By: Grace Goracci, MD

Colon cancer is the third leading cause of cancer deaths in all women. It is the second leading cause of cancer deaths in Afro-American women. Less that 50% of women have been screened for colon cancer. However, statistics suggest that about 70% of women over the age of 40 have had a mammogram and about 80% of women have had Pap tests.

Colon cancer is preventable and curable if appropriate screening is done (similar to breast and cervical cancer).

The following women should be screened for colon cancer: 1) any woman over the age of 50 (as this is when polyps generally begin to grow). 2) Women with the following histories should possibly be screened before the age of 50: a) a strong family history of colon cancer or polyps (such as in a parent or sibling) b) a personal history of colon polyps or a long history of inflammatory bowel disease. There is evidence to suggest that women with a family history of different types of cancer (such as breast, ovarian, uterine or other organs) may be at a slightly higher risk of developing colon cancer.

Environmental factors associated with a lower risk of colon cancer include exercising regularly (30min/day), taking calcium supplements and eating a lot of fruits and vegetables. Factors associated with a higher risk of colon cancer include obesity, cigarette smoking and possibly eating a lot of red meat.

Colon cancer generally starts as a growth or polyp in the lining of the colon. However, not all polyps change to cancer. As some of the polyps continue to grow, there can be mutations or changes in the genes of these cells that eventually lead to colon cancer. If polyps are removed when they are small, colon cancer can be prevented in most cases.

There are usually no early symptoms to suggest that a woman could have colon cancer. As polyps grow larger and potentially start changing to colon cancer, symptoms such as a change in bowel habit (either diarrhea or constipation), blood on the toilet paper or in the stool, anemia or occasionally stomach pain can develop. For women with hemorrhoids who see small amounts of blood on the toilet paper, be aware that hemorrhoids are not the only cause of this type of bleeding. I have on rare occasions found polyps, colitis (inflammation in the wall of the colon) and even colon cancer in women with this history.

Colonoscopy is presently the gold standard of tests for screening for colon cancer. A colonoscopy involves the direct visualization of the lining of the colon. First, the colon must be totally cleaned out by using a specific combination of laxatives and diet (as prescribed by your physician) the day before the procedure. This is done in the privacy of your home. Most people say that this cleaning process is the worst part of the test. The colonoscopy is usually done at a surgicenter or hospital as an outpatient procedure. Once you arrive at the designated area, an IV (intravenous) is started so that you can receive medicine to put you to sleep during the procedure (ie: you will not remember the procedure in most cases). A colonoscope is a long, thin tube with a “camera” on the end. The colonoscope is passed through the rectum and around the colon (or large bowel) until it reaches the part of the colon where the appendix is located. Polyps can grow in any part of the colon. Most polyps are the size of a dime and can be removed during the colonoscopy. Occasionally some polyps cannot be safely removed by this method because of their size and/or shape. These latter growths are usually removed surgically.

Colonoscopy is a safe procedure in experienced hands. Complications can occur but are rare. The frequency of repeat colonoscopies depends on if any polyps are found on the initial colonoscopy, as well as your medical and family history (usually every 3-10 years).

Presently most medical insurance providers, including Medicare, now pay for colonoscopies. There are some organizations in Delaware, such as screening for life, that can financially assist eligible women with a limited income and/or who do not have medical insurance.

Many women are embarrassed about discussing bowel related issues with their doctors and do not want to take the time out of their hectic schedules to have a colonoscopy done, especially when they have no symptoms. However, I would recommend that you take a few precious moments for yourself. It will give you great peace of mind and could even save your life!

Dr. Goracci is moving her office to 10 Darwin Drive, Newark, DE (located off of Kirkwood Highway near Harmony Road) and is presently accepting new patients. For more information or to schedule an appointment, contact her office at 302-453-9171.

Publisher’s Note:

When I met with Dr. Grace for the paper the first thing that struck me was the fact that she had to be one of the most gentle, easy to talk with doctors that I had ever met. When I was a young person doctors like her were common, but today they are a rare find. I hope that she will never lose that touch of human concern that she displays.

Dr. Goracci has a GI practice located off of Kirkwood Highway in Newark, DE. She is an Attending at Christiana and Wilmington Hospitals. Before coming to Delaware, she spent 12 years in a group GI practice in Elmira, NY. Her practice in NY consisted of 90-95% female patients.

Dr. Goracci attended Jefferson Medical College and completed her Internal Medicine Residency at Thomas Jefferson University Hospital in Philadelphia. She completed her GI Fellowship at the Combined NIH-Georgetown-VA Program in Bethesda, MD.

Community involvement includes active participation and leadership roles in both Boy Scouts and Girl Scouts with her son and daughter. She has also served on several committees at her prior church in NY.