By Salina Lee, MD
Despite remarkable advances in detection and treatment of colorectal cancer, it remains the second-largest cause of cancer mortality in the United States. This statistic looms despite the fact that colorectal cancer is one of the most treatable cancers there is because early detection, thus cure, is entirely possible.
What makes this unique among the other cancers for which we have screening tools is that prevention is also possible. This is because we can identify and remove premalignant lesions before they become cancer. So what accounts for the stark contrast between this grim statistic and our known ability to prevent, detect and cure this cancer? Lack of screening. The most common signs and symptoms of early colon cancer are — nothing at all. That’s why we so strongly recommend screening for colorectal cancer.
Current guidelines recommend colorectal cancer screening for adults between the age of 50 and 75. This may start earlier for those at higher risk (family history of colorectal cancer, chronic inflammatory bowel disease, polyposis syndromes or patients of African-American descent).
After the age of 75, we recommend screening on an individual basis. There are a variety of recommended screening tests. The gold standard is the colonoscopy, which provides both screening and prevention. Not only can it detect early stage cancers, but also precancerous lesions called polyps, can be removed to potentially prevent a cancer from developing.
By Deb Song
I just want to thank everyone for the overwhelming response to part one of the video series on my cancer journey at Rush.
Testing and diagnosis have been key parts of this wild ride I am currently on.
Like most women, I dreaded the idea of having to take time out of my busy schedule to get a mammogram.
In my career as a media relations expert covering breast cancer stories, I have filmed many mammograms.
They looked uncomfortable and unpleasant.
The doctors and technicians are so nice and make such a huge effort to make it seem less scary, but let’s be real. Who wants to have their breasts examined and squished in a machine? Definitely not me.
So, when it was time for me to schedule my first mammogram, I wasn’t really up for it. I could have made every excuse to put it off or ignore it.
I had a good excuse, too! I just had an unrelated major surgery and was recovering from it. I had a huge abdominal scar that hurt and was still healing, and I had just started back at work. Did I really want to be back in the hospital for more tests and procedures? I just wasn’t in the mood to do it, and I didn’t want to take the time off to get a mammogram.
Jill Feldman with radiation oncologist Gaurav Marwaha, MD, left, and medical oncologist Philip Bonomi, MD.
By Jill Feldman
I have been fighting lung cancer indirectly, and now directly, for 36 years, and most of it has been an uphill battle. I lost my dad and two grandparents to lung cancer when I was 13, and then my mom and aunt, Dede, died of lung cancer when I was in my 20s. I was shocked and upset that in the 14 years between my dad being diagnosed with lung cancer and my mom being diagnosed, there was not a single advancement in lung cancer treatment, despite it being the No. 1 cancer killer. My family and I felt helpless and hopeless, and while there wasn’t any research on hereditary lung cancer, I knew our familial lung cancer wasn’t just a coincidence.
I did what I could to get educated, be an advocate for myself and my family and to help advance a cause that many were not aware of and/or not interested in. While doing so, in 2009, I was diagnosed with lung cancer at 39 years old. My kids were 6, 8, 10 and 12 — and their only association with the disease was death. They were scared, and my greatest fear was becoming a reality. I was following in my family’s footsteps, and there wasn’t any promising research that convinced me the path would change.
For many years, the only distinction doctors could make was whether a person had small cell or non-small cell lung cancer, and patients had three treatment options: surgery, radiation and chemotherapy. It wasn’t even until the 1990s that combination chemotherapy regimens were approved. Still, there was debate whether it was even worth treating lung cancer because in many cases, the toxicity was worse than the disease, and the benefits from chemotherapy were marginal.
Immunotherapies have changed how we treat the disease
By Philip Bonomi, MD
One of the things I learned early on in medical school is never to forget that it’s a privilege when a patient puts his or her trust in you to take care of them. I have never taken that privilege lightly. My goal has always been to prolong meaningful life and relieve suffering for my patients. That’s been my personal mission statement throughout my career.
And those goals are not always easy when it comes to treating lung cancer. When I started out in medicine, some of the treatments we tried for lung cancer were simply not effective. There were not a lot of options for our patients and often the prognosis was poor.
But through my long career, I have seen that perseverance, believing in an idea and not giving up on it can pay off.
Enter immunotherapies. When I was in medical school in the late 1960s, we had high hopes for immunotherapy. We thought it was going to be very important for treating patients with cancer. But then, we saw one failed study after another over the next few decades.
By Thurston Hatcher
So if you haven’t heard already, March is Colorectal Cancer Awareness Month. And if you have, you’ve probably also heard a few reminders that it’s time to get that colonoscopy you’ve been dreading.
As an employee of a health care institution, I consider it my professional obligation to inform you that I’ve had one, and it ain’t that bad. Want to hear more? Perhaps not, but I’ll tell you anyway.
Colonoscopies generally are recommended for people age 50 and older, since they account for more than 90 percent of colorectal cancer cases. The procedure, which involves running a thin, tubelike instrument through the colon, helps doctors spot precancerous polyps so they can be removed before they turn into cancer.
As it happens, I wasn’t quite 50 when I had mine, but I had a few minor symptoms that might fall into the “cause for concern” category. My primary care doctor and gastroenterologist weren’t particularly alarmed, but they wanted to play it safe, and they figured I was close enough to my golden years to experience this rite of passage.
Gina meets with medical oncologist Marta Batus, MD, and thoracic surgeon Christopher Seder, MD.
As a lifelong smoker, Gina knew the risks of smoking — but, like many people, she pushed these thoughts out of her mind.
“For years, my very dearest friend and I would sit on the phone together, have coffee and smoke cigarettes,” Gina remembers. “Then she was diagnosed with lung cancer and died from it. Even though I saw what she and her family went through, I was still in denial that anything could happen to me.”
Five years ago, at age 70, Gina got a wake-up call to start taking control of her health: She was diagnosed with breast cancer.
She had a mastectomy at Rush and was soon cancer-free. With a new lease on life, she began running, cut down to three cigarettes a day, and started listening to shamanic drum chants and doing positive-thinking exercises. She also continued her regular breast cancer follow-ups at Rush with medical oncologist Melody Cobleigh, MD, and nurse practitioner Teri Dougherty, NP.
Still, Gina’s smoking history and age put her at high risk for lung cancer. So at an appointment last summer, Dougherty talked to Gina about her risk factors and suggested that Gina was a good candidate for a lung cancer screening test — a low-dose CT scan that can detect lung cancer at its earliest stages, before symptoms arise and when it may be most curable.
Jill Feldman with Philip Bonomi, MD, a medical oncologist at Rush
Lung cancer specialists at Rush are among five worldwide recipients of the International Association for the Study of Lung Cancer’s inaugural Cancer Care Team Award. Jill Feldman, a patient at Rush, introduced them at a recent ceremony in Japan. Here’s her story:
When I was 13, I lost two of my grandparents to lung cancer, and six months later my dad died of lung cancer. Then in my 20s, both my mom and close aunt died of lung cancer.
Needless to say I was devastated and felt helpless, so I started doing advocacy work with LUNGevity Foundation, a national lung cancer organization. I also began getting scans every few years. All was good until 2009. I was 39 years old, had four small children and was president of LUNGevity, so there just aren’t words that can describe how I felt when I was diagnosed with lung cancer, the same disease that I literally watched kill both of my parents.
I have been in and out of treatment for the past 8 1/2 years. Lung cancer will be a lifelong roller coaster ride for me, but because of a better understanding of lung cancer biology, advancements in treatments, and my dedicated, passionate, collaborative care team, the cancer can be managed as a chronic disease, for now.