Colonoscopy

Tomorrow I am scheduled to arrive at our local hospital early in the morning for a colonoscopy.   March is Colon Cancer Awareness Month. Over the past few decades, more people have been surviving colon cancer, and fewer people have been dying from it. This is thanks to improvements in colon cancer screening. Screening can find colon cancer early before symptoms develop, when it’s easier to treat. Screening can also find growths called polyps so they can be removed before they turn into cancer.

For the past 7 years I have been a volunteer for the American Cancer Society.  One of the things that ACS talks a lot about is early detection.  Colon cancer is the third leading cause of cancer-related deaths in the United States among men and women, and is expected to cause about 50,000 deaths during 2013. The fact is that colon cancer is highly treatable. If it’s found and treated early, the 5-year survival rate is about 90%. Because many people are not getting tested, only about 4 out of 10 are diagnosed at this early stage when treatment is most likely to be successful. 

The American Cancer Society recommends regular colon cancer screening for most people starting at age 50. People with a family history of the disease or other risk factors should talk with their doctor about beginning screening at a younger age.  Regular screening is one of the most powerful weapons for preventing colon cancer. If polyps are found during colon screening, they can usually be removed before they have the chance to turn into cancer. Screening can also result in finding cancer early, when it is easier to treat and more likely to be curable.

When I went to my family doctor for a physical earlier this year he told me that I should think about a colonoscopy.  A colonoscopy is one of those things that no one want to think about.  I decided that I had to practice what I preach about screening and early detection.  I found it a bit ironic that I scheduled a colonoscopy  during Colon Cancer Awareness Month.

According to the American Cancer Society, your lifestyle choices affect your colon cancer risk.  You can lower your risk by eating more vegetables, fruits, and whole grains, and less red meat (beef, lamb, or pork) and less processed meat (hot dogs and luncheon meat). You should limit alcohol to no more than than 1 drink a day.  You can help lower your risk for colon cancer by getting more exercise and staying at a healthy weight. Smoking also increases the risk,so if you smoke, try to kick the habit. 

I am at a higher risk for colon cancer than the general population because of my family history.  My Uncle Delbert lost his battle with colon cancer several years ago.  I lost not only an uncle, but a friend and someone who was willing to help anytime.  I will never know if his outcome would have been different if he had been screened for colon cancer.  By the time his cancer was found it was in advanced stages. I feel certain that screening would have prolonged his life.  Along with my uncle, the majority of Americans do not receive the American Cancer Society recommended colon cancer screening.  How many lives would be saved if more people were screened?

If you haven't been screened for colon cancer please talk to your doctor.  If you think that a colonoscopy will be unpleasant, just talk to someone who had colon cancer.   Go ahead and do it.  If I can do it anyone can.  The life you save may be your own.

Coping With Cancer

On thing that I have never done on this blog is to re-post articles written by others.  This post is the exception to the rule.  Recently my Mom had a CT scan.  Although the doctor didn't find what he was looking for, the CT scan showed a large tumor on one of her kidneys.  She was immediately sent to a specialist who referred her to another specialist, and less than a week after the CT scan, she was scheduled for surgery.

All of a sudden, the work that I have done with Relay For Life and the American Cancer Society came sharply into focus.  It became even more personal.  One of the things that I was concerned about was how she would be treated.  Everyone seems to have an opinion about cancer.  In my work with the American Cancer Society one of the things that I have seen over and over again is a distrust of "standard treatments" and doctors in general.

Mom was hesitant to tell people that she had cancer because she had witnessed previously the unsolicited advice and alternative cures pressed on friends who were diagnosed with cancer.  She wanted for me to ask for prayers in church, but wanted me to stress that her treatment was set and that she didn't want unsolicited advice.  I was trying to figure out a tactful way to do that, when she brought me an article from the January 24, 2013 Adventist Review.  I was able to use a couple of quotes from the article to get my message across.  I so appreciated this article that I am re-posting it here.

The article is titled "Coping With Cancer" and subtitled "How To Support A Friend Or Family Member Dealing With Cancer".  It was written by Allan R. Handysides, who is a board -certified gynecologist and is the Director of the Health Ministries Department of the General Conference of Seventh-Day Adventists.

COPING WITH CANCER
By Allen R. Handysides


Cancer is not a single disease entity. Rather, it includes a spectrum of disorders that share a common mechanism. Advances in diagnostic capabilities and the use of population-screening techniques have resulted in cancers being detected in their very early stages-even in "precancerous" stages. It's this capacity to diagnose early cancer that may have softened its image in the minds of many; but cancer is still a malignant and often lethal condition. On the other hand, fear often induces denial or paralysis.

Svetlana was a young Russian physician, newly arrived in Canada with her two delightful children. She was studying for Canadian exams that would permit her a medical residency slot. Her engineer husband supported them financially. She came to see me for routine Pap smears. To my surprise, the report came back indicating "abnormal cells of unknown derivation." The pathologist I used was a proven expert, and I took the report extremely seriously. Colposcopy, endocervical curettage, and endometrial biopsy were all noncontributory to a diagnosis, so I performed a laparoscopic exam.

Upon first viewing the peritoneal cavity, it appeared pristine and healthy, just like its 34-year-old owner. Closer inspection, however, revealed a gelatinous,pale,blueberry-sized lesion on the left ovary. I carefully biopsied it, and then turned my scope to visualize the rest of the cavity. Aided by the magnifying capacity of the laparoscope, I found the peritoneum to be dotted with tiny salt- grain-sized flecks, also of a clear, pale, jelly-type nature. These, too, I biopsied.

A few days later the reports came back, indicating "ovarian/peritoneal cancer." It was clearly widespread and at a late stage, although of very recent onset. She had a particularly virulent form of cancer, and despite the full panoply of therapies, she was dead within five years; as would be 84 percent of people with such widespread cancer.

I recount this story to emphasize the lethal nature of some cancers. I could equally tell of astounding recoveries that, even to a seasoned, skeptical clinician such as I, appear miraculous. I have experienced 50 years of mind-boggling advances in medicine and seen dogged, relentless physicians battle this disease; and yet, I've also witnessed a mysterious groundswell against "standard treatments" that seems to mirror a postmodern mind-set of there being no absolutes, only what we as individuals personally believe. In such a milieu the repeated call for an evidence-based rationale for therapy often goes unheeded.

Alternative Therapies

Many people decide to use what they erroneously term "alternative therapies." An alternative route would take you to the same destination; in the case of cancer, an alternative therapy should provide equal or nearly equal chances of cure. People often do not realize that once a therapy has been shown to be an "alternative" with supporting evidence, it becomes a part of the "standard therapy"-although possibly rated as a second or third alternative.

In Adventist circles  lifestyle elements that have been shown to possibly reduce risk of contracting cancer are often promoted as cures. An illustration of the difference between prevention and cure is that of behaviors that lower the risk of a broken leg and the measures required to promote its healing. Prevention and cure are totally different "animals," and while we strongly recommend lifestyle measures for prevention, it's dishonest, negligent, and frankly dangerous to suggest that such measures are curative"

There is absolutely no reliable statistical basis to suggest that diet can cure cancer. In the community of church members are those who sometimes choose to interfere with the treatments being recommended by health professionals. Such self-appointed "experts" may hold a degree in some different field, but without trepidation opine about another person's best course of action. Some go so far as to indicate that a person taking standardized therapy must lack faith. What can one know about another's level of spirituality or faith? No wonder the Lord commands us to "judge not." Does this mean lifestyle measures are useless for treatment? No, but the evidence isn't there.  It's not "illogical" to suggest lifestyle might be a good "adjuvant" approach, but not an "alternative."

Undergoing Tests

Many hesitate to undergo all the tests their doctors suggest they take. Indeed, there are doctors who order more tests than are necessary, often from a mind-set of covering every base and protecting themselves against claims of negligence. In situations of cancer, however, exact staging of the disease strongly influences the selection of treatment, so full exploration permits a more appropriate selection.

Finding a Doctor

A question some ask is "How can I find a suitable doctor to treat my cancer?" Experiences recounted online are not always reliable. One rule of thumb is if a primary-care physician is routinely careful, thoughtful, and gives you full attention, you can safely trust that they will use the same concern in finding you a specialist.

Good doctors encourage second opinions. Very often physicians associated with a teaching institution are more knowledgeable, while the doctor running a high-volume practice might be more "technically skilled." Never feel awkward about asking for a second opinion, but keep in mind that it's "bad form" to switch doctors without including the referring physician in the decision. Perfect honesty with your physician will be appreciated, and may actually teach the caregiver about patients' perceptions.

Supporting Someone With Cancer

Perhaps an important area to explore is how to be supportive of that friend, church member, or family member who has been diagnosed with cancer. Unsolicited opinions are probably about as welcome as insistence of your favorite color scheme or sofa for your friend's new family room. Unless you are a qualified expert, you would be wise to keep your opinion to yourself; indeed, if you are an expert, your advice will probably be to listen to the patient's own similarly qualified experts.

Support should be given in a general-not a specific-way. Hope is the greatest gift you can give a patient with cancer. Despite dreadful statistics, there are always those who defy the odds.  Hope can positively influence outcomes.  Hope builds faith, so build the patient's hope and faith.

You want the patient to feel uplifted by your contact, and you transmit support more fully with loving, prayerful interaction rather than prescriptive, dogmatic talk. A hug and a touch often do far more than your favorite lecture on the benefits of pomegranate juice.

When an individual chooses a course of action, especially if it has been based upon expert advice, the wisest course of action for a friend is to affirm such a choice. If you feel compelled to share your "cherished beliefs," do so as an addition, not a replacement, of the chosen therapy. It's often forgotten that the good Lord gave us all freedom of choice. If He is so gracious, shouldn't we be gracious too?

Messengers of Hope

Everyone who contracts cancer or has a family member with cancer is barraged with advice. In the Adventist community there are "guilt trippers," who assert the condition is a direct consequence of some neglected lifestyle imperative, as well as some "extremists," who insist their particular concoction is a "surefire" cure. The advice to all of us would best be to "lay off" of such gratuitous, often ill-founded advice. Be kind,loving, hopeful, reassuring, optimistic, and pleasant. Take the person out for a nice meal or other happy diversion. Pray with them, but don't be too sanctimonious. Rejoice in the gospel message, but don't paint a dark picture  of sin and it's effects.

Ask yourself, "How does my interaction buoy this dear soul's spirit?" If you can't make the patient cheerful, at least don't contribute to depression.  The gospel is good news, so let's be messengers of hope!