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.