HEALTH MATTERS: Screening, early detection help prevent colorectal cancer


March 8, 2018

About four years ago, Thomas Lopez was having the time of his life at his brother’s birthday party in Las Vegas.

“I was having so much fun that I wasn’t ready to go back to work so I extended my vacation,” Lopez said. “The problem was in order to return to work without penalty, I needed a physician’s medical note to account for the additional days off work.”

It turns out that decision to stay in Vegas and not return to work immediately, saved his life. Lopez went to his physician and reported that he was experiencing blood in his bowel movements.

“I thought it was hemorrhoids,” Lopez said.

One of the common problems with hemorrhoids, which are swollen veins in the anus or lower area of the rectum, is bleeding during bowel movements.

“After the doctor asked me a few embarrassing questions, he examined me and prescribed a stool test,” Lopez said. He did not have hemorrhoids, but the stool test was inconclusive.

“Stool testing is easier than a colonoscopy (no preparation, no procedure, much less expensive),” said Dr. Ricardo Reznichek, associate clinical professor in the Department of Urology at the David Geffen School of Medicine at UCLA and director of the Global Cancer Initiatives at UCLA Center for World Health. “However, it can only, if positive, suggest that cancer may be present — that’s why it is necessary to repeat it every year. If the test is ever positive, a colonoscopy must to be done as the next step.”

Lopez learned the hard way not to self-diagnose medical symptoms.

“My doctor was concerned about my bleeding so he ordered a colonoscopy,” Lopez said. “I was told I had Stage 3 colorectal cancer on March 9, 2013. The doctor removed 19 cancerous lymph nodes.”

“At last we have ways to detect and remove colon polyps and early colorectal cancers before they grow and threaten our lives,” Reznichek said. “However, there are some big buts. We can’t wait for symptoms such as seeing blood in our stools. Early detection or “screening” is recommended for all men and women over 50 years of age (even sooner than 50, if there is a family history). And, if our primary care doctor hasn’t been arranging for us to be screened, we need to be bold and ask for it to be done.”

The earliest stage of colorectal cancers are called stage 0 (a very early cancer), and then range from stages 1 through 4. There are between 100 and 150 lymph nodes in the mesentery of the colon.

“I had never heard of colorectal cancer but the diagnosis felt like a death sentence,” Lopez said. “I was encouraged to stand up against cancer when Jason, my son who was 13 at the time, posted a heartfelt message to me on his Instagram.

“It said, ‘Dad, stay strong. Fight for me and our family. Don’t give up. You are my role model. You are my everything. Don’t let anythinng get in the way of that. Love you Dad!’”

He framed the instagram post as a constant reminder to never give up and do whatever possible to beat cancer. “My son’s message changed my life,” Lopez said. “I prayed to God to let me live long enough to watch my son graduate from high school.”

President Bill Clinton officially dedicated March as National Colorectal Cancer Awareness Month in February 2000 to address the importance of colorectal cancer screening and knowing the risk factors, symptoms and treatment. When the cancer is limited to the colon, it is a colon cancer. When the cancer involves the rectum as well as the colon it is a colorectal cancer.

“Colorectal cancer kills. It is the second leading cause of cancer deaths in California,” Dr. Reznichek said. “When it is found early, 90 percent of the time it can be treated successfully.”

While people 50 and older are at a higher risk for colorectal cancer, it is on the rise for people under 50. Lopez was 35 when diagnosed.

One in 10 people are diagnosed before they reach age 50. If everyone age 50 and older were screened regularly, 6 out of 10 deaths from colorectal cancer could be prevented.

The World Cancer Research Fund estimates that 20 percent of the cancer cases in the United States are due to the combined effects of excessive alcohol consumption, poor nutrition, physical inactivity and excess weight.

Source: Aurora Healthcare

More than 15.5 million Americans with a history of cancer were alive on Jan. 1, 2016.

For 23 years, Lopez has worked as a vault supervisor at a local casino. When he learned of his critical medical condition, he was not about to continue to gamble on the warning signs or how to fight the disease.

“I had blood in my stool periodically. It was not an everyday occurrence but it was there.”

Lopez waited about nine months from the first time he noticed the blood to his doctor visit.

“The choice to make should not be whether to be screened, but rather what type of screening test to select,” Dr. Reznichek said. “One option is to have a colonoscopy every 10 years. Or you can choose to have a fecal/stool test that must be done every year (followed by a colonoscopy only if the test is positive). Discuss the options with your doctor. Either option is acceptable. Doing neither is not an option.”

According to the American Cancer Society, colorectal cancer can be prevented. However, it is one of the five most common cancers in men and women in the United States. Colorectal cancer is also one of the leading causes of cancer death in the United States.

“It was very difficult to cope with the acceptance of having cancer. I cried myself to sleep at night for the first three weeks. I questioned God everyday ‘why me?’” Lopez said. “If I remember correctly, I have a 30 percent chance of of any type of cancer reoccurring.”

The cancer society explains five common myths about colorectal cancer.

Myth: Colorectal cancer is a man’s disease.

Truth: Colorectal cancer is almost as common among women as men. Each year in the U.S., about 71,000 men and 64,000 women are diagnosed with colorectal cancer.

Myth: Colorectal cancer cannot be prevented.

Truth: In many cases, colorectal cancer can be prevented. Colorectal cancer almost always starts with a small growth called a polyp. If the polyp is found early, it can be removed, stopping colorectal cancer before it starts.

Myth: African Americans are not at risk for colorectal cancer.

Truth: African-American men and women are diagnosed with and die from colorectal cancer at higher rates than men and women of any other U.S. racial or ethnic group.

Myth: Age doesn’t matter when it comes to getting colorectal cancer.

Truth: Most colorectal cancers are found in people age 50 and older. For this reason, the American Cancer Society recommends you start getting checked for this cancer when you’re 50.

Myth: It’s better not to get tested for colorectal cancer because it’s deadly anyway.

Truth: Colorectal cancer is often highly treatable. If it’s found and treated early (while it’s small and before it has spread), the five-year relative survival rate is about 90 percent. But because many people are not getting tested the way they should, only about 4 out of 10 are diagnosed at this early stage when treatment is most likely to be successful.

Source: Cancer Treatment Centers of America

“A colonoscopy is performed after intestinal preparation that includes a liquid laxative — it can be nasty but is necessary. Then, under sedative medication to make the procedure painless, a flexible telescope is used to look up the colon from anus to appendix,” Dr. Reznichek said. “Any polyps or suspicious areas are directly removed. Benign (non-malignant) but pre-cancerous polyps usually take about 10 years to develop and change into cancer. If polyps or tumors are found and completely removed, colonoscopy is repeated more often than the usual 10 years.”

“My father had the beginning stages of prostate cancer,” Lopez said. “There is no history of colon cancer in the family but I told my brothers to get a colonoscopy.”

Lopez begin oral chemotherapy in March 2013, which was combined with 25 days of radiation.

“I had surgery on July 25, 2013 for the removal of cancerous lymph nodes and a surgical procedure for an ileostomy.”

An ileostomy is surgically placed in the abdominal wall. The external pouch catches digested food.

“In August, a port was installed in my chest for chemotherapy treatments,” Lopez said. “In November 2013, I had a reversal surgery for my ileostomy.”

The reversal surgery reconnects a section of small intestine to the large intestine, allowing a patient to evacuate feces through the anus instead of an artificial opening created in the abdomen.

Lopez continued chemotherapy until March 2014. He is no longer on medication but gets an annual colonoscopy.

For nearly four years, he has been cancer free. The scars from his year-long battle is the only reminder of colorectal cancer.

Lopez spends time with his family, plays baseball on Sundays and volunteers at the American Cancer Society to help raise funds and awareness about the early detection and screening to prevent colon cancer.

“It was a long an difficult road but it was worth it,” Lopez said.

Resources:

American Cancer Society – www.cancer.org

Conway Medical Center Foundation – www.cmcfoundationsc.com

Colon Cancer Coalition – www.coloncancercoalition.org

Cancer Treatment Centers of America – www.cancercenter.com

Marie Y. Lemelle, MBA, a public relations consultant, is the owner of Platinum Star PR and can be reached on Twitter @PlatinumStar or Instagram @PlatinumStarPR. Send “Health Matters” related questions to healthmatters@wavepublication.com and look for her column in The Wave.

 

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