Trucker M.D.
Colon cancer and truckers
USEFUL FACT: The colon is the large intestine and extends from the right lower abdominal wall, up and across the upper abdomen and down the left side to the rectum.

By John McElligott, MD
with Jeffery Heinrich, Ed.D, PA-C

The culprit behind nearly 50 percent of all requests for assistance from the St. Christopher Fund is cancer. Skin, lung, pancreatic, liver, kidney, prostate and bladder cancers all have one thing in common: They can usually be detected early at a reasonable cost. That's the good news. The bad news is that one cancer is dangerously silent and therefore more difficult to detect.

Colon cancer is not only silent in its early stages, but also expensive to detect. Like all cancer, early detection is imperative for a successful treatment results.

Colon cancer is more difficult to diagnose in professional truck drivers. Most of the symptoms are ones that truckers demonstrate due to lifestyle and diet, so no alarm bells go off. These symptoms include constipation; sense of incomplete bowel movement; blood on the toilet paper; bright red or maroon-colored stool; and black stool.

The latter two would seem to be an obvious flag, but truck stop bathrooms are not necessarily a place where truckers can stop and check their stool for changes. In addition, some drivers take supplements with iron, which can mask the true color of the stool.

The symptoms of colon cancer located on the right side – or at the beginning of the colon – can be vague. Those symptoms may consist of nausea and vomiting, and nonspecific abdominal pain. These symptoms will rapidly change when the obstruction becomes more complete. Such an obstruction produces a slow but progressive abdominal pain and more common symptoms, such as weight loss and fatigue.

Most professional truck drivers do not undergo a complete physical examination on a regular basis. The DOT physical examination is nowhere close to a complete exam. Sadly, as a result, most drivers who are diagnosed have already reached the advanced stage of colon cancer. At that point, of course, cancer has often spread to other parts of the body.

So be safe and consider being tested. LL

Important memo from Dr. John

St. Christopher Fund MeRV to the rescue. Jon Osburn, Greg McDermand and I have found a fecal occult blood (FOB) test that is custom made for truckers. This test is unique in that it is more sensitive than previous tests done by doctors in their office. And truckers will be able to order it through the St. Christopher Fund hot line (877-332-4483), or get it from the MeRV. I will be overseeing all testing.

Early detection

Why is it more difficult to detect cancer in a professional driver than in any other person? The reasons are as follows:

  1. Doctors are not easily accessible when you are driving a big truck;
  2. Drivers are not willing to seek medical care;
  3. Drivers have a hard time getting a complete physical examination with fecal occult blood (FOB) test;
  4. Gastroenterologists are expensive and they don't work on weekends;
  5. Cost of a colonoscopy is $3,000 to $5,000 – and that is not all; There are additional costs for anesthesiologist and pathologists;
  6. Bowel prep is challenging to do in a truck without the proper facility; and
  7. Drivers may need two or three days off the road.

Editor's note: John McElligott is an MD and Fellow of the American College of Physicians. Jeff Heinrich, who serves as the column's medical editor, has a Doctor of Education degree and PA-C, which means Physician Assistant-Certified.