In July 1999, I learned I was pregnant with my son. My sister was pregnant, too, and due to deliver in the fall. I was excited to share my happy news. But my father, then 65, had news of his own: he had been diagnosed with stage III colorectal cancer.
My dad was depressed. He blamed his cancer on long-ago junk-food indulgences, including one summer when he “ate ice cream for lunch every day.” His tumor responded well to neoadjuvant chemoradiation, though, and after surgical resection, he had a temporary ileostomy. He’s a proud survivor and still receives newsletters from Memorial Sloan-Kettering Cancer Center, where he was treated.
My mother’s father had had colon cancer, too. He died in 1976 at age 70, a few months after diagnosis. My grandfather and my father exemplify some of the important changes that have taken place in the field of colon cancer treatment and prevention over the past several decades.
Certainly, advances in diagnosis and treatment of colorectal cancer give us good reason for hope, and the landscape keeps evolving: 1999 is not 1976, and 2011 is not 1999.
For instance, colonoscopy and the stool guaiac test were just introduced in the late 1960s. Video-guided endoscopies did not come into use until the late 1970s. Cisplatin(Drug information on cisplatin) was approved in 1971, the year that President Nixon declared a “war on cancer” in his State of the Union Address and asked for $100 million to fund research. The first national cancer patient education program, I Can Cope, was founded in 1977.
Contrast this with a cancer-management milestone from around the time my father was being treated: in 2001, initial findings from the Human Genome Project were made available, along with advanced DNA sequencing technologies that continue to shed light on clinically important genomic changes in certain cancers. In 2008 at ASCO, for example, practice-changing research showed colorectal cancer patients with KRAS gene mutations do not respond to the EGRF inhibitor cetuximab(Drug information on cetuximab) (Erbitux), leading ASCO to issue a Provisional Clinical Opinion in January 2009 recommending KRAS testing for all colorectal cancer patients.
On the screening front, in 2010, a large randomized controlled trial of 170,000 + people in the UK showed one-time screening of men and women 55–64 years old with flexible sigmoidoscopy reduced bowel cancer incidence by one third.
And in the March 2011 issue of the Journal of the American College of Radiology, a study analyzing American Hospital Association survey data reported that virtual colonoscopies are on the rise in US hospitals, even though the procedure is not covered by Medicare.
Clearly, screening is vital to colorectal cancer prevention, and to better outcomes when malignancies are found. Improvements in screening—and increased efforts by advocacy groups and celebrities to educate the public about its importance—have played a role in improved survival of colorectal cancer patients over the past decades. In an Annual Report to the Nation authored by researchers from the NCI, CDC, ACS, and the North American Association of Central Cancer Registries, these healthcare leaders pointed out that “if Americans increase use of screening, adopt more favorable health behaviors and pair that with optimal treatment outcomes, overall colorectal cancer mortality rates could decrease by 50% by the year 2020.
The CDC provides excellent resources as part of its “Screen for Life: National Colorectal Cancer Action Campaign." You can send a “This Is Personal” customizable electronic educational greeting card from the CDC website urging friends, family members, and coworkers to be screened for colorectal cancer. The message is hopeful: “Colorectal cancer is the second leading killer in the US, but it’s largely preventable. If you’re 50 or older, please get screened.”
Because my sister and I are at higher risk for colorectal cancer, we both had our first colonoscopies before age 50. While the “bowel prep” isn’t much fun, it’s really not so bad, either. (Cold apple juice and good movies help.)
March is National Colorectal Cancer Awareness Month. We can help each other to reduce deaths from colorectal cancer. Please, tell people you care about that colorectal cancer can be prevented. Encourage them to be screened today.