  As a result, instead of leading in the second season with a ratings favorite of weight loss, the doctor in Dr. Oz did the right thing.  He aborted the original premier of weight loss originally scheduled because of the surprising colonoscopy findings and refocused the premier on the nitty gritty about hunting down the second leading cause of cancer deaths and filmed his most personal show ever.

He argues, rightly, that we must make time to do the right things.  Had he not been the host of his show, he would have been inclined to do procrastinate as he is a "sloppy patient"".  "Lifestyle is not the cure all by itself."  Part of being healthy and staying healthy is getting screened for cancer, high blood pressure, high cholesterol, and diabetes.

Dr. Oz had no symptoms, no family history of colon polyps or colon cancer.  What is particularly heart wrenching is that thirty-two thousand Americans died of colon cancer because they were never screened.  When caught early, colon cancer is highly curable.

According to Dr. Oz's expert, the majority of patients with colon polyps have no symptoms.  In other words, a deadly time bomb could develop and you wouldn't even know it unless you looked.  Even more disturbing is that seventy percent of patients with colon cancer have no family history.

Although Dr. Oz recommended that all Americans age 50 years and older be screened for colon cancer with a colonoscopy, his polyp was discovered at the distal sigmoid which would have been easily reached with a sigmoidoscopy.  Other options for colon cancer screening also include a virtual colonoscopy, stool testing, stool DNA testing, or barium enema, which are all recommended by the American Cancer Society.

My personal belief is out of all the options to screen for colon cancer, starting at age 50 all Americans who are otherwise healthy and have no family history of colon cancer or polyps should opt either for annual stool testing with a sigmoidscopy every five years or colonoscopy every 10 years. There is nothing magical or superior about a colonoscopy per se as it can also miss colon cancers or polyps as well . Research finds them equally as effective.

The biggest obstacle to preventing colon cancer deaths is that Americans simply don't want to be screened. Colon cancer screening is something I've been passionate about since residency training, when I learned one of my colleague's father died at a young age because of it. Getting my patients to want to have an invasive procedure like a sigmoidoscopy or colonoscopy is incredibly hard.  Yet, I have my 30 second elevator speech nailed.  With Dr. Oz's public campaign, I can refine it even further to this
If Dr. Oz, arguably a very healthy individual, had a colon polyp, why can't you?

As doctors we need to lead by example. Thanks Dr. Oz for doing the right thing!
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