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#cancer#colonoscopy#more#risk#procedure#screening#don#drink#should#years
Discussion Sentiment
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Discussion (234 Comments)Read Original on HackerNews
The procedure was a piece of cake. As the standard is where I'm from (Norway), I was only administered some sedatives - but honestly I couldn't feel much difference. I watched the procedure on the screen, which was quite fascinating.
The worst part, by far, was the emptying / prepping. A month prior to the colonoscopy I took a stool sample (negative for blood), but my doc wanted to be safe.
In the end they nothing was found, not even polyps.
EDIT: I had put of going to it for the longest time, but a friend of mine (35 years old) was diagnosed with stage 4 last year, which pushed me to get it checked out. He had experienced prolonged constipation, that's it. When the tumor was found, the cancer had spread to both of his lungs and liver. He's still alive, and fighting it.
And the FIT+DNA test is so cheap and easy, you can do it every year or three instead of every 10 years with the colonoscopy.
She still recommends colonoscopies for high-risk patients, but she thinks the risks outweigh the benefits for low-risk patients, so she recommends Cologuard in those situations.
I appreciate this risk-adjusted and probabilistic approach rather than one-size-fits all recommendations.
The big issue has been that in the US, the followup colonoscopy was often no longer covered by insurance as it was no longer classified as part of the preventative medicine tier, and instead was now a different sort of procedure. My understanding is that this is no longer true though.
This is anecdote by induction.
There's also risks of false positives/negatives for some tests which complicate matters as well.
Not at the statistical level. Death rate from complications is about 1 in 10,000: https://www.endoscopy-campus.com/ec-news/risk-of-death-from-...
This. The procedure itself was a snap (I was completely sedated; I'm in Canada), but it was NOT a fun 2 days of "pooping" pure liquid and being hungry. I don't think I was away from the toilet for more than 20 minutes at a time.
I suggested to the pharmacists at my local pharmacy they should recommend butt cream when someone buys the prep stuff. Not sure if they do it, but all agreed it was a good idea.
And although I didn’t try the diaper rash cream, Balneol was definitely a life saver.
If you have no prior intestinal diseases and are in for a routine check, ask for the quick-acting one. You will have to drink the same total amount of liquid, but at least most of it will not be drinks of your choosing.
Also get anal cream, and apply it once before going to the toilet.
Protip to those who have it coming up: Ask for the pill prep instead of the "sludge" prep. You end up spending the day on the toilet either way, but at least it doesn't taste as bad with the pills.
A decent number of patients can't/don't get through all the liquid in which case the pills are far better.
> Sodium phosphate is no longer recommended as a bowel preparation regimen due to its serious side effects
Essentially, put in the effort and do the liquid bowel prep.
Consider adding flavour drops to your drink, icing it or turn it into a slushie to make it slightly more interesting to drink. The PEG will make the ice crystals slightly more smoother.
https://www.ncbi.nlm.nih.gov/books/NBK535368/
> In the end they nothing was found, not even polyps.
Same here, thank god.
Aren’t there a lot of different drinks, though (at least 3 or 4)?
E.g. I know Miralax can be an option for some which practically is tasteless.
No, the worst part is the risk of puncture. Rare, but it happens. Happened to a colleague of mine.
I was the same age. My doctor saw signs in an early blood test, and followed it up so mine got detected relatively early. My test was positive for Lynch syndrome, and I am now a colonoscopy veteran.
My pro tip would be to take the day off work. Trying to work while drinking the solution in the morning didn't really work.
If you catch it at precancerous or stage 1, it can often be removed with minimal side effects.
Sounds like for you the red flag symptoms were something else, but others shouldn't treat it this way.
So what you do is, schedule it for weeks or months out as you can and use that to develop good eating and fiber habits over that time. You have a deadline and real stakes in the game. You will literally hurt more unless you get that straight before then.
Win-win.
As described in one of the great modern tales of legend:
https://singletrackworld.com/2009/02/the-picolax-thread-retu...
- I take 100g proteins, 30g fibers daily
- Red meat once a week but never fried
- Most of the protein comes from eggs, yoggurt, chicken and various plant based sources
- No white bread
- No added sugars, no deserts except fruits
- Nothing fried
- No added salt
- No canned food
- Saturated fats kept at minimum.
- No spicy food
- No alcohol
The results are incredible. I lost 8 kg, my blood samples are perfect, my pulse dropped with 10, I sleep better, no migraines (I had those for years). Also this year I was the only one in the family that didn't got any cold, and that's quite hard with two kids going to kindergarten.
It's hard in the first two weeks, but afterwards it's becoming your daily routine. I also use an app to track various stats. The gameification of the diet also helped me a little.
I urge you to try this. To make it more manageable start small. For example avoid fast food for 2 weeks. Don't put any mayonnaise in your food for 1month. Stop eating white bread. And then add more and more restrictions. The hardest fight is the urge to eat sugar and drink alcohol, give it time.
I haven't heard about any risk with the natural emulsifier in egg yolk though.
I was eating spicy food and it irritated my intestines. I have enough fibers to never get constipated.
At lunch I usually have chicken breast or fish and some carbs (usually rice, or baked potatoes, rarely some simpla pasta). Salads, carrots, tomatoes, cucumbers, cooked vegetables, home made soups.
Then I have smaller meals with more fruits, or yoggurt with less fat. Or soups.
But of course I don't want to mess up. I roughly eat like you do
Kefir, eggs, chicken breast, potatoes, beans, rice, oats, fruits, vegetables, a little olive oil, low fat cheese and raw seeds (pumpkin) or raw nuts.
To be honest making the calories today is easier than not making your calories. Go to any supermaket you have caloric bombs everywhere and in everything.
Is life even worth living anymore?
Unlike the usual Bettridge's law, the answer to the headline is only a qualified "No".
It is a "So is all other cancers!", which is pretty bad news for folks who are young and healthy right now.
EDIT: having thought that over a third time, I am not sure it makes any sense.
That being said, I can see a few plausible biases (though none of them explain the scale of the increase IMO):
1. CRC risk is correlated with some previously fatal, but now curable disease. The mechanism would be that your high-risk CRC patients would die due to yellow fever or something in 1970, meaning they don't have the chance to get CRC. The important thing is that it would have to "artificially" remove high-risk patients from the age group, but not low risk patients.
2. CRC risk is noticeably higher at 24 than it is at 20, and all-other-cause mortality is significantly lower today. That would lead to a higher proportion of 24-year-old "years" in the calculation.
3. People used to die of CRC before it was caught, which caused it to not be recorded as a cancer incidence.
1 seems unlikely, and even if true shouldn't make a big difference. 2 seems the most possible, but still unlikely to make a huge difference. I don't know enough about how they determine cause of death to know if 3 is a possible outcome.
The overall age-adjusted cancer rate has been going down, and the death rate even more so.
https://seer.cancer.gov/statfacts/html/all.html
https://en.wikipedia.org/wiki/Betteridge%27s_law_of_headline...
A week or two later, I got a bill for several thousand dollars, and I just had to roll with it. I believe that in the US, there is a certain age, after which, they're covered.
There is a lot of confusion over this point, even among support agents for health insurance companies.
i) The Affordable Care Act specifies that all Marketplace health plans must cover colorectal cancer screening for adults 45 to 75 years at zero cost [i]. That means no copay and no coinsurance, even if you haven't met your deductible. You pay $0.
ii) That generally means that colonoscopies will be zero-cost for anyone in that age bracket, but only if it is a "screening". If you have symptoms, the service may be billed as diagnostic rather than preventative, which takes it out of the "zero cost" category
iii) All of the above is separate from whether the procedure is "covered" or not, because "covered" in the context of health insurance means "your plan covers this, subject to your normal deductible, copay and coinsurance, so long as it is medically necessary". If something is truly "not covered" then your insurance pays $0 and the provider will bill you the full, undiscounted cost of the procedure.
In other words, there is a difference between "your plan covers this (as it does for any other regular medical care)" and "your plan covers this at zero cost, as it falls into one of the narrowly defined 'preventative care' buckets as defined by the ACA"
It's common for people to confuse these things.
In your case, it sounds like the procedure was not covered at zero cost (as expected, as you are not in the 45-75 age bracket defined by the ACA, and in any case your procedure was diagnostic, not preventative), but it was "covered" by your health insurance in that you paid your regular deductible and copay, rather than the insurance company saying "your plan does not cover this procedure (at all)" and then the hospital billing you the full cost of the procedure, which would be tens of thousands of dollars.
[i] https://www.healthcare.gov/preventive-care-adults/
IMO, the fundamental issue for preventative screening is there is basically no amount of money I would not part with (of my money, the insurer's money, or private debt) to not die. I expect this is true for most people, and it makes preventative screening a tricky topic. In recommending screening for those >x age, you will miss some detectable, preventable and treatable cancer risk for those <x age, purely for cost. No one wants to be explicit about that though!
I think the only way out of that uncomfortable conversation is making screening so cheap via automation that you can basically run it for very low incremental cost as often as individual risk tolerance permits. This would be paid for on the back of earlier interventions vs late-stage, expensive interventions.
Similar things happen in any general surgery, for example you can get your tubes removed and send up with all your endometriosis that you weren't able to diagnosis removed as well
I don't think so. You have a reference?
Therefore, all polyps should be removed. (Sending them all to the lab might be superfluous though)
Though I regurgitate this information based off conversations with gastroenterologists not one off studies.
One of our better microscopes these days is DNA sequencing, especially for cancer, and the particular base mutations and the sequences in which they occur give heavy clues about the types of mutagens that are going on. The DNA damage from UV radiation from the sun and bulky adduct repair from smoking damage are vastly different. Even when cells have a defect in a repair mechanism, you can tell which repair mechanism is broken based on the particular base changes in which context.
A study from 2025 reapplied these Alexandronv signatures to colorectal cancer with a global set of cohorts, and suggests that colibactin, a mutagen produced by some strains of E. coli and related bacteria, could be driving some of the increase in early age colorectal cancer:
https://www.nature.com/articles/s41586-025-09025-8
Of course we don't know exactly how much of the increase, or the other explanations; causality is multi-causal and I bring this particular cause up because it's one of the stronger leads so far. But when we've lost our keys in the night, even if its easiest to look under the light of the streetlamp, that doesn't mean its the only place we might find them.
My Gastroentrologist told me just recently that the stool test (Cologuard) is very accurate but must be repeated every 3 years as opposed to getting a Colonoscopy which should be repeated every 7 to 10 years
The important part is both are good, so get one.
36 polyps were found. Some of elevated risk. So now I get yearly screening. But by the sounds of the type of polyps I had, if I had waited until the screening age I would have had high chances of cancer.
While certainly deaths are a more reliable indicator than diagnoses, you always expect to see an increase in “deaths from X” when you more aggressively screen for X. The intervention of cancer treatment comes with serious risks, and screening sometimes finds cancers that would otherwise never be a problem.
We’re talking about very subtle differences in population-level trends, so these kinds of errors matter.
Methyl cellulose is in gluten-free bread and in most fake meat products.
Some emulsifiers are found in mayo, other sauces and "ice cream". Not just vegan brands, but overall.
> The random-effects model demonstrated a significant inverse association between plant-based dietary patterns and CRC risk (hazard ratio [HR], 0.91 [95% CI, 0.85–0.97])
But as you guessed it varies between healthy and un-heatly diets:
> This protective association was strengthened when the definition of plant based patterns specifically emphasized the inclusion of healthy plant foods
However those un-healty foods are not restricted to plant-based meal (evidence: any supermarket shelf or snack restaurant), and lentils, tofu or seeds are as much -or more- likely to be found in a long term vegan dish than an impossible burger. As you noted it's "Not just vegan brands, but overall". For the mayo I recommend tahini instead (way more tasty) or just olive oil but if you really need it:
0 https://www.statista.com/statistics/1264382/top-motivations-...1 https://www.sciencedirect.com/science/article/pii/S1091255X2...
Try asking a doctor for asymptomatic screening (for anything), they usually say "There's a schedule for such screenings at age X, you're too young for that. There's also proven negative effects of excessive screenings."
Which kinda makes sense, as they supposed to have protocols/schedules for all kinds of healthcare. We're talking here about changing that protocols/schedules. But doctors (and insurances) are generally reluctant.
So my actionable question is "How do I convince my doctor to get the screening?"
In my 40s I asked my doc what I should get screened for and when. He said to wait until 50. Now I wait here on death row with stage 4 colorectal cancer.
What did you want your doctor to say, instead?
I guess we have to pay for it ourselves. It's not exactly cheap, but perhaps worth it.
My anecdote (M, 35) is that I got one after experiencing symptoms that turned out to be unrelated, but they did find pre-cancerous polyps so now I will be getting them more regularly. I received received meaningful early detection and peace of mind. Also aside from the prep, its a very convenient procedure. You get put under anesthesia and do a quick time travel.
What kinds of symptoms are people actually seeing? Or, without graphic details of your bowel habits, is this a "you'd know it when you see it" type of situation, where it would probably be obvious?
WebMD just says: change in bowel habits, blood in stool (would this be obvious?), anemia (how would you notice this?), unusual gas (uh, what is normal?), unexplained weight loss, fatigue, vomiting?
Unexplained weight loss and vomiting seem obvious, but the rest I'm not sure I'd even notice.
And "unusual" usually means unusual for you. So if you don't change your diet or habits, but suddenly get a ton of gas, fatigue, need to go to the bathroom way more often or have a different experience going to the bathroom, it's worth mentioning to do your doctor.
[0] https://en.wikipedia.org/wiki/Simpson%27s_paradox
No:
Colorectal cancer is going up in young people.
Yes:
Various kinds of cancer are going up in later generations. (Definitely at younger ages, possibly at all ages.)
Reminder
This blog endorses colorectal cancer screening. We don’t yet know if colonoscopies are better than other methods of screening (sigmoidoscopy, stool tests), but we do know that screening is better than not screening. When caught early, CRC is highly treatable, often with only surgery (no chemotherapy or radiation) and a return to normal activities within a couple weeks.
What I’m wondering about is…why?
As in…why is cancer rising among the later generations? Smoking has substantially fallen and this has led to a sharp decrease in lung cancer rates. So why are cancer rates overall increasing for those born in the later generations?
Presubably if you detect eveything earlier, every one of the detected cases would be younger if all else were equal.
In case you aren't aware of dynomight yet, there is a great backlog of posts to read.
https://www.yahoo.com/entertainment/celebrity/articles/kathy...
https://www.usatoday.com/story/entertainment/celebrities/202...
If its the polyp removal, I can certainly see how that could lead to problems. But you're a little stuck: even if you use another technique to do the scan, you still have to remove any polyps you find, don't you?
I'm not sure what the botches are here. In the sigmoidoscopy they took out a couple of polyps, in the colonoscopy (more recently than the sigmoidoscopy) they just did a cancer check-up given family history.
I wish those articles discusses the "botches", I'd like to know since from my understanding these are pretty safe procedures
Based on your concern, the question is whether 'botched' procedures are more or less of a risk (both in incidence and consequence) than non-screening.
Read the safety statistics and let it override the anecdotes. Colon cancer is easy to prevent and a horrible way to die.
The complication rate for colonoscopy is about 3 in 1000, and that is skewed towards people who have polyps, which in and of themselves could be dangerous if not removed.
So it's always a risk tradeoff. You can skip the procedure and risk the effects of the disease it's supposed to detect instead. But if you do the math, you're statistically better off doing the procedure.
Avoid risk where you can afford.
Where it costs you nothing.
I've had multiple surgeries under general anaesthesia. Twilight sedation was pretty much the same experience (at least for me): eyes slowly get heavy, then all of a sudden 'it's too damn bright in here, someone turn the damn lights off!.... Oh, that was quick...'
But not at Kaiser.
$17k later…
(1) Vitamin-D (drops)
(2) Magnesium (as Magnesium aspartate hydrochloride trihydrate)
(3) Psyllium shells (you won't take too much)
(4) Move your body!
Yes. Nothing to see here. And stop abusing quotation marks.
Can someone who's read it confirm?
Did you miss the BILLIONS in lawsuits against RoundUp and other herbicides?
Did you miss all the deregulation by the first and now second Trump administration allowing crazy levels of pollution and toxicity among all the industries?
They are still using leaded fuel in prop aircraft at hundreds of airports around the country and world, spraying it on unknowning population
Our environment has never been more dangerous yet people never more ignorant or carefree
Biden's EPA filing:
The agency says it is standing by its conclusions that, as registered, glyphosate doesn't pose major risks to human health..."
Any US admin always serves the Big Business, and people's health is just a bump on the road.
Then some clown downvotes this straightforward question. Brilliant.
Human biology is orders of magnitude more efficient than AI; that’s in regards to intelligence and processing the world around us.
It is not only more efficient but more complex but yet simple. Therefore, the complexity of our biology is a result of efficiency. An efficiency that allows us to process the world and achieve homeostasis in the most simple way. I’d like to see a machine achieve the same without having any type of vulnerability or weakness to corruption.
The real problem is that as lifespans get longer, silent chronic diseases progress over the span of decades without anyone noticing.
I mean look at human teeth. Horses have extra long teeth that emerge slowly out of the jaw over time as they get worn down. Their teeth are absolutely massive and yet their average dental lifespan is 20 years, up to 25 years if they are lucky and have been fed low abrasive food. Same with cows, after 20 years they have worn their teeth down and are called gummers.
Meanwhile humans who brush their teeth with fluoride and hydroxyapatite, and use interdental brushes of the correct size for each tooth gap, can basically keep their teeth all the way into their 80s. Mammals with a similar life span as humans such as elephants have gone through several sets of teeth after 70 years.
Humans are built for longevity. If we died at 30, nobody would give a crap about any type of cancer.