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Let’s Talk About Colon Cancer

 

Eng

Written by Dr. Ady Oster

People do not talk about colon cancer very much.  Perhaps this is because it’s embarrassing to discuss, perhaps because they do not know much about it. That is a shame, because colon cancer is common and it is one of the most preventable cancers.

Colon cancer is the fourth most common cancer among Asian Americans, for both men and women (after breast, prostate, and lung) and (because it is more deadly than prostate cancer) colon cancer is the third most common cause of cancer deaths. While a few people with colon cancer have family members who also had colon cancer, most colon cancer occurs in people who do not have a family history of this cancer.

Cancers occur when a group cells grow out of control. Initially, they remain in one organ forming a lump. In time they can spread to other organs.  Most cancers are much more easily treated when they are still in one organ. Colon cancers start as a polyp. These are small, warty-looking bulges in the inside lining of the colon.  Over time, some of these polyps can become cancers (10% in ten years), invade the lining of the colon, and eventually spreading to other organs. Because polyps are small, they do not cause pain, diarrhea or constipation.  It is impossible to feel polyps.  The only way to know if you have a polyp is by having a doctor look at the inside of the colon.  If polyps are removed, they can no longer become cancer. Therefore, the best way to prevent colon cancer is to have a colonoscopy to look for and remove polyps.

Most polyps and cancers cause bleeding (not visible) into the stool. Usually it is too small to be visible, but it may be detectable with special stool tests. Another way to look for polyps or colon cancer is to have stool tested for microscopic blood. Older tests required eating a special diet for several days and collecting several stool samples. Newer tests do not require any special diet and only one stool sample. If any blood is found, a colonoscopy will be required to find the source of the blood and remove any polyps that are found.  If no blood is found, stool tests will need to be repeated every year in order to provide adequate reassurance that no polyps or cancers are in the colon.

During a colonoscopy, a doctor uses a long, flexible fiberoptic scope to examine the entire colon.  If any polyps are found, they are usually removed at that same time. Since polyps take several years to develop and will take even longer to become a cancer. People without any polyps can safely wait ten years between each colonoscopy. People who do have polyps will need to have colonoscopies more often, depending on how many and how big these polyps were. People are usually sedated for a colonoscopy, so most people do not remember having the procedure.  Unfortunately, in order for doctors to clearly see the lining of the colon, it must be cleaned of any stool. Therefore, people are asked to drink only clear liquid on the day or two prior to the test. On the evening before the test, they need to drink medicine that cleans the stool in the colon by causing diarrhea. This can be uncomfortable for a few hours.

The risk of cancer increases with age. Most people should begin testing for polyps or colon cancer at age 50.  People who have family members with colon cancer should talk to their healthcare provider about the right age to start.

Despite the embarrassment or discomfort, it is important to talk about colon cancer. Talk to your primary care doctor about whether colon cancer testing is appropriate for you.  Talk to your loved ones to make sure they have talked to their doctor about colon cancer. You can make an appointment to meet with a primary care provider here at Charles B. Wang Community Health Center by calling (212) 379-6998 for Manhattan, and (718) 362-3006 (37th Ave) or (929) 362-3006 (45th Ave) for Queens. For more information, visit the internal medicine webpage.

Written by Dr. Ady Oster. Dr. Oster is the section chief of internal medicine at the Charles B. Wang Community Health Center. He received his medical degree from the Albert Einstein College of Medicine, and completed his residency training at Yale-New Haven Hospital and University of California at San Francisco. Dr. Oster is board-certified in internal medicine.

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Man Up – Talk to Your Doctor About Sexual Health

Portrait of Mid Adult Man in Nanluoguxiang, Beijing

Written by Dr. Gail Bauchman

Women are more likely to see a doctor for regular check-ups than men, and yet it is so important that men have regular checkups to discuss all aspects of their health. Sexual health is one area that is incredibly important for men to understand. As a doctor at the Charles B. Wang Community Health Center, here are a few aspects of sexual health that I discuss with male patients.

When you see your health care provider for a routine physical exam or to be screened for sexually transmitted infections (STIs), you will be asked some rather personal questions. These questions are important for your provider to better understand your health risks and provide the best possible treatment.  Some of the questions may involve your sexual practice. For instance, what are you doing to prevent pregnancy? What is your partner using to prevent pregnancy? How many partners have you had in the last year? Do you have sex with men, women or both? What do you do to protect yourself from sexually transmitted diseases and HIV?  Do you know how to use a condom appropriately?

Condom use offers protection against some sexually transmitted infections, including HIV infection. They also offer some protection against pregnancy, but condoms along with the withdrawal method are considered to be the least effective methods to prevent pregnancy.  About 18 women out of 100 will get pregnant within the first year with condom use.

That is why it is important to know what your partner is using to prevent pregnancy. Your health care provider can help answer your questions about contraceptive methods for both you and your partner and help you decide on the most suitable methods. Learn more about birth control and family planning by reading this factsheet.

Question: if the condom breaks and your partner is not using an additional contraceptive method, do you know what to do next to protect her from getting pregnant? The answer is having your partner use emergency contraception.  One of the easiest options is if you or your partner buys a pill that does not require a prescription, called Plan B. The pill should be taken within 5 days of having unprotected sex, but the sooner it is taken the better. Plan B is not 100% effective, but does help reduce the chances of pregnancy.

Your provider may also ask you questions about whether you ever had any STIs. STIs can be transmitted through vaginal, anal, and oral sex and many of them do not cause symptoms, at least in the beginning.  If you do have symptoms such as urinary frequency, discharge from the penis or ulcers on the penis, seek out medical care to get treated. A urine sample is all that is required to test for the most common STIs, such as chlamydia and gonorrhea. Without testing and treatment, you may unknowingly pass these infections on to your partner. Chlamydia and gonorrhea can cause a serious pelvic infection in women that may lead to infertility. Some STIs in pregnant women can also impair fetal development or be passed on to their babies during childbirth. Learn more about STI’s by reading this factsheet.

For the protection of yourself, your partner, and your child, we encourage all men to receive annual physical exams and be screened for STIs whenever they have a new partner.

Come visit us at the Charles B. Wang Community Health Center to get your annual check-up and discuss these as well as other important health issues. Our OBGYN department offers family planning services and counseling to both men and women to help you improve your sexual health and achieve your reproductive life plan, whether you are seeking to have children or preventing pregnancy. You can make an appointment at our OBGYN department by calling (212) 966-0228 for Manhattan or (718) 886-1287 for Queens. Find more information by visiting our OBGYN webpage. You can also make an appointment to meet with a primary care provider by calling (212) 379-6998 for Manhattan, and (718) 362-3006 (37th Ave) or (929) 362-3006 (45th Ave) for Queens. Visit the internal medicine webpage.

Written by Dr. Gail Bauchman. Dr. Bauchman is a physician at the Charles B. Wang Community Health Center. She attended Stony Brook Medical School, and specialized in family medicine. She is board certified from the American Board of Family Medicine.