BOSTON (CBS) – A health boost or bust? More than half of all Americans buy some form of vitamins or supplements making it a $27 billion industry. But are vitamins worth the money? Some, but not all, vitamins do pack a needed health punch. Folic Acid is key for women who are pregnant or want to get pregnant. Omega 3′s are popular for their potential fighting cardio vascular disease.

To keep bones strong: “Women, because of the increased risk of osteoporosis and bone health problems, should be particularly vigilant about getting adequate vitamin D and calcium,” says Dr. JoAnn Manson of Brigham and Women’s Hospital.

Dr. Manson has been studying the effects of vitamins for years. She cautions that mega-doses of vitamins could be an unhealthy option. “I think it’s very important for the public to understand that more is not necessarily better.” For example: too much iron has been linked to cardiovascular disease. “Also, men may want to avoid higher doses of vitamin E because it was recently linked to an increased risk of prostate cancer,” says Dr. Manson.

And that expected health boost from a multi-vitamin might be more fiction than fact.

“It’s really not of much value and may be a waste of money,” explains Dr. Manson. The experts agree, if you have a balanced diet you likely don’t need a multi-vitamin. In some cases it might even be bad for your health. A recent study found an increased risk of death in older women taking too many mutli-vitamins or other supplements.

So, in the end there’s still no substitute for eating right. And be sure to talk to your doctor about what’s right or wrong for you.

Dr. JoAnn Manson is now investigating the health benefits of vitamin D3 and omega-3 fatty acids. If you’d like to participate log onto www.vitalstudy.org.

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What is laparoscopic surgery?

Laparoscopic or “minimally invasive” surgery is a specialized technique for performing surgery. In the past, this technique was commonly used for gynecologic surgery and for gall bladder surgery. Over the last 10 years the use of this technique has expanded into intestinal surgery. In traditional “open” surgery the surgeon uses a single incision to enter into the abdomen. Laparoscopic surgery uses several 0.5-1cm incisions. Each incision is called a “port.” At each port a tubular instrument known as a trochar is inserted. Specialized instruments and a special camera known as a laparoscope are passed through the trochars during the procedure. At the beginning of the procedure, the abdomen is inflated with carbon dioxide gas to provide a working and viewing space for the surgeon. The laparoscope transmits images from the abdominal cavity to high-resolution video monitors in the operating room. During the operation the surgeon watches detailed images of the abdomen on the monitor. This system allows the surgeon to perform the same operations as traditional surgery but with smaller incisions.

In certain situations a surgeon may choose to use a special type of port that is large enough to insert a hand. When a hand port is used the surgical technique is called “hand assisted” laparoscopy. The incision required for the hand port is larger than the other laparoscopic incisions, but is usually smaller than the incision required for traditional surgery.

What are the advantages of laparoscopic surgery?

Compared to traditional open surgery, patients often experience less pain, a shorter recovery, and less scarring with laparoscopic surgery.
What kinds of operations can be performed using laparoscopic surgery?

Most intestinal surgeries can be performed using the laparoscopic technique. These include surgery for Crohn’s disease, ulcerative colitis, diverticulitis, cancer, rectal prolapse and severe constipation.

In the past there had been concern raised about the safety of laparoscopic surgery for -cancer operations. Recently several studies involving hundreds of patients have shown that laparoscopic surgery is safe for certain ¬colorectal cancers.

How safe is laparoscopic surgery?

Laparoscopic surgery is as safe as traditional open surgery. At the beginning of a laparoscopic operation the laparoscope is inserted through a small incision near the belly button (umbilicus). The surgeon initially inspects the abdomen to determine whether laparoscopic surgery may be safely performed. If there is a large amount of inflammation or if the surgeon encounters other factors that prevent a clear view of the structures the surgeon may need to make a larger incision in order to complete the operation safely.

Any intestinal surgery is associated with ¬certain risks such as complications related anesthesia and bleeding or infectious complications. The risk of any operation is determined in part by the nature of the specific operation. An individual’s general heath and other medical conditions are also factors that affect the risk of any operation. You should discuss with your surgeon your individual risk for any operation.

To find a Colon and Rectal Surgeon near you please visit www.fascrs.org.

© 2008 American Society of Colon & Rectal Surgeons

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By Andrew Spiegel, Esquire
Chief Executive Officer, Colon Cancer Alliance

When is the last time you talked about colon cancer? It’s a disease no one wants to talk about, yet it is the second leading cause of cancer death in the United States. A lot of work has gone into bringing awareness to this disease, but because it deals with part of the body that our society is uncomfortable talking about, many suffer needlessly because they postponed a colonoscopy or neglected it altogether.

March is National Colorectal Cancer Awareness Month, and a great opportunity to openly discuss the disease and learn how we can prevent it. Understanding risk factors, symptoms, and screening options will not only help in avoiding the disease, but could mean the difference between life and death.

Many believe that if they have no symptoms, they are in the clear, but this kind of thinking can be deadly. Colon cancer most often has no symptoms until it has already progressed to later stages, making it much more difficult to treat. The good news is that a routine colonoscopy every 10 years starting at age 50 for most individuals could help save thousands of lives in this country every year because polyps can be found and removed before they have a chance to turn into cancer.

It is important to realize that colon cancer doesn’t just affect those over the age of 50 nor does it affect just men. In fact, statistics show that colon cancer affects both genders equally. According to the Centers for Disease Control, nearly 150,000 people will be diagnosed with colon or rectal cancer this year with women accounting for 70,000 new cases. Everyone should be aware of the risk factors. Knowing your family health history is imperative. If someone in your family battled colon cancer OR had colon polyps, you probably need to be screened earlier and should talk to your doctor right away. Also, if you suffer from Crohn’s Disease, ulcerative colitis or Inflammatory Bowel Syndrome (IBS), you are at an increased risk of developing this disease.

The results of screening are undeniable. Screening can reduce colon cancer deaths by up to 90%. Colon cancer is one of the most preventable diseases and is a very curable cancer…if it’s caught early. Sadly, too many cases are diagnosed in the later stages of the disease when treatment is challenging.

The Colon Cancer Alliance is working hard to change the way people talk about colon cancer, encouraging frank and open discussions at events across the country. On March 2nd, Dress in Blue Day will sweep across the nation, uniting survivors and families and spreading the message that this is a disease we can do something about – if we take action and get screened. Why blue? Much like the pink ribbon for breast cancer, the blue star of hope is the universal symbol for colon cancer. Participants in the Dress in Blue Day program spearhead educational and fundraising events in their offices, schools and communities.

One in 19 Americans will be diagnosed with colon cancer, but you have the power to change that by starting a simple conversation with your family and friends and making sure you’re taking care of YOU. But I hope you won’t stop there. If you’d like to join the fight against this disease, the Colon Cancer Alliance has a multitude of volunteer opportunities. Please visit www.ccalliance.org to find out how you can help.

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Andrew Spiegel is the Chief Executive Officer of the Colon Cancer Alliance (CCA), the leading national patient advocacy organization dedicated to increasing screening rates and survivorship. The CCA provides hope and support to patients and their families, while saving lives through screening, access, awareness, advocacy and research.

To learn more, visit www.ccalliance.org.

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In many cases, colorectal cancer can be prevented. Still, it’s one of the 5 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. Don’t let these 5 common myths stop you from getting the lifesaving tests you need, when you need them.

Myth: Colorectal cancer is a man’s disease.

Truth: Colorectal cancer is just as common among women as men. Each year, about 150,000 Americans are diagnosed with colorectal cancer, and about 50,000 die from the disease.

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, doctors can remove it and stop colorectal cancer before it starts. These tests can find polyps: double contrast barium enema, flexible sigmoidoscopy, colonoscopy, or CT colonography (virtual colonoscopy).

To help lower your chances of getting colorectal cancer:

• Get to and stay at a healthy weight.
• Be physically active.
• Eat a diet with a lot of fruits and vegetables, whole grains, and less red or processed meat.
• Limit the amount of alcohol you drink.
• Don’t use tobacco in any form.

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 US racial or ethnic group. The reason for this is not yet understood.

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

Truth: More than 90% of all colorectal cancers are found in people who are 50 and older. For this reason, the American Cancer Society recommends you start getting checked for this cancer when you are 50. People who are at a higher risk for colorectal cancer — such as those who have colon or rectal cancer in their families — may need to begin testing when they are younger. Ask your doctor when you should start getting tested.

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 is found and treated early (while it is small and before it has spread), the 5-year survival rate is about 90%. But 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.

To find out if you are at an increased risk for colorectal cancer and what you can do to try to keep from getting this disease, please read Colorectal Cancer Early Detection.

Last Medical Review: 05/10/2011
Last Revised: 05/10/2011

Learn more about colon cancer at cancer.org/colon.

© American Cancer Society

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Why should there be a postoperative follow-up program?

Surgery is the most effective treatment for colorectal cancer. Even when all visible cancer has been removed, it is possible for cancer cells to be present in other areas of the body. These cancer deposits, when very small, are undetectable at the time of surgery, but they can begin to grow at a later time. The chance of recurrence depends on the characteristics of the original cancer and the effectiveness of chemotherapy, if needed, or other follow up treatment. Patients with recurrent cancers – if diagnosed early – may benefit, or be cured, by further surgery or other treatment.

Another good reason for postoperative follow up is to look for new colon or rectal polyps. Approximately one in five patients who has had colon cancer will develop a new polyp at a later time in life. It is important to detect and remove these polyps before they become cancerous.

How long will my follow-up program last?

Most recurrent cancers are detected within the first two years after surgery. Therefore, follow up is most frequent during this period of time. After five years, nearly all cancers that are going to recur will have done so. Follow up after five years is primarily to detect new polyps, and can, therefore, be less frequent but advisable for life.
What might I expect at my follow-up visit?

Your doctor will examine you approximately every two or three months for the first two years, and discuss your progress. A CEA blood test can be done, as a method of trying to detect recurrence of cancer. Because this test is not totally reliable, other follow up examinations may be advised. These examinations may include flexible sigmoidoscopy (an examination of the rectum and lower colon with a flexible, lighted instrument), colonoscopy (examination of the entire colon with a long flexible instrument), chest x-rays, and sometimes CT scans or ultrasound tests.

What about my family?

Close relatives of patients with colon and rectal cancer (parents, brothers, sisters, children) are at increased risk for the disease. Because of this, periodic examination of the lining of the colon, using a colonoscope to detect small polyps, is advised. If polyps are promptly detected and removed, cancers cannot develop. Other factors which increase the risk of developing polyps or cancer include cancer occurring at an early age, and a personal history of breast or female genital cancer.

To find a Colon and Rectal Surgeon near you please visit www.fascrs.org.

© 2008 American Society of Colon and Rectal Surgeons

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By Andrew Spiegel, Esquire
Chief Executive Officer, Colon Cancer Alliance

One in three people 50 years or older has not been screened for colon cancer, yet screening could help save their lives. This statistic is just one of the troubling findings of a national study by the Colon Cancer Alliance, the leading national patient advocacy organization dedicated to increasing screening rates and survivorship, and Quest Diagnostics, a leading diagnostic testing company. The two organizations recently teamed up to uncover the barriers that prevent people from being tested for colon cancer (also known as colorectal cancer), the second leading cause of cancer-related deaths in men and women in the U.S.

Screening by colonoscopy, fecal immunochemical tests and other methods help identify colon cancer in early stages when it is still highly treatable. For this reason, the American Cancer Society recommends screening for every man and woman of average risk, beginning at age 50. African Americans, smokers and anyone who has a family history or other risk factors should be tested even earlier. Yet, the Colon Cancer Alliance study found that many people 50 and over are not being screened. Moreover, the barriers to screening ranged from the lack of recommendation for screening by a healthcare professional to time and cost constraints. The study also suggested that fear of the bowel preparation, side effects and anesthesia typically associated with colonoscopy are additional barriers.

“Any death from colon cancer due to a failure to screen is a tragedy that could have been prevented,” said Andrew Spiegel, chief executive officer of the Colon Cancer Alliance. “I encourage people to talk to their health care providers about the importance of colon cancer screening, their risk factors for colon cancer, and the different screening tests available. With increased screening rates, deaths from colon cancer may one day be a thing of the past.”

Colon cancer is the 2nd leading cause of cancer deaths in America, and worldwide. About 50,000 Americans and over 600,000 people worldwide die each year from what is a very preventable disease. The Colon Cancer Alliance recently partnered with its European equivalent, EuropaColon to form an international colon cancer advocacy organization, Global Colon Cancer Alliance. The goal of the Global organization is to teach people worldwide how to advocate for colon cancer screening programs and share some of the successes learned in the US and Europe.

Colon cancer is the most preventable major cancer through screening. There are no excuses for not undergoing a simple screening test to prevent a very deadly disease which takes the life of an American every 9 minutes. We encourage all to talk to their doctor about whether a colon cancer screening test is appropriate for them. 1 in 19 Americans will be diagnosed with colon cancer, but you have the power to change that by starting a simple conversation with your family and friends and making sure you’re taking care of YOU. But I hope you won’t stop there. If you’d like to join the fight against this disease, the Colon Cancer Alliance has a multitude of volunteer opportunities. Please visit www.ccalliance.org to find out how you can help.

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Andrew Spiegel is the Chief Executive Officer of the Colon Cancer Alliance (CCA), the leading national patient advocacy organization dedicated to increasing screening rates and survivorship. The CCA provides hope and support to patients and their families, while saving lives through screening, access, awareness, advocacy and research.

To learn more, visit www.ccalliance.org.

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By Durado Brooks, MD, MPH

Embarrassing! Painful! Disgusting!!

These are some of the words that come to mind for lots of folks when they think about getting tested for colorectal cancer. Let’s face it – this involves a part of the body and bodily functions that people don’t talk about in polite conversation. Hopefully I can convince you that they (and you) need to get past this attitude and get on with testing.

Cancers of the colon and the rectum (the last sections of the digestive system) are extremely common. In fact, they’re the third most common cancer in US men and women. The good news is the rates of this disease have been falling steadily over the past 20 years, and a big part of the decrease is directly related to testing for colorectal cancer. You see, not only can testing help find the disease early, when it’s highly treatable, but testing can actually help to prevent the disease! That’s because most colorectal cancers start as a small, non-cancerous growth called a polyp. Finding and removing these polyps stops cancer before it starts.

You’d think that with these proven benefits people would be lining up to get tested – yet 4 out of every 10 adults who should get tested are missing out on this possibly life-saving opportunity. Why? There are a lot of myths about colorectal cancer that people use as excuses to avoid getting tested. The following are some of the myths about testing, as well as the facts people need to know.

Myth/Excuse: “No one in my family had colorectal cancer, so I don’t need to get tested.”

Fact: Most people who get colorectal cancer DO NOT have a family history of the disease. The most common reason for getting colorectal cancer is simply getting older. Risk starts to go up around age 50 and continues to rise for the rest of your life. If you have a family history of the disease your risk is even higher, but, family history or not, everyone 50 and older should get tested.

Myth/Excuse: “I’m not having any symptoms so I don’t need to worry.”

Fact: Many people who are diagnosed with colorectal cancer have no symptoms, and people with polyps rarely have symptoms. If you wait to get tested after symptoms develop you might miss the chance to prevent the disease or to find it before it grows and spreads.

Myth/Excuse: “If I have cancer there is nothing they can do about it, so why bother getting tested?”

Fact: Colorectal cancer is one of the most treatable forms of cancer. When the disease is found at an early stage (before it spreads outside of the colon) most people can be treated very successfully and go on to live long, full lives. Regular testing increases the chance that the disease will be found at this early, most treatable stage.

Myth/Excuse: “The tests are embarrassing and painful!”

Fact: There are actually a number of different tests for colorectal cancer. The most common tests are stool tests and the colonoscopy. Stool tests are used to look for small, invisible amounts of blood passed in a bowel movement that might indicate a polyp or cancer. These simple tests are performed in the privacy of your home. A colonoscopy is done by a specialist in a hospital or outpatient center. The test is done in a private room with no other patients around. A thin lighted tube is inserted into the rectum and allows the doctor to view the inner lining of your colon. Many people fear that this test will be painful. In fact, people who are having a colonoscopy are given medicine to help them relax; many people sleep through the exam.

Most of the complaints about colonoscopy actually are not about the test, but instead are about preparing for the test. In order for the doctor to get a good look at the colon lining the colon has to be cleaned out with strong laxatives, so people spend a lot of time in the bathroom during the evening before the test. This is not convenient and it’s not comfortable, but it’s a small price to pay for a test that may save your life.

March is National Colorectal Cancer Awareness month. Take this opportunity to talk about it! If you haven’t been tested, talk to your doctor. If you’ve been tested, talk to your family and friends. Make sure they know the facts and encourage them to get tested. Accept No Excuses!

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Dr. Brooks is director of prostate and colorectal cancers for the American Cancer Society.

Get more insights from the experts at the American Cancer Society at cancer.org/expertvoices.

© American Cancer Society

One in 20 people drinks the equivalent of more than four cans of soda each day, even though health officials say sweetened beverages should be limited to less than half a can.

The Centers for Disease Control and Prevention released the figures Wednesday in a report said to be the government’s first to offer national statistics for both adults and kids.

Sweetened drinks have been linked to the U.S. explosion in obesity and related medical problems, and health officials have been urging people to cut back for years. Some officials have proposed an extra soda tax and many schools have stopped selling soda or artificial juices.

But advocates say those efforts are not enough, and on Wednesday a coalition of 100 organizations announced a new push. The effort includes the American Heart Association and the some city health departments who plan to prod companies to stop the sale of sugary drinks on their property or providing them at business meetings — as Boston’s Carney Hospital did in April. There will also be new media campaigns, like one starting soon in Los Angeles that will ask “If you wouldn’t eat 22 packs of sugar, why are you drinking it?’

The new CDC report may be ammunition. It found:

–About half the population drinks a sugared beverage each day.

–Males consume more than females, with teenage boys leading the pack.  On average, males ages 12 through 19 drink the equivalent of nearly two cans of soda each day.

–Poor people drink more than the more affluent. Low-income adults got about 9 percent of their daily calories from sugary beverages; for high-income adults it was just over 4 percent.

–Blacks get more of their calories from sweetened beverages than other racial and ethnic groups. The study is based on in-person interviews of more than 17,000 people in the years 2005 through 2008. They were asked to recount everything they ate and drank in the previous day. However, diet sodas, sweetened teas, flavored milks and 100 percent fruit juice did not count.

Healthy-eating recommendations call for people to limit sugary beverages to about 64 calories per day. That’s a little less than half of a 12-ounce can of regular Coca-Cola, which is 140 calories.

In other terms: An average can of sugared soda or juice has 10 to 12 teaspoons of sugar.

There have been efforts to reduce children’s access to sodas and sports drinks in schools, with beverage companies agreeing to remove full-calorie soft drinks. But the CDC study found more than half of the drinks are consumed at home. Less than 1 percent are bought at schools or day-care centers.

That’s why some members of the coalition argue that parents shouldn’t drink sweetened beverages, so they don’t serve as a poor example at home. They hope drinking soda will become as unfashionable as smoking.

A spokesman for Carney Hospital — the 149-bed Boston facility that stopped allowing full-calorie soft drink sales — said the approach makes sense. When the policy was implemented in April, sales of beverages dropped, but have gone back up, as more people apparently are adjusting to water and other non-sweetened drinks.

The hospital’s Dorchester neighborhood has high rates of diabetes and other weight-related illnesses, said spokesman Joe Burnieika. “We can’t afford to feed people’s bad habits if we can give them a healthy alternative,” he said.

In a statement, the American Beverage Association on Wednesday suggested that the coalition’s effort was misguided. Citing sales data and some other research, the industry group said sales of full-calorie soft drinks have been declining, which they credited to soda makers offering more no-calorie and low-calorie options and
improved calorie labeling on the front.

These initiatives “will contribute far more to solving complex health issues like obesity than (the coalition’s) sound bite solution that offers plenty of hype but no substance,” the statement said.
——
Online: CDC report

Amgen today announced the FDA plans to decide by April 26 on its application to expand the use of its bone treatment drug Xgeva to prevent or delay the spread of advanced prostate cancer. The drug is currently used to prevent bone related events such as bone loss and fractures in men undergoing androgen deprivation therapy.

In trials for the new indication, Amgen has reported that Xgeva outperformed a placebo in a late-stage study of how it works in preventing the spread of advanced prostate cancer to bones where prostate cancer is most likely to spread. A monthly treatment of the injectable drug increased bone metastasis-free survival by about four months on average compared with a placebo.

“This is very promising news for patients, says Jonathan W. Simons, president and CEO of the Prostate Cancer foundation which has funded many studies related to Xgeva for improving survivorship of patients. “Not only can Xgeva prevent damage to bone as a result of treatment, it looks as if we may soon have a powerful new tool to prevent bone metastases.”

This story originally published by the Prostate Cancer Foundation.

They say blood donations in May and June were at the lowest level the Red Cross has seen in more than a decade, but demand for blood products remained steady.

The agency says the situation has created a critical need for all blood types, especially type O negative which can be used to treat any patient.

The Red Cross asks eligible blood donors to come forward. It also asks sponsors and community leaders to recruit blood donors across the states.

The agency provides blood to 73 hospitals and must have 650 people give blood each day to meet demand in Massachusetts and Rhode Island.

(© Copyright 2011 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

Would you ever consider rubbing your feet with vodka?

Well, that’s one unorthodox treatment for foot odor. Dr. Albert Levy, a family doctor, says the alcohol in the vodka can work like an antiseptic, killing odor causing fungus and bacteria.

There are many cures which sound crazy, but actually work.

For example, duct tape can help eliminate warts. A recent academic study found covering a wart with this all purpose tape works better than the traditional treatment of freezing them off.

WBZ-TV’s Paula Ebben reports.

The duct tape basically suffocates the wart causing it to shrink over time. “A wart is a virus, so you don’t want the virus to thrive,” said Dr. Levy.

Another unconventional treatment involves tension headaches. Just grab a pencil, but instead of writing with it, clench it in your teeth.

This will relax your jaw, and the muscles that connect it to the temple area. “This position of the pencil may alleviate TMJ,” said Dr. Levy.

Foods can also play different roles as well. For example, try yogurt to combat bad breath.

Applying olive oil to your skin can help alleviate eczema.

A teaspoon of sugar really can help rid hiccups.

Powered cloves on a cut can help keep it from getting infected. Dr. Levy added that many dentists have used this trick for years.

Listerine can perform other functions besides freshening your breath. It also helps blisters heal and stay clean. Just dab it on three a day until the area dries out and no longer hurts.

Of course doctors say that if anything is serious or persists for a long period of time, you should be seen by a medical professional.

In January 2003, I was 42 and completing my first year of my pediatric residency. My life was extremely busy; I was working 80 to 120 hours a week. When I first complained of being tired, it was attributed to my age and work schedule. Over the next eight months, my symptoms worsened; I became anemic and had blood in my stool.

In August 2003, I was admitted to the hospital. By the end of the week, I had my surgery and diagnosis – Stage IV colon cancer. I started chemotherapy, and during the next two and a half years, I had two recurrences. The first was in my liver and ovary, and the second in my abdominal lymph nodes and my pancreas.

Miraculously, I have been NED (no evidence of disease) since May 2006. I believe that one of the main reasons for my status is my vigilance in following through on my treatment and having my side effects appropriately managed.

Cancer treatment can be difficult; therefore, it is important to aggressively manage any side effects in order to have the opportunity to complete treatment. I cannot stress enough how important this is. Aggressive side effect management increases your likelihood of completing treatment. The main reason that people don’t complete treatment is unpleasant side effects.

Everyone responds differently to treatment, and therefore, not every individual experiences all side effects to the same degree. Talk with your doctor about every pill you are taking, including supplements, as some may interfere with treatment. If a medication is not working, ask your doctor about other options. Be persistent!

Laura Potter

Here are some of the most common side effects of colorectal cancer treatment and how they can be managed or treated:

Nausea and Vomiting

It is important to treat chemotherapy-induced nausea and vomiting early and aggressively. There are numerous prescription medications available for treating CINV. If a medication is not working, talk to your doctor about trying something else.

Diarrhea

After colon resection, it will take some time for your digestive system to adjust. By trial and error, you will discover which foods you can tolerate. Treatments include prescriptions such as Sandostatin®, a long-acting injection, and over-the-counter loperamide.

Fatigue

If you experience treatment-related fatigue, it is important to rest when you are tired. Plan activities for when you have the most energy. Ask for help from family or friends when fatigue interferes with daily activities. Fatigue may also be a result of depression, pain, or sleep problems. Let your doctor know if you have any of these symptoms.

Peripheral Neuropathy

This may involve tingling and pain in your hands and feet and an inability to tolerate cold. Symptoms of peripheral neuropathy usually regress after treatment ends. However, up to 3.5 percent of people still have neuropathy four years after treatment ends. Some anti-epileptics, antidepressants, and creams are helpful in reducing the symptoms of peripheral neuropathy. It is also helpful to ingest foods and liquids at room temperature and to keep a pair of gloves near the refrigerator so that you can wear them when getting items out of the fridge or freezer, as your hands will be sensitive to the cold.

Mucositis or Candidiasis

Mucositis, or candidiasis, is the painful inflammation and ulceration of the mucous membranes lining the digestive tract. It is commonly known as a yeast infection and is caused by a fungus. Symptoms include white patches or plaques and cold sores. Mucositis can be treated with Magic™ mouthwash, antifungal prescription medicines, local anesthetics, and analgesics. Do not use hydrocortisone, as it will exacerbate the mucositis. The infection can spread, so do not assume that your pain is a hemorrhoid. It could be candidiasis, and hemorrhoid cream will only worsen the condition. Transient lactose intolerance may also occur with mucositis.

Hand and Foot Syndrome

This involves blistering and peeling of the hands and feet; it also affects the nails. Treatment involves gently applying mild skin creams to the affected area. To prevent exacerbations, take cool showers, wear thick cotton socks, avoid constrictive shoes, avoid friction and heat, and stay well hydrated.

The goal is to complete treatment. Unfortunately, this is not always possible. However, by properly managing treatment-related side effects, you increase the likelihood that you will complete your recommended treatment.

This article was originally published in Coping with Cancer magazine, March/April 2010. Reprinted by permission of COPING® magazine, www.copingmag.com.

One of the keys to eradicating colon cancer is awareness. Being aware of risk factors, symptoms, family history and screening options will not only help in fighting the disease itself, but could mean the difference between life and death.

Colon cancer is the second leading cause of cancer death in the U.S. A lot of work has gone into bringing awareness to this disease, but because it deals with part of the body that the general public is uncomfortable talking about, many suffer needlessly.

Andrew Spiegel (credit: Colon Cancer Alliance)

The stigma associated with this cancer still looms large. Colon cancer kills nearly 50,000 Americans yearly and almost 150,000 new cases of colon or rectal cancer will be diagnosed this year, according to the American Cancer Society.

A screening test such as a colonoscopy is a preventative measure that works. When you turn 50, get screened. If you have risk factors such as a family history of the disease, talk to your doctor. You may need to be screened earlier. The results are undeniable. Screening can reduce your risk of developing colon cancer by up to 80%. Colon cancer is one of the most preventable and curable cancers… if it’s caught early. Colon cancer doesn’t discriminate. It affects everyone, no matter your race or gender.

The Colon Cancer Alliance has developed a variety of local and national programs to help bring greater awareness to this disease. Our efforts are getting people talking and that’s a first step to making colon cancer a thing of the past.

No one expects to be diagnosed with colorectal cancer, especially a former professional football player who takes pride in staying in good physical condition. Yet that’s exactly what happened to former Philadelphia Eagles wide receiver Vince Papale. Vince, 56, is now on a crusade to encourage men and women over age 40 to get screened for colorectal cancer.

“I am a big-time advocate of colorectal screening for people my age, especially men who might think it’s not macho, because it saved my life,” said Vince, a South Jersey resident. “My mission is to save lives. A single screening examination performed on people with no symptoms beginning at age 40 – 50 will greatly increase the chances of long-term survival from the disease or preventing it altogether.”

Married with two young children, Vince had no reason to believe he was ill. His yearly cardiovascular test results looked more like those of someone 10 or 20 years younger. Vince appeared to be the picture of health and vitality.

“As far as I was concerned, I was healthy as a horse,” recalled Vince, who defied the odds in 1976 to make the Eagles as a 30-year-old-rookie. (He still holds the record as the oldest rookie in NFL history who never played college football, excluding kickers.)

Yet Vince’s wife wisely suggested that, because of his age, he should undergo a full physical. Vince’s family physician detected blood in his stool and referred him to Dr. Scott Goldstein, a colorectal surgeon at Thomas Jefferson University Hospital in Philadelphia and a Fellow of American Society of Colon and Rectal Surgeons (ASCRS).

In April 2001, Dr. Goldstein performed a colonoscopy – an exam using a scope that views the entire colon – and found several polyps. During the procedure, Dr. Goldstein was able to remove all but one of the polyps, which were non-cancerous. A month later, he performed another colonoscopy and removed the remaining polyp, which was cancerous.

“The procedure was quite painless,” Vince explained. “I was given an anesthetic and was out for a few minutes.”

In June 2001, Dr. Goldstein performed laparoscopic surgery to remove 18 inches of Vince’s colon as a precaution to make sure the cancer had not spread. The procedure took 6 1/2 hours but went smoothly. Because the disease was caught early and had not spread, Vince did not need radiation or chemotherapy treatment.

“Vince is a classic example of how early screening before symptoms occur can prevent colorectal cancer from ever developing or becoming life threatening,” said Dr. Goldstein. “The possibility of curing patients after symptoms develop is only 50%, but if colorectal cancer is found and treated at an early stage before symptoms such as bleeding or abdominal pain develop, the opportunity to cure it is 80% or better.”

The laparoscopic surgery enabled Vince to recover extremely quickly. He was in the hospital for just four days instead of the expected 10 and went back to work after just a week after the procedure. Vince, who worked as a television and radio broadcaster after his football career, is now a senior account executive for higher education marketing at Sallie Mae, which offers federally guaranteed loans to students and universities.

“My recovery was extraordinary because of the procedure and my conditioning,” Vince said. “I worked out before the surgery and prepped myself like it was the Super Bowl. Three days after the surgery I was walking two miles in the hallway.”

Normally, it is recommended that patients follow up with their surgeons every three months for the first couple of years after surgery. But after examining Vince in October 2001, Dr. Goldstein said he would not have to see him again until May 2002.

In addition to being proficient in general surgery, colorectal surgeons like Dr. Goldstein have specialized training, knowledge, and surgical skill with regard to problems of the colon, rectum, anus, and small bowel. Studies have shown that patients treated by colorectal surgeons are more likely to survive colorectal cancer because of the surgeons’ additional education, training, and experience performing a high volume of colorectal surgeries.

This information is courtesy of the American Society of Colon & Rectal Surgeons (ASCRS). Visit their website for more patient success stories.

Three years ago, 61-year-old Sharon Tschider from Bismarck, North Dakota, noticed she had bleeding with her bowel movements. Married and the mother of seven children, at first she thought the bleeding was coming from hemorrhoids resulting from her many pregnancies. But after the bleeding continued for two months, she went to her gastroenterologist. He performed a colonoscopy, an exam using a scope that views the entire colon, and found a rectal cancer.

“It was devastating news,” says Sharon, who found her hometown of 75,000 praying for her and sending her hundreds of get well cards. “I’d never been sick, and I’m a high-energy, positive thinking, type-A personality.”

Her gastroenterologist referred Sharon to Bruce Wolff, MD, a colorectal surgeon at the Mayo Clinic in Rochester, Minnesota. In addition to being proficient in general surgery, colorectal surgeons like Dr. Wolff have specialized training, knowledge and surgical skill with regard to problems of the colon, rectum, anus, and small bowel. Studies have shown that patients treated by colorectal surgeons are more likely to survive colorectal cancer because of the surgeons’ additional education and training and experience performing a high volume of colorectal surgeries.

Dr. Wolff determined that the cancer was low in the rectum, the organ that stores stool. “A cancer like Sharon’s takes seven to 10 years to develop from a benign polyp,” explains Dr. Wolff. “If patients like Sharon come to me early for a routine check-up, I perform a colonoscopy and can detect and remove their polyps before they become cancerous. By the time Sharon reached me, her tumor was fairly large and her best option was low anterior resection surgery to remove the tumor, with the possible addition of radiation and chemotherapy.”

“Sharon’s surgery involved removing the cancerous tumor near her rectum, and then performing a coloanal anastomosis, with the addition of a ‘colonic J-pouch’ to improve frequency,” describes Dr. Wolff. “To do this, I turned the colon around on itself and created a pouch shaped like a ‘J’ that would eventually prevent the need for a colostomy bag.” The “colonic J pouch” procedure is a recent advance in colorectal surgery that enables patients to have less frequent bowel movements after removal of the rectum. A temporary loop ileostomy was performed to allow the J-pouch to heal before using it.

Sharon’s surgery went smoothly, and she recovered at home. “I can’t recommend more the importance of home health care,” states Sharon. “I needed to be with family and friends; it was really important to my healing.”

Sharon bounced back to her old busy life: three months after her surgery she took a trip to Hawaii. “I even went snorkeling, jumping ten feet off the side of a boat, with my ileostomy bag tucked under my bathing suit,” says Sharon, with a laugh.

When the ileostomy was removed, her trips to the bathroom were reduced to four to six times a day, down significantly from the 50 times a day she counted pre-surgery. Now at age 64, Sharon has had her annual colonoscopy, and she won’t need another exam for two years.

“Timing is everything,” sums up Sharon. “If the tumor had penetrated the rectal wall it would have been all over – I never could have had this life-saving surgery. The whole painful ordeal changed my life. But today I have a very good life.”

This information is courtesy of the American Society of Colon & Rectal Surgeons (ASCRS). Visit their website for more patient success stories.

What exactly is the colon and what is its function? Read this article to learn the answers to these questions, and more.

What is the Colon?

The colon is also known as the large bowel or large intestine. It is an organ that is part of the digestive system (also called the digestive tract) in the human body. The digestive system is the group of organs that allow us to eat and to use the food we eat to fuel our bodies.

What Does the Colon Do?

The colon plays a very important role in how our bodies use the food we eat. Here is how food travels through the body.

1. Food begins in the mouth where it is chewed by the teeth into smaller

pieces. The salivary glands release juices to help, and the tongue and saliva turn the food into even smaller pieces that will fit into the fit into the esophagus. The esophagus is a 10-inch-long tube that connects to the stomach. Muscles in the esophagus move food into the stomach.

2. In the stomach, gastric juices—protein substances called enzymes— break down the food into smaller bits. The stomach has powerful muscles that churn up the food until it’s a creamy liquid. This material moves into the small bowel.

3. In the small bowel, the food particles get even smaller. More juices from the pancreas, liver and gallbladder mix together in the small bowel. Here is where all the important vitamins and nutrients in food move through the blood vessels that are in the lining of the small bowel. The blood takes the nutrients to other organs in the body. The nutrients are used to help repair cells and tissue.

4. What is left over, which is mostly liquid, then moves into the colon. The water is absorbed in the colon. Bacteria in the colon break down the remaining material. Then the colon moves the leftover material into the rectum.

5. The rectum is like a storage-holder for this waste. Muscles in the rectum move the waste, called stool, out of the body through the anus.

Healthy eating is good for your overall health, but having a low-calorie, high-fiber diet that includes many fruits and vegetables is important to a healthy colon. A healthy colon will rid your body of the leftovers it no longer needs. Your stool is filled with bacteria, so it is important to pass this out of your body. If your colon isn’t working the way it should, you will experience problems such as bloating, gas and pain.

Talk with your health care provider about colorectal cancer. Colorectal cancer is preventable, and is easy to treat and often curable when detected early. Ask your health care provider what kind of screening test you should have and when.

This information is courtesy of the American Society of Colon & Rectal Surgeons (ASCRS). Visit their website for the latest information on colorectal cancer.

What is colorectal cancer? What’s a polyp? What causes the deadly disease? Here are some answers to the questions you may have about colorectal cancer.

What is colorectal cancer?

Colorectal cancer is cancer of the colon and rectum that begins with the development of non-cancerous polyps on the lining of the colon and rectum.

What is a polyp?

Polyps are mushroom-like growths that form when cells lining the colon grow, divide and reproduce in an unhealthy, disorderly way. Polyps can become
cancerous over time, invading the colon wall and surrounding blood vessels, and spreading to other parts of the body.

What causes colorectal cancer?

The exact causes of colorectal cancer are unknown, but the disease appears to be caused by both inherited and lifestyle factors. Lifestyle factors – such as cigarette smoking, lack of physical exercise, and obesity – may increase the risk of developing the disease. Genetic factors may determine a person’s
susceptibility to the disease, whereas dietary and other lifestyle factors may determine which at-risk individuals actually go on to develop the disease.

How common is colorectal cancer?

Colorectal cancer is the second leading cause of death from cancer in the United States, and the third most common cancer overall. This year, more than 56,000 Americans will die from colorectal cancer and more than 140,000 new cases will be diagnosed. In fact, more women over the age of 75 die from colorectal cancer than from breast cancer. Eighty to 90 million Americans (approximately 25 percent of the U.S. population) are considered at risk because of age or other factors.

Who is at risk for colorectal cancer?

Men and women aged 50 or older are at almost equal risk of developing colorectal cancer, and those who have a personal or family history of colorectal cancer or polyps are at high risk of developing the disease. Anyone who has a long-term personal history of inflammatory bowel disease also is at high risk.

How can you prevent colorectal cancer?

See your doctor for yearly screenings if you are aged 50 or older. Be sure to maintain a diet low in animal fat and high in fruits, vegetables and fiber. Get
regular exercise and avoid cigarette smoking. Keep alcohol consumption in moderation.

What are the screening options for detecting colorectal cancer?

Screening tests are the best way to find and remove polyps before they become cancerous, or to find an early cancer, when treatment can be most effective.
Several screening options exist. These include the fecal occult blood test (FOBT), flexible sigmoidoscopy, double contrast barium enema, and colonoscopy. Patients should talk to their colorectal surgeon or other healthcare provider to find out which screening method is right for them.

This information is courtesy of the American Society of Colon & Rectal Surgeons (ASCRS). Visit their website for the latest information on colorectal cancer.

In the following maps, the U.S. states are divided into groups based on the rates at which people developed or died from colorectal cancer in 2007, the most recent year for which statistics are available. The rates are the numbers out of 100,000 people who developed or died from colorectal cancer each year.

Rates of Getting Colorectal Cancer by State

The number of people who get colorectal cancer is called the colorectal cancer incidence. In the United States, the risk of getting colorectal cancer varies from state to state.

Colorectal Cancer Incidence Rates,* by State, 2007^†

(credit: www.cdc.gov)

*Rates are per 100,000 and are age-adjusted to the 2000 U.S. standard population.

^†Source: U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2007 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2010. Available at: http://www.cdc.gov/uscs.

Deaths from Colorectal Cancer by State

Rates of dying from colorectal cancer also vary from state to state.

Colorectal Cancer Death Rates,* by State, 2007^†

(credit: www.cdc.gov)

*Rates are per 100,000 and are age-adjusted to the 2000 U.S. standard population.

^†Source: U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2007 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2010. Available at: http://www.cdc.gov/uscs.

Visiting the doctor can be a scary time for some, even when all that’s expected is a routine check-up. So imagine the kinds of worries some may have when it’s time for a colorectal screening. Four patients share their experiences undergoing the exam.

Tom, Age 66

“Even as a health professional who should know better, I had delayed and delayed getting a colonoscopy until well beyond the recommended initial screening age. Delay, of course, was due to the uncertainty about the discomfort of the procedure and prior cleansing process. Finally, my wife’s ‘encouragement’ and my sister having had the procedure done and finding several pre-cancerous polyps eventually got to me!”

“I had my first colonoscopy when I was 60 and it turned out to be simple, pain-free and not at all what I had worked it up to be. I did have one pre-cancerous polyp, but am really lucky that I had it removed at that point.”

Harriett, Age 88

“I’m a colon cancer survivor. I’m doing fine now. It’s been 14 years since I found out I had colon cancer and had surgery and chemotherapy.”

“At the time, routine screening for this disease was not discussed or done, and my doctor never told me to get tested. Of course, now I know that having a colonoscopy can find polyps and the doctor can even remove polyps during the test. I think if I had been tested earlier, the doctor could have removed polyps from me and they never would have turned into cancer.”

Kevin, Age 56

“I may have a slight bias when it comes to having appropriate cancer screening completed at the right age. I have been working in the cancer field for many years and have heard the important messages about the need to get screened for colorectal cancer beginning at age 50. I also knew I had options; that more than one screening method can be effective. What I didn’t anticipate was the personal ‘support’ from my friends and colleagues asking days before my 50th birthday and regularly thereafter, did you make your appointment yet? The reminders were regular and the approaches varied from offering assistance if I needed help with driving to an appointment to comments like, I should know better and how come I haven’t made my appointment yet! Letting the shock of turning the new decade pass, and juggling a very busy work schedule, I finally made the call months later to schedule a colonoscopy.”

“When I saw my doctor, I let him know I needed a referral for one and he said to me, ‘This is a switch, a patient asking for it!’ I was pleasantly surprised by how quickly I was able to make the appointment and that I didn’t have to wait months and months for the procedure. But then I began the dread of anticipating the preparation for it. In hindsight, it was all fine and the actual day really went quite smoothly. When I checked in that morning, the nurse asked me why I was there and I said, ‘Do you have a place to check off “peer pressure” as the reason for the appointment?’ During the screening, I was glad that I was only mildly sedated so I could watch and interact with the doctor and staff. I got to ask questions and see everything. I am one of those people that it helped give me comfort to be able to participate vs. just lie there. I was glad they were open to my involvement.”

“Most importantly, I am done and the news was good! I have a sense of relief that I have done one more important thing to help take care of myself. Now it is my turn to offer the personal ‘support’ to friends and family as they come of age!”

Cindy, Age 58

“My mother had colon cancer. Luckily, she was treated and is well now. But because my mother had it, my doctor thought I should get tested when I was in my mid-40s. I remember drinking all of the ‘special’ stuff the day before (to clean out the colon). That was the hardest part of getting tested. During the test (I had a colonoscopy), I wanted to know what was going on, so I wasn’t totally asleep. I actually watched it on a television monitor and it was interesting! They didn’t find anything, and I was told to come back after I was 50.”

“Well, I’m over 50 now, and have had two more colonoscopies. I had polyps both times and they were removed during the colonoscopy. I didn’t have any symptoms at all… this proves how valuable screening for colorectal cancer is. While I don’t know for certain that the polyps would have turned into cancer, I’m glad I won’t have the chance to find out!”

“I tell everyone I can to get screened for colon cancer. I know, from seeing my mother go through treatment, that getting tested is no big deal compared with getting treated.”

This information is courtesy of the Centers for Disease Control & Prevention (CDC). Visit their website for the latest information on colorectal cancer.

Avoiding alcohol, regular exercise, and sticking to a healthy diet are just a few of the ways you can reduce your chances of developing colorectal cancer.

Six Steps To Lowering Your Risk Of Colorectal Cancer

1. Get regular colorectal cancer screenings beginning at age 50. If you have a personal or family history of colorectal cancer or colorectal polyps, or a personal history of another cancer or inflammatory bowel disease, talk to your doctor about earlier screening.
2. Eat between 25 to 30 grams of fiber each day from fruits, vegetables, whole grain bread and cereals, nuts and beans.
3. Eat a low-fat diet.
4. Eat foods with folate such as leafy green vegetables.
5. If you use alcohol, drink only in moderation. Alcohol and tobacco in combination are linked to colorectal cancer and other gastrointestinal cancers. If you use tobacco, quit. If you don’t use tobacco, don’t start.
6. Exercise for at least 20 minutes three to four days each week. Moderate exercise such as walking, gardening, or climbing steps may help reduce your risk.

Self-Test on Colorectal Cancer

Colorectal cancer – cancer of the colon and rectum – is the second leading cancer killer in the United States and all women and men aged 50 and older are at risk. The good news is that colorectal cancer is preventable and, if detected early, curable.

Depending upon your age and family history, you could be at risk for developing this disease. If you answer “yes” to any of the following five questions, talk to your colorectal surgeon or other healthcare provider about getting screened for colorectal cancer (screening means getting tested for a disease even if you don’t have symptoms):

1. Are you aged 50 or older?
2. Has a parent, brother, sister or child of yours had colorectal cancer?
3. Has a parent, brother, sister, or child of yours had colon polyps?
4. Do you have a chronic inflammatory bowel disease such as ulcerative colitis or Crohn’s disease?
5. Talking With Your Health Care Provider About Colorectal Cancer

Talking To Your Health Care Provider About Screening

Screening tests for colorectal cancer can save 30,000 lives each year. These tests not only detect colorectal cancer early, but can prevent colorectal cancer. In one test, non-cancerous polyps are removed before they become cancer. When you turn 50 years old, or if you are younger and have a family or personal history of colorectal polyps, colorectal cancer, inflammatory bowel disease, or breast, uterine or endometrial cancer, you need to talk to your health care provider about colorectal cancer screening tests.

Here are 12 questions to help you begin this important conversation:

1. I just turned 50 years old. Should I be tested for colorectal cancer?
2. I don’t have any family history of colorectal cancer or of colorectal polyps. Should I still be screened? Or….. My medical history and/or family medical history put me at an increased risk for colorectal cancer; should I be screened at a younger age and more often?
3. I understand there are a number of screening tests available, would you tell me about each of these tests and the pros and cons of each?
4. I don’t know which screening test is appropriate for me now. Which test do you recommend and why?
5. Will you perform the test? If not, who will?
6. Will I be awake or asleep during the test?
7. Will the test hurt?
8. How will I learn the results of the test?
9. What kind of follow-up care will I need if the tests show a problem?
10. If the tests show nothing wrong, when should I be tested again?
11. What is the cost of these tests? Will my insurance cover the cost?

This information is courtesy of the American Society of Colon & Rectal Surgeons (ASCRS). Visit their website for the latest information on colorectal cancer.

This article explains the importance of testing for symptoms that may reveal a disease or condition that could lead to colon or rectal cancer.

What is screening or surveillance?

Many polyps and cancers of the colon and rectum do not produce symptoms until they become fairly large. Screening involves one or more tests performed to identify whether a person with no symptoms has a disease or condition that may lead to colon or rectal cancer. The goal is to identify the potential for disease or the condition early when it is easier to prevent or cure. Surveillance involves testing people who have previously had colorectal cancer or are at increased risk. Because their chance of having cancer is higher, more extensive or more frequent tests are recommended.

Why is screening important?

Colorectal cancer is known as a “silent” disease, because many people do not develop symptoms, such as bleeding or abdominal pain until the cancer is difficult to cure. In fact, the possibility of curing patients after symptoms develop is only about 50 percent. On the other hand, if colorectal cancer is found and treated at an early stage, before symptoms develop, the opportunity to cure is 80% or better. Most colon cancers start as non cancerous growths called polyps. If the polyps are removed, then the cancer may be prevented. Major surgery can usually be avoided.

What screening tests should be done?

A number of tests are currently available to screen for colorectal cancer:

• Colonoscopy
• Virtual Colonoscopy
• DNA-Based Stool Test
• Sigmoidoscopy
• Fecal Occult Blood Testing (FOBT) and
• Double Contrast Barium Enema

The simplest screening test for colon and rectal cancer is testing of the stool to detect tiny amounts of invisible blood; this is called fecal occult blood testing. This test has been available for many years, is inexpensive and very simple. Unfortunately, it only detects cancer or polyps which are bleeding at the time of the test. Only about 50% of cancers and 10% of polyps bleed enough to be detected by this test. Therefore, further screening is necessary for accurate detection of cancers and polyps.

Flexible sigmoidoscopy is a test which allows the physician to look directly at the lining of the colon and rectum. During this test, which is performed in the physician’s office, the lining of the lower one-third of the colon and rectum can usually be seen. This is the portion of the lower intestine which accounts for most polyps and cancers. When flexible sigmoidoscopy is combined with testing the stool for hidden blood, many cancers and polyps can be detected.

When a polyp or cancer is detected by flexible sigmoidoscopy, or if a person is at high risk to develop colon and rectal cancer, colonoscopy provides a safe, effective means of visually examining the full lining of the colon and rectum. Colonoscopy is used to diagnose colon and rectal problems and to perform biopsies and remove colon polyps. Most colonoscopies are done on an outpatient basis with minimal inconvenience and discomfort.

A barium enema or x-ray of the colon is almost as good as colonoscopy in detecting large tumors, but it is not as accurate for small tumors or polyps. The combination of barium enema and sigmoidoscopy is better than either test alone, but not as good as colonoscopy.

When and how often should testing be done?

For people who have none of the risks described earlier, digital rectal examination and testing of the stool for hidden blood are recommended annually beginning at age 40. Flexible sigmoidoscopy is recommended every 5 years at age 50 or older. A double contrast barium enema every 5 to 10 years, and colonoscopy every 10 years are acceptable alternatives.

Surveillance is recommended for people in the following high-risk groups:

• People who have had any pre-cancerous polyps found and removed should have colonoscopy one to three years after the first examination. Double-contrast barium enema is an alternative to colonoscopy but does not allow removal of polyps.
• People with a close relative, such as sibling, parent or child who has had colorectal cancer or a pre-cancerous polyp should have the same screening as people of average risk, but it should begin at age 40 or 5 years before the age at which the youngest was diagnosed.
• People with a family history of colorectal cancer in several close relatives and several generations, especially cancers occurring at a young age, should receive genetic counseling and consider genetic testing for a condition called hereditary nonpolyposis colorectal cancer. People with this family medical history should have an examination of the entire colon preferably colonoscopy every two years starting between the age of 20 and 30, and every year after age 40.
• People with a family history of an inherited disease called familial adenomatous polyposis (FAP) should receive counseling and consider genetic testing to see if they are carriers for the gene that causes the disease. People with this gene or whose tests are inconclusive should have a flexible sigmoidoscopy annually beginning at puberty to see if they are expressing the gene. If polyposis is present, they should discuss with their physician the need for total colectomy, which involves removing all the colon and rectum.
• People with a personal history of colorectal cancer should have a complete examination of the colon within one year after the cancer is initially detected and surgically removed. If this exam is normal, they should have a follow-up exam within three years. Examinations to evaluate the entire colon include colonoscopy or flexible sigmoidoscopy with a double-contrast barium enema.
• People with a history of extensive inflammatory bowel disease for 8 or more years should consider having a colonoscopy examination of their colon conducted every one to two years.
• Women with a personal history of breast or female genital cancer (ovary or uterine) have a 15% lifetime risk (1 in 6) of developing colon cancer. They should undergo colonoscopy every 5 years, beginning at age 40.

This information is courtesy of the American Society of Colon & Rectal Surgeons (ASCRS). Visit their website for the latest information on colorectal cancer.

Some say ignorance is bliss, but experience tends to prove otherwise. Make sure you’re informed about the truths and misconceptions concerning colorectal cancer by reviewing this list of myths and realities concerning the disease.

Myth:

There is nothing I can do about getting colorectal cancer.

Reality:

Few Americans know that colorectal cancer may be preventable. A low-fat diet, high in vegetables and fruits, and exercise may reduce your risk of developing the disease. Since most colorectal cancer develops from non-cancerous polyps – grape-like growths on the lining of the colon and rectum – screening methods can detect and remove polyps BEFORE they become cancerous.

Myth:

Colorectal cancer is fatal.

Reality:

Colorectal cancer is curable when detected early. Ninety-one percent of patients with localized colorectal cancer (confined to the colon or rectum) are alive five years after diagnosis. But only 37 percent of all colorectal cancers are diagnosed at this stage. The remaining 63 percent of patients come to the doctor when the disease has spread regionally or to distant parts of the body.

Myth:

Screening (testing for a disease even if the patient has no symptoms) is only necessary for individuals who have symptoms.

Reality:

Since early colorectal cancer often has no symptoms, it is important to obtain regular screenings. Screening is checking for cancer in person with no symptoms. Men and women who are 50 or older should get screened regularly for colorectal cancer. Men and women who are at high risk because they have a personal or family history of colorectal cancer or polyps, or a personal history of inflammatory bowel disease, might need to be screened before age 50. In addition, women who have a personal or family history of ovarian, endometrial or breast cancer may need to be screened before age 50. Talk to your colorectal surgeon or other healthcare professional about when you should begin screening. About 75 percent of all new cases of colorectal cancer occur in individuals with no known risk factors for the disease, other than being 50 or older.

Myth:

Colorectal cancer strikes only older, white men.

Reality:

Colorectal cancer strikes both women and men. It is estimated that 67,000 new cases of colorectal cancer will be diagnosed in women this year – it is the third leading cause of cancer death among women. And it is estimated that more than 62,000 new cases of colorectal cancer will be diagnosed in men this year. Of the approximately 56,000 people who will die from the disease this year, slightly more than half will be women. African Americans and Hispanics are more likely to be diagnosed with colorectal cancer in its advanced stages.

Myth:

Colorectal cancer screening is not covered under most health plans.

Reality:

The Health Care Financing Administration (HCFA) expanded Medicare coverage in 1998 to include colorectal cancer screenings. Many commercial health plans also cover the cost of screening.

This information is courtesy of the American Society of Colon & Rectal Surgeons (ASCRS). Visit their website for the latest information on colorectal cancer.

Colorectal cancer – cancer of the colon and rectum – is the second leading cause of cancer-related deaths in the United States for both men and women combined. The general population faces a lifetime risk for developing the disease of about 5 percent, while someone whose family has a history of colorectal cancer has a 10 to 15 percent chance of developing the disease. The risk rises to over 50 percent in people with ulcerative colitis and those whose family members harbor specific genetic mutations.

Approximately 140,000 new cases of colorectal cancer will be diagnosed and 56,000 people will die from the disease this year. Surpassing both breast cancer and prostate cancer in mortality, colorectal cancer is second only to lung cancer in numbers of deaths in the United States.

Colorectal cancer strikes men and women with almost equal frequency. In addition, it is often a silent disease, developing with no symptoms at all. When symptoms do occur they may include the following:

• Blood in or on the stool
• Change in bowel habits
• Stools that are narrower than usual
• General stomach discomfort (bloating, fullness, and/or cramps)
• Vomiting
• Diarrhea, constipation, or feeling that the bowel does not empty completely
• Frequent gas pains
• Weight loss for no apparent reason
• Rectal bleeding
• Constant tiredness

Although these symptoms are not specific for colorectal cancer and can occur in healthy people, if you have any of these symptoms that are intermittent or persistent please inform your doctor or health professional immediately.

Polyp-related colorectal cancer can be prevented. The disease develops from benign polyps. Polyps are growths on the lining of the colon and rectum that can be either flat (sessile) or mushroom-like (pedunculated). Removing these polyps before they become cancerous may prevent cancer from developing.

A low-fat, high-fiber diet and regular exercise can also lower your risk of developing colorectal cancer.

Colorectal cancer can be cured in up to 90 percent of people when it is discovered in its early stages. It is estimated that approximately 40,000 lives a year could be saved through widespread adoption of colorectal cancer screening and early treatment in men and women.

African Americans and Hispanics are more likely to be diagnosed with colorectal cancer in advanced stages. Incidence rates for colorectal cancer in these groups have been on the rise – colorectal cancer has increased 46 percent among African-American men and 10 percent among African-American women. (Sources: National Center for Health Statistics: Vital Statistics for the United States, 1993. Washington, DC, Public Health Service, 1998. American Cancer Society, Surveillance Research, 1996.)

Alaska Native women have the highest mortality from colorectal cancer of any other racial and ethnic group in the United States. (Source: Documentation of the Cancer Research Needs of Indians and Alaska Natives, Native American Monograph No. 1. National Institutes of Health, National Cancer Institute, 1994.)

The risk of developing colorectal cancer increases with age. All men and women aged 50 and older are at risk for developing colorectal cancer, and should be screened. Some people are at a higher risk and should be screened at an age younger than 50, including those with a personal or family history of inflammatory bowel disease; colorectal cancer or polyps; or ovarian, endometrial or breast cancer.

Current screening methods include fecal occult blood testing (a simple chemical test that can detect hidden blood in the stool), flexible sigmoidoscopy (a visual examination of the rectum and lower portion of the colon, performed in a doctor’s office), double contrast barium enema (barium x-ray), colonoscopy (a visual examination of the entire colon) and digital rectal exam. Colorectal cancer screening, including colonoscopies, costs are covered by Medicare and many commercial health plans.

This information is courtesy of the American Society of Colon & Rectal Surgeons (ASCRS). Visit their website for the latest information on colorectal cancer.

Did your grandparents have colon cancer? Have any of your relatives ever had polyps? Knowing the answers to questions like these could tell you if you are at an increased risk for colon cancer. Colon cancer is the second leading cause of cancer related death in the U.S. Take the time to learn your health history. You may need to tell your doctor to “Screen my colon!” earlier than you thought.

You and your family members are at a greater risk of developing colon cancer if you have a family history of:

• Colon or rectal cancer

• Cancer or rectal polyps

• Stomach or bowel problems

Although everyone should be tested for colon cancer beginning at age 50, if you have a family history of colon cancer, you and your close family members (parents, brothers, sisters, or children) should begin getting regular screenings for colon cancer even earlier to catch the disease in its early stages, when it is most easily treatable. Colon cancer, also called colorectal cancer, often does not have symptoms. If you wait for symptoms to occur before getting screened, this cancer may be tougher to treat. Screening tests help your doctor find and remove polyps to prevent colon cancer before these polyps develop into cancer. Read more about who should be tested and when.

As each generation ages, important information about your family health history can be forgotten or lost. Start a dialogue with your family today. Through the Colon Cancer Alliance website, you can download a free Family Health Tree to complete with your family. Don’t wait. Get the conversation started!