I had been avoiding it for years, but one’s 30th rotation around the sun brings about many changes. I turned 32 in July and started seeing a new primary care physician in New York City in February. Five minutes into our first appointment he said those dreaded words, “Today we’ll also do an anal pap.” I did what any self respecting warrior spirit man in his 30s would do and tried to jump out of my own body. It was time to face the music. Given my family history, I’m now at the age where I must include colorectal cancer pap smear screenings as part of my preventative healthcare.
On Turtle Island, colorectal cancer is the third most commonly diagnosed cancer (excluding skin cancer) with both men and women being impacted by the disease. Women are screened more often during their gynecological exams, while colorectal cancer in men is too often undetected due to lack of screening. Whether it’s men not advocating for the screening, doctors not taking the time to offer it, or a mixture of both, colorectal cancer has become a leading and silent killer among men.
Panicked and in a sweat, I took down my pants and underwear and leaned over the exam table. The doctor used a thin cotton swab to collect the sample; the entire process took less than 60 seconds. I can honestly say that I made a big deal over nothing. The doctor also explained that if the screening was reactive that I would then be referred out for a simple procedure. So why do so many men go unscreened for colorectal cancer?
With all cancers, early detection is crucial. Colorectal cancer symptoms can include blood in your stool and drastic changes in bowel movements, or no symptoms at all. It is important to remember that the body’s response system is limited and these symptoms can also be completely unrelated to colorectal cancer. Which is why a screening by a healthcare professional is so important. So don’t launch into a frenzied Internet search after this article.
Accessing healthcare services on the rez is all too often a challenge, but usually the only place urban NDNs can receive comprehensive healthcare under IHS. However, I found that even in a city like New York that is saturated with resources and linkages to care, it was still very challenging finding a doctor who took my insurance. Thus, being guilty myself of not setting foot in a doctor’s office in two years.
Cancer.org projects 50,260 colorectal cancer related deaths in 2017. A disheartening statistic when you consider how treatable it is when caught early, with the five-year survival rate of those who were diagnosed with stage 1 colorectal cancer being 92 percent.
My intention here is not to bombard you with facts and statistics, but rather to begin a transparent dialogue about how men view the importance of their own health, and how we approach it. Why do men avoid the doctor?
One could argue many psycho-social factors. Numerous health surveys show that men site fear, shame, discomfort, and lack of free time, as reasons for not getting their “turn your head and cough” annual physical.
Having some of the most private and sensitive parts of your body examined can feel very invasive, and a good physician will be understanding and accommodating. Knowing when your doc isn’t a good fit for your needs and finding one who is can improve the quality of your overall health and healthcare experience. Many men still aren’t comfortable with being an advocate for their own health, but in the age of the 15 minute appointment slot, showing up for a doctor's appointment prepared to ask questions and express needs clearly and firmly is paramount.
Men also let life's burdens spill over into their rationale for taking the reigns of their health, as health disparities can be burdensome to deal with. We feel overwhelmed with the very thought of it, so we do nothing or procrastinate. You know the saying “Guys wait until it's fallin’ off to go to the doctor’s.”
Isn’t it time we begin opening up to our brothers, uncles, sons, fathers, grandfathers, nephews, cousins, and friends about our general health? Silence perpetuates stigma and shame. We should be encouraging by reminding one another that these exams DO actually save lives, and that there’s so much more at stake than our foolish pride. Stop the high school locker room teasing and instead be empowering, even offer to attend the doctor's appointment with someone to show support. It’s totally worth going out on a limb for someone you love considering that 60 percent of colorectal cancer deaths could be prevented with a doctor’s office screening.
I’m glad that I didn’t let my fear and discomfort get in the way that afternoon, especially with how minimally invasive and painless it was. We are responsible for our own physical, mental, emotional, and spiritual well being. We can't let the reason for disproportionate male colorectal cancer deaths be due to that fact that we let it be so. It’s your rectum, and it’s your colon. Get them checked.