Listening to music while undergoing colonoscopy can help one bear the procedure. (Chris Jackson/WPA Pool/Getty Images)
This is a question I’m frequently asked, and my answer remains the same. I’d rather face 15 minutes of immodesty to months of dying slowly from cancer of the large bowel. So don’t be fooled by a recent newspaper headline stating that colonoscopy isn’t 100 percent foolproof. If you use this report as an excuse for not lying on the colonoscopy table, you could be making be a fatal error.
The gold standard for diagnosing colon cancer has always been colonoscopy. But scientists at The Institute for Clinical Evaluative Sciences and the Universities of Toronto and Western Ontario recently reported a study showing that colonoscopy failed to diagnose cancer in 4 percent of cases. So what does this mean?
It emphasizes once again that there are only two things for sure in this life: death and taxes. Rockets costing millions designed by world-class scientists sometimes blow up. It follows that procedures done by lesser mortals always have an element of error.
Why does this happen in colonoscopy? How can the batting average be improved? There are a few basic rules.
Rule No. 1. Doctors cannot diagnose what they can’t see. To diagnose colon polyps, a video colonoscope is inserted into the large bowel. This sends a color picture from inside the colon back to a TV screen. But to see polyps, the bowel must be 100 percent clean. If patients don’t take laxatives followed by copious amounts of water prior to the exam, particles of fecal matter can hide polyps.
Rule No. 2. Practice makes perfect whether you’re designing rockets or performing colonoscopy. There are now more doctors who perform this procedure. But no doubt some missed polyps are due to doctors who are less skilled in this technique. Fewer polyps will be missed as they become more experienced.
Rule No. 3. The more doctors look, the more they see. If doctors try to rush through this procedure, it increases the chance of error. So it’s prudent not to keep asking the doctor “How much longer will it take?”
Rule No. 4. Music reduces psychological and physiological stress. If more doctors played music during colonoscopy, patients would be more relaxed and more polyps would be detected. A U.S. study showed that music decreased anxiety and heart rates, and blood pressure did not increase.
The benefits of music should not come as a surprise. Soldiers go into battle emboldened by music. It’s also used in labor rooms to ease the pain of childbirth. It’s believed that music increases blood levels of endorphins, a morphine-like substance. So relax and concentrate on the music.
Some studies show that ample amounts of calcium may decrease the risk of this malignancy.
Take a lesson from Uganda, where colon cancer is rarely seen. Ugandans consume huge amounts of fiber resulting in soft stools that prevent constipation. Some researchers believe regular bowel movements stop cancer-causing substances from prolonged contact with the intestinal cells.
Remember that colon cancer does not develop overnight. It results from the growth of polyps. They’re not rare. Studies show that over the age of 50, one in three people has developed a polyp, which if removed, prevents this disease.
So don’t let fear, temporary discomfort, or lack of dignity prevent you from having this procedure. And forget the 4 percent figure. Remember, if a polyp is present and colonoscopy is not done, the miss rate is 100 percent!
Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His Web site is Mydoctor.ca/gifford-jones
