Sharon Denise Allison-Ottey
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Colon Cancer: You, Your Family and Your Life

Colon Cancer: You, Your Family and Your Life

What We Must Know and Do

Sharon D. Allison-Ottey, MD (aka Dr. Sharon)

www.drsharononline.com

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It is with great sadness that we learned today of yet another victim of colon cancer. The Christian community was rocked by the news of the death of MaLinda Sapp, the wife of the Gospel Icon Pastor Marvin Sapp. In the latest issue of Gospel Today, Rev. Sapp is featured on the cover and in an interview he says that it was his wife that pushed him to record his best selling single, “Never Would Have Made It”. It is our hope that these words will comfort him, his family and the Body of Christ during this time of loss for it will take God’s love and comfort to get them through this season.

Pastor Sapp says in the article, “Sometimes life’s most difficult seasons yield the greatest blessings”. I ask that the Body of Christ mourn the loss of Lady MaLinda Sapp and support the family with prayer. It is right and healthy to mourn when those whom we love leave this earth. However, I ask that we pay homage to her life and legacy by educating ourselves about colon cancer. This doesn’t have to be a long, drawn out, boring lecture or scientific article that you can’t understand written by a doctor or other healthcare provider. It involves taking small steps towards prevention, early detection and screening.

According to the American Cancer Society, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States. The American Cancer Society's most recent estimates for the number of colorectal cancer cases in the United States are for 2010:

  • 102,900 new cases of colon cancer (49,470 in men and 53,430 in women)
  • 39,670 new cases of rectal cancer (22,620 in men and 17, 050 in women)

Overall, the lifetime risk in men for developing colorectal cancer is about 1 in 19 (5.2%). This risk is slightly lower in women (1 in 20). Colorectal cancer is the third leading cause of cancer-related deaths in the United States when men and women are considered separately, and the second leading cause when both sexes are combined. It is expected to cause about 51,370 deaths (26,580 in men and 24,790 in women) during 2010.

The death rate from colorectal cancer has been dropping in both men and women for more than 20 years. There are a number of likely reasons for this. One is that polyps are being found by screening and removed before they can develop into cancers. Screening is also allowing more colorectal cancers to be found earlier when the disease is easier to cure. In addition, treatment for colorectal cancer has improved over the last several years. As a result, there are now more than 1 million survivors of colorectal cancer in the United States.

Colorectal cancer is NOT a death sentence. As with most cancers, early detection is key and we must equip ourselves with information on prevention, screening and treatment. So, what should we do? Here are my quick recommendations followed by more information from the American Cancer Society.

  1. Basic Steps from Dr. Sharon

 

  • Know your family history

      Families should talk about diseases that “run in the family” and keep a record of them.

  • Look at your stool for blood or black tarry stools

      If you notice any change in your stool habits, discuss with your physician or healthcare provider.

  • If you have a family history, tell your doctor and get screened EARLY

      Most physicians will recommend that you begin screening before age 50 if there is a family history.

  • Send back in your stool cards to your doctor if given to you at your YEARLY physical after age 50.

      If your doctor does not give you stool cards, ASK for them. If you don’t’ understand how to use them, ask for help.

      Also make sure that you are getting your rectal exam performed by your healthcare professional during your physical exam.

  • Get a Colonoscopy every 10 years after age 50 unless there is a personal or family history (or flexible sigmoidoscopy every 5 years)
  • Get the results of your tests, don’t assume that everything is fine if you don’t hear from your doctor.

      If there is a recommendation for follow-up, make sure to do just that FOLLOW Up!

  • As with everything give your health to God in prayer but also understand that healthcare professionals are often His "Angels" of healing.

      Don’t walk in fear, walk in faith!

Facts and Information that You Need to Know

(From the American Cancer Society www.acs.org)

What is colorectal cancer?

Colorectal cancer is cancer that starts in either the colon or the rectum. Colon cancer and rectal cancer have many features in common.

Colon

What causes colorectal cancer?

While we do not know the exact cause of most colorectal cancers, there are certain known risk factors. A risk factor is something that affects a person's chance of getting a disease. Some risk factors, like smoking, can be controlled. Others, such as a person's age, can't be changed.

But risk factors don't tell us everything. Having a risk factor, or even many risk factors, does not mean that you will get the disease. And some people who get the disease may not have any known risk factors. Even if a person with colorectal cancer has a risk factor, it is often very hard to know what part that risk factor may have had.

Risk factors you cannot change

Age: The chances of having colorectal cancer go up after age 50. More than 9 out of 10 people with colorectal cancer are older than 50.

Having had polyps or colorectal cancer before: Some types of polyps increase the risk of colorectal cancer, especially if they are large or if there are many of them. If you have had colorectal cancer (even if it has been completely removed), you are more likely to have new cancers start in other areas of your colon and rectum. The chances of this happening are greater if you had your first colorectal cancer when you were younger.

Having a history of bowel disease: Inflammatory bowel diseases, like ulcerative colitis and Crohn's disease, increase the risk of colon cancer. In these diseases, the colon is inflamed over a long period of time. If you have one of these diseases your doctor may want you to have colon screening testing more often. (These diseases are different than irritable bowel syndrome (IBS), which does not increase colorectal cancer risk.)

Family history of colorectal cancer: If you have close relatives (parents, brothers/sisters, or children) who have had this cancer, your risk might be increased. This is especially true if the family member got the cancer at a younger age. People with a family history of colorectal cancer should talk to their doctors about when and how often to have screening tests.

Certain family syndromes: A syndrome is a group of symptoms. The 2 most common inherited syndromes linked with colorectal cancers are familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC).

If your doctor tells you that you have a condition that makes you or your family members more likely to get colorectal cancer, you will probably need to begin colon cancer testing at a younger age, and you might want to talk about genetic counseling.

Race or ethnic background: Some racial and ethnic groups such as African Americans and Jews of Eastern European descent (Ashkenazi Jews) have a higher colorectal cancer risk. Among Ashkenazi Jews, several gene mutations have been found that lead to an increased risk of colorectal cancer.

Risk factors linked to things you do

Some lifestyle-related factors have been linked to colorectal cancer, too. In fact, the links between diet, weight, and exercise and colorectal cancer risk are some of the strongest for any type of cancer.

Certain types of diets: A diet that is high in red meats (beef, lamb, or liver) and processed meats (like hot dogs, bologna, and lunch meat) can increase your colorectal cancer risk. Cooking meats at very high heat (frying, broiling, or grilling) can create chemicals that might increase cancer risk. Diets high in vegetables and fruits have been linked with a lower risk of colorectal cancer.

Lack of exercise: Getting more exercise may help reduce your risk.

Overweight: Being very overweight increases a person's risk of having and dying from colorectal cancer.

Smoking: Most people know that smoking causes lung cancer, but long-time smokers are more likely than non-smokers to have and die from colorectal cancer. Smoking increases the risk of many other cancers, too.

Alcohol: Heavy use of alcohol has been linked to colorectal cancer.

Diabetes: People with type 2 diabetes have an increased chance of getting colorectal cancer. They also tend to have a worse outlook (prognosis).

The American Cancer Society and several other medical organizations recommend earlier testing for people with increased colorectal cancer risk. These recommendations differ from those for people at average risk. For more information, talk with your doctor.

Can colorectal cancer be prevented?

Even though we don't know exactly what causes colorectal cancer, there are some steps you can take to reduce your risk.

Screening tests: Regular colorectal cancer screening or testing is one of the best ways to help prevent colorectal cancer. Screening is the process of looking for cancer in people who don't have any symptoms of the disease. Some polyps, or growths, can be found and removed before they have the chance to turn into cancer. Screening can also help find colorectal cancer early, when it is small and more likely to be cured.

If you have a history of colorectal cancer in your family, you should talk with your doctor about when and how often to have screening tests.

Genetic testing, screening, and treatment for those with a strong family history: If you have a strong family history of colorectal polyps or cancer, you should think about getting genetic counseling to help you decide whether genetic testing or earlier screening may be right for you. Before getting genetic testing, it's good to know ahead of time what the results may or may not tell you about your risk. These tests are not perfect, and in some cases may not be able to give you solid answers. This is why meeting with a genetic counselor before testing is a key part of deciding whether testing is right for you.

Diet and exercise: You can lower your risk of getting colorectal cancer by taking charge of the risk factors that you can control, such as diet and exercise. It is important to eat plenty of fruits, vegetables, and whole-grain foods and to limit your intake of high-fat foods. Getting enough exercise is also important. The American Cancer Society recommends at least 30 minutes of physical activity on 5 or more days of the week. Forty-five to 60 minutes of exercise on 5 or more days of the week is even better.

Avoiding too much alcohol may also help lower your risk of colorectal cancer. The American Cancer Society recommends no more than one drink per day for women or 2 per day for men.

Weight: Being overweight or obese raises the risk of colon cancer in both men and women, but the link seems to be stronger in men. The American Cancer Society recommends that people try to stay at a healthy weight throughout life by balancing what they eat with physical activity. If you are overweight, ask your doctor about a weight loss plan that will work for you.

Vitamins and minerals: Some studies suggest that taking a daily multivitamin containing folic acid or folate can lower colorectal cancer risk. Other studies suggest that getting more calcium and vitamin D can help. One recent study suggested that a diet high in magnesium may also reduce colorectal cancer risk in women. But not all studies have found these supplements reduce risk. More research is needed on this subject.

Aspirin and other drugs: Aspirin and drugs like ibuprofen (Motrin®, Advil®) and naproxen (Aleve®), seem to lower the risk of colorectal cancer and polyps. A drug called Celebrex® also reduces polyp formation for some people with FAP. But these medicines can have serious or even life-threatening side effects such as stomach bleeding. For this reason, experts do not advise the general public to take them to try to prevent colorectal cancer. If you are at high risk for colorectal cancer, talk to your doctor about what you should do.

Female hormones: Combined hormone replacement therapy (HRT) in women after menopause may reduce their risk of getting colorectal cancer. But those women on HRT who do get colorectal cancer may have a faster growing type. The decision to use HRT should be based on a careful discussion of benefits and risks with your doctor.

Survival rates for colorectal cancer

Some people with cancer may want to know the survival rates for their type of cancer. Others may not find the numbers helpful, or may even not want to know them. Whether or not you want to read about survival rates is up to you.

The 5-year survival rate is the percentage of patients who are alive 5 years after their cancer is found. The numbers here include people diagnosed with colon cancer who may have later died from other causes, such as heart disease.

People with colon cancer tend to be older and may have other serious health conditions. This means the percentage of people surviving the colon cancer itself is likely to be higher, and many of them live much longer than 5 years.

While the numbers below are among the most current we have, they are from people who were first treated many years ago. Because cancer treatment continues to improve, the survival rates for people now may be higher.

Survival rates for colon cancer by stage

    Stage
    5-year Survival Rate
    I
    74%
    IIA
    67%
    IIB
    59%
    II C
    37%
    IIIA
    73%*
    IIIB
    46%
    IIIC
    28%
    IV
    6%

*In this study, survival was better for some stage IIIA than for some stage IIB. The reasons for this are not clear.

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