Entries in Colon cancer (12)


Older Americans Over-Screened for Colon Cancer

iStockphoto/Thinkstock(NEW YORK) -- Screening is the best way to prevent colon cancer.  So everyone should get a colonoscopy, right?  Not so fast.

The recommendations for colorectal cancer screening are pretty clear: Start screening at age 50 and continue through age 75 with a colonoscopy every 10 years, a sigmoidoscopy every five years or a fecal blood test every year. Those who have a high risk for colon cancer should be screened more often and starting at a younger age.

For people over 75, it all comes down to benefits and risks.

The benefit of colon cancer screening is that it can detect precancerous polyps before they have a chance to develop into cancers.  Removing the polyps takes care of the problem.  However, most polyps develop into cancers quite slowly, and the procedure to spot and remove them carries risks like bleeding, infection and perforation of the colon.

Why worry about detecting a cancer that will do no harm in your lifetime?  You only want to do the screening when the benefits of extending life by preventing cancer outweigh the risks of the screening itself.  For most people, the right cutoff is age 75.

Unfortunately, it looks like a lot of older Americans are unnecessarily putting themselves at risk.  A study published this week in JAMA Internal Medicine found that 32 percent of the colonoscopies performed in people ages 76 to 85 were probably inappropriate. 

It’s one thing to get a colonoscopy when it is likely to be beneficial; it is entirely another matter to have one done when you don’t need one.

It might seem like the more you get screened, the healthier you’ll be.  But that’s just not true.  Here are some of the latest screening recommendations to help you avoid getting over-tested:

  • Cervical cancer: Pap test every three years for women between the ages of 21 and 65; no screening for women older than 65, unless they are at high risk for cervical cancer, or for women younger than 21.
  • Prostate cancer: No PSA-based screening for prostate cancer at any age.
  • Breast cancer: Mammogram every two years for women between the ages of 50 and 74.  Screening based on risk factors and a conversation between doctor and patient for those younger than 50.  Women 75 and older should also base screening decisions on a conversation with a doctor.
  • No screening at all for testicular cancer, pancreatic cancer or ovarian cancer.

On top of their medical risks, unnecessary medical tests cost time and money.  So do yourself a favor and invest in the tests that are right for you.

Copyright 2013 ABC News Radio


Fearing Cancer, Woman with Lynch Syndrome Has Colon Removed

Courtesy Lynne Fisher(NEW YORK) -- What would you do to reduce the chance of dying of cancer?  How far would you go if you had a 70 to 90 percent chance of contracting bowel cancer -- and your uncle, mother, father and two of your brothers had died from it?

Lynne Fisher decided she would do almost anything.  So, even though she showed no signs of cancer at all, Fisher, 51, a former mental health worker, agreed to undergo what might sound like a radical surgery: doctors removed nearly her whole colon and rerouted her small intestine to perform the functions of her large intestine.

The side effects were horrific, she said.  For a year, Fisher struggled to control her bowel movements.  She fought depression, and she hated her large scars and the 28 staples that had been left in her body.  Her Multiple Sclerosis returned.

"When you're in it, it's like a dark tunnel," she told ABC News in a long phone conversation about her medical history.

But then, one day, she realized the surgery had helped saved her life.  And since then, she's never looked back.

"What's a year out of your life compared to dying?" Fisher said from her home in central England.  "I get to watch my dogs grow up, my children grow up, my grandchild, I get to see my cherry blossoms in the tree, I get to see the sun shining in the morning, I get to go on holiday -- I get to see life."

Genes that cause breast cancer have been discussed widely for years.  But less well known is Lynch syndrome, the gene mutation that Fisher and her much of her family inherited.

It's unclear how many Americans have Lynch syndrome, but up to 7 percent of colon cancers occur in people with the disease, according to the National Institutes of Health.  It's also unclear how many Americans choose to have the surgery that Fisher had: prophylactic subtotal colectomy, which doctors describe as a major surgery that, while elective, can often save lives.

"A person will select the option of sub-total colectomy because the entire colon is at very high risk for cancer," said Dr. Henry Lynch, who discovered Lynch syndrome in the 1960s and is now the chairman of Preventive Medicine and Public Health at Creighton University and the director of Creighton's Hereditary Cancer Center.  "Lynch syndrome goes from one generation to the next.  And it has an early age of onset in colon cancer."

Copyright 2013 ABC News Radio


To Prevent Colon Cancer, Get Your Butt to the Doctor

Ryan McVay/Thinkstock(NEW YORK) -- Colorectal cancer -- cancer of the colon or rectum -- is the second leading cause of cancer-related deaths in the United States, according to the Centers for Disease Control and Prevention.

Yet, it’s one of the most treatable cancers there is, even in its later stages.

ABC News’ chief health and medical correspondent Dr. Richard Besser held a tweet chat on Monday to raise awareness on how to prevent and treat colon and rectal cancer.  His special guest was ABC talk show host Katie Couric, whose husband, Jay Monahan, died of the disease in 1998.

CDC director Dr. Tom Frieden and chief medical and scientific officer of the American Cancer Society Dr. Otis Brawley tweeted their thoughts, along with experts from the National Institutes of Health; the Colon Cancer Alliance; Mayo Clinic; New York University Langone Medical Center; and the Dana Farber Cancer Institute.

Here are four things the experts say you must know about keeping your colon happy and healthy:

1. Get Screened

Most colon cancers begin as polyps, lumps growing on the lining of the colon wall that can develop into cancer.  Regular screening after the age of 50 is essential for detecting and removing these polyps before they become cancerous.

“Roughly six of 10 deaths from colon cancer could be prevented if everyone age 50+ got screened routinely,” Frieden tweeted.

If your test comes back clean, you won’t need another one for 10 years.  However, if your test shows abnormalities, you should be screened more often.

2. Colonoscopies Aren’t that Bad

The preferred method of screening is colonoscopy in which a doctor gently inserts a long, flexible tube with a light and camera on the end into your rectum to scope out signs of cancer.  The test itself is no big deal.  You’re under anesthetic and won’t feel a thing.

Prep is another matter.  Before the test you need to clean out your colon by drinking copious amounts of a vile-tasting liquid, then retiring to the bathroom for the better part of a day.

3. Don’t Die of Embarrassment

“There may be blood in stool, a change in bowel habits, diarrhea or a change in weight,” experts from the NIH noted.

Experts from Dana Farber added, “A month or more narrowing of the stools, straining, change in stool shape are all symptoms of bowel problems.”

As many of the tweeters noted, people often ignore these symptoms or are too embarrassed to talk to the doctor about them.

4. Know the Risks

Age is an important risk factor.  Colon and rectal cancers most often strike people over the age of 50, but the disease can strike at any age.  Although anyone can get colorectal cancer, it’s deadliest for minorities, because they’re less likely to get tested or seek treatment, the experts from the Colon Cancer Alliance said.  If someone in your family has had colon cancer, this increases your risk too.

As several tweeters noted, Lynch syndrome -- an inherited condition -- puts someone at increased risk of colon cancer and other cancers.  Doctors estimate that about three out of every 100 colon cancers stem from Lynch syndrome, and the disease often occurs at an earlier age.

Copyright 2013 ABC News Radio


Colorectal Cancer Awareness Month Kicks Off with Inflatable Colon in NY

Courtesy YORK) -- A giant inflatable colon was on display in New York City's Times Square on Friday to kick off National Colorectal Cancer Awareness Month.

The 20-foot, walk-through colon with 3-dimensional representations of Crohn's disease, colorectal polyps and the different stages of colon cancer is officially called the Prevent Cancer Super Colon.  It has been displayed around the country for years to draw attention to colon issues and get people talking

Colorectal cancer, the combined name for colon and rectal cancers, is the third most common cancer diagnosed in the United States, according to the American Cancer Society, which estimates that about 143,000 new cases will be diagnosed by the end of 2013.  Colorectal cancer is expected to cause nearly 51,000 deaths in the U.S. this year alone.

Symptoms can include bloody stools, persistent stomach pain or irregular bowel movements that don't go away.  And there's an embarrassment factor that can keep patients from going to the doctor, said Dr. Jordan Berlin, a gastrointestinal oncologist at the Vanderbilt-Ingram Cancer Center.

"In Canada, there's a promotion to get people to go to colon cancer screenings that had naked butts on billboards," Berlin said.  "They're trying to say, yes, you're embarrassed to talk about it, but it is it really worth risking your life not to talk about this?"

He said colorectal cancer is one of the top five causes of rectal bleeding, but it's the fifth one.

"It's the one you don't want to miss," he said.

Still, he said attitudes are slowly shifting toward more openness about colon problems as people learn that colonoscopies aren't "that bad."  A colonoscopy is a 30-minute test in which a doctor inserts a tube with a camera on the end of it into the patient's anus to check the entire colon for cancerous or precancerous growths.  The patient, of course, is sedated.

The Centers for Disease Control and Prevention recommends routine colonoscopies for people over the age of 50.  However, younger people with other risk factors, such as a family history of colon cancer, polyps or Crohn's disease, should also get routine screenings.

"You don't have to be 50," said Carlea Bauman, president of Fight Colorectal Cancer, a national advocacy group that kicked off its most recent awareness campaign with the giant colon in Times Square.  

"We're trying to raise awareness among the general population," she said.  "When people are diagnosed early, it's very survivable.  When people are diagnosed late, it's far less survivable.  It can make the difference between life and death."

Copyright 2013 ABC News Radio


Study Looks at Impact of High-Carb Diet on Colon Cancer Treatment

iStockphoto/Thinkstock(NEW YORK) -- High-carb diets may lead to cancer recurrence or death for late-stage colon cancer patients, according to a new study. High glycemic diets, which include breads and baked goods, also can lead to the same outcomes.

Researchers, led by Dr. Jeffrey Meyerhardt of the Dana-Farber Cancer Institute in Boston, looked at data submitted by 1,000 stage-three colon cancer patients. After evaluating the effects of carbohydrates, fructose and glycemic loads on colon cancer treatment, they found a link between the cancer and the carbs and glycemic load intake.

The study's authors, who reported their findings Wednesday in the Journal of the National Cancer Institute, say the research points to a greater need for attention to obesity and exercise.  Other studies have shown that obesity and inactivity also increase risk of cancer recurrence and death.

Some diet and nutrition experts say the study's findings are merely observational and are not indicative a cause-and-effect relationship.

"We cannot make dietary recommendations based on this study alone," Lona Sandon, a registered dietician and assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center, told HealthDay.

"And it is insufficient to change recommendations [about diet] that already exist; that is, maintain a healthy weight, increase physical activity and choose a healthy diet with limited excess sugars," she said.

Copyright 2012 ABC News Radio


Aetna Pays Arizona Man's Cancer Bills, After CEO Tweets with Him

Courtesy Arijit Guha(NEW YORK) -- Arijit Guha, an Arizona State University graduate student, returned from a trip to India with a stomach ache and only one month later learned he had Stage IV colon cancer.

As tough as his diagnosis was at the age of 30, learning that his insurance company would place restrictions on paying for his cancer treatments was almost as gut-wrenching.

Guha had a generous policy under the university's health plan for which he paid $400 a month, but its carrier, Aetna, had an annual ceiling on pay-outs.  After surgery and chemotherapy, he had exhausted the lifetime $300,000 limit.

Although the Affordable Healthcare Act has eliminated lifetime caps, those requirements have not yet taken effect in student plans, according to the Chronicle of Higher Education.

Outraged, Guha turned to Twitter and other social media to make his case, one that affects millions of Americans who face staggering medical bills.

But last week, Aetna CEO Mark T. Bertolini, a former paramedic who has had his own share of medical crises, tweeted directly with Guha and agreed to pay "every last penny" of his bills.

"The system is broken, and I am committed to fixing it," said Bertolini on his Twitter account, according to the Arizona Republic, which first covered the story.  "I am glad we connected today and got this issue solved. I appreciate the dialogue no matter how pointed. I've got it and own it!"

Guha, now 31 and in remission, told ABC News, "I am incredibly pleased and in shell shock and trying to figure out what just happened.  It's a huge relief."

It turns out Bertolini and Guha have much in common.

In 2001, Bertolini's then 16-year-old son son, Eric, was diagnosed with a rare and deadly lymphoma, according to a profile in the Hartford Courant.  And in 2004, when he was president of Cigna, Bertolini was disabled after being nearly killed in a ski accident.  He also eventually donated a kidney to help save his son.

Bertolini admitted the current healthcare system was "broke" and tweeted, "There is a lot to do to make it right."

Meanwhile, Guha had raised $120,000 through T-shirt sales in his edgy campaign "Poop Strong," which riffs on cancer survivor Lance Armstrong's "Live Strong."  And now that Aetna has stepped in, Guha said he will donate all of it to three cancer charities in Arizona.

Copyright 2012 ABC News Radio


Can an Aspirin a Day Keep Cancer Away?

Brand X Pictures/Thinkstock(NEW YORK) -- A daily aspirin may cut your risk of cancer, new research suggests. But doctors advise that there's no reason for everyone to start taking it -- at least not yet.

In three studies published in the Lancet and the Lancet Oncology on Tuesday, British researchers analyzed data from more than 50 studies and found that those who took daily aspirin for at least three years were less likely to develop cancer -- and if they did, it tended to be less advanced. Patients who took daily aspirin were 36 percent less likely to be diagnosed with metastatic cancer, or cancer that had already spread throughout their body.

Additionally, individuals taking aspirin for five years or more were 15 percent less likely to die from cancer. Previous research had only shown such benefits for patients taking aspirin for longer periods of time.

Nowhere was the evidence stronger than it was for colon cancer. Researchers found that patients who were diagnosed with localized colon cancer while taking daily aspirin halved the chance that their disease would spread.

Aspirin is a relatively inexpensive and easy-to-take medication that millions of Americans already use. The U.S. Preventative Services Task Force recommends men between the ages of 45 and 79 take aspirin daily to prevent heart disease, and they also recommend that women aged 55 to 79 take a daily aspirin to ward off stroke. The notion that this same medication may be able to prevent cancer is significant.

Cancer experts contacted by ABC News said they are excited about what these findings might mean for future research and treatment.

"This is very encouraging information," says Dr. Roy Herbst, Chief of Medical Oncology for the Yale Cancer Center in New Haven, Conn. "It suggests that aspirin could play a very important role in cancer prevention."

"I am intrigued by the consistency of the findings and this is something that can be implemented quickly that people are not opposed to," said Dr. Kristen Moysich, professor of oncology at the Roswell Park Cancer Institute in Buffalo, N.Y. "It is an easy thing to do."

But precisely how patients might benefit from aspirin has yet to be fully understood, doctors say.

"No one knows exactly what the mechanism is of how aspirin helps prevent cancer," said Asad Umar, chief of the Gastrointestinal and Other Cancers Research Group of the National Cancer Institute.

Umar said aspirin's anti-inflammatory action might have something to do with the benefits that researchers have seen. Others, like Jay Whelan, suggest aspirin may interfere with the processes in the body that cause tumors to grow.

"Aspirin also probably works in ways that we don't quite understand," said Whelan, who heads the Department of Cellular and Molecular Nutrition at the University of Tennessee, Knoxville. "We don't know the mechanism, and it is very difficult to make a blanket public health statement without knowing the mechanism."

"While this backs everything up, I think people should consult their physicians."

The research may not be the last word on aspirin and cancer. Previous studies -- including the large Women's Health Study and the Physicians' Health Study -- have suggested no link between aspirin consumption and reductions in cancer occurrence or cancer-related death. The researchers behind the current study wrote that they excluded these major pieces of research because patients in these studies did not take aspirin on a daily basis.

Even then, the conclusions of the new research do not support a specific dose of aspirin -- so even if there is an effect, those who hope to benefit from it may find themselves at a loss over how much to take.

And although aspirin is a commonly used medicine available over the counter, it is not necessarily safe. People taking aspirin have an increased risk of bleeding, including bleeding in the gastrointestinal tract. This can be very dangerous, and the risk of it happening increases with higher doses.

Most agreed that before medical experts can make any concrete recommendations, further study is needed.

"Because these results are new, it will take time for the broader scientific community to evaluate the data in the context of existing knowledge and to consider whether the clinical guidelines should be changed," said Eric Jacobs, strategic director of Pharmaco-Epidemiology at the American Cancer Society, Inc.

"It is important for patients to follow colon cancer guidelines already in place and get their recommended colon cancer screening tests."

Copyright 2012 ABC News Radio


Proof at Last? Colonoscopy and Cancer Prevention

iStockphoto/Thinkstock(NEW YORK) -- Do you really need that colonoscopy? It’s a question that seems simple at first. After all, as more Americans routinely undergo the oft-dreaded colonoscopy with each passing year, cases of colorectal cancer have continued to drop.

Yet data from large, conclusive studies that prove this test, currently the primary weapon in a doctor’s arsenal to catch colon cancer early, actually saves lives has so far been lacking.

Some doctors believe that new research, released Wednesday by the New England Journal of Medicine, takes a big step in this direction. In the study, researchers led by Ann G. Zauber of Memorial Sloan-Kettering Cancer Center in New York suggest that removing non-cancerous growths known as polyps could have a big impact on death from colorectal cancer. Doctors routinely remove these benign polyps during a colonoscopy. The new study indicates that people who have polyps removed slash their risk of death from colorectal cancer by more than 50 percent over the next decade and a half compared to the general population.

“This study confirms the suspected benefit of colonoscopy as it relates to reducing mortality from colorectal cancer,” says Dr. Fritz Francois of NYU Medical Center, who was not involved with the study.  He added that while certain questions still remain surrounding the overall body of research on colonoscopy, “the important message is clear: colonoscopy saves lives.”

Not so fast, say other cancer experts. Dr. Rita Redberg of the University of San Francisco, editor of the journal Archives of Internal Medicine, was less impressed by the new study. She said a major shortcoming of the study was that it did not factor in the so-called “healthy-user effect.” In other words, she said, those people in the study who received colonoscopies and had polyps removed may very well be more healthy than the average person in the general population -- perhaps doing things like eating a healthier diet, exercising or taking medications regularly. These aspects of their lifestyle may lower their chances of developing colon cancer even before colonoscopy is considered.

The healthy-user effect has confounded medical professionals before. Redberg said the healthy-user effect is, “the same reason we thought hormone replacement therapy [HRT] was protective against heart disease for women for many years, until a randomized trial was done.”  In the case of HRT, when such a trial was performed, researchers actually found a slight increase in heart disease and strokes among women taking the measure that was supposed to have improved their health.

Other doctors contacted by ABC News agreed that it is difficult to make any conclusions from the study at hand. That said, government health agencies have made prevention of colorectal cancer a top priority and, as a result, have strived to encourage more Americans to have screening colonoscopies. Current guidelines recommend that every American age 50 to 75 undergo screening colonoscopy -- though CDC data suggest 22 million Americans who should be getting screened aren’t.

The stakes for preventing colorectal cancer are high. In the U.S., among cancers that affect both men and women, colorectal cancer is the third most common and the second-leading cause of cancer death, according to the CDC. And the idea that finding and removing precancerous polyps before they turn into cancer seems a logical way to try and solve the problem.

So will doctors ever know conclusively whether or not colonoscopy and the removal of benign polyps save lives? Most experts contacted by ABC News believe so.

“If your doctor finds a polyp on colonoscopy, that’s a tissue we know may turn into cancer,” said Dr. Eric Esrailian, a gastroenterologist at UCLA. “It can be removed during the procedure and the cancer never develops....We can basically prevent cancer.”

Until this can be proven more conclusively, most agree that routine screenings may help -- and are unlikely to hurt.

Copyright 2012 ABC News Radio


Loafing Could Be Lethal, Study Says

db2stock/Getty Images(WASHINGTON) – New data from the American Institute for Cancer Research suggests that more than 90 thousand cases of colon and breast cancer diagnosed every year may be caused by lack of physical activity, according to USA Today. The findings are being presented today in Washington, D.C. and refers to 49,000 cases of breast cancer and 43,000 cases of colon cancer.

This research confirms the long-standing theory that a simple 30 minute walk can lower the risk of cancer. Experts and the American Cancer Society are among those who have always emphasized the importance of exercise as a way to stay healthy and lower the risk of cancer and other chronic diseases.

What’s new about this study is that it actually gives an estimate of the number of cases that could be prevented if the individuals were more active.

USA Today reports that the calculations are based on U.S. physical activity data and cancer incidence statistics. Analysis of more than 200 cancer studies worldwide suggest that physical activity would reduce the risk of breast cancer, colon cancer, and endometrial cancer by 25-30 percent.

The health risk associated with “sitting disease” is not isolated to cancer either.

Alpa Patel, an American Cancer Society epidemiologist, conducted a study to investigate the general health dangers of sitting too long without moving. In this study of about 123,000 people, she found that the risk of dying early was significantly higher for those people who spent more time sitting than being active.

Patel suggests taking a “break” from sitting, and making sure to get up and walk around periodically during the day.

Copyright 2011 ABC News Radio


Could Mozart Decrease Your Risk of Colon Cancer?

Stockbyte/Thinkstock(HOUSTON) -- Doctors were more likely to detect precancerous polyps during colonoscopies if they had Mozart playing in the background, a small study found.

It only included two doctors, but for one, listening to Mozart more than tripled the polyp detection rate from 21.25 percent to 66.7 percent, researchers from the University of Texas Health Science Center at Houston reported Monday at the American College of Gastroenterology's annual meeting. Undetected, the polyps -- called adenomas -- can become cancerous.

“Anything we can do get those rates up has the potential to save lives,” study author Dr. Catherine Noelle O’Shea said in a statement. “While this is a small study, the results highlight how thinking outside the box -- in this case using Mozart -- to improve adenoma detection rates can potentially prove valuable to physicians and patients.”

The polyp detection rate for the other doctor studies rose from 27.16 percent to 36.7 percent.

The study adds weight to the “Mozart effect” -- the long-standing observation that listening to music can lead to a short-term improvement on some mental tasks. Some experts attribute the performance boost to a more positive mood or increased arousal. Others say complex music triggers a response in the brain that makes it better equipped to tackle an additional task.

Untreated, adenomas can lead to invasive colorectal cancer -- the third most common cancer diagnosed in men and women in the U.S. and the second leading cause of cancer death in both sexes combined, according to the American Cancer Society. But when detected early, adenomas can be removed.

The U.S. Preventive Services Task Force recommends routine screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy and colonoscopy in men and women aged 50 to 75.

To reduce the risk of colorectal cancer, the American Cancer Society recommends maintaining a healthy weight and an active lifestyle, eating a healthy diet high in fruits, vegetables and grains, and low in red meats -- and moderate consumption of alcohol.

Copyright 2011 ABC News Radio

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