Mickey Martinez was a vigorous 64-year-old with a smashing smile and a backhand to match. Fluent in four languages, he devoted his professional life to public service and his personal life to being a good husband, father, grandfather and neighbor.
Although he saw a physician regularly, his doctor never prescribed a routine colonoscopy, an examination of the colon and rectum that can stop cancer, often even before it begins.
The American Cancer Society recommends the test at age 50 and again at age 60. But by the time Martinez realized something was not quite right withhis digestive tract and had a colonoscopy, it was too late. Colon cancer had already invaded his liver.
A strong and otherwise healthy man, Martinez bounced back quickly from two major operations, tolerated three years of chemotherapy better than most people weather a bad cold and continued winning tennis tournaments. But eventually cancer claimed the ultimate victory.
Most colon cancers arise in an adenomatous polyp. It typically takes about 10 years for a benign polyp to become cancerous, and removing such polyps through colonoscopy can stop any cancer formation. More frequent exams -- say, once every two years -- are recommended for anyone found to have polyps or colon cancer and for those whose close relatives have had the disease.
Though it commands far less attention than, say, cancers of the breast or prostate, colorectal cancer is the leading non-smoking-related cancer killer of Americans. It is the third most common type of cancer and the second leading cause of cancer deaths. This year, the cancer society predicts, about 145,290 cases will be diagnosed and 56,290 people will die of it.
Both statistics represent needless deaths: This disease is largely preventable and, if diagnosed early, nearly always curable, often with surgery alone.
Fewer than a third of Americans over 50 have ever had a colonoscopy, the test that can beat this cancer into the ground by finding the polyps that give rise to the disease.
The excuses made for avoiding the test -- fear of discomfort, expense, inconvenience, embarrassment -- are, in my view, lame. At 63, I recently underwent my second screening colonoscopy. It was a painless outpatient procedure done under sedation, and my colon got a clean bill of health.
While colonoscopy is hardly my favorite medical exam, it is not half as challenging as most people who've never had one seem to think.
By far the worst part is the preparation -- a thorough cleansing of the bowel so that the gastroenterologist can get a clear view of the lining of the entire large intestine.
For my first exam five years ago, I was restricted to a diet of clear liquids and Jell-O for a day and had to consume a gallon of a laxative drink, staying close to a toilet for many hours.
But for the second exam, my pretest diet included yogurt and ice cream (without pieces), which assuaged my hunger, and the cleansing was stimulated by a glass of salty liquid midafternoon.
The exam itself involves insertion of a long, narrow, flexible tube with a light at the end that allows the physician to view the lining of the entire colon and rectum on a screen.
If a suspicious area is detected, a biopsy instrument can be threaded through the tube to collect a tissue sample.
Much publicity has been given of late to what is called a virtual colonoscopy -- an examination of the colon done via a CT scan (or, sometimes, an MRI).
Since no tube is inserted, there is no discomfort or need for sedation. But if any abnormality is suspected, a regular colonoscopy will have to be done.
Jane E. Brody writes about health for the New York Times.