It's not every day you get asked to be the star of an internet video, but when Dan Logan was approached by his gastroenterologist to have his next colonoscopy broadcast live on Facebook, the 64-year-old jumped at the opportunity.
Dr. Barry Lumb, a gastroenterologist at Hamilton Health Sciences in Hamilton, Ont., called Logan while he was on vacation in Peru.
"He said they wanted to broadcast my colonoscopy live on the internet," Logan says. "I thought, sure, why not?"
Lumb has performed more than 15,000 colonoscopies in his 30-year career. But that's not nearly enough, he says of the procedure that involves placing a camera on a lighted tube one metre up into someone's bowels to look for signs of colon cancer, the second-most common cancer in Canada.
"If you find a polyp, you prevent cancer, and I find a polyp in about 30 per cent of people," he says.
It takes five to 10 years for a polyp to grow into a full-blown cancer, and many polyps are harmless.
Lumb has watched people who hadn't been screened die of colon cancer. If their cancer had been caught earlier, he believes, they would have survived.
"I feel terrible. A surgeon here died of colon cancer. He had symptoms for a year and didn't get scoped."
'Any port in a storm'
Lumb is desperate to increase screening rates to catch colon cancer early. He has tried many avenues to raise awareness, but this is his first attempt at going viral.
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"Any port in a storm," he says of turning to live Facebook broadcasts. "Everyone is on social media. I can take the message directly to people and interact with them."
Logan is not the first person to have his colonoscopy broadcast live.
Watch a replay of Logan's colonoscopy below.
In 2000, journalist Katie Couric, whose husband had died of colon cancer, underwent the procedure live on NBC's The Today Show in an effort to reduce stigma around it.
A study in the Archives of Internal Medicine found that there was a "Katie Couric effect" — a 20 per cent increase in colonoscopies occurred in the United States, but after nine months, rates returned to normal.
The authors concluded that "a celebrity spokesperson can have a substantial impact on public participation in preventive care programs" yet the impact may not be sustained.
One reason celebrity attention may not lead to sustained change is because it's not interactive, says Daniel Cabrera, an assistant professor of emergency medicine and member of the Social Media Network at the Mayo Clinic in Rochester, Minn.
Investing in social media
"We are social beings; the opportunity to have real-time engagement and share experiences taps into human inclination and creates a community sense that traditional PR is not able to do," he says of social media.
"In the 1800s, we invested in railways to connect people. Today, we invest in social media to engage with people where they are.
'It's our duty as physicians to use the social media space to advance patient care and public policy,' - Daniel Cabrera
"It's our duty as physicians to use the social media space to advance patient care and public policy," he says, because interactive efforts are viewed as more trustworthy.
For Hamilton Health Sciences communications manager Calyn Pettit, that means "reaching people where they are and doing something to earn their time."
In the waiting room at Hamilton's Juravinski Hospital, Logan was quiet and a little anxious before his procedure.
He'd had moments of regret — the night before, he wished he hadn't agreed to the live broadcast — but after three previous colonoscopies, he knows what to expect.
'Right thing to do'
"I thought it was the right thing to do," he says of his willingness to take part. "I want people who need one to go get one."
For Logan, colon cancer is personal. His mother died of the disease in her 50s, when he was just 27.
"It was long. She lost a lot of weight. It was terrible," he says as he recalls her illness. "I guess in a way I'm doing this for her."
A close friend also lost his 23-year-old daughter to colon cancer a few years ago.
"It was shocking," he says.
For Logan, it's important to get people talking about colon cancer.
"I hope more people talk about it, and get [screening] done."
Still, he admits it's a little bit taboo to talk about colonoscopies with his friends. "They asked me what I was doing this week, and I said: 'Not much.' "
Fewer men screened
His wife, Frances, who came with him to the hospital for the procedure, laughs.
"He doesn't tell anybody … men don't talk about medical stuff," she says.
Lumb knows this all too well.
"Only 40 per cent of people get screened, and men less than women," he says, noting that breast cancer screening rates are much higher.
"There is a huge opportunity to improve screening rates and save lives," he says.
"People think it's icky or painful or embarrassing," he says of the push-back he hears in his office. "Some people say: 'Over my dead body,' but most are just looking for reassurance."
Cancer Care Ontario recommends that everyone 50 to 74 years old be screened every two years with a stool test.
'Just a baby' polyp
If a test reveals traces of blood, a colonoscopy is recommended every five years. Those with a family history of colon cancer, such as Logan, start having colonoscopies earlier in life. The risk of bowel damage during a colonoscopy is 1:1,000.
During the colonoscopy, Lumb stares at a TV screen showing an image of Logan's bowel wall as he answers questions coming in live on Facebook and Twitter.
Lumb says Logan will get a dose of a painkiller and a sedative, even though the bowel wall doesn't have pain nerves.
"It shouldn't hurt," he tells the audience.
Lumb's not fazed when he finds a small polyp.
"It's just a baby," he says as he snips it out. "That's why we're here today."
"You did good there, Barry," Logan says after the procedure is done. "Completely painless."
Petitt says the broadcast was a success. There were more than 2,000 live views and 14,000 people viewed it in the first 24 hours.
One viewer tweeted: "All my fears are gone."