Colon Cancer, Dementia Prevention, and Your Socks

Sometime in your mid forties, you start thinking of words like “prevention” and “screening”, the “serious stuff” beyond what you thought was reasonable, like getting your teeth cleaned, your eyes examined and, if you have one, having your cervix checked.

Also in your forties and female, you enter Mammogram land, no walk in the park I’ve been told by many. The mega medical centers relish mammograms as cash cows, contacting the freshly mammogramed, but now terrified ‘you’ back for a “slight abnormality” and “further imaging”. They make this call on a Friday, ruining your weekend and when you call back, the first available appointment is in 6 weeks. Second imaging may be followed by a third, 3-D MRI three months later and finally a smiley report, “All’s well. Looks like everything is fine”, except your damaged psyche as you grapple with PTSD from the health care system. Oh, and the MRI was not covered by your insurance.

As you approach fifty, you think about that colonoscopy, in fact, you’ve thought about it several times. Well meaning friends tell you the “prep” is the worst part. Others “love” their gastroenterologist (Freud would like details about that relationship). For many reasons, gastroenterologists are prone to early retirement.

With the new Cologuard test fully covered by your insurance, and very accurately picking up early colon cancers and polyps, you really don’t need a colonoscopy these days. The only folk who are disqualified are those with first degree relatives with colon cancer or a personal history of polyps, ulcerative colitis, or Crohn’s Disease.

The mega medical centers around Chicago each employ about 100 gastroenterologists whose paycheck comes mainly from colonoscopies, so if you want a Cologuard, be firm with your primary care provider who is likely to discourage it. She won’t mention that colonoscopies can be dangerous (perforation, bleeding). Putting some of your poop in a Cologuard plastic bucket is not.

But now we come to the purpose of this Health Tip.

Each year there are approximately 150,000 new cases of colon and rectal cancer diagnosed in the U.S. 150,000, got that? Hold that number in your head.

Each year there are approximately 300,000 new cases of invasive breast cancer diagnosed in the U.S.

300,000, got that too?

Now, each year there are 500,000 new cases of Alzheimer’s Disease and related dementias.

So statistically your risk for Alzheimer’s is higher than your risks for breast and colon cancer combined.

But since there’s no mammogram or colonoscopy to screen for Alzheimer’s, you must rely on prevention, which fortunately is the same for all three. You should be able to recite in your sleep: a healthy diet, regular exercise, no tobacco, good sleep, reduce sugar.

Plus, there’s an add-on for Alzheimer’s prevention:

GET YOUR HEARING CHECKED REGULARLY AND IF YOUR AUDIOLOGIST ADVISES YOU TO WEAR A HEARING AID, DON’T ARGUE WITH HER (OR HIM). Read this from the Washington Post.

Hearing loss can cause: impaired use of brain power as the hard of hearing person is concentrating so much on what is being said that other parts of the brain literally wither from disuse. MRIs of untreated hard of hearing patients show shrinkage of the temporal lobe which then fails to make connections to other parts of the brain. And finally, hearing loss leads to social isolation, one of the most significant risk factors for developing dementia.

Just like you need to go to a good optometrist for an eye exam, you do need to see a good audiologist for a hearing exam. I know hearing aids are sold over the counter like WalMart socks but unlike your feet, ‘one size does not fit all’. You will really not be able to test yourself accurately. I’ve been going to Hearing Health Service for forty years, and they’re excellent but there are plenty of certified professional audiologists. Just don’t do it yourself or you might end up tossing your OTC hearing aids in the same drawer as your WalMart socks and your Walgreens reading glasses.

Be well,

David Edelberg, MD