[salgernon]

I went to the urgent care when I had what I thought was hemmoroids - the urgen care doctor hadn't seen anything quick like what she saw and sent me for a colonoscopy. Normally "they" recommend starting periodic colonoscopies at 50.

When the procedure was finished, I was told they would analyze the result, but I had a cancerous tumor and they sent me for a CT scan which confirmed stage iv colon cancer with liver metastasis. I'm now 8 months into chemo and after having my sigmoid colon removed, seem to have "stable disease" in my liver. I was otherwise asymptomatic.

Another chap at my company wasn't so lucky. He got hit by a car and lost consciousness. They did an MRI to check out his brain - and found tumors. A CT scan showed the same don't diagnosis as me, but his was far more advanced, with mean mastastasasis to the liver, lungs and brain. He passed away about 5 months later and was otherwise asymptomatic.

In both our cases, A blood test given after the diagnosis (CEA) showed highly elevated numbers - perhaps two orders of magnitude from nominal.

So my question would be: given that this blood test was a marker for our disease, why can't it be given more regularly as part of a routine checkup? I realize there are other reasons for a false positive, but couldn't it be an indication that further testing should be done? Yes a CT scan can cost $1500, but my chemo costs $12,000 per month.

[acveilleux]

The issue is either False positive followed by heavyweight, risky and invasive checks or the non-committal of many radiology reports "further evaluation recommended..."

Basically, radiologists are more afraid of being sued for missing something then they are of being sued for being too cautious. Evasive language is a defence against the latter.

This is a uniquely American condition BTW. Most other places, the liability rules are different and doctors aren't as afraid of lawsuits / insurance premium hikes.

[Grazester]

Can I ask your age? I am in my early 30's and thinking of getting a colonoscopy, not necessarily without merit but potentially for the reason you did.

[salgernon]

I'm 44. They said the tumor may have been detectable 10 years ago. There is no history of colon cancer in my family, although my father had prostate cancer treated in his fifties. (He's 89 now and still drives have myself to his weekly poker game. Does pretty well at it too, from what I hear.)

Colon cancer can be effectively treated when Caught in it's early stages. During my (first) colonoscopy they found another tumor that got removed in the first of several surgeries, and it had clear margins and required to further treatment.