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Took medicine for interstitial cystitis. Diagnosed with breast cancer. Should I go for colonoscopy?

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Practicing since : 1962
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I have a question regarding whether or not I am a good candidate for colonoscopy, but first here's the bacl story: I have had intersittital cystitis for 24 years, diagnosed at age 40 by XXXXXX, MD of Elmiron fame and fortune(the drug made my condition much worse). He told me to practice bladder retraining, a solution I found unacceptable considering his fee and my pain, and sought treatment from XXXXXX, MD, formerly of fame and fortune (her license was revoked about 10 years ago).For 2-3 years, we tried a variety of things and finally discovered that 1 mg daily of unopposed estradiol not only eased my symptoms but put me in remission for up to five years at a stretch and allowed me to maintain my globe-trotting career as a travel/women's health magazine editor/writer. At age 50, I had a major bleed and my OB-GYN added prometrium to the mix. At age 60, I was diagnosed and treated for Stage 1 breast cancer (lumpectomy and radiation, no lymph node involvement. It was so long to estrogen and hello to sexual intercourse that was so painful we had to improvise. I saw the lovely Dr. DiSiai down at UC Irvine, who encouraged me to use a little vaginal estradiol, but it wasn't enough to make sex comfortable, so I stopped after 3 months. Since going off estrogen, I have averaged one IC flare a year, each one lasting six weeks or so. I've been putting off a colonoscopy for years--Gillespie claimed it would trigger a flare--but I just returned home from a year abroad to a scary 20-pound weight loss (hopefully from facetious hyperthyroidism--the compounding pharmacy abroad apparently tripled my dose from 120 mg to 360 mg)--an elevated pulse of 120 mg. and major anxiety. I went off the meds three weeks ago and thought I was gaining weight, but the scale hasn't budged and it appears what I thought was belly fat may indeed be abdominal bloating, which, coupled with the weight loss, is worrisome. I am getting an abdominal ultrasound and pap next week and seeing my medical and surgical oncologist the following week. I would like to schedule (and I'm sure they will recommend) an MRI and colonoscopy to rule everything out. I'm not scared of the procedure or even the prep (although I doubt the gastroenterologist will like hearing I'e been taking Senna laxatives for years to relieve pressure on my bladder). But I'm a little nervous that the procedure will throw me back into a flare. I know it's worth it, but I just want to know if this is a likely scenario so I can clear my travel schedule. Also, would love any advice/insights on how long it will take my thryoid to normalize. I have been off the meds for three weeks and my pulse has dropped from 102 to 86. Is it too soon to see any results? I am five feet, 90-95 pounds, now down to 78 pounds, and eat five healthy lowis-carb mini-meals a day. I have always worked out every day and have been using a daily 5-mile hike in the am and an hour on the ellipitcal trainer at in late afternoon to quell panic and promote sleep--although I'm wondering if this is counterproductive in terms of weight regain. Thanks so much for your help. I would love to hear from a urologist who specializes in IC as well as a gastroenterologist regarding colonoscopy. Are the new ultrasound procedures a possible alternative?
sorry for the typos and repeating myself. i'm new to this forum, a little nervous, and can't figure out how to fix them. my pulse is down from 102 to 86, not 120 to 86.
Posted Thu, 18 Apr 2013 in Digestion and Bowels
Answered by Dr. Charles S Narasi 35 hours later
I read your very detailed history and I am impressed that you have managed to survive many issues affecting your health. I am not an expert in Interstitial Cystitis but I have had patients that were under care by experts.
Your most important part of history is breast cancer.
With a personal history of any kind of cancer, especially breast cancer, you are a candidate for screening colonoscopy.
You are over 50 years old and you have had some bowel problems.
I am not sure why you were told about flare up of IC if you underwent preparations for colonoscopy.
Currently the colonoscopy preps are pretty safe and are being used in very elderly patients and also those with cardiac problems.
As for ultrasound, that is not helpful in detecting colon polyps.
You may be talking about "CT-Colography" or Virtual colonoscopy using CT scanner. This procedure also involves colon cleansing.
There is some concern about increased radiation exposure.
Also, this procedure can pick up polyps larger than 1 cm. in size but not smaller ones which could be pre-cancerous. The other disadvantage is, if a polyp or growth is found, you still need a colonoscopy for removal or biopsy of the lesion. The contrast material used during the procedure could cause kidney problems and with our history of IC, I would not opt this.
I don't see any significant potential harmful effects from the prep that is used for colonoscopy. You can certainly discuss with your urologist. In your case, colonoscopy is definitely indicated.
You can look up American College Of Gastroenterology website and go to patient information section and you will get informative guidance. By the way, March is Colon Cancer awareness month.
I wish you the very best.
Above answer was peer-reviewed by
Follow-up: Took medicine for interstitial cystitis. Diagnosed with breast cancer. Should I go for colonoscopy? 16 hours later
Thanks very much for your advice. I will schedule one asap.
Answered by Dr. Charles S Narasi 6 hours later
You are very welcome and glad to be of help to you

I wish you the very best.
Above answer was peer-reviewed by
Follow-up: Took medicine for interstitial cystitis. Diagnosed with breast cancer. Should I go for colonoscopy? 6 hours later
thanks again. as long as i am scared to death and you sound like a very straight shooter, just level with me and tell how much damage taking one laxative per day for the past 25 years has done to my colon. i've been reading all about the microscopic changes and am terrifed, but once again was advised by a well-meaing but ill informed urologist that this was better than being constipated for my colon health. I wish she had lost her license before I met her!! On the positive side, at least for my colon but certinaly not my breasts, I took HRT for 20 years and it sounds like that may offer me some protective effect? Or does the protection wear out once you stop using HRT? It's been four years now. i took estradiol and prometrium. on the positive side, i guess, there's no history of colon cancer in the family and I exercise daily, take 5,000 IUs of vitamin D daily and try to get 4-8 servings of veggies a day (I know the research is not conclusive on the link between consuming adequate produce and reducing colon cancer) , at least when i'm not in a flare. i really appreciate your help, Dr, Narasi, and if you didn't live in India, I would be on your doorstep on Monday for the prep. Thanks again for giving it to me straight. XXXXXX
Answered by Dr. Charles S Narasi 2 hours later
Hello again XXXXXX,
Thanks for your kind comments. Taking one laxative daily for the past 25 years has probably made your colon depend on it for action. Previously cretain laxative drugs containing phenolphthalein had shown to cause damage to the lining of the colon. I do not believe the newer laxatives have that ingredient anymore.

I doubt that you have any significant damage to the lining of the colon.
I think Vitamin-D and aspirin has beneficial effects in someone who already has had colon cancer surgery.
HRT, I can't see the colon cancer connection.
Wish you the very best.
Above answer was peer-reviewed by
Follow-up: Took medicine for interstitial cystitis. Diagnosed with breast cancer. Should I go for colonoscopy? 6 hours later
Thanks again and have a blessed Easter. I apologize for getting your location wrong--I knew you were in XXXXXXX and somehow typed India. I will try low-dose aspirin as I have read the studies; research has shown that HRT decreases risk of colon cancer by 20 percent, but I think the benefits lapse when you stop taking it.
Answered by Dr. Charles S Narasi 8 hours later

Thank you again and I wish you too a Very Happy Easter.

Hope it will all be good news.
God Bless.
Above answer was peer-reviewed by
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