Q. I have been getting colonoscopies

yearly since 1999, the year my older sister passed away from colon cancer.

Each year, polyps have been found and removed. Is there anything I can

do to prevent their growth?

- R.G., Merrick, N.Y.

A. As long as you're having

regular colon surveillance, removing any colon polyps seen, you'll

be fine. Colon cancer doesn't just show up. It starts out as polyp,

an outgrowth of tissue from the wall of the colon.

Although your polyps seem to

grow rather quickly, most polyps grow over several years; the time it

takes from the beginnings of a polyp to early colon cancer is estimated

to be 5-10 years.

What causes polyps? We're

not certain, but it definitely appears that genetic factors play a part.

Beyond that, we know that a diet high in saturated fat and cholesterol

increases the risk of colon cancer. A high fiber diet helps to speed the

passage of stool through the colon, so there's less time for the

colon lining to be exposed to various toxic substances formed by intestinal

bacteria. Fresh fruits and veggies contain anti-oxidants which may protect

the colon's lining. Age is a definite risk factor. Colon cancer is

pretty uncommon before the age of 50, but rises rapidly as we age.

are precancerous. Some are "hyperplastic" and have no malignant

potential. But you can't tell just by looking at them. They need

to be removed and sent for biopsy.

Two new technologies are available

to screen for colon polyps. The first involves swallowing a video capsule

and taking pictures along its path. While it may be an option for low/average

risk folks, its limitation is that any polyps seen cannot be removed.

Virtual colonoscopy uses CT scanner technology to take 3-D images of the

colon. Its limitations are that small polyps might go undetected and any

polyps seen cannot be removed.

Q. Can you write about diabetic

neuropathy? - M.M., Allentown, Pa.

A. One of the complications

from years of diabetes can be permanent nerve damage - especially

of the feet. While some folks simply lose the feeling in their legs, others

may experience painful burning that can be quite debilitating. But diabetes

doesn't just stop there. Other nerves may be permanently damaged,

including the nerves that supply the heart, brain, eyes and digestive

tract.

Once the damage is done, there's

nothing we can do to reverse it. That's why it's so important

to identify folks who are diabetics and don't know it. Most folks

who are diagnosed with diabetes probably have had it for a few years before

it was picked up on bloodwork.

A fasting blood sugar of 126

or higher on two or more occasions means you have diabetes. But we do

see diabetics with fasting blood sugars under 126. A helpful test for

suspected and known diabetes is called a "hemoglobin A1C." Although

not intended as a screening test, it gives a ballpark average of blood

sugar control over the last 3 months. A reading of 6.0 percent or greater

means you're a diabetic. Good control of diabetes is a reading of

6.5 percent or less. The better the diabetic control, the lower the risk

of long-term complications.

Controlling pain from diabetic

nerve damage is difficult. Oxycontin is a very powerful narcotic with

great pain control, but with potential for abuse when used long-term.

One surprisingly effective approach is to use anti-seizure medications

like Topamax, Lamictal and Neurontin. Some have found relief with a low

dose of the antidepressant Elavil, 25-50mg at bedtime - even if there's

no depression. Capsaicin cream, an extract of the pepper plant, can cause

numbing relief of a burning diabetic foot. One last treatment that's

sometimes overlooked is to improve blood sugar control. Those with sub-optimal

diabetic control often find dramatic relief from diabetic leg pain by

simply taking more medication to lower their blood sugars into an acceptable

range.

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