Bowel Issues and Colonoscopy for Cancer Survivors

Bowel issues, colonoscopy?

I apologize for the inconvenience.
I am referring to the question #129130 that I previously asked, and I appreciate the doctor's response.
Some time ago, I experienced a similar issue, and after changing my bowel habits and washing with clean water immediately afterward, I felt much better.
However, recently, after a few days of diarrhea, I have been feeling a sensation of a foreign body in the anal area.
I'm not sure if I'm just overly concerned or too sensitive about it.
I would like to ask for further advice.
I have researched information regarding colonoscopy and found that individuals with a history of breast cancer and thyroid cancer should pay special attention to colorectal cancer.
Since I have been diagnosed with stage I follicular thyroid cancer (having had half of my thyroid removed and currently on medication) for almost three years, and I am also in a high-risk group for breast cancer, should I be particularly vigilant about my gastrointestinal health? Does this classify me as being in a high-risk group?
I have regular follow-ups for my lungs and bones, including chest X-rays, thyroid ultrasounds, and blood tests, but there has been no mention of gastrointestinal evaluations.
Earlier this year, I underwent a fecal occult blood test during my company's health check, which came back normal, but I did not have a colonoscopy.
Is it necessary for someone with thyroid cancer to undergo a colonoscopy? Or can I manage my health by following the doctor's recommendations without being overly anxious?

Kong, 20~29 year old female. Ask Date: 2017/10/19

Dr. Ke Fangxu reply Surgery

What you mentioned refers to a specific group known as Lynch syndrome, which is associated with certain genetic defects that increase the risk of developing multiple malignancies.
However, not all thyroid cancer patients belong to Lynch syndrome; genetic testing is necessary to confirm this.
Fortunately, such patients are relatively rare among Eastern populations.
Therefore, it is recommended to undergo regular routine examinations.
If there are concerns, a colonoscopy every 3 to 5 years may also be considered.

Reply Date: 2017/10/19

More Info

Understanding bowel issues and the importance of colonoscopy for cancer survivors is crucial, especially for individuals with a history of cancer, such as thyroid or breast cancer. Your concerns about bowel health and the potential for colorectal cancer are valid, particularly given your medical history and the increased risk factors associated with certain cancers.

Firstly, it’s important to recognize that individuals with a history of certain cancers, including breast and thyroid cancers, may have a higher risk of developing colorectal cancer. This is particularly true if there is a family history of colorectal cancer or if you have had previous polyps detected during any colonoscopy. The presence of polyps can increase the risk of colorectal cancer, and regular surveillance through colonoscopy is often recommended for those at higher risk.

In your case, since you have been diagnosed with stage I follicular thyroid cancer and are considered a high-risk individual for breast cancer, it is advisable to maintain vigilance regarding your gastrointestinal health. While your recent fecal occult blood test (FOBT) was normal, this does not entirely rule out the presence of colorectal issues. Colonoscopy is a more definitive test that allows for direct visualization of the colon and rectum, and it can also facilitate the removal of any polyps that may be present.

Regarding your recent symptoms, such as diarrhea and the sensation of an "alien" presence in the anal area, it is essential to monitor these closely. Changes in bowel habits can be due to various factors, including dietary changes, stress, or gastrointestinal infections. However, given your cancer history, it is prudent to discuss these symptoms with your healthcare provider. They may recommend a colonoscopy to rule out any significant issues, especially if these symptoms persist or worsen.

As for the frequency of colonoscopies, guidelines generally recommend that individuals at average risk begin screening at age 45, while those at higher risk may need to start earlier and have more frequent screenings. Since you have a history of thyroid cancer and are in a high-risk category for breast cancer, it would be wise to consult with your oncologist or a gastroenterologist about the appropriate timing for your next colonoscopy. They can provide personalized recommendations based on your overall health, family history, and any previous findings.

In summary, while it is understandable to feel anxious about your gastrointestinal health, especially after a cancer diagnosis, it is essential to follow up with your healthcare provider regarding your symptoms and screening recommendations. Regular monitoring through colonoscopy can help detect any potential issues early, allowing for timely intervention if necessary. Your proactive approach to your health is commendable, and maintaining open communication with your healthcare team will be key in managing your overall well-being.

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