Colon cancer has few early signs
DEAR DR. DONOHUE: Will you address the signs of early colon cancer? I am 71 and had a colonoscopy when I was 65. In the past month, some of my stools have been in small pieces. They are not black, but could this be the start of something? I worry about it. — S.G.
ANSWER: Colon cancer has the reputation of being a deadly cancer because, in its early stages, it produces few notable signs or symptoms. It doesn’t usually kick up a fuss until it has grown large or spread to sites far from the colon. This is the reason why people are urged to have a colonoscopy — a scope exam of the colon — when they turn 50 and to stay on a schedule for repeat colonoscopies thereafter. Most colon cancers start out as colon polyps, which are warty, little growths from the colon lining. Only a visual inspection of the colon detects them. It takes about five years of growth for a potential cancer polyp to become a cancer menace.
The colon begins on the lower right side of the abdomen and rises on the right side to just below the liver. Right-sided colon cancers often ooze blood that turns the stool black. The blood loss can be great enough to produce anemia and the signs of anemia — breathlessness and fatigue. On the upper right side, the colon takes a 90 degree turn and crosses to the left upper side of the abdomen. Cancers in this part of the colon lead to crampy abdominal pain and often colon blockage. From the upper left side, the colon descends to eventually become the rectum. Cancers in this colon segment frequently narrow the stool, require straining during a bowel movement and often produce red blood in the feces.
Your stool change isn’t a common sign of colon cancer. However, it is a change and should be reported to the doctor who performed your colonoscopy. Ordinarily, a repeat colonoscopy isn’t scheduled for 10 years. Your doctor can evaluate this change and tell you if you should have your next colonoscopy now.
The booklet on colon cancer describes this common and potentially lethal cancer and its treatments. Readers can obtain a copy by writing: Dr. Donohue — No. 505, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I have a tremor in both hands. However, my greatest concern is that my voice is changing to being raspy and shaky. I am self-conscious when I speak, and I fear this will affect my socialization. Explaining essential tremor is difficult. The frequent question is: Why “essential”? The dictionary defines “essential” as something important and necessary. — L.R.
ANSWER: Essential tremor questions amount to the most-asked questions I get. That shows what a common malady it is. Not only do the hands shake, but the head might nod in a yes-yes or no-no motion, and the voice often becomes tremulous. The same medicines used for control of shaking hands — propranolol and primidone — can control vocal tremor and head tremor.
“Essential” is a terrible choice of word. In medical circles, “essential” often means that the cause is not known. The common kind of high blood pressure is essential hypertension.
DEAR DR. DONOHUE: What can I do to have a normal life when I have an underactive thyroid gland? I am very weak and tired all the time. I do take Synthroid, but it’s not helping. Can you help? — D.F.
ANSWER: Synthroid, thyroid hormone, should eliminate the signs or symptoms of an underactive gland. Perhaps you need a boost in your prescription.
If this isn’t the case, then the doctor has to consider the long list of the many other causes of fatigue. Hidden infections, diabetes, low blood sodium, sleep apnea and heart failure are only a small sample of those causes. Depression is often overlooked as a cause, and that’s regrettable. Depression can and should be treated, and most often treatment is successful.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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