Wednesday, October 25, 2006

An Unwanted Journey: Day 0337 - 5 Year Recurrence Rates

Fear of recurrence is one of the most powerful emotions experienced during recovery. Because I was warned about such emotions prior to entering this transitional period, I think the impact is less severe than would otherwise be the case. I do worry occasionally about recurrence, but for the most part I think I have a relatively healthy and realistic attitude about the future.

Next month I will have another colonoscopy conducted by my surgical oncologist, the person most familiar with the anatomy of my colon and rectum. I am actually looking forward to this, primarily because I anticipate that no polyps will be found and that everything on the "inside" is clean. Then I will wait another 2 years for the next colonoscopy, followed by a 5 year wait.

Fortunately, a recent study from Indiana University has found that the chances of having colorectal cancer 5 years after a colorectal screening with no precancerous growths or polyps found is very low. Followup screening is a somewhat contentious issue among gastroenterologists, the American College of Gastroenterology recommending a 10-year interval rather than the standards used in Ontario and British Columbia. Those two jurisdictions have moved in the opposite direction and have studies supporting the change.

From my personal perspective, the more frequently I have colonoscopies, the better. It is the gold standard; nothing compares to what some term "optical" colonscopies, even the more recently favoured "virtual" colonoscopies. Patients who fear recurrence, and especially those like myself who have endured radiation, surgery, and chemotherapy, are quite willing to undergo the indignity of a colonoscopy just to assure themselves that their worries are without foundation.

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