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User Info Ready To Rise Up Yet? Medicine Is KILLING You.; entered at 2019-05-14 13:10:59
Tickerguy
Posts: 157211
Registered: 2007-06-26
@Drifter -- that's the problem with a "routine" colonoscopy. Yes, it can catch polyps (benign) or cancer (not!) Removing the former may or may not prevent progression to the latter; a benign growth doesn't OFTEN turn into a malignant one, but if it does it's bad obviously.

Procedurally the test has a roughly 0.4% serious complication rate itself. That doesn't sound awful but in fact it's pretty bad -- about 1 in 250. If you're the one then life gets EXTREMELY bad in that a punctured colon can kill you or leave you with a PERMANENT ostomy bag and ALWAYS winds up as an extremely serious situation with major surgery required to correct it along with an extremely high risk of septic shock and all sorts of other nasties since what's IN your colon has no business being loose in your abdomen -- all of which YOU will get the bill for. Note that the risk of colon cancer ITSELF is roughly a ~4% lifetime risk; you're betting on a procedure with a 1/10th the risk of severe injury or death to catch a disease that has a 4% LIFETIME incidence.

If they remove a polyp that rate of severe complications rises to between 2-3% or damn close to the risk of the disease itself. The latter is also getting into the fairly high risk area (1 in 50 to 1 in 33!) which is justified if the polyp was going to turn into cancer but definitely is not if it wasn't going to.

Further, the question IF cancer is detected is "does it change the end outcome?" If the answer is NO then the test is worthless. That one is VERY hard to get clean data on -- I've been unable to obtain any sort of real statistical answer to that and that's the critical question because if it detects cancer but the cancer still ultimately kills you then the test is worth ZERO. In fact if it sets you on an immediate course of action that trashes your quality of life AND ultimately kills you then the test has NEGATIVE value (since otherwise the time until you discovered the cancer via some other means would be GOOD time and you just turned it into BAD time.)

As a result I don't have a well-formed opinion on this one for someone without specific risk factors that place their risk of the underlying disease above the statistical average. I'm ESPECIALLY slant-eyed toward "routine re-tests" on a timed basis if you have one done and it's negative.

Colon cancer killed my mother but she was a ripe old bird and everyone dies of SOMETHING. She went 2+ years past original diagnosis; they cut the tumor out but did not have to remove enough colon to prevent her from having normal bowel function and she refused chemo and radiation post-op; ultimately she had a couple of bad weeks at the end but the rest of the time she had remaining was good. I can't argue with any part of the choices she made nor do I suspect she would given the outcome.

Last modified: 2019-05-14 13:18:50 by tickerguy

2019-05-14 13:10:59