A Mother’s Battle With Advanced Colon Cancer

In the fall of 2003, Bridget Beranek, a 44-year-old wife and mother of two young girls, was gearing up for a busy holiday season filled with family functions, parties and shopping. So when she began to lose her appetite and energy, Bridget initially chalked it up to holiday stress.

When the New Year came and went, but Bridget’s symptoms were still present, she knew it was more than stress. After several visits to her primary care physician, Bridget saw an internist, and underwent a colonoscopy. In March 2004, she was diagnosed with stage IV colorectal cancer that had spread to her liver.

“I know it sounds cliché, but I couldn’t believe this was happening to me,” said Bridget. “Scheduling a colonoscopy was not a priority for me because I was under 50 and lived a healthy lifestyle. I ate right, didn’t drink or smoke, and went regularly for a mammogram. One thing I learned from this experience is that colon cancer is a disease more people, especially women, need to be better informed about.”

The American Cancer Society reports that colorectal cancer, commonly referred to as colon cancer, is the second-leading cause of cancer-related death in the United States, second only to lung cancer. It is also the third most common cancer diagnosed in both men and women.

Risk factors for colon cancer include a family or personal history of the disease, intestinal polyps or chronic inflammatory bowel disease, obesity, a high-fat diet, and being age 50 or older. Symptoms may include changes in bowel habits, abdominal discomfort, vomiting, fatigue, blood in the stool or unexplained weight loss, though many people are diagnosed without any symptoms.

The Centers for Disease Control and Prevention (CDC) recommends men and women over age 50 who have an average risk for colon cancer receive screening. Higher-risk patients, such as those with a family history of the disease, should talk with their physicians about when they should begin screening.

Fortunately for Bridget, a new treatment for metastatic colorectal cancer had just been approved by the FDA, only weeks before her diagnosis. Her oncologist decided to treat her with a combination of traditional chemotherapy and a targeted therapy called Avastin® (bevacizumab). Though she occasionally has side effects such as fatigue, Bridget’s cancer has responded to the treatment and she is doing well. She is thankful to be able to spend time with her husband and daughters, and to practice her favorite hobby, photography.

Typically, metastatic colorectal cancer patients undergo surgery followed by chemotherapy. Today’s targeted therapies, which are designed to attack cancer cells in a more specific way than chemotherapy, provide an additional tool for doctors to use in treating this disease. Avastin, for example, is an angiogenesis inhibitor, which means it interferes with the blood vessels that feed cancer tumors, to help prevent tumors from growing and spreading to other parts of the body. Avastin is approved for use in combination with intravenous 5-fluorouracil-based chemotherapy for first-line treatment of patients with metastatic colorectal cancer.

It is important to keep in mind that Avastin has been associated with side effects in colorectal cancer. Serious side effects occur rarely, but can include gastrointestinal perforation and slow or incomplete wound healing and blood clot complications. Other more common side effects seen in clinical trials include nosebleeds, high blood pressure, proteinuria (too much protein in the urine, which may be a sign of kidney damage), weakness, pain, diarrhea, and a reduced white blood cell count.

Because everyone is different, it is not possible to predict what side effects an individual may experience. If you have questions about side effects or treatment with Avastin, talk to your doctor or another member of the health-care team.

Testing For Inherited Colon Cancer

Inherited colon cancer is an issue that both men and women need to be concerned about. Since this type of cancer is part of the DNA coding there is nothing you can do prevent the fact that you may have it. However, you can get tested for inherited colon cancer and therefore your doctor can help you prevent it from affecting your lifestyle.

Even though inherited colon cancer is still a major ailment in or society, the number of deaths from it continue to drop due to various types of testing that have been implemented over the past 15 years. Early screenings at annual check ups can identify any development of polyps. The removal of them will prevent colon cancer from starting and from spreading.

Once polyps have been discovered on an individual, they will be scheduled for regular follow up appointments. These may be every three months, six months, or annually depending on the family history of inherited colon cancer and the amount of polyps that were discovered. Those with high cholesterol are also at a greater risk of inherited colon cancer. Getting tested for that can help to detect factors that can be controlled as everyone can choose to reduce the amount of fatty foods they consume.

Testing for diabetes is common for those with inherited colon cancer as well. Statistics show that individuals with diabetes are 1/3 more likely to be diagnosed with inherited colon cancer. Effective treatment of their diabetes can help to offset the development of the colon cancer.

There are different types of screenings that a person can have completed in order to be tested for inherited colon cancer. A fecal blood test can be done annually when the individual goes in for a regular check up. There is a flexible sigmoidoscopy that can be conducted every five years. A full colonoscopy only has to be done once every ten years. Your doctor can tell you what tests they recommend you engage in based on your family history, your current health issues, and your age.

Inherited colon cancer is an issue you really need to be concerned with it there is any family history of it at all. It is ranked as the third highest form of cancer diagnosed in the United States. It is the second largest cause of cancer related deaths in the United States as well. While it does affect slightly more males than females both sexes need to be aware of their family history. If this isn’t possible then early testing should be part of preventative measures.

More than one million people in the United States have been diagnosed with inherited colon cancer and are survivors. Due to the progressing of testing for it and aggressive treatment options early diagnosis definitely has contributed to their ability to beat the odds. It can take up to ten years from the first signs of inherited colon cancer being recognized to a person developing incurable cancer that will spread and result in their death.

‘Buddy Bracelet’ Spreads Awareness of Colorectal Cancer

Colorectal cancer is 90 percent preventable and 90 percent treatable when detected early, yet it continues to be the second leading cause of cancer-related death in the United States.

To help spread the message about the importance of early detection, the Cancer Research and Prevention Foundation and its 54 partners have joined together to celebrate National Colorectal Cancer Awareness Month by introducing the “Buddy Bracelet,” a unique and powerful way to promote public awareness of the disease.

“Today, in a sea of colored bracelets, the blue Buddy Bracelet stands out by creating a clever way for people to take their health into their own hands,” said Carolyn Aldigé, president and founder of the Cancer Research and Prevention Foundation. “The bracelet spreads the message that colorectal cancer is preventable, treatable and beatable.”

Launched in 2004 to celebrate National Colorectal Cancer Awareness Month, the Buddy Bracelet reminds those who wear it to get screened for colorectal cancer. After the person is screened, he or she gives the bracelet to a family member, friend or colleague, passing on the powerful message about talking with a health care professional about colorectal cancer. The bracelet then is transferred from that person to another person and so on.

The bracelet’s theme, “Wear it, share it, because you care,” is a message that could save thousands of lives.

People at average risk for

colorectal cancer should get screened starting at age 50. Younger people can help support the Buddy Bracelet effort by learning about their families’ medical histories, starting a dialogue about colorectal cancer with their health care professionals and reminding loved ones to get screened.

Caregivers Play Key Role in Disease Management of Older Colon Cancer Patients

Colon cancer patients who are 65 and older may benefit from a caregiver’s involvement, and caregivers may ultimately have a major impact on patients’ disease management, according to a survey of oncologists commissioned by the Alliance for Aging Research.

Ninety percent of oncologists feel that caregivers have a moderate to major impact on the decision-making process. Unfortunately, only about 64 percent of colon cancer patients in this age group have caregivers’ support.

“Physicians should encourage patients to enlist a caregiver and involve them in the treatment decision-making process,” said Dr. Stuart Lichtman, associate attending physician at the Memorial Sloan-Kettering Cancer Center.

More than half of oncologists who agree that colon cancer patients 65 and older have a more difficult time managing their disease than younger patients also agree that these patients are generally less proactive about researching available treatment options. Seventy-seven percent said that such patients experienced better disease outcomes with a caregiver’s involvement due to increased communication. Additionally, caregivers play an important role in providing emotional support, participating in doctors’ visits and in decisions about disease management options and providing transportation to appointments.

“It is clear that caregivers are key to ensuring that colon cancer patients 65 and older receive the best care,” said Daniel Perry, executive director of Alliance for Aging Research. “Since managing colon cancer can be a complicated and confusing process especially for the aging population, a caregiver, whether a spouse, child, friend or neighbor, should be actively involved.”

“Crossing Jordan” star Miguel Ferrer, who lost his father, José Ferrer, to colon cancer, is partnering with the Alliance for Aging Research in a program called “Caring for the Aging,” to educate colon cancer patients and caregivers about the importance of active involvement in the treatment of the disease. This awareness program is sponsored by sanofi-aventis.

“The involvement of my stepmother helped ease my father’s decision-making process as he went down a difficult path,” Ferrer said. “I encourage all caregivers and family members to become actively involved and ask the right questions to ensure the best possible outcomes for their loved one.”

Eliminating Barriers To Colon Cancer Screening

There is good news for those concerned about colon cancer. Physicians know that colon cancer screening saves lives. Yet an estimated 148,000 Americans, both women and men, are diagnosed with colorectal cancer each year, and every year approximately 55,000 will die-the nation’s second deadliest cancer. Yet, it’s believed most of these deaths could be prevented through proper screening.

However, experts from the American College of Gastroenterology (ACG) warn that too few Americans are getting screened. Colorectal screening rates remain very low, even though Medicare and many private plans pay for screening tests.

Despite increasing public awareness of colon cancer screening tests through the efforts of Katie Couric and others, many people continue to face obstacles to screening. Even Medicare beneficiaries, for whom incidence and death from the disease are highest, encounter problems with access to screening colonoscopy.

Congress Can Help

“Pending legislation in the U.S. Congress, such as the Colon Cancer Screen for Life Act (S.1010/ H.R. 1632), promises to remove Medicare’s barriers to screening,” says ACG President Dr. Jack A. DiPalma of Mobile, Alabama. “But only one small improvement, the waiver of the Medicare deductible, was approved for 2006, so much remains to be done.”

Research indicates that colon cancer arises from precancerous growths or polyps that grow in the colon. When detected early, these growths or polyps can be removed, actually preventing the development of colon cancer.

“With improved use of colon cancer screening, we can save lives,” adds Dr. DiPalma.

The College currently recommends colonoscopy every 10 years beginning at age 50 for average-risk individuals as the preferred screening strategy to prevent colon cancer.

For patients with higher risk factors such as a family history of colon cancer or a previous personal history of polyps, and for African Americans, ACG recommends earlier and/or more frequent screening with colonoscopy.

New At-Home Test Aids In Cancer Screening

There’s encouraging news for the millions of Americans at risk for colon cancer. A new, easy-to-use fecal occult blood test (FOBT) is available for at-home screening and is designed specifically to detect colon cancer at its earliest stages.

Hemoccult ICT is a new, safe and affordable FOBT screening option for colon cancer-the second leading cause of cancer-related death in the United States. Despite its high incidence, colon cancer is a highly treatable cancer, with a 90 percent survival rate when detected early. Unfortunately, only half of the more than 80 million Americans over age 50 have been screened for colon cancer.

The American Cancer Society recommends annual screening with a FOBT for both men and women beginning at age 50. Annual colon cancer screening with FOBT has been proven to decrease mortality by 33 percent when compared with no screening. Because colon cancer can take three to 10 years or longer to develop in the average patient, it is important to begin screening prior to developing symptoms.

FOBT vs. Colonoscopy

For years colonoscopy has been the most well-known test in colon cancer screening. While widely regarded as the gold standard, colonoscopy does have some drawbacks:

• Colonoscopy costs between $300 and $1,000, and while covered by insurance for many, millions of Americans lack health insurance.

• Standard colonoscopy can be overwhelming for some people due to the fact that the procedure is usually done under sedation, and because patients are required to follow a special diet and take a very strong laxative before the exam.

• Due to a limited number of trained professionals and the equipment needed to perform the tests, the maximum number of colonoscopies that can be performed in the United States each year can accommodate only a quarter of the Americans in need of screening.

Unlike other available FOBTs, the new Hemoccult ICT has no drug or dietary restrictions-allowing people to begin testing at their convenience. If a test comes back positive, a follow-up colonoscopy typically is recommended.