A Breakdown of a C-Scope Procedure

A colonoscopy can save you life. Let me explain. I was a resident, working in a
resident’s clinic. He walked in. He was a working man, maybe in his mid-forties. I
don’t know his name. This is because I never had a chance to get to know him. He was a
plumber, electrician, or something like that. It was certainly a career that did not provide
health insurance. This was why he was at the resident clinic. He had tough calloused
hands, hands of a working man. Long slightly unkempt hair, but clean. During the
consultation, his eyes continued to glance around, including a nervous twist of his neck,
and shifting in his seat. He obviously felt out of place. Despite the patient’s discomfort,
he presented for a consultation that likely saved his life.

You see, his complaint was that he had “pressure” with defecation; this was
accompanied with occasional blood in his stool. Both of these symptoms were
significant enough that he overcame his nervousness and sought medical care. It was an
easy decision to recommend and then proceed with a colonoscopy. At the time of the
colonoscopy, a small polyp, about the size of a cherry, was found in his rectum. This
was removed during the colonoscopy. Cancer was found in the polyp, but it had not
invaded the rectum. Therefore, he was essentially cured of the cancer. Most likely, the
patient returned to work the next day. He did not even return for follow up to the best of
my knowledge. Typically, these polyps caused no symptoms until they are much larger,
he was extremely fortunate that the symptoms occurred and he subsequently sought
medical attention. Untreated this would have been found much later, requiring a major
operation, and decreased chance of a cure.

Another patient comes to my mind. This patient, I know very well. We will call
him JD. He also was a working man. He was force into early retirement by his
employer. He had never been sick and had no medical problems. He could not afford
health insurance and since he had never been sick, elected to “wing-it” without health
insurance for the six years until he qualified for Medicare. JD was transferred to my care
late one evening. Long story short, he was immediately taken to the operating room.
Four hours later, and in the middle of the night, I was sitting in the OR waiting room
explaining to his precious wife the finding during the operation. JD had a large
completely obstructing colon cancer. The operation required removing his entire colon,
and giving him a permanent iliostomy. As tough as he was, he recovered from the
operation in near record time. He never complained of pain, although I knew he hurt.
He also adjusted and accepted the iliostomy as only a man of his class would.
Unfortunately, we were just there to late. He underwent radiation and chemotherapy. He
also has several more major operations. If was just so sad, we were there to late. The
cancer eventually returned and JD succumbed to the cancer about three years after I first met him.

As best we know, every colon cancer starts as a small polyp, amendable to
removal at the time of the colonoscopy. The world we live in is not perfect, but at the
least the cancer can be found early, giving a patient the best chance possible of beating
the cancer, should it occur.