Oncology (General Cancer)/cancer


QUESTION: hello, Dr. Higby

I'm 80+ and in general good health.
I've lost about 5 lbs in 1 (last) year, dropping from 172 to 167 lbs.
Should I be concerned about cancer or some other illness?
I'm in good health, excellent appetite, good sleeper, normal bowel habits.

I've been reading about miR-21 as a reliable indicator of the presence of color cancer. I prefer it over a colonoscopy and its risks.
If miR-21 is not the answer, then what about a barium enema? The idea of a colonoscopy  just turns me off,

Your opinion, please.

Thank you.


ANSWER: At your age it is quite common to loose a chunk of weight and then level off at a new level.  The test you are speaking of is not very sensitive, and if it is positive, you'd have to have further investigation, which would be a colonoscopy.  A barium enema is a reasonable way to rule out something large, but if something is found, you'd need a colonoscopy.  I've had four, and while they aren't pleasant, once you've had one you will wonder why you worried so much.  Of course given your lack of symptoms and your age, you certainly can make the decision not to have one.  Hope this helps.  

---------- FOLLOW-UP ----------

QUESTION: Hello again, Dr. Higby!

Your reply, regarding a colonoscopy, brings me to a potential problem.

I have an inguinal hernia, not particularly large nor small.
Does the hernia pose as a barrier to the colonoscopy procedure? Would the gastroenterologist insist on or advise removal of the hernia before proceeding with his examination?

Thank you.


A hernia is a  weakness in the inguinal wall, and sometimes a  loop of bowel can move into the hernia.  If that is the case, it can be "reduced" which means it can be pushed back into the abdomen, or not reduced, in which case it poses a danger.  It sounds to me like you haven't had a loop of bowel in your hernia.  The other thing is that the colon almost never falls into a hernia; it is sort of tied down with a membrane so isn't as mobile as the small intestine.  So I strongly doubt that your gastro would  consider the herna a contraindication to a colonoscopy.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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