How Old Is Too Old for Colorectal Cancer Surgery?
When a reasonably healthy octogenarian gets a diagnosis of colon cancer, the issue of age is bound to come up. How old is too old for colon cancer surgery? What are the risks? What kind of recovery and quality of life can the very elderly expect afterward? Is it worth it? Johns Hopkins explores these questions and others in this Special Report.
Few studies have looked at how the elderly fare after colorectal cancer treatment and pursued these hard-to-ask questions. But in the ones that have, the short answer is that octogenarians and even nonagenarians can fare as well as younger seniors, if they are in otherwise good health.
It is true that the risks of colorectal cancer surgery are higher for some older people. An analysis of 28 studies found lower survival rates among the elderly who have coexisting health conditions, are diagnosed at an advanced cancer stage, and have to undergo emergency procedures. Another study found that octogenarians with early stage cancer survived 10 or more years after colorectal cancer surgery if they had no chronic illnesses.
It appears that quality of life after colorectal cancer treatment can be as good for octogenarians as it is for younger seniors -- even in the face of coexisting illness, according to a Canadian study that compared the outcomes of people over age 80 with those in their 60s. The average age of the older group was 83 years at the time of colorectal cancer surgery, while the "youngsters" ranged in age from 65-69. People in both groups underwent comparable surgical procedures and had similar coexisting health problems (such as hypertension and diabetes), although the older group had somewhat less advanced (lower-stage) cancers.
The responses to a survey on quality of life and functioning before and after colorectal cancer surgery were remarkably similar in both groups. Before surgery, both worried about pain, becoming a burden, and death. After colorectal cancer surgery, there were no major changes or differences between the groups in terms of their ability to perform daily functions or their overall health, sexual function, or quality of life.
Too Early To Draw Firm Conclusions?
The Canadian researchers emphasize that their study findings are preliminary, and some results may be biased. While the results are preliminary, the study provides further ammunition for the argument that determining which patients are candidates for colorectal cancer surgery shouldn’t be made solely on the basis of chronological age. High-functioning elderly people who undergo colorectal cancer surgery appear able to retain their ability to function and maintain a good quality of life.
Experts note that regardless of age the outcome of colorectal cancer surgery is likely to be better under these conditions:
* The cancer is at an early stage. Most people in the study had stage 0, I, or II cancer; none had stage III or IV.
* The person about to have treatment is functioning at a high level before surgery and in good general health, without multiple serious chronic diseases. People who have three or more chronic diseases -- such as diabetes, rheumatoid arthritis, or heart disease -- tend to have poorer outcomes.
* The surgery is seen as a positive action, and the person with cancer is aware of the procedures to be performed and the potential outcomes. Other issues that could affect outcomes at any age include a family history of longevity and a good support system of family and friends.
Posted in Colon Cancer on July 15, 2008
Saturday, July 19, 2008
Thursday, July 17, 2008
My Colon Cancer Abdominal Resection
My Colon Cancer Abdominal Resection
November 2003
My first surgery was for tonsils. Maybe I was seven. I remember wanting popcorn after surgery but my mom brought ice cream. I think I stayed overnight in the hospital.
In my thirties I had two hernia repair surgeries. I had to rest a few days. No big deal. In your thirties you still think you can live forever. Hernia repair was just a speed bump in my race through life. I had stitches in my crotch so it was hard to sit up and it hurt to laugh. I did not want my friends with a sense of humor to come see me in the hospital. One friend brought me lilies and made me watch the Night of the Living Dead.
In my forties I had three nasal polyp surgeries. These were outpatient and easy because I had no real fear of dying. Surgery was quick and recovery was a short duration. I had support at home and was surrounded by friends.
Preparing for colon cancer surgery was scary. My cancer diagnosis felt like the kiss of death. I carried the intense fear of dying on the operating table during my abdominal resection. I did not know if they would be able to remove all the cancer from my body. Maybe the cancer was spreading. Maybe I would die slowly wasting away as cancer spread through my body.
After my diagnosis I got a second opinion from another doctor. He confirmed I had colon cancer. Next step was to find a surgeon to do the procedure. Carrie and I met with the doctor. I asked questions and Carrie wrote down answers. I was still overwhelmed about my cancer diagnosis. The doctor who did my colonoscopy called me on my personal cell phone to make sure I got my abdominal resection surgery scheduled as soon as possible.
I made sure my health insurance would cover my procedures. The night before my surgery I had to empty out my lower intestine and colon. No food or water after midnight.
Early in the morning, Carrie, my brother, and Carrie’s parents brought me to Sutter Hospital in Sacramento. An armband was placed on my left arm. When you enter a medical center for surgery, you submit to the surgical procedures. I took off my street clothes, glasses, watch, and changed into a blue and white hospital gown. I was just another medical patient now. I gave my medical files, my wallet and car keys to Carrie. I call this my surrender to surgery.
I laid down on a gurney. I tried to relax. I was really cold. The nurse covered my legs with a warm blue blanket. Then another nurse brought elastic stockings. These were to be worn to prevent blood clots. Then my legs were surrounded with a device that massaged my legs.
Next step to prepare me for surgery was for a nurse to start an IV. Unfortunately for me a young nurse in training was assigned to me to find a vein. After several failed attempts I asked for a more experienced nurse. I noticed Carrie was getting squeamish. Carrie had fainted during one of my earlier surgeries. I suggested she find my brother David to keep me company. An experienced nurse arrived to start my IV. She found a vein immediately. She connected the needle in my arm to clear tubing and a bag of glucose.
I tried to relax. My brother and I were surrounded with a curtain. This was supposed to provide privacy in a crowded surgical waiting room. I looked into my brother’s blue eyes to draw upon his strength. We were both scared. We both were trying to be brave.
My surgeon opened my private curtain and said “Good Morning.” He looked at my medical chart. A surgical mask hung around his neck. I was probably ab resection number two on his list. For him this was just another medical procedure.
“Do you have any questions, Mr. Beckstein?” he asked.
“No.” I replied.
Another nurse appeared through the curtain to position adhesive strips on my body. These were for the EKG machine and other electronic devices. She disappeared.
My anesthesiologist arrived. He looked at my chart.
Is he old enough to practice medicine? I thought to myself. He looks so young! Hope he knows what he is doing I thought.
“I am Doctor Saunders. We spoke on the phone last night. I will start a drug to help you to relax and then when we are in the operating room you will go to sleep. “Do you have any questions, Mr. Beckstein?” he asked.
“No.” I replied. I am ready for my surgery Doctor.
I was glad my brother David was by my side. We listened to the noises coming through my privacy curtain. The anti-anxiety medicine was starting to smooth the edges of my experience.
One month before my surgery a friend recommended “Successful Surgery.” A compact disk by Belleruth Naparstek. This guided imagery and affirmations helped me prepare for this day. I played the CD at home several times to help me relax and to prepare for this stressful surgery. The day of the procedure, I forgot to bring the CD into the operating room but I could recall Belleruth’s voice.
“You will see a shimmering….” I could hear her voice telling me to relax. Her entire message was there in my brain ready to recall before my procedure.
My body began to relax as the IV medication helped me feel warm and safe. I felt like I was in a movie. My brother disappeared from view like a ship floating out to sea. My gurney rolled through big stainless steel doors and I entered the operating room. The room was very bright. I saw my surgeon and my anesthesiologist looking at me as the nurse hooked up my electrodes to the EKG.
“Ready Mr. Beckstein?”
Yes.
Fade to black.
Notes from my medical record…
A small bowel resection was performed while the patient was under general anesthesia. A nine inch incision was made in the abdomen. The diseased part of the colon was removed and the two healthy ends were sewn back together. The abdominal incision was closed. The Abdominal Resection was successful. Twenty-five lymph nodes were removed for testing.
Post-OP
“Can you hear me Mr. Beckstein?”
The recovery room nurse’s voice was far away. Maybe I could understand every other word. Like a spotty cellphone connection. I was surrounded by muffled voices drifting into my field of hearing.
A machine was inflating and deflating the blood pressure cuff squeezing my right bi-cep. It recorded a reading of 130 over 79. Pulse 60.
“Can you open your eyes Mr. Beckstein?”
“I rather not Nurse, I thought to myself. Leave me alone. I do not want to wake up. Let me sleep a little longer.”
Out of focus lights appeared through the fog covering my body.
“If you can hear my voice blink your eyes Mr. Beckstein.”
I blinked.
I was officially awake following my abdominal resection. My body felt heavy. I considered trying to move my arms but I felt like a lead blanket was covering my chest and arms like a dentist office x-ray procedure.
Nurses and doctors were walking back and forth around my gurney. Other patients were wrapped in white sheets like Egyptian mummies. No dead people here. Think I am in the recovery room. No privacy curtain here. Big wide open room where the nurses watch patients like bees buzzing in a field of flowers.
I was bored looking at the ceiling tiles, I had a wild idea. Maybe I could move the fingers of my left hand! I wiggled a few fingers. Hey they moved. Next I tried to bend my elbow and move my fingers. Success. Do I dare explore my belly to feel the incision? I was curious and scared at the same time. Conflict. What to do? I pushed away the hospital blanket to bravely explore my midsection only to be stopped with bandages and gauze and wide strips of adhesive tape. Better not to proceed to the incision just yet. Maybe too much information.
Beep. Beep, beep.
The EKG recorded my heart beat with the latest digital display for the nurse.
I was breathing.
My heart was beating.
I was alive.
I was done with surgery.
I did not die on the operating table.
Do I still have cancer in my body?
Did they dig it all out?
“You are doing very well Mr. Beckstein” my surgeon and my primary physician were looking at me. They both had a big smile. Both in surgical scrubs.
“In a few minutes they will move you to your hospital room. You get some rest. We will talk to your family now. Do you have any questions?”
“Did you remove all the cancer during this surgery, doctor?”
“Yes.”
I thanked them and drifted off to sleep. I felt no pain. Morphine floated into my bloodstream and I was grateful. I was grateful to be alive.
Someone pushed my gurney into a huge elevator. A few moments later my body was transferred from gurney to my hospital bed.
I was alone.
November 2003
My first surgery was for tonsils. Maybe I was seven. I remember wanting popcorn after surgery but my mom brought ice cream. I think I stayed overnight in the hospital.
In my thirties I had two hernia repair surgeries. I had to rest a few days. No big deal. In your thirties you still think you can live forever. Hernia repair was just a speed bump in my race through life. I had stitches in my crotch so it was hard to sit up and it hurt to laugh. I did not want my friends with a sense of humor to come see me in the hospital. One friend brought me lilies and made me watch the Night of the Living Dead.
In my forties I had three nasal polyp surgeries. These were outpatient and easy because I had no real fear of dying. Surgery was quick and recovery was a short duration. I had support at home and was surrounded by friends.
Preparing for colon cancer surgery was scary. My cancer diagnosis felt like the kiss of death. I carried the intense fear of dying on the operating table during my abdominal resection. I did not know if they would be able to remove all the cancer from my body. Maybe the cancer was spreading. Maybe I would die slowly wasting away as cancer spread through my body.
After my diagnosis I got a second opinion from another doctor. He confirmed I had colon cancer. Next step was to find a surgeon to do the procedure. Carrie and I met with the doctor. I asked questions and Carrie wrote down answers. I was still overwhelmed about my cancer diagnosis. The doctor who did my colonoscopy called me on my personal cell phone to make sure I got my abdominal resection surgery scheduled as soon as possible.
I made sure my health insurance would cover my procedures. The night before my surgery I had to empty out my lower intestine and colon. No food or water after midnight.
Early in the morning, Carrie, my brother, and Carrie’s parents brought me to Sutter Hospital in Sacramento. An armband was placed on my left arm. When you enter a medical center for surgery, you submit to the surgical procedures. I took off my street clothes, glasses, watch, and changed into a blue and white hospital gown. I was just another medical patient now. I gave my medical files, my wallet and car keys to Carrie. I call this my surrender to surgery.
I laid down on a gurney. I tried to relax. I was really cold. The nurse covered my legs with a warm blue blanket. Then another nurse brought elastic stockings. These were to be worn to prevent blood clots. Then my legs were surrounded with a device that massaged my legs.
Next step to prepare me for surgery was for a nurse to start an IV. Unfortunately for me a young nurse in training was assigned to me to find a vein. After several failed attempts I asked for a more experienced nurse. I noticed Carrie was getting squeamish. Carrie had fainted during one of my earlier surgeries. I suggested she find my brother David to keep me company. An experienced nurse arrived to start my IV. She found a vein immediately. She connected the needle in my arm to clear tubing and a bag of glucose.
I tried to relax. My brother and I were surrounded with a curtain. This was supposed to provide privacy in a crowded surgical waiting room. I looked into my brother’s blue eyes to draw upon his strength. We were both scared. We both were trying to be brave.
My surgeon opened my private curtain and said “Good Morning.” He looked at my medical chart. A surgical mask hung around his neck. I was probably ab resection number two on his list. For him this was just another medical procedure.
“Do you have any questions, Mr. Beckstein?” he asked.
“No.” I replied.
Another nurse appeared through the curtain to position adhesive strips on my body. These were for the EKG machine and other electronic devices. She disappeared.
My anesthesiologist arrived. He looked at my chart.
Is he old enough to practice medicine? I thought to myself. He looks so young! Hope he knows what he is doing I thought.
“I am Doctor Saunders. We spoke on the phone last night. I will start a drug to help you to relax and then when we are in the operating room you will go to sleep. “Do you have any questions, Mr. Beckstein?” he asked.
“No.” I replied. I am ready for my surgery Doctor.
I was glad my brother David was by my side. We listened to the noises coming through my privacy curtain. The anti-anxiety medicine was starting to smooth the edges of my experience.
One month before my surgery a friend recommended “Successful Surgery.” A compact disk by Belleruth Naparstek. This guided imagery and affirmations helped me prepare for this day. I played the CD at home several times to help me relax and to prepare for this stressful surgery. The day of the procedure, I forgot to bring the CD into the operating room but I could recall Belleruth’s voice.
“You will see a shimmering….” I could hear her voice telling me to relax. Her entire message was there in my brain ready to recall before my procedure.
My body began to relax as the IV medication helped me feel warm and safe. I felt like I was in a movie. My brother disappeared from view like a ship floating out to sea. My gurney rolled through big stainless steel doors and I entered the operating room. The room was very bright. I saw my surgeon and my anesthesiologist looking at me as the nurse hooked up my electrodes to the EKG.
“Ready Mr. Beckstein?”
Yes.
Fade to black.
Notes from my medical record…
A small bowel resection was performed while the patient was under general anesthesia. A nine inch incision was made in the abdomen. The diseased part of the colon was removed and the two healthy ends were sewn back together. The abdominal incision was closed. The Abdominal Resection was successful. Twenty-five lymph nodes were removed for testing.
Post-OP
“Can you hear me Mr. Beckstein?”
The recovery room nurse’s voice was far away. Maybe I could understand every other word. Like a spotty cellphone connection. I was surrounded by muffled voices drifting into my field of hearing.
A machine was inflating and deflating the blood pressure cuff squeezing my right bi-cep. It recorded a reading of 130 over 79. Pulse 60.
“Can you open your eyes Mr. Beckstein?”
“I rather not Nurse, I thought to myself. Leave me alone. I do not want to wake up. Let me sleep a little longer.”
Out of focus lights appeared through the fog covering my body.
“If you can hear my voice blink your eyes Mr. Beckstein.”
I blinked.
I was officially awake following my abdominal resection. My body felt heavy. I considered trying to move my arms but I felt like a lead blanket was covering my chest and arms like a dentist office x-ray procedure.
Nurses and doctors were walking back and forth around my gurney. Other patients were wrapped in white sheets like Egyptian mummies. No dead people here. Think I am in the recovery room. No privacy curtain here. Big wide open room where the nurses watch patients like bees buzzing in a field of flowers.
I was bored looking at the ceiling tiles, I had a wild idea. Maybe I could move the fingers of my left hand! I wiggled a few fingers. Hey they moved. Next I tried to bend my elbow and move my fingers. Success. Do I dare explore my belly to feel the incision? I was curious and scared at the same time. Conflict. What to do? I pushed away the hospital blanket to bravely explore my midsection only to be stopped with bandages and gauze and wide strips of adhesive tape. Better not to proceed to the incision just yet. Maybe too much information.
Beep. Beep, beep.
The EKG recorded my heart beat with the latest digital display for the nurse.
I was breathing.
My heart was beating.
I was alive.
I was done with surgery.
I did not die on the operating table.
Do I still have cancer in my body?
Did they dig it all out?
“You are doing very well Mr. Beckstein” my surgeon and my primary physician were looking at me. They both had a big smile. Both in surgical scrubs.
“In a few minutes they will move you to your hospital room. You get some rest. We will talk to your family now. Do you have any questions?”
“Did you remove all the cancer during this surgery, doctor?”
“Yes.”
I thanked them and drifted off to sleep. I felt no pain. Morphine floated into my bloodstream and I was grateful. I was grateful to be alive.
Someone pushed my gurney into a huge elevator. A few moments later my body was transferred from gurney to my hospital bed.
I was alone.
Wednesday, July 9, 2008
Fitting Exercise into Your Life
Being physically active has so many health benefits. So if you are thinking you can't possible fit 30 minutes or more of exercise into your daily routine, these tips from Johns Hopkins can help.
If finding enough time to exercise seems too much to contemplate, remember that any exercise is better than no exercise and small steps are the key to eventually making larger changes in your habits. What this means is that you shouldn’t forgo exercise altogether just because you can’t find the time or energy to exercise for 60 minutes a day -- even 30 minutes of exercise on most days of the week offers significant health benefits. Here are some strategies you can try to increase your amount of physical activity
Replace sedentary activities with more active ones.
For example, instead of watching television while sitting on the couch, take a walk while listening to a book on tape or talking on your cell phone. Or at least try doing some calisthenics while watching your favorite show.
Look for stolen moments throughout your day to add activity.
Climb the stairs instead of taking the escalator, walk instead of taking your car or public transportation, do a lap around the mall before you start shopping, and return your cart all the way back to the supermarket instead of leaving it in the nearby cart bay.
Buy a pedometer.
This step counter will help you assess how many steps you’re taking per day. We and other experts recommend 10,000 steps a day (equivalent to about 5 miles), although most people walk much less than that. Start off by tracking the number of steps you take on a typical day. Then, try to increase your step count by 500–1,000 steps every 2–3 weeks. Keep a record of your step counts and reward yourself (not with food, of course) when you reach your goal.
Plan for exercise every day.
Mark out 30 minutes or more a day for physical activity and stick to it as if it’s an important meeting or appointment. Individuals who become habitual exercisers are those who make physical activity a priority.
Calories Burned During Moderate vs. Vigorous Activities
Calories Burned Per Hour for a 154-lb Person
Hiking 370
Light gardening/yard work 330
Dancing 330
Golf (walking and carrying clubs) 330
Bicycling (less than 10 mph) 290
Walking (3.5 mph) 280
Weight lifting (general light workout) 220
Stretching 180
Running/jogging (5 mph) 590
Bicycling (more than 10 mph) 590
Swimming (slow freestyle laps) 510
Aerobics Walking (4.5 mph) 460
Heavy yard work (chopping wood) 440
Weight lifting (vigorous effort) 440
Basketball (vigorous) 440
*People who weigh more than 154 lbs. will burn more calories per hour and people who weigh less than 154 lbs. will burn fewer calories per hour when engaged in the activities listed here. Source: Dietary Guidelines for Americans, 2005.
Posted in Nutrition and Weight Control on July 9, 2008
Thursday, June 26, 2008
A Good Stick for a Blood Test
As a colon cancer patient, you will be getting many blood tests. I recommend you find the most experienced staff to take your blood. Experienced patients call it a “good stick.” Remember the staff who do their job well and thank them. You will want to find them next time you need a blood test.
I kept a file copy of the requested lab tests and make sure the results are sent to all the doctors that need to know the results. File folders track my progress and organize my papers. This helps me with billing and taxes time.
As the technician is drawing blood, review what lab tests are going to be conducted on your blood and find out when the results will go to your doctors. An exceptional patient is proactive with your health care.
If the lab technician is inexperienced they will keep trying to find a vein and end up bruising your arm. This is called a bad stick. Not a big deal if you just need a blood test for routine lab work and you can go home and calm down.
Unfortunately for me I got a bad stick while getting ready for my abdominal resection surgery. I had an inexperienced nursing student made numerous attempts at trying to find a vein and miss. I got more stressed from this treatment. I felt like a pincushion. She gave up on one arm, then my wife fainted. I asked for my brother to enter the prep area and help calm me down. Finally she got an IV started in my other arm.
I found it hard to relax and let go of my worries about surgery with a bad stick. I was relieved to run the Belleruth Naparstek Imagery Before Surgery recording in my head and relax before surgery.
I kept a file copy of the requested lab tests and make sure the results are sent to all the doctors that need to know the results. File folders track my progress and organize my papers. This helps me with billing and taxes time.
As the technician is drawing blood, review what lab tests are going to be conducted on your blood and find out when the results will go to your doctors. An exceptional patient is proactive with your health care.
If the lab technician is inexperienced they will keep trying to find a vein and end up bruising your arm. This is called a bad stick. Not a big deal if you just need a blood test for routine lab work and you can go home and calm down.
Unfortunately for me I got a bad stick while getting ready for my abdominal resection surgery. I had an inexperienced nursing student made numerous attempts at trying to find a vein and miss. I got more stressed from this treatment. I felt like a pincushion. She gave up on one arm, then my wife fainted. I asked for my brother to enter the prep area and help calm me down. Finally she got an IV started in my other arm.
I found it hard to relax and let go of my worries about surgery with a bad stick. I was relieved to run the Belleruth Naparstek Imagery Before Surgery recording in my head and relax before surgery.
Tuesday, June 24, 2008
Fecal Occult blood test screening for Colon Cancer
Don't assume a normal annual test for fecal occult blood (FOBT) means you can postpone your colonoscopy. According to Frank Herlong, M.D., Associate Professor of Medicine, Gastroenterology Division at Johns Hopkins and Health After 50 Board Member, FOBTs are no longer relied upon for colon cancer screening -- though some doctors may use them to test for gastrointestinal bleeding from causes other than cancer.
Before colonoscopies became widely available and covered by insurance, annual FOBTs were an affordable and easy-to-use tool for colon cancer screening. But FOBTs have always been notoriously unreliable. Most employ a chemical called guaiac that changes color if blood is present in the stool sample. Guaiac also reacts with certain fruits and vegetables and with blood from red meat, which increases the likelihood of "false positive" results. All positive results must be confirmed by colonoscopy.
Immunochemical FOBTs, or IFOBTs, test for a protein specific to human blood. They are widely available and more accurate than guaiac based tests. But no matter which FOBT you use, a negative result does not necessarily mean that you are safe. Case in point: A recent study published in The New England Journal of Medicine found that an expensive DNA-based FOBT was capable of detecting 26% more invasive cancers and potentially precancerous growths than a common guaiac-based FOBT. But even this vastly superior DNA-based test identified only 51% of all invasive cancers detected by colonoscopy.
The most important thing to keep in mind is that not all precancerous growths or colon cancers cause bleeding; by the time they do, the cancer may be advanced. In contrast to all types of FOBTs, a colonoscopy detects -- and removes -- growths whether or not they cause bleeding. Thus, colonoscopy is your best protection against colon cancer.
Tuesday, June 10, 2008
Dave Barry's Colonoscopy Journal
June 10, 2008
This is from newshound :
... I called my friend Andy Sable, a gastroenteritis, to make an appointment for a colonoscopy. A few days later, in his office, Andy showed me a color diagram of the colon, a lengthy organ that appears to go all over the place, at one point passing briefly through Minneapolis . Then Andy explained the colonoscopy procedure to me in a thorough, reassuring and patient manner. I nodded thoughtfully, but I didn't really hear anything he said, because my brain was shrieking, quote, 'HE'S GOING TO STICK A TUBE 17,000 FEET UP YOUR BEHIND!'
I left Andy's office with some written instructions, and a prescription for a product called 'MoviPrep,' which comes in a box large enough to hold a microwave oven. I will discuss MoviPrep in detail later; for now suffice it to say that we must never allow it to fall into the hands of America 's enemies.
I spent the next several days productively sitting around being nervous. Then, on the day before my colonoscopy, I began my preparation. In accordance with my instructions, I didn't eat any solid food that day; all I had was chicken broth, which is basically water, only with less flavor. Then, in the evening, I took the
MoviPrep. You mix two packets of powder together in a one-liter plastic jug, then you fill it with lukewarm water. (For those unfamiliar with the metric system, a liter is about 32 gallons.) Then you have to drink the whole jug. This takes about an hour, because MoviPrep tastes - and here I am being kind - like a mixture of goat spit and urinal cleanser, with just a hint of lemon.
The instructions for MoviPrep, clearly written by somebody with a great sense of humor, state that after you drink it, 'a loose watery bowel movement may result.' This is kind of like saying that after you jump off your roof, you may experience contact with the ground.
MoviPrep is a nuclear laxative. I don't want to be too graphic, here, but: Have you ever seen a space-shuttle launch? This is pretty much the MoviPrep experience, with you as the shuttle. There are times when you wish the commode had a seat belt. You spend several hours pretty much confined to the bathroom. You eliminate everything. And then, when you figure you must be totally empty, you have to drink another liter of MoviPrep, at which point, as far as I can tell, your bowels travel into the future and start eliminating food that you have not even eaten yet.
After an action-packed evening, I finally got to sleep. The next morning my wife drove me to the clinic. I was very nervous. Not only was I worried about the procedure, but I had been experiencing occasional return bouts of MoviPrep spurtage. I was thinking, 'What if I spurt on Andy?' How do you apologize to a friend for something like that? Flowers would not be enough.
At the clinic I had to sign many forms acknowledging that I understood and totally agreed with whatever the heck the forms said. Then they led me to a room full of other colonoscopy people, where I went inside a little curtained space and took off my clothes and put on one of those hospital garments designed by sadist perverts, the kind that, when you put it on, makes you feel even more naked than when you are actually naked.
Then a nurse named Eddie put a little needle in a vein in my left hand. Ordinarily I would have fainted, but Eddie was very good, and I was already lying down. Eddie also told me that some people put vodka in their MoviPrep. At first I was ticked off that I hadn't thought of this, but then I pondered what would happen if you got yourself too tipsy to make it to the bathroom, so you were staggering around in full Fire Hose Mode. You would have no ch oice but to burn your house.
W hen everything was ready, Eddie wheeled me into the procedure room, where Andy was waiting with a nurse and an anesthesiologist. I did not see the 17,000-foot tube, but I knew Andy had it hidden around there somewhere. I was seriously nervous at this point. Andy had me roll over on my left side, and the anesthesiologist began hooking something up to the needle in my hand. There was music playing in the room, and I realized that the song was 'Dancing Queen' by ABBA I remarked to Andy that, of all the songs that could be playing during this particular procedure, 'Dancing Queen' has to be the least appropriate.
'You want me to turn it up?' said Andy from somewhere behind me. 'Ha ha,' I said. And then it was time, the moment I had been dreading for more than a decade. If you are squeamish, prepare yourself, because I am going to tell you, in explicit detail, exactly what it was like.
I have no idea. Really. I slept through it. One moment, ABBA was yelling 'Dancing Queen, Feel the beat of the tambourine,' and the next moment, I was back in the other room, waking up in a very mellow mood. Andy was looking down at me and asking me how I felt. I felt excellent. I felt even more excellent when Andy told me that It was all over, and that my colon had passed with flying colors. I have never been prouder of an internal organ.
ABOUT THE WRITER
Dave Barry is a Pulitzer Prize-winning humor columnist for the Miami Herald.
Sunday, June 1, 2008
Protect Yourself Against Prostate Cancer
Simple Steps to Protect Yourself Against Prostate Cancer
Reducing your risk of prostate cancer begins with the big picture, those well-publicized major lifestyle changes that are widely recommended but often difficult to accomplish. Then there are the smaller details: cancer-protective foods, supplements, and medications. A serious prostate cancer risk-reduction program encompasses both approaches.
Achieving a healthy weight, committing to regular exercise, and altering long-ingrained dietary habits are the most important steps you can take to protect yourself from prostate cancer. And their payoff goes far beyond the prostate. These lifestyle changes could reduce your risk of nearly all the most devastating diseases: heart disease, stroke, diabetes, Alzheimer’s disease, and many other forms of cancer. What’s more, they work together to improve your health. Here are some strategies to consider:
Weight management.
The links between obesity and prostate cancer continue to strengthen. Fat cells churn out a slew of substances that fuel the development and progression of cancer. These include estrogen, testosterone, and insulin-like growth factor. Men who are obese also are more likely to be diagnosed with advanced prostate cancer. The possible reasons are that obese men tend to have larger prostates (making tumor detection more difficult), and their prostate specific antigen (PSA) scores are often deceptively low.Regular exercise.
Vigorous physical activity appears to protect against prostate cancer. Men who exercise regularly are less likely to be diagnosed with advanced or fatal prostate cancer. Some evidence suggests that vigorous physical activity may also slow its progression.Dietary changes.
Adopting a plant-based diet can reduce your risk of prostate cancer and improve your overall health. This dietary approach focuses on fruits, vegetables, legumes (like beans and peas), whole grains, seeds, and nuts. Soy foods (like soy nuts and tofu) also appear to be protective. Aim for at least nine fruits and vegetables a day.
To get all the cancer-fighting nutrients you need, try to include a “rainbow” of fruits and vegetables each day -- reds, oranges, yellows, greens, and blues/purples. Brightly colored fruits and vegetables are rich in carotenoids, cancer-fighting substances that serve as coloring agents in plant foods. Also be sure to include at least one serving per day of a cruciferous vegetable (like broccoli, cabbage, or cauliflower). These vegetables contain other types of cancer-fighting chemicals.
Specific Foods, Supplements, and Medications. Ongoing research into prostate cancer prevention has identified a number of individual substances that may be protective:
Lycopene. The carotenoid lycopene is found in tomatoes, pink grapefruit, and watermelon. Cooked tomato products such as spaghetti sauce and ketchup are the richest source.
Pomegranates. Pomegranates and pomegranate juice have recently been found to cause prostate cancer cells to self destruct. Among men with prostate cancer, daily glasses of pomegranate juice have slowed the increase in PSA levels after treatment.
Omega-3 fatty acids. Omega- 3 fatty acids are a type of polyunsaturated fat found abundantly in fatty fish (like salmon, sardines, tuna, and halibut) and fish oil. Flaxseeds, walnuts, and canola oil contain a weaker, but still beneficial, plant-based form of these healthful fats. Omega-3s have anti-inflammatory and anticancer effects. Several studies have suggested that men who eat fish two or more times per week have a lower risk of developing prostate cancer.
Selenium and vitamin E. These two nutrients are being tested for their potential protective effects in SELECT (Selenium and Vitamin E Cancer Prevention Trial) -- the largest clinical study ever launched about prostate cancer prevention, coordinated by the U.S. National Cancer Institute. Several smaller studies have shown benefits, but until the SELECT results are in, doctors recommend against taking large amounts of either nutrient. A multivitamin that includes both is the best bet for now.
Vitamin D. Vitamin D plays an important role in regulating cell growth and has been associated with a reduced risk of prostate cancer. The dietary sources of vitamin D include fortified milk and fatty fish. The way to boost your body's natural productin of vitamin D is to spend about 15 minutes a day (without sunscreen) in the sun.
Statins. Prostate cancer researchers are discovering the important role inflammation plays in the development of prostate cancer. High cholesterol levels also may increase the risk. The cholesterol-lowering medications known as statins tackle both problems. In a study that Johns Hopkins researchers participated in, men who took statins had half the risk of developing prostate cancer compared with nonusers.
NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) also reduce inflammation and appear to lower the risk of prostate cancer. These medications target a protein called COX-2, which is believed to help prostate cancer cells spread.
Prostate Disorders Special Report by Johns Hopkins Health Alerts is owned and operated by University Health Publishing. June 1, 2008
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