Colorectal Cancer: Nip it at the BUTT

The month of March is Colorectal Cancer Awareness Month in Singapore:

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If you are over 50, or have loved ones who are 50, make sure you are screened for colorectal cancer:

1. Fecal Immunochemical Test (FIT)

  • Detects the presence of small amounts of blood (that can t be seen with the naked eye) in the stools.
  • Is safe, quick and easy to do, and can be done at home, without the need to change your diet before the test.
  • Should be done once a year

2. Colonoscopy

  • Uses a flexible tube (colonoscope) to look at the inner lining of the large intestine (colon and rectum).
  • Takes about 20 30 minutes to complete
  • Has to be done in a hospital by a doctor trained in doing colonoscopies
  • Should be done once every 10 years
  • In Singapore, specialist trained in colonoscopies are Gastroenterologist, Colorectal Surgeons, General GI Surgeons. (in some countries only Gastroenterologist do coloscopies and other endoscopic procedures)

Most colon cancers develop from polyps, however polyps are usually asymptomatic, which means they don’t bleed, they don’t cause change of bowel habits and they don’t cause abdominal pain or abdominal discomfort. Polyps however, are easily removed and after doing so almost entirely eliminates the risk of it developing into a cancer.

In my personal opinion, both men and women above 50 should go for a colonoscopy and subsequently repeat the screening once every 10 years. Firstly the FIT test detects blood, which means that if your polyp doesn’t bleed you wouldn’t detect it which is unfortunate, and if it did bleed and the FIT test shows positive, they would still send you to have a colonoscopy done to find out the exact pathology. Either way someone’s got to look up your butt to be sure.

Most people are turned off by the idea of a long black scope snaking up through your butt and a team of human beings staring at your insides on a HD TV screen for what may seem to be an eternity, but just to help ease your nerves:

  1. You can opt for sedation, where you are semi-conscious, i.e. you’d probably be rambling rubbish to doctors telling them how your colon looks so weird or how the nurses are so nice and pretty and that you are so embarrassed, but you’d probably wouldn’t remember a thing when the drug wears off. Yes… it’s also called the date-Rape drug when abused… Sure thing is, it’ll save you from the discomfort and embarrassment. You should note that you would probably want to take the day off and not do it as a lunch time procedure before heading back to the office as some websites or doctors would offer although i have come across many business professionals transiting in Singapore rushing to Mt E to have their colonoscopy done. They however are doing it fully awake! The sedation drugs take a while to wear off and even after you think you are okay, you’d never know.
  2. A team of doctors/nurses staring at the screen is probably a good thing as 2 pairs of eyes are better than 1 and 3 are better than 2. Polyps may be as small as 0.5 cm in a 100 cm long colon. you don’t want to miss it.
  3. An eternity may be too long, but a reassuring 2 mins is definitely too short. During a colonoscopy, endoscopists push in the scope far enough to reach the cecum (end of your large colon). It is only during the withdrawal where they would start the screening proper. much like the view you have above. Very good practitioners can probably finish the whole procedure in 2 mins, however, studies have suggested that a colonoscopy withdrawal time of at least 6 minutes is associated with an increased adenoma detection rate in patients undergoing colorectal cancer screening. Which means if your endoscopist is completing the procedure in 5 mins you probably wanna ask him to have another go.

In an effort to raise awareness of colorectal cancer, award-winning local film maker, Royston Tan lends his hand to save our Singaporean Asses.

Scientific Weight Loss Tips by AsapScience

Video

Find out great tips on how to lose weight Scientifically in this short comprehensive video by AsapSCIENCE. Here’s a brief summary:
1. Exercise
2. Don’t skip meals
3. Eat breakfast
4. Add more protein and low fat dairy to your diet
5. Drink more Soup
6. Keep a food Journal
7. Count your calories
7. Use a smaller plate
8. Sleep more
9. Reduce your stress levels

A baby now free of HIV has doctors talking about ’cure’

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Dr. Deborah Persaud of the Johns Hopkins Children’s Center. She helped discover the case of a toddler who is close to being “cured” of HIV

Background:
The Human Immunodeficiency Virus (HIV), the virus that causes AIDS, has currently no cure. WHO estimates that there are 1.5 million pregnant women living with the HIV virus of which, only 57% are receiving adequate antiretroviral treatment effective in preventing mother-to-child transmission of the virus. HIV infected people, including children who contracted the virus from their mothers, undergo Antiretroviral Therapy (ART) which involves taking a “cocktail” of drugs in order to keep the virus suppressed. ART is lifelong and the virus returns the moment the patient stops taking the drugs.

In the case of the baby being “cured” of HIV, the baby had been given a cocktail of antiretroviral drugs at a dose higher than normal within 48 hours of being infected (being born). This suppressed the virus down to undetectable bloods levels, which is desirable as if the virus is unable to be detected in the blood, it also means that the virus cannot damage the immune system. subsequently, the baby underwent regular HIV treatment. It was reported that the baby had missed her regular checkups for several months however found to be free of virus. Fearing that they had been treating a uninfected baby, they checked the patients history again, and confirmed that the baby was HIV positive at birth. Using highly sensitive genetic testing, they finally found evidence of genetic material from the virus. While this is not a cure, it is a functional cure where the the virus, while still being in the body does not effect any damage to the immune system.

Implication:
Babies being born to HIV positive mothers are unique because doctors can identify when they are being infected. Thus if this “cure” is replicable, HIV positive new born children maybe able to avoid lifetime ART.

Read the full story below:

A baby now free of HIV has doctors talking about ’cure’.