• cobaltpath a day ago |
    I wonder if the higher proportion of stromal cells in young tumors is a direct result of specific dietary components or gut microbiome variations rather than just inherent biology. The study mentions looking at how cell programs interact with diet and microbes, but it seems early onset cases often present with distinct inflammatory profiles in the colon itself before tumor formation.

    It would be interesting to see if these long non-coding RNAs show up consistently in pre cancerous polyps in younger patients or only after malignant transformation. If they are elevated early on, that could actually help solve the diagnosis problem where many late stage cancers are found, assuming we can target them specifically.

    • yread a day ago |
      The lncRNA is common in all CRCs but the stroma content in healthy tissue usually increases with age
  • andai a day ago |
    Does this track differences between generations (i.e. environmental changes), or the age-related differences within a single cohort, or somehow both at once?
  • Spacecosmonaut a day ago |
    I'm 35. I had a preventative colonoscopy done (I had to insist). I payed out of pocket since these checkups normally start at 50.

    Adenoma found and removed.

    This is a type of cancer that is almost entirely preventable with screening. Get your tubes checked.

    • sevenzero a day ago |
      I'd rather die over having a tube up my ass, and I've seen my father die to this exact type of cancer.
      • Spacecosmonaut a day ago |
        I think its okay when you tell the doctor no homo.
        • sevenzero a day ago |
          Surely
        • ackbar03 a day ago |
          I think you need to get the doctor to say it, not the other way round
      • taskforcegemini a day ago |
        not sure if that makes it better for you, but usually you are knocked out and don't know what is happening during the procedure. Much worse is the preparation starting days before with disgustingly tasting things that intentionally give you diarrhea (and maybe make you puke) to clear the path, and no food at all
        • Findecanor a day ago |
          People get a safe but vile-tasting laxative by default. If you don't have any known problems with your colon then you could ask for a faster-acting laxative that is easier to get down.

          I have a condition so I have a colonoscopy every year. Once I had found out about there being a fast-acting option, I've always chosen that.

          I've never done it sedated. I prefer to watch the screen and and ask questions. I've found the view quite fascinating, actually. The doctors and nurses have always been professional, focused on the colon: not the butt. There is absolutely nothing sexual about it. I've never felt pain: only some tension, and that's been because of gas (needed to get a clear view). It is perfectly safe unless your colon has some illness of some sort. The worst part has always been the prep.

        • sevenzero a day ago |
          Yea I know, my life just isn't worth living and I'd prefer not to have something shoved up my ass to prevent something that could end it early cuz I am too foolish to do it myself.
      • zfree a day ago |
        To anyone wondering about this, I did it last year. You don't remember the procedure at all, you're just left with the blissful afterglow of the drugs they use to make you sleep. That stays with you for a couple of days. The uncomfortable part is the day before when you have to do a cleanse. Worth it.
        • DoingIsLearning a day ago |
          > You don't remember the procedure at all, you're just left with the blissful afterglow of the drugs they use to make you sleep.

          Technically this will vary depending on the protocol. I have friends in this field and in some countries they effectively knock you out with sedation. Others you might get some anxiety medication and only sedate elderly or uncollaborative patients.

          Regardless of that everyone should absolutely get checked but just wanted to make sure we don't set unrealistic expectations.

        • Tade0 a day ago |
          I've been reading about this and my sources said the preparation phase takes a week. Does it not have to be a week then?
          • jdsleppy a day ago |
            Never a week, I can't imagine how you would find a source that says so. Source for 1-2 days: https://www.mayoclinic.org/tests-procedures/colonoscopy/abou...
            • Tade0 21 hours ago |
              The sources are in my native language, so it's likely the local practice is outdated.
          • blue_sauce_bean a day ago |
            I’m literally having a colonoscopy today (Wednesday), so I’ll say what my prep has been.

            Starting on Friday, I followed a “low residue diet”. This primarily meant no fibrous fruits/veg or whole nuts/seeds. It was inconvenient but not hard.

            Yesterday I started a “clear liquid diet”, which meant that I did not eat anything and only drank apple juice, gatorade, and the prescription prep solution. Starting at 5pm and going until about 6:45p, I drank half of the prep solution, which was like 64oz of stuff that tasted like flat Sprite. Right about the time I finished drinking, the draining out the other end began. It wasn’t a problem, and didn’t hurt, but I did visit the bathroom about 10 times over the next 2 hours with another few throughout the night.

            I slept great overnight, and now I’m getting ready to start the second half of the prep solution. I’ll drink it over a 90 minute span, beginning four hours before I am scheduled to arrive at the endoscopy clinic.

            (I’m also planning to have my colonoscopy without sedation. I have a very high pain tolerance, and was told that I’ll be able to watch the realtime video feed!)

            • FuriouslyAdrift a day ago |
              Around here, they refer to the day of drinking the solution as "The Night of a Thousand waterfalls"
            • andrewjf 9 hours ago |
              how'd it go
          • fnordlord a day ago |
            It might depend on the doctor also. I had one last year and, from what I remember, there was no prep besides the 24 hour fast/liquid diet before the procedure. I was long overdue to the first one but I won't be from here on out. The entire thing was easy.
        • Lwerewolf a day ago |
          Did it without sedatives, nothing special. Common thing in northern Europe - not so much in eastern. Stomach checkup as well, cause you might as well at that point - the equipment and specialists are there.

          A friend's girlfriend got stage3(?) recently, not 30 yet. My dad passed away ~5 years after diagnosed stage4. I had some pretty nasty IBD which, along with the mention of my family history, _finally_ got them to agree to do it. Anyways, all clean, other than h.pylori that got taken out with the first round - stomach - apparently exceedingly common here.

          Watch your shit, get your stuff checked. I still had the needles set up in case perforation occurred and they had to sedate and do exploratory.

      • david-gpu a day ago |
        Everyone who goes through the procedure says the same thing: it really is no big deal and the procedure itself is less of a problem than the laxatives you need to take the day before.

        You are not going to catch the gay for having a colonoscopy, if that is your fear.

        • sevenzero a day ago |
          My fear is mostly shame to be honest. Never had an issue with gay stuff as I kissed my homies on the cheek before
          • david-gpu a day ago |
            Shame of what? From whom? GI doctors and their teams do this all day long. And nobody sane is going to shame you for following a medical procedure.

            It really is not a big deal to go through it.

            • SpecialistK 13 hours ago |
              > GI doctors and their teams do this all day long.

              I've had an extended conversation about this with an ER nurse friend, in which I reminded her that although the staff go through the gamut all day every day and it's normal for them, the patient (hopefully) does not and whatever procedure(s) are new and scary.

              Add in the fact that (sexualized) abuse and med students using anesthetized patients for training without explicit consent is more common in the medical field than any of us would like, and people having concerns strong enough to avoid treatment sounds pretty reasonable to me.

              "we see this all the time" may settle a few concerns, but it makes others (such as the power imbalance) worse.

          • BigTTYGothGF a day ago |
            The only thing they might possibly judge you on is how well you followed the prep instructions. They've all seen thousands of assholes, most of them professionally, and will forget about you as soon as they wheel you back to the recovery room.
            • strictnein 21 hours ago |
              > The only thing they might possibly judge you on is how well you followed the prep instructions.

              Same with if you get snipped. I didn't realize that "shaved" meant with a safety razor and I just trimmed with a beard trimmer. I ended up having two younger women give me a proper shave as I laid there, which was about the dumbest I ever felt in my entire life. Made for a great story for my friends though.

      • BigTTYGothGF a day ago |
        It's just a butt, you don't have to be any more precious about it than about anything else that gets stuck into your body.
        • sevenzero 19 hours ago |
          I dont want anyone to touch me, not in the face, not on my belly and especially not my anus.
          • preg_match 16 hours ago |
            Ok well you will have to be touched in order to receive medical care, particularly surgeries. I’ve had been touched while unconscious during surgeries. It was either that or die.

            If it makes you feel any better, it is literally impossible to remember it. You can’t be traumatized by it even if you wanted to.

      • aaa_aaa a day ago |
        Dude it is nothing compared to any type of cancer. Besides, you are mostly sedated and dont remember a thing.
    • thin_carapace a day ago |
      I don't intend to disagree, merely to suggest that while doing the right thing one would be best off considering the potential aspects inflicted to themselves, in this case colonoscopy deaths are one in ten thousand from memory
      • Spacecosmonaut a day ago |
        I suspect that risk calculus depends on where you live.
        • tonyedgecombe a day ago |
          Probably how old you are as well.
    • hawk_ a day ago |
      Did you suspect you had a higher chance than general population? If so why?
      • Spacecosmonaut a day ago |
        Not really. I try to live a pretty healthy lifestyle. I work as a cancer researcher, so I have more contact with these data.
        • hawk_ a day ago |
          That's crazy. And you don't deal with wet lab I imagine, so just a freak occurrence.
          • Spacecosmonaut 20 hours ago |
            50/50 wet lab & computation. We do large genetic screens in vitro.
            • hawk_ 7 hours ago |
              Neurosurgeons are at a higher risk of certain dementias and the purported mechanism is exposure to brain tissue during surgery. Any chance the same could be true for GI tract or cancers in general?
    • solids a day ago |
      Wow, did you have any kind of symptoms?
      • Spacecosmonaut 20 hours ago |
        None
    • jml78 a day ago |
      I did the same at 42 due to my mom consistently having polyps. Insurance refused to cover. I was told I would have had cancer by 45 most likely.

      Had no symptoms, now I get one every 5 years.

    • gonzalohm a day ago |
      Did your insurance pay after finding out that you actually needed one?
      • Spacecosmonaut 20 hours ago |
        Hah no, I suppose it doesnt work like that
    • 747-8I a day ago |
      Commenting to save your's.
    • knotz a day ago |
      I am 59. Got colorectal cancer at 54. I did't notice anything until it was almost too late. I was lucky and it was removed just in time. After inspection it seemed I have polypsyndrome and now have a yearly cleanup. So, yes, get your colonscopy before 45.
  • helterskelter2 21 hours ago |
    I'm late to this thread, and I've mentioned this story here before several times (under other usernames I lost the password to), but it bears repeating:

    I had family who was experiencing symptoms of CRC in their late 30's or early 40's, which they reported to their PCP. PCP repeatedly denied them a referral to a specialist and insisted they were too young for CRC. This goes on for about a year. Finally, with worsening symptoms, my family member 'remembered' that their 'aunt' had passed of CRC when they were very young. This got them a referral to gastroenterologist, who got them a colonoscopy. (All this trouble, even though their symptoms were textbook and got so bad they couldn't make it ten steps to the bathroom).

    However! The colonoscopy came out clean, but my family member was still experiencing worsening symptoms. Finally the gastroenterologist schedules a CT or MRI, which spotted a huge tumor in their colon and they were diagnosed stage 4. The tumor was in their sigmoid (the right-angle turn your colon makes), and only the tip of the tumor was protruding from the colon wall itself, so when the doctor performed the colonoscopy and failed to fully inflate the colon, they did not see anything there. This delayed diagnosis by another few months which may have been critical to their prognosis.

    They fought for eight years against cancer and the insurance company, and were scheduled to undergo a procedure earlier this year at Yale which may have eliminated the cancer in their peritoneum (often the last holdout for metastasized CRC, and with our current medicine, basically impossible to remove, I'm told), until a certain American president cut funding to basically all medical research. They passed a few months after they would have had the procedure.

    Do not ignore the symptoms, and make sure to absolutely force the issue with your PCP/doctor if the symptoms persist, even if your colonoscopy comes back clear. PCP's don't want to upset insurers with useless referrals and many get their egos bruised if you think you know better. Even MD's will half-ass a colonoscopy if they get too comfortable with their judgement. You have to be your own advocate in America's medical system because nobody gives a shit if they get you killed, so long as they don't have to pay for it.

    IIRC doctors wanted to lower the age for CRC screening but insurers didn't want to pay for it, so don't fall into a sense of security because you "aren't old enough".

    And for those of you worried about a stranger looking up your ass, I've had a coloscopy myself and it's not that bad. These people look up stranger's assholes all day every day.

    • Fr0styMatt88 18 hours ago |
      This is so frustrating. I intellectually understand the whole thing around incidentalomas and the way testing’s false-positive rate can make universal testing harmful, but still. If you want the test, you should be able to get the damn test.