Life-Saving Info

Hi friend,

No one wants to talk about dying, except for those guys who pretend they never will. And yet, it’s the conversation we all should be having.

To be clear, we’re all thinking about it – a lot. But it’s hard to bring up. As Vox points out, this avoidance can have serious repercussions. For instance: “Less than half of US adults have a will, which dictates financial and estate preferences after death,” and “only about 45 percent of adults have a living will, which dictates wishes around medical care.” It’s easy to see how that could be bad.

To get you started, the New York Times pulled an interactive guide together, and it’s worth bookmarking. It includes advice on affordable ways to get your affairs in order, such as free estate planning documents; the comment section is full of helpful tidbits, too.

This week’s feature is about another adult task worth doing: getting a colonoscopy. You know, summer fun! Read on for that, plus a few recommendations for your weekend.

Bye,
Your friends at Gloria

I assumed when I was 45, I’d get a Cologuard test instead of a colonoscopy. The ads were everywhere, and pooping in a cup seemed much preferable to a day of fasting, GoLytely, and diarrhea, followed by sedation and a medical procedure that had a tiny chance of puncturing my colon.

At my annual physical, my doctor noticed I wasn’t up to date with my screening. When I told her I wanted to do Cologuard, she asked me about any family history of colorectal cancer. 

“Just my Aunt Lissie who died of colon cancer at age 53,” I said.  

“That makes you higher risk,” she said.

I mentioned my Ashkenazi Jewish heritage. Her eyes got wide. “We studied Ashkenazi Jews in medical school,” she said. “They have higher rates of colon cancer. You need a colonoscopy.” 

“I’m scared that my colon will be perforated.”  

She said that was extremely unlikely. She also warned me that Cologuard only detected 42 percent of precancerous polyps. 

“Have I convinced you to get a colonoscopy?”  “Uh, I guess, maybe,” I said. 

If my doctor hadn’t viewed me as higher risk, I would have had no idea that Cologuard or a FIT test was the wrong test for me. And why should I have? 

Unlike Cologuard, colonoscopies don’t have an $800 million marketing budget or a brand deal with Lil Jon. What he says in his “Get Low #2” video featuring a golden toilet – that “the Cologuard test can catch pre-cancer before it becomes cancer” – is a bit misleading. It can, but as my doctor told me, only less than half the time. And if you have a positive result from Cologuard, you still have to get a colonoscopy. Colonoscopy catches and removes 95 percent of precancers. It remains the gold standard because it doesn’t just detect cancer, it removes lesions that may become cancer. 

I underwent my first colonoscopy at age 45 last month. I wasn’t sure what my doctor would find, but I didn’t expect her to remove a 25 mm polyp that was roughly an inch long. Nor did I anticipate waking up with my first tattoos — both inside my rectum. The tattoos help her to more easily check for recurrence during future colonoscopies, my doctor told me. She also let me know I had a few clips in my rectum because she had to use a special technique called endoscopic mucosal resection to remove the polyp with a tiny, hot, lasso-like device. None of this sounded like stuff that usually happened during a routine colonoscopy, so I became a little worried. 

The polyp was “most likely precancerous,” she told me as my brain, foggy with propofol, processed the information that there was a tiny (maybe not so tiny?) chance I had cancer. I would have to wait two to three days for the biopsy to come back. My blood pressure shot up. I didn’t want to freak out, but when I googled the size of the polyp and found it had a 40 to 50 percent chance of being cancerous, I got scared. I couldn’t even finish my post-colonoscopy Jersey Mike’s turkey sub. 

Colorectal cancer is now the second leading cause of cancer death in women under 50, and the first for men. In 2022, 20,805 people in the U.S. were diagnosed with early-onset colorectal cancer. Many women don’t realize colorectal cancer could affect them, says Dr. Travelle Ellis, senior medical officer of Exact Sciences, the makers of Cologuard screening kits. “[Colorectal cancer] hasn't really been brought up to women as aggressively as [it has to] men.” Colorectal cancer screening rates are low for all demographic groups, but Black and Hispanic women are even less likely to get screened than white women. Black and Hispanic women are also more likely to die from the disease. 

Nobody knows why these cancers are increasing in the under-50 crowd. While the same lifestyle factors causing colorectal cancers in the over-50 crowd — obesity, poor diet, sedentary lifestyle, smoking, and alcohol — could be to blame, researchers say these cannot fully explain the rise in younger people. Other concerns, including antibiotic overuse, changes in the food supply, air and water quality, magnetic fields, and circadian rhythms are also being investigated, according to Andrea Dwyer, director of the University of Colorado Cancer Center and advisor to the non-profit Fight Colorectal Cancer.

Dwyer was instrumental in lowering the screening age. Around 2017, she began hearing more and more anecdotal stories of young people diagnosed with colorectal cancer. After digging into the scientific literature, she found a 2015 report showing evidence of an increase among younger people. 

Yet it wasn’t until she went to an advocacy event that she realized she really needed to change the way we think about colorectal cancer. At the event, she approached a group of 40- and 50-something women and asked when they were diagnosed. They said they didn’t have the disease, but their daughters, who were 18 to early 20s, did. “Oh, they’re here at the conference with you?” she asked. No, the women told her, they’ve all died. “I went to the bathroom and just started sobbing,” Dwyer said. 

You know those pieces that you always fall back on when you can’t figure out what to wear? They’re usually simple, easy, and classic – like these three items from Ayr, which help us get out of the house faster most mornings.

If it’s super hot out, we turn to these silk shorts. They’re comfy, but not too PJ-like, and the heavyweight silk feels fancy. For cooler days, we love this silk pant, which looks cute with a tee, a button-down, or come fall, a sweater. And we’re always reaching for this denim shirt, which is great on its own or for popping over a tank. #partner

TO WATCH It’d be cool if the new Naked Gun meant the return of more big-box slapstick films. The movie has the DNA of the goofy ‘80s-era franchise, but crams in even more humor, and features Pamela Anderson as a romantic interest.

TO SHOP: This lightweight tinted mineral sunscreen is our everyday essential. It makes our skin look flawless, is great for sensitive skin, and protects with a water-resistant, broad-spectrum SPF 50 formula. Even better news: It’s part of a sitewide 20 percent off sale, which also includes their powder sunscreen, Brush-On Shield SPF 50, for easy reapplication — even over makeup. Shop the entire sale here. #partner

TO LISTEN It’s been 30 years since Elliot Smith’s band, Heatmiser, released their last record, Mic City Sons. It’s being re-released with 12 bonus tracks; take a listen here. For something less melancholic, this new Tame Impala single offers a chill summer vibe.

TO TRY We’ve never attempted to “fat wash” tequila for a cocktail, but you can get a step-by-step on the technique with this delicious-sounding recipe. It sounds advanced, but it’s really not.

A fascinating take on Ghislaine Maxwell’s character. • “When your husband is in a Hampton’s scandal.” • The beauty industry is interested in middle-aged women, but getting the execution right is tricky. • All the Golden Girls episodes are available on streaming, just FYI.

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