Hart works in the hospital's Endoscopy Department, where colon cancer screening tests are performed, using an endoscope to examine the inside of the digestive tract.
Nobody understands better than Hart the value of early screening for colon cancer, the fourth most common cancer in this country, and the second leading cause of cancer deaths.
Two years after she ignored her own advice about having a screening test, Hart says, she experienced some rectal bleeding, "which we all think is hemorrhoids. And a lot of times it is."
But rectal bleeding also can be a symptom of colon cancer.
Hart had a colonoscopy, the most effective test for colon cancer. The procedure enables a physician to look inside the entire large intestine with a scope attached to a long, flexible, lighted tube that is inserted in the rectum. It can reveal early signs of cancer, such as abnormal growths called polyps, inflamed tissue, ulcers, bleeding and muscle spasms.
"I was lucky," Hart says. "When they went in to look, the cancer hadn't gone anywhere. I had to have a portion of my colon removed. If I had gone in and had the test when I was 50, it probably would have been only a polyp, and I wouldn't have had to have surgery. So there's good reason to have that early screening."
Eight years after her surgery, Hart is cancer-free.
But she wants others to know how important it is to have a colon cancer screening test. She is joining with medical professionals across the country to spread that message in March, which has been designated as National Colon Cancer Awareness Month.
It is important for people to know that colon cancer strikes 145,000 Americans every year, and that 55,000 people die from the disease every year, says Dr. Elliot Morris, a gastroenterologist who works in the Endoscopy Department at St. Pat's.
"The average person has about a 6 percent chance of developing colon cancer," Morris says. "Awareness, thankfully, is growing."
And awareness is the key to preventing and successfully treating colon cancer, he adds.
"It's probably the most amenable cancer to prevention and early intervention," says Morris.
Numerous studies have shown that a colonoscopy is the best screening test to detect early signs of colon cancer, he says. One major study indicated that the incidence of colon cancer was 90 percent less among people who have had a colonoscopy than those who haven't, according to Morris.
"A lot of people think it's a male disease," he says. "It is not. Slightly more females than males are affected. The big question we get here is, 'I don't know why I'm here. I'm feeling fine.' I ask them if they get mammograms and Pap smears. You do that as a preventative measure. A colonoscopy is even more important, because we can detect lesions before they become cancer.
"The vast majority of colon cancer results from things called polyps, which are small growths that can grow bigger and bigger, and over a period of time can become cancer. A colonoscopy allows us to detect and remove them before they become cancer."
If polyps or other unusual tissue is found in the colon, a physician can remove them during a colonoscopy using tiny instruments passed through the scope. That tissue is then sent to a lab for testing. If there is bleeding in the colon, the physician can pass a laser, or other device through the scope and use it to stop the bleeding.
"Unfortunately," says Morris, "if you wait for symptoms to develop, we've waited too long."
Some symptoms of colon cancer are pain, bleeding, constipation or changes in bowel movements, and weight loss.
"Those are signs of more advanced lesions," Morris says.
Physicians recommend that everyone over the age of 50 have a colonoscopy, he adds. And if there's a family history of colon cancer people should consult their doctor and have the test at an earlier age. Physicians recommend having a colonoscopy every 10 years.
Other screening tests for colon cancer are available, including a yearly fecal blood test; a sigmoidoscopy, which is a limited version of a colonoscopy; a barium enema every five years; and a new X-ray test called "virtual colonoscopy."
None of those tests are nearly as effective in detecting signs of cancer as a colonoscopy, however, according to Morris. And a positive test in any of them should be followed up with a colonoscopy.
On the horizon, Morris says, a DNA test may help to determine the likelihood of developing colon cancer. But that may not be very useful for the general population, he says.
A colonoscopy takes only 15 or 20 minutes, according to Morris. The patient is given pain medication and a sedative and doesn't remember anything about the procedure. Patients are kept resting in the hospital for an hour or two afterward while they recover from the sedative.
The worst part of the procedure, says Hart, is the preparation.
A patient preparing for a colonoscopy must only ingest "clear fluids" for one to three days beforehand to make sure the colon is empty. A clear-fluid diet means fat-free bouillon or broth, Jell-O, strained fruit juice, water, plain coffee, plain tea, or diet soda.
In addition, most patients are given a strong laxative the night before the test to cleanse the colon.
That, says Hart, can be unpleasant for patients.
"People hear such terrible things about a colonoscopy," Hart says. "But people really shouldn't be afraid of it. What puts most people off is the prep."
The expense of a colonoscopy also discourages some people, she adds. Some insurance companies cover the procedure at age 50, she says, while others cover it only at older ages unless a person has symptoms of colon cancer.
Colonoscopies are performed at both Community Medical Center and St. Patrick Hospital in Missoula.
So, if you're over 50, take Hart's advice: Don't wait.
Reporter Daryl Gadbow can be reached at 523-5264 or at dgadbow@missoulian.com.
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