colorectal cancer section

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Colorectal Cancer Screening Edition

Thursday, June 16, 2011

Facts About

ColorectalCancer

Colorectal cancer is the secondleading cause of cancer death in theUnited States, claiming almost 50,000lives each year.

The American Cancer Society esti-mates that almost 147,000 new caseswill be diagnosed in 2011, and theoverwhelming majority of victims canbe cured if their cancer is detected ear-ly.

Colorectal cancer can strike anyone,regardless of age. However, 90 percentof cases occur in people over age 50.

Partly because of disproportion-ate screening, African-American menand women have a higher risk of de-veloping colorectal cancer and a lowersurvival rate compared to Caucasians,Asians, Hispanics and Native Ameri-cans.

Risk factors: A personal history of colorectal

polyps, inammatory bowel disease orpreviously treated colorectal cancer

A family history of colorectal can-cer, other cancers and benign colonpolyps

Eating a diet high in fat or a dietlow in fruits and vegetables

Obesity Smoking Alcohol useMore than 80 percent of all cases

of colorectal cancer can be preventedwith recommended screening. Despiteits high incidence, colorectal cancer isone of the most detectable and, if foundearly enough, most treatable forms ofcancer.

Screening can prevent colorectalcancer by nding and removing polyps

BY DURADO BROOKS, MD, MPHDirector of Prostate and Colorectal Can-cers -- American Cancer Society

Embarrassing!Painful!Disgusting!!These are some of the words that come

to mind for lots of folks when they thinkabout getting tested for colorectal cancer.Lets face it - this involves a part of thebody and bodily functions that peopledont talk about in polite conversation.Hopefully I can convince you that they(and you) need to get past this attitude and

get on with testing.Cancers of the colon and the rectum

(the last sections of the digestive system)are extremely common. In fact, theyrethe third most common cancer in U.S.men and women. The good news is therates of this disease have been fallingsteadily over the past 20 years, and a bigpart of the decrease is directly re lated totesting for colorectal cancer.

You see, not only can testing helpnd the disease early, when its highlytreatable, but testing can actually help toprevent the disease! Thats because mostcolorectal cancers start as a small, non-cancerous growth called a polyp. Findingand removing these polyps stops cancerbefore it starts.

Youd think that with these proven

benets people would be lining up to gettested - yet four out of every 10 adultswho should get tested are missing outon this possibly life-saving opportunity.Why? There are a lot of myths about col-orectal cancer that people use as excusesto avoid getting tested. The following aresome of the myths about testing, as wellas the facts people need to know.

Myth/Excuse: No one in my family

Never Been Tested for Colon

Cancer? Whats Your Excuse?

had colorectal cancer, so I dont need toget tested.

Fact: Most people who get colorectalcancer DO NOT have a family history of

the disease. The most common reason forgetting colorectal cancer is simply gettingolder. Risk starts to go up around age 50and continues to rise for the rest of yourlife. If you have a family history of thedisease your risk is even higher, but, fam-ily history or not, everyone 50 and oldershould get tested.

Myth/Excuse: Im not having anysymptoms so I dont need to worry.

Fact: Many people who are diagnosedwith colorectal cancer have no symp-toms, and people with polyps rarely havesymptoms. If you wait to get tested aftersymptoms develop you might miss thechance to prevent the disease or to nd itbefore it grows and spreads.

Myth/Excuse: If I have cancer thereis nothing they can do about it, so whybother getting tested?

Fact: Colorectal cancer is one of themost treatable forms of cancer. When thedisease is found at an early stage (before itspreads outside of the colon) most peoplecan be treated very successfully and goon to live long, full lives. Regular testingincreases the chance that the disease will

be found at this early, most treatable stage.

Myth/Excuse: The tests are embar-rassing and painful!

Fact: There are actually a number ofdifferent tests for colorectal cancer. Themost common tests are stool tests andthe colonoscopy. Stool tests are used tolook for small, invisible amounts of bloodpassed in a bowel movement that mightindicate a polyp or cancer. These simpletests are performed in the privacy of yourhome.

A colonoscopy is done by a specialistin a hospital or outpatient center. The test

is done in a private room with no otherpatients around. A thin lighted tube isinserted into the rectum and allows thedoctor to view the inner lining of yourcolon. Many people fear that this test willbe painful. In fact, people who are havinga colonoscopy are given medicine to helpthem relax; many people sleep through theexam.

Most of the complaints about colonos-copy actually are not about the test, butinstead are about preparing for the test.In order for the doctor to get a goodlook at the colon lining the colon has tobe cleaned out with strong laxatives, sopeople spend a lot of time in the bathroomduring the evening before the test. This isnot convenient and its not comfortable,

but its a small price to pay for a test thatmay save your life.

If you havent been tested, talk to yourdoctor. If youve been tested, talk to yourfamily and friends. Make sure they knowthe facts and encourage them to get tested.

Accept No Excuses!

For more information visit The AmericanCancer Society Web site http://cancer.org

Cancers of the colonand the rectum arethe third most com-mon cancer in U.S.

men and women

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before they become cancerous. Unfortu-nately, most colorectal cancers are not dis-covered until after the cancer has spread.

A patient diagnosed with colorectal can-cer that is conned to the colon or rectumhas a 90 percent chance of surviving veyears or longer. If the cancer has spread tosurrounding tissue the survival rate dropsto 66 percent. And if the cancer has spread to

distant organs, the survival rate plunges to8.5 percent

SymptomsPatients with early stages of colorectal

cancer typically experience no symptoms.In later stages, when the cancer has ad-vanced, symptoms may include changes inbowel habits, blood in the stool or rectal

bleeding.

LouAnnda Larson may owe her life toher aching feet.The 55-year-old mother of three grownchildren had long suffered from foot painthat requires her to use a wheel chair tomove any more than short distances.

In October 2010, she traveled to theUniversity of Iowa Hospitals and Clin-ics to determine the cause and possibletreatments for her foot pain. Doctors per-formed a comprehensive physical examthat included a fecal occult blood test. Thetest results showed traces of blood in herstool.

It was the rst time Larson had everundergone any type of screening forcolorectal cancer in spite of her historyof gastrointestinal problems. She had hergall bladder removed at age 24. Later, she

suffered from diverticulosis an inam-mation of the colon wall. Still, she thoughtthe test result was no big deal.

I gured it was probably hemor-rhoids, she said.

But gastroenterologist Adrian Holmthought differently and scheduled Larsonfor a colonoscopy.

Not fully knowing what to expect fromthe preparatory solution she needed todrink prior to the colonoscopy, Larsondrove two-and-a-half hours from Clintonthe day prior to the test and checked into ahotel to prepare for the exam.

Its not fun. Youd be kind of weird ifyou thought it was, she added. But thestuff they have you drink just tastes likesalty water. Theres no big deal to it. But

after a while you get some c ravings. I re-

Clinton Woman Saved by Timely Screeningally wanted a hamburger.

As for the procedure the next day, Youfeel absolutely nothing, Larson said,adding she was awake during most of theexam and even spoke with Dr. Holm whoshowed her the single polyp he removedfrom her colon.

He got really reective for a momentand said, when I nd something earlyand I know Ive saved somebody, it reallymakes me feel worthwhile, she said.

Confronting CancerA few days later, Larson got the news

that the single polyp removed from hercolon was cancerous.

I was shocked, she said. You alwayshear about people having 20 polyps or 25polyps. I had one and I never expectedthat one to be cancerous.

What Larson didnt know at the timewas that her long-running history of diver-ticulosis increased her risk of developingpolyps and potentially colon cancer.

If I had waited another year, it couldhave been too late, Larson said. Peopleare not aware that once cancer gets intothe blood stream or the lymph nodes, youare going to die.

Coming to grips with her newlydiagnosed cancer was the hard part. Afterall, LouAnnda was the matriarch of thefamily. She hosted all of the holidayparties for her two sons, daughter andve grandchildren. She was the one whohelped her husband, Bill, run his construc-tion business, ordering material, payingthe bills and scheduling the jobs.

I would rather take a beating than

tell my family I have cancer and I didntknow what the outcome was going to beat that time, she said. But I had friendswho had cancer and died and I was madthat they didnt tell me, that they didntsay something, that they didnt give methe opportunity to say good-by and that Iloved them.

A few days after Thanksgiving, Larsonchecked into the hospital where gastroin-testinal surgeon Dr. John Byrn removed aone-foot-long section of her colon.By Christmas, Larson said she began to

feel good again. In March, she was told by

her doctor that no more treatments werenecessary, but that she needs to have acolonoscopy every year from now on. Itsa prescription she plans to follow.

So many times, the symptoms ofdifferent diseases also could be symptomsof aging, she said. So were still withthe generation where you dont run to thedoctor all the time.

Although walking continues to be dif-cult, Larson is now easing back into workwith the construction business, contactingclients and hosting family get togethers.It has been a difcult time to get backinto it, but I am.

LouAnnda Larson

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More Facts


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Craig Phinney is back at work at a jobhe loves, two years and two major surger-ies after a doctor told him he would neverwork as a police ofcer again.

In January 2009, the 22-year veteran ofthe Ankeny Police Department and a vet-eran of 24 years of military service wentto see his doctor for what he expected tobe a routine colonoscopy. It was a yearlyritual for Phinney since he was diagnosedwith ulcerative colitis 12 years earlier.

But this exam was different and morethorough than he had experienced before.Three weeks later, as he and his wife,Shirley, were about to leave home for aFriday evening get-together with friends,Phinney had a four-minute phone con-versation with his gastroenterologist thatchanged everything.

He said my career as a police ofcerwas over, and You wont be chasing badguys anymore, I had cancer, Phinneysaid, adding he had just reached the pin-nacle of his career, having returned to hisrst love, patrol duty, after spending fouryears in the detective squad investigatingnancial crimes. Adding to the stress, acorporate reorganization briey posed thepossibility that Shirley Phinney could loseher job or be asked to relocate.

Our whole life was turned upsidedown, he said.

Depression started to set in, Phinneyadded, until he sat down with Dr. MichaelPage, a colorectal surgeon with the IowaClinic who told Phinney, If you havea little faith in me, Ill get you back in

uniform in 20 weeks.

Crime Fighter Fights Back Against Colorectal CancerOn March 24, Page removed Phinneys

entire colon, pronouncing the surgerysuccessful and telling Phinney that therewould be no need for further treatments.Yet recovery was far from easy. It was amiserable ordeal for six weeks, he said.

Because his entire colon was removed,Phinney temporarily required a colostomypouch, a removable bag that was attachedto his abdominal wall to collect waste thatnormally passes through the digestivesystem. He also was readmitted to the hos-pital for two weeks to treat a deep woundinfection.

After a second operation to reconstructPhinneys bowel, the ofcer suffereddehydration, requiring another week in thehospital.

Getting His Life Back

Yet true to his ghting spirit, Phinneywas able to return to work at 5:30 a.m.,July 1, 2010, four-and-a-half weeks earlierthan Dr. Page predicted.

Its still emotional for me, he said,choking back tears. That morning, walk-ing in to cheers and claps, it was over-whelming.

Phinney, now 52, was determined notonly to work, but also to serve as a rolemodel for other cancer survivors. He em-barked on a program of physical tness he lost 55 pounds and 18 total body inchesin just 15 weeks.

The tness program involved certiedprofessional trainers as well a proper nu-trition, both critical elements in maintain-

ing a healthy lifestyle.

He also founded an organization, CopsAgainst Cancer, a group that encour-ages people to undergo colorectal cancerscreening and helps colorectal cancerpatients cope with their disease.

Phinney, who just celebrated his second

birthday in his new cancer-free life noted

that in the two years since his surgery,the rate of colorectal cancer diagnosed inpeople younger than 35 has increased 65percent.

This colon cancer is not our parentsdisease anymore. It can attack anyone.

Ankeny police ofcer Craig Phinney

ColonscopyHave Fun With It!Sure, setting an appointment to un-

dergo a colonoscopy can bring on a lit-tle anxiety. But the exam is completelypainless. Doctors often say approach-ing the procedure with a sense of hu-mor can be helpful.

Dave Barry, columnist for The Mi-ami Herald has pulled together a listof quotes patients said to their doctorswhile undergoing the procedure.

Take it easy, Doc. Youre boldlygoing where no man has gone before!

Find Amelia Earhart yet?

Can you hear me NOW?

Are we there yet? Are we thereyet? Are we there yet?

Any sign of the trapped miners,Chief?

You put your left hand in, you takeyour left hand out...

Hey! Now I know how a Muppetfeels!

If your hand doesnt t, you mustquit!

Hey Doc, let me know if you ndmy dignity.

And.

Could you write a note for my wifesaying that my head is not up there?

Dr. Michael Page performs approxi-mately 600 surgeries per year. Hewould like to do fewer.

Approximately 60 percent of Pagessurgeries are major abdominal opera-

tions. Most of the surgeries are for pa-tients who are diagnosed with colorectalcancer that could have been prevented,if only they had been screened earlier.

Its a recurring theme, said Page, acolorectal surgeon for The Iowa Clinicwho practices at the John StoddardCancer Center in Des Moines and alsoserves on the Medical Advisory Boardfor the Iowa Department of PublicHealths (IDPH) Iowa Get Screened:Colorectal Cancer Program (IGS).

I see people that are 55 or 60 thatwill come in with cancer and the rstthing they say is, My family doctorhas been bugging me for ve years toget screened for colorectal cancer.Page said. Five years ago, that cancerwouldnt have been a cancer. It wouldhave been a small polyp. We couldhave snipped it off and things wouldhave been great.

Only Method for Early DetectionSeven of every 10 people diagnosed

with early-stage colorectal cancer ex-perience no symptoms. Screenings are

Colorectal Surgeon UrgesPatients to Get Screening Done

the only reliable methods to detect thedisease. The United States Preventa-tive Services Task Force (USPSTF)recommends all adults undergo regularscreenings beginning at age 50 or ear-

lier for patients who have a history ofcolorectal disorders or who have fam-ily histories of colorectal cancer.

Page says lack of awareness, mis-perceptions that health plans wont payfor screenings, or fear of the unknown,contributes to low rates of colorectalcancer screening.Somebody may have told them acolonoscopy is uncomfortable; andpeople dont really like the idea of put-ting a scope up your backside, Pageadded.

Pages typical patient has alreadyundergone a colonoscopy and has beendiagnosed with colorectal cancer. Still,

he says if the cancer has been discov-ered before it has spreads beyond thecolon or rectum, the patient has a 90percent chance of surviving ve yearsor longer.

We consider youre cured fromyour cancer at ve years, Page said.When I have patients come in for theirfth-year anniversary check-up andI can say, Hey, listen. Youre cured,

Dr. Michael Page treats hundreds ofcolorectal cancer patients every year,many of whom could have avoidedcancer with proper screening.

thats a big deal for them. Ive had pa-tients who had parties for themselvesand theyve brought in owers andthey do all kinds of neat things. Thatsthe most rewarding part for me.


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