Testing It Up

Two weeks ago, Bee Gees’ Robin Gibb made headlines following his death at the age of 62 due to colon cancer that spread to his liver. His tragic demise highlighted the killer disease which is highly preventable with regular colon screening.

Colon cancer is the second leading cause of death in the United States. But unlike other types of cancer, it is largely treatable when detected early. While there are several ways to monitor your colon, the gold standard for early detection is colonoscopy, which is recommended every 10 years.

Colonoscopy checks the rectum and entire colon using a lighted instrument. It’s the only cancer detection test that allows doctors to find and remove polyps before they turn into cancer. Many people are often discouraged taking the test because they dread the preparation which requires extensive full bowel movement to clean out the colon. In administering the test, the physician uses a thin, flexible tube with a small video camera attached to one end to examine the six-foot long colon. The patient is typically sedated during the entire procedure; thus, no tinge of pain will be felt.

According to studies, colonoscopy is 60% to 90% effective at preventing colon cancer. Other colon cancer testing methods available are sigmoidoscopy, fecal occult blood test, and double contrast barium enema.

Screening for colon cancer is almost always associated with a colonoscopy, a procedure that is not exactly popular among patients. A new study, published online in the New England Journal of Medicine, found a new screening technique effective for detecting colon cancer and reducing cases and fatalities for colorectal cancer.

The study included an analysis of data gathered from 10 national research sites, including the University of Minnesota. The data was provided by nearly 29,000 patients at the University of Minnesota, who participated in a randomized trial which compared flexible sigmoidoscopy screening with people who only underwent colon cancer screening if they asked for it, or if their doctor recommended it.

Those who underwent sigmoidoscopy screening were found to have a 26 percent lower rate of death due to colorectal cancer, when compared against those who received the usual care. In addition, those who belonged to the sigmoidoscopy screening group had a 21 percent lower incidence of colorectal cancer, because precancerous tissues are detected earlier.

Timothy Church, principal investigator for the University of Minnesota, shared that he hoped patients who do not want to undergo colonoscopies may choose to undergo a flexible sigmoidoscopy instead – a procedure that only examines the lower colon, and is less invasive than a colonoscopy, which examines the entire colon.

Church shared: “Individuals who want to be screened to colorectal cancer should choose the method that appeals to them the most — the one that they’re the most likely to do… The most important test is the one that you’re going to do.”

The American College of Physicians (ACP) recently released a new clinical guideline for colorectal cancer screening, which called for screening for average-risk individuals to begin at the age of 50.

The new guidelines also indicated that fecal occult blood testing (FOBT), flexible sigmoidoscopy, and colonoscopy are acceptable screening methods for people who have average risk of developing colon cancer.

The ACP recommended further that a screening interval of 10 years should be observed after an initial negative colonoscopy, while patients who underwent sigmoidoscopy should undergo screenings every five years. Fecal occult blood tests, on the other hand, should be conducted annually. These screenings should stop at the age of 75.

Patients who have high risk for developing colon cancer, however, should begin screening at the age of 40, or when they reach the age where they are 10 years younger than the age when the youngest relative who suffered from colon cancer was diagnosed. The recommended screening method for people who have high risk of developing colon cancer is colonoscopy.

Amir Qaseem, MD, PhD, director of clinical policy at the ACP, and co-authors wrote: “Currently, no evidence shows that screening more frequently than recommended improves patient outcomes or reduces cancer-related deaths… On the other hand, screening more frequently than recommended can contribute substantially to avoidable healthcare costs.”

The ACP guideline consists of the following guidance statements:

• Every patient should have an individualized risk assessment for colorectal cancer.
• Clinicians should begin screening average-risk patients at age 50 and high-risk patients at age 40 (based on specific family history).
• FOBT, flexible sigmoidoscopy, and optical colonoscopy are all acceptable means of screening for average-risk patients.
• Screening should end at age 75 or when patients have less than a 10-year life expectancy.

March is National Colorectal Cancer Awareness Month, and all across America, efforts are being made at spreading awareness regarding the colorectal cancer, including the importance of prompt disease detection.

In observance of Colorectal Cancer Awareness Month, a hospital in Indiana is offering colorectal cancer screening home kits throughout the month of March. The kits consist of fecal occult blood tests, a screening tool that is used to help detect colorectal cancer. A colonoscopy is typically recommended to anyone who receives a positive test result after a fecal occult blood test.

Franciscan St. Anthony Health hospital is giving out free testing kits, which are available during business hours throughout the month of March, at the following laboratories: Franciscan St. Anthony Health, 301 W. Homer St., Michigan City; HealthPartners, 1225 E. Coolspring Ave., Michigan City; Franciscan Omni Health & Fitness, 810 Michael Drive, Chesterton. Completed kits are to be returned to the laboratory at Franciscan St. Anthony Health, or mailed using the envelope included in the kit, by April 6th.

Colorectal cancer is the second leading cause of death in the United States. It is, however, highly preventable, if detected soon enough. Hospital officials say that if Americans aged 50 years old and older underwent screenings regularly, as many as 60 percent of deaths attributed to colorectal cancer could be prevented.

Colorectal cancer begins in either the colon or the rectum, with most types starting off as a polyp – a noncancerous growth in the lining of the colon or the rectum that, if left untreated, may eventually become cancerous. Colorectal cancer symptoms include rectal bleeding, weakness, and weight loss.

The Centers for Disease Control and Prevention (CDC) associated an increase in colorectal cancer screenings in the last decade with a decrease in cases of colorectal cancer, as well as deaths due to the disease.

This was revealed in the CDC’s Morbidity and Mortality Weekly Report on Tuesday, according to a feature on the Los Angeles Times. Colorectal cancer is the second leading cause of cancer-related deaths in the country.

The report indicated that as colorectal cancer screenings increased for people aged 50 to 75, from half to two-thirds of those who belong to that age group, the rate of colorectal cancer cases decreased from 52.3 cases per 100,000 in 2003, to 45.4 per 100,000 in 2007. In the same time period, the number of deaths attributed to colorectal cancer decreased from 19 to 16.7 per 100,000.

CDC director Dr. Thomas R. Frieden shared: “That’s a remarkable increase in screening… but we are concerned that it is beginning to level off.” He went on to say that if everyone in the 50-75 age group had been tested for the disease, then many of the deaths due to colorectal cancer in 2007 could have been prevented.

Most agencies recommend three types of screening for colorectal cancer:

• An annual fecal occult blood test, which can be administered at home;
• A flexible sigmoidoscopy, to be administered by a healthcare provider, every five years. This entails the use of an endoscope by a physician, in order to view the lower portion of the colon, or the sigmoid colon; and
• A colonoscopy every 10 years.

Los Angeles Health Screening

Katie Couric, news anchor for CBS and known advocate for colon cancer awareness-related causes, urged New Yorkers to get screened for colon cancer, according to a feature on the New York Daily News.

Colon cancer screening and awareness is a cause that is close to Couric’s heart, as she lost her husband Jay Monahan to the disease 13 years ago. Monahan was 42 at the time of his death.

“Make That Call” is a campaign that will run for the first half of March, which is being observed as colon cancer awareness month. The campaign includes educational posters, which have already been set up in libraries, Duane Reade stores, New York Health & Racquet Club gyms, and other outlets, as well as TV spots that feature the CBS news anchor. The objective of the campaign is to encourage anyone who is over the age of 50 to schedule a colonoscopy. Those who have a history of colon cancer in the family are advised to undergo a colonoscopy even before reaching the age of 50.

During the campaign’s launch at the Jay Monahan Center for Gastrointestinal Health at the New York-Presbyterian Hospital Weill Cornell, Couric shared: “My daughters don’t have a father to watch them grow and mature and thrive… I think about that all the time.” Of her late husband, she said: “He struggled for nine months and was so courageous.”

People generally shy away from colonoscopies because they are invasive in nature. Couric shared the following of undergoing the procedure: “I can’t tell you I was really psyched about it… Some things in life are just a responsibility you have to do.”

Despite being the second-leading cause of cancer deaths in the United States, colon cancer has a 90 percent cure rate if it is caught early enough, according to experts.

New York Health Screening

As we usher in the month of March, we leave behind the month of red and think blue: for colorectal cancer.

March is colorectal cancer awareness month, and this year marks the conduct of the third annual “Dress in Blue” Day, an effort towards raising awareness regarding colorectal cancer. People are enjoined to don blue outfits on Friday, March 4.

Colorectal cancer is the second leading cause of death due to cancer in the United States. According to information provided by the American Cancer Society, an estimated 51,370 men and women died from colorectal cancer in 2010.

One of the things that have been widely written about colon cancer is the fact that it often does not exhibit symptoms until its advanced stages, but is treatable if detected early enough. It is for this reason that awareness and education is key towards preventing or effectively managing the disease.

A feature on the website of the American Cancer Society shares myths regarding colon cancer that may be preventing you from taking the tests that you need.

Myth: Colorectal cancer is a man’s disease.

Women can also develop colorectal cancer; it is, in fact, as common among women as it is among men.

Myth: Colorectal cancer is fatal, so testing is of no use.

Colorectal cancer can be treated if it is found and treated early, with a 5-year survival rate of 90 percent for cancers detected while these are still small, and before it has spread. One of the reasons for the rather low survival rate is the fact that many people are not getting tested, and only 4 out of 10 patients are diagnosed at the disease’s treatable stage.

A feature on Time shared that a Lab – the living, breathing kind, and not the one with all the gadgets and test tubes – has the ability to detect early-stage colon cancer, almost as accurately as a colonoscopy can.

In a study conducted by Dr. Hideto Sonoda of the Department of Surgery and Science Graduate School of Medicine at Kyushu University and his colleagues, a Labrador retriever was trained to sniff out colon cancer. Breath and stool samples of more than 300 patients were collected right before they received colonoscopies; of this population, 48 had recently been diagnosed with bowel cancer. The rest of the population was a mix of healthy people, cancer survivors, or were suffering from another colorectal illness.

The samples provided by the patients were provided to the trained dog for smelling. Using the breath samples, the Lab was at least 95% accurate at detecting colon cancer, when compared against a colonoscopy. When smelling the stool samples, the dog was even more accurate at 98%.

In addition, the Lab was able to differentiate between polyps and malignancies, and was good at detecting early stage cancer – something that colonoscopies can’t do.

Trevor Lockett, a bowel cancer researcher with the Commonwealth Scientific and Industrial Research Organization in Australia, shared the following with Bloomberg News: “Detection of early-stage cancers is the real holy grail in bowel cancer diagnosis because surgery can cure up to 90% of patients who present with early stage disease.”

The thing is, the idea of coming into a testing center “manned” by dogs seems to far-fetched, and it may be something that will never become mainstream. The feature mentioned, however, that the study’s findings may pave the way for the development of non-invasive colon cancer screening procedures based on scents.

It is an accepted fact that while colon cancer is ranked as among the leading causes of cancer-related deaths, the disease can be curable for as long as it is detected in its early stages. Unfortunately, colon cancer screening can involve invasive and uncomfortable procedures that some people shy away from. It is for this reason that part of colon cancer research focuses on developing non-invasive ways of detecting the disease.

A feature on Bloomberg Businessweek shares the results of early trials conducted on a new non-invasive test for colon cancer.

Dr. David A. Ahlquist is a professor of medicine and a consultant in gastroenterology at the Mayo Clinic in Rochester, Minnesota. He is the lead researcher in a study that conducted preliminary testing on new technology called the Cologuard sDNA test; according to the Businessweek feature, the test works by identifying specific altered DNA in cells, which are shed into the patient’s stool by pre-cancerous or cancerous polyps.

The discovery of DNA abnormality will still call for a colonoscopy in order to confirm the results.

Dr. Ahlquist shared that Cologuard is the first non-invasive test that has the ability to detect pre-cancerous polyps, and is the only test that can spot cancer in all locations in the colon. The test also does not call for the patient to undergo special preparation.

Preliminary trials showed that the test was able to identify 64 percent of pre-cancerous polyps, and 85 percent of full-blown cancers. A presentation of the findings of the study was to be conducted by Dr. Ahlquist at the meeting on colorectal cancer, sponsored by the American Association for Cancer Research, in Philadelphia.

In a recent post, we shared with you some of the improvements that will make colonoscopies even better. While these improvements will not yet make the screening procedure perfect, they will at least improve its performance in as far as assisting doctors in making more accurate diagnoses is concerned.

Colorectal cancer is one of the diseases that can be rather difficult to detect in time, being as it were that the condition does not usually produce symptoms during its early stages. The thing, though, is that early detection is extremely important for this disease, as it can spell the difference between survival and – well, what the opposite of survival is.

This is why we feel that it may be worth our while to reiterate the various symptoms that we ought to be sensitive to in order to catch colorectal cancer early on. We have already shared these in various posts at equally various points in time, and the coincidental announcement of advances in colonoscopies may be a good time to bring this up again. After all, who will be asking for colonoscopies if no one recognizes the symptoms that ought to bring them to their doctor’s office?

First are noticeable changes in bowel movements, which include either persistent constipation or diarrhea. One should also be conscious of feeling like one cannot empty one’s bowel completely, or noticing rectal bleeding.

Observing one’s stool is important for those who are wary of colorectal cancer. Dark patches of blood in or on the stool as well as having long, thin “pencil stools” should set off alarm bells – although we are not in any way implying that it is time to panic. One should also be conscious of intermittent abdominal discomfort and bloating, as well as persistent unexplained fatigue and loss of appetite or weight.