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Over 50? Time to screen for colon cancer

It was just a chance conversation, but it may have very well saved her life

While visiting a friend at MUSC's Hollings Cancer Center, Peatsy Hollings ran into Daniel Nixon, M.D., the center's associate director of Prevention and Control, who she sees for nutrition advice.

“During the conversation, Dr. Nixon asked me when I last had a colonoscopy,” Hollings said. “He said that anyone between the ages of 50 and 55 should have a baseline screening for colon cancer. I was 62 at the time.”

Hollings, a Charleston native who has been married to U.S. Sen. Fritz Hollings for 28 years, wasted no time in setting up an appointment for a screening.

Robert Hawes, M.D., professor of medicine in MUSC's Digestive Disease Center, used a colonoscope, a thin fiberoptic tube that transmits light and produces an image by way of a small video chip located in the tip. As the instrument advanced through the colon, the images are shown on a television screen. Hollings was lightly sedated during the procedure, and felt no pain. Before the examination, she drank a citrus-flavored solution that cleaned out her colon so the doctor could get a clear view.

During the screening, Hawes discovered two polyps. The bigger of the two was flat and was located in a portion of the colon near where the small bowel and the large bowel (colon) meet. The other was shaped somewhat like a mushroom, and was small and easily removed.

“Biopsies from the large polyp, while not showing cancer, revealed that the tissue was likely progressing toward that end.” Hawes said. “It needed to be removed.”

Hollings didn't hesitate. “When I heard the probability of cancer was there, I decided there was no sense in wringing of hands,” she said. “I wanted to get it over with.”

After thorough discussion with Hawes and Paul Baron, M.D., associate professor of surgery in MUSC's Surgical Oncology Division, Hollings elected to have the polyps removed surgically. She was admitted to MUSC Medical Center, where Baron removed the section of colon containing the polyps. Hollings was discharged after three days. She will need to undergo a colonoscopy periodically in the future to look for any new polyps.

“I think more physicians of all kinds should make their patients aware of this screening,” Hollings said. “The problem is that so often by the time there are symptoms of colon cancer, it's really too late to do anything. In my case, no one had ever mentioned it to me.”

Celebrities such as Katie Couric have brought colon cancer to the forefront. The popular “Today” show host lost her 42-year-old husband to the disease last year. “So it's not an old person's disease,” Hollings said.

Most people should get an initial screening at age 50, Hawes recommends. If you have a first-degree relative—a parent or sibling—who has had colon cancer, screening should begin at age 40. Sen. Hollings took his wife's advice, and he too got a screening colonoscopy. “They found a tiny growth near the appendix,” she said. “It was not a typical polyp like I had, but it needed to be removed.” The growth was removed, and the senator was discharged after two days.

Hollings acknowledges there are people who are embarrassed to discuss something like colon cancer, its symptoms or the screening process with anyone, including their doctors. “Maybe because I'm in political life and there are no secrets, I say ‘so what,’ but people should remember that their doctor is a professional who deals with this kind of thing every day. There's really nothing new to them.”

Hollings continues seeing Nixon. “As a result of eating more roughage, drinking more water and cutting out wine, I've lost 15 pounds,” she said. Despite their busy political lives, which may involve one or more drop-ins or other functions on any given night, Sen. and Mrs. Hollings make every effort to skip the appetizers and eat at home, she said. They also exercise.

Editor's note: The article is reprinted from Health connection newsletter.