Dear OncoLink "Ask The Experts,"
Could you please better define what is meant by "a change in bowel habits"? For several months my husband has had an increase in the frequency of bowel movements He is 52, obese, sedentary, quit smoking a year ago, and has a family history of lung cancer. He is often fatigued but has not lost weight. He refuses to have a colonoscopy or even complete a fecal occult blood test. Is this of concern?
Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor, responds:
The term "change in bowel habits" is vague, and probably deliberately so. It can mean almost anything including a change in frequency, consistency (diarrhea or constipation) or in caliber of the stools. While colon cancer can be a cause for these changes, it is obvious that many other things can do the same thing. In fact, causes other than cancer are probably more frequent. The same could be said for rectal bleeding. That being said, in the appropriate population, such as people like your husband, these are symptoms that should prompt a person to be certain that it isn't cancer that is causing the problem. As you stated, colonoscopy is the best way of doing this. Fecal occult blood tests, flexible sigmoidoscopies or barium enemas are other options although they are not as good at evaluating the entire colon. Anything would be better than nothing, however. Screening for colon cancer is recommended to start at the age of 50, thus he should start with recommended screening anyway. With current techniques, a colonoscopy is a safe and comfortable procedure. If it were negative, another one would not need to be done for 5 to 10 years.