Monday, June 20, 2005

Go shove a camera up your ass.
Essentially, that's what a colonoscopy is. Simply put. Okay, you're also able to insufflate, deflate, suction, squirt and put a snare wire in too.
I had mine done today.
Which meant I was on a clear-liquid diet for the preceeding 24 hours. And nil by mouth 4 hours before. Had nothing but chicken broth and Jell-o for dinner yesterday.
("Yum yum, are you sure you don't want to have some of this apple pie?" my idiot housemate taunted me)
Also had to consume some of that phospho-soda purgative. I bet that stuff would dissolve even hardened concrete; the type they use for ICBM silos. Cleared out my gut in no time.
Why on earth did I get one done? you may ask.
Colorectal cancer screening. Dad had colon cancer at 52. His mom died of colon cancer at 35. Thankfully, my exam was normal.
Why on earth am I sharing this on my blog? you're probably wondering.
Well. I don't know. I guess I feel that there's still a lot to be said about health screening awareness in Malaysia. Especially in the younger-middle aged crowd. It's hard to accept that one would get a test done while one is healthy (or, perceived to be).
As one of my brothers once put, "What? Get that test done when I'm healthy? Crazy-wan ar??"
But that's precisely the point of screening. Doing a test and catching a disease while it's in its early stages.
Of course, screening has its limits or criteria too; that the test has reasonable sensitivity and specificity, and that something can be done to improve outcome if the disease is caught early.
Also, at least in my family, the concept of 'family doctor' is not quite there. Usually, we see the most convenient doc when we're sick. Hardly have an annual health exam and get our cholesterol or glucose checked.
What surprised me though when I was home last year, was that these labs were now offering all forms of blood tests for cancer markers, most if not all of which have not been shown in studies to be good markers and are not sanctioned by most medical bodies in the world. Package A: CEA, CA19-9, alpha-fetoprotein, Package B: CA125, etc etc.
Consider this, in the USA (sorry, don't have Malaysia's data handy, but it shouldn't be too different) colon cancer is the 3rd most common cancer in men and women. 1 in 9 women will develop breast cancer in their lives. There are some of us, who believe that songstress Anita Mui's death (Bless her soul) was avoidable with routine Pap smears, because cervical pre-cancer and cancer is so slow-growing that in this day and age, should not be allowed to progress to such an advanced stage.
Yet, how often do we screen? I remember talking to my good friends' wives, all women in their mid-late twenties, who thought I was crazy when I said they should be getting annual Paps.
"Won't happen to me" is the favourite mantra.
Having said all that though, much of this depends on the infrastructure of the medical system; I'm not sure what the availability of colonoscopies and mammograms and Paps are in smaller towns.

Over here, the standard recommendations we adopt and suggest are:

  • Colon cancer screening beginning at 50 years (or 10 years younger than the age of diagnosis of the first degree relative) by means of colonoscopies every 10 years, or flexible sigmoidoscopies with barium enemas every 5 years
  • Pap smears annually starting at 21 years of age, earlier if sexually active before then, which may be decreased to every 3 years with 3 consecutively normal results
  • Mammograms every 1-2 years starting at 50

But I guess this is not an ideal world. Ok. That's that. Now I need to go and eat 2 days' worth of meals.