Colorectal Cancer: Catch It Early! Get Screened!

It was 2003 and Laura Porter’s second year of pediatric residency at Howard University in Washington, D.C., when she noticed something just wasn’t right. Sure she was overworked, tired, pale and pained, but after seeking diagnoses from Howard’s doctors, the 43-year-old was repeatedly told she was anemic.

And although Porter had a history of an upper gastrointestinal bleed, the blood in her stool made her think anemia was not it.

“I knew something was wrong, but I didn’t want to think it was cancer,” Porter said.

“I think women are ignored when they have symptoms,” she said. “Not only do the doctors dismiss them, but (the patients) dismiss the symptoms themselves.”By August, she found herself at Washington Adventist for a colonoscopy after some persuading by her partner. Within two days she was being prepped for surgery for stage four colon cancer.

Most colorectal cancers begin with the forming of polyps or grape-sized growths on the lining of the colon or rectum. Normally the polyps are benign, but later can develop into cancerous growths, making routine checks vital to detect the development of polyps when there are no present symptoms.

The colon and rectum both play integral functions in allowing the body to dispose of waste. They are part of the large intestine in the digestive tract. The colon absorbs the liquid form of food that has been broken down and passes the remains into the colon as waste so it can be removed from the body. Once the polyps have become cancerous, symptoms can include feeling constantly tired, vomiting, weight loss and blood in solid waste.

Although colon cancer has a higher mortality rate than breast and prostate cancer, about 90 percent of colon cancer deaths are believed to be preventable with routine checkups, according to the Cancer Research and Prevention Foundation.  Regular screenings  help prevent colorectal cancer from developing, by catching any abnormalities in the colon or rectum.

The cancer had penetrated the wall of Porter’s colon, wrapped itself around multiple lymph nodes and tapped her liver as its next landing place.

“They took it seriously when my stool was the color of bricks,” Porter said. “My doctor had tears in his eyes; he said ‘I’m so sorry I should have known.’ Nobody thought of it and maybe that’s because they were all too close to it.”

Rounds of chemotherapy followed in 2004 along with surgery to remove thymus tissue  in her chest.

It was around this time that Porter said she decided to stop avoiding people with cancer and attend a Colon Cancer Alliance  (CCA) meeting.

“I think my reluctance was kind of denial,” she said. “I didn’t want anything to do with people with cancer. I read all the MD Web sites and information and it said I was going to die, that I had a 30-percent chance of survival. They talked about prolonging your life but that wasn’t good enough for me.”

After attending a meeting, Porter said she gained a new perspective.

“It wasn’t until I got involved in the Colon Cancer Alliance and saw, ‘My God there are people younger than me and they have hope,” she said, adding that attendees range from newly diagnosed patients to survivors. “My involvement with them and the conference and everything gave me the hope, the hope I thought I had, but was lacking.”

The outlook proved vital the following year when doctors found a cancer spot on Porter’s liver in January and went in for surgery in June. After treatments the biopsy of the liver came out normal, but cancer had spread to Porter’s right ovary and both were removed.

In August, the 46-year-old decided to stop treatments early because of the side effects.

“For me it’s a matter of quality of life,” Porter said. “I don’t want to sacrifice quality of life for quantity of life. I was taking so many different drugs for nausea I was stoned half the time.”

And although physicians don’t use the word remission, Porter has been recovering long enough to start entertaining the idea of pursuing a career in medicine. Until then she said she will continue to work with CCA by participating in their online chat sessions and translating medical information to consumer terms on their Web site, so younger people will be aware of colon cancer.

Currently, it is recommended that they begin regular screenings as a person nears the age of 50. However, for minority groups, it is recommended that screenings begin at age 45 because colorectal cancers, cancers of the colon or rectum, have been caught in the later stages in African-Americans and Hispanics at younger ages. They are also the second most common cause of cancer-related death in both men and women, after lung cancer.

Regular exercise, a diet laden with fruits and vegetables and maintaining a healthy weight can help decrease a person’s risk of developing colorectal cancer, which increases with age.

But even as a survivor, Porter said it is difficult to get people to be proactive and talk about their colons and rectums when they think of themselves as healthy.

Similar obstacles have also proven to be a factor for the Cancer and Research Prevention Foundation  (CRPF), which is touring the super colon around the nation and enacting new ways to develop region-specific action plans.

“There’s a great disparity in the American Indian/Alaska native community, especially around colorectal cancer,” said Jasmine Greenamyer, Director of Colorectal Cancer Initiatives. “Most native communities have worked on diabetes but cancer, especially colorectal cancer, has not been talked about.”

To combat the disparity, a working meeting has been funded for May by the Center for Disease Control and Prevention (CDC).

CRPF is also in the second year of a pilot program that bundles prevention once a month at the Spanish Catholic Center in Northwest Washington, D.C.
The screenings take about two hours to complete, covering topics such as colon, cervical and breast cancers and diabetes. Attendance has yet to be overwhelming, according to Erica Childs, assistant director of evaluation and outreach, but they plan to continue advertising for the free services.

“I think the general public is not aware of when they should get screened,” Childs said. “They’re reluctant because of the screening method and what it entails. But the demonstration is a way for the underserved community to come out and get screenings along with other tests.”

 

U.S. Department of Health and Human Services Office of Minority Health
By Fia Curley