Murrell and Kay in 2010, when she was first diagnosed. (courtesy Cedars-Sinai)
After three of her family members died from colon cancer, one California woman pushed to have herself screened early— which may have saved her life. Now, in honor of Colon Cancer Awareness Month, she and her doctor are working to remind people of the importance of early detection of the third-leading cause of death in the U.S.
Gena Kay, 47, lost her father at age 50, her paternal aunt at 56, and her grandfather all to colon cancer. Her paternal uncle also received a diagnosis, but it came early enough that he was able to beat the disease. While the designated age for a colonoscopy is 50, due to her family’s history, Kay pushed to be screened earlier and underwent her first test at age 42, even though she didn’t have symptoms.
“Honestly I thought I was being proactive and get a pat on the back, but I wasn’t expecting [a diagnosis] at all,” Kay, who lives in North Hollywood, Calif., told FoxNews.com. “The good thing about a colonscopy is that it can catch it before it has gotten to where it’s hopeless.”
The colonoscopy revealed that Kay had a polyp with stage 1 colon cancer. Doctors removed the tumor, along with about a 12 inches of her colon, and she was cleared of the disease without requiring chemotherapy.
Polyps are typically removed during a colonoscopy, but in rare occasions surgery is required for larger polyps, which run a 30 to 40 percent risk of becoming cancer, Dr. Zuri Murrell, Kay’s doctor, a colon and rectal surgeon and director of the Colorectal Cancer Center at the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, told FoxNews.com. If cancer forms, it can drain into the lymph nodes, through which it can spread to other parts of the body. In a colon resection operation, surgeons must remove an adequate amount of lymph nodes from the surrounding area to prevent it from spreading. Kay had 20 of her lymph nodes removed.
According to the American Cancer Society, colorectal cancer—cancer that starts in the colon or rectum— is the third leading cause of cancer-related deaths in the U.S. when men and women are considered separately, and the second leading cause when both sexes are combined. An estimated 93,090 new cases of colon cancer and 39,610 new cases of rectal cancer will be diagnosed in 2015; colorectal is expected to cause about 49,700 deaths during 2015.
On Thursday, the National Colorectal Cancer Roundtable announced its initiative to increase screening rates to 80 percent by 2018, which according to their estimates would prevent an additional 21,000 colorectal cancer deaths per year by 2030.
A preventable outcome
Colon cancer is unique because it’s only one of two cancers that have tests that prevent it from occurring: a pap smear detects changes in cervical fluid and a colonoscopy can find and remove polyps before they become cancer.
While at-home stool sample tests are becoming more and more popular, Murrell recommends going for a colonoscopy as the best way to check for polyps.
One thing that makes colon cancer especially dangerous is that the symptoms can be hard to notice. The most common symptom of colon cancer is nonspecific abdominal pain and/or a change in bowel habits. If you normally have a certain number of bowel movements a day, and that changes, be aware of that, Murrell said.
“You are your own best advocate,” he said. “What happened with Gena, having her family history, even though she didn’t have symptoms, she persisted and persisted to get her colonoscopy.”
Surprisingly, hereditary colon cancer is rare, Murrell said. Experts aren’t sure exactly why it skips certain people, as it has with Kay’s relatives in her generation, but researchers are studying how different genes and pathways affect inheritance.
In the first two years after her diagnosis, Kay was screened annually. Now, she goes once every three years and if tests continue to show no polyps, will only be required to be tested once every five years.
The dangers of a late diagnosis
Proactive screening with colon cancer is especially important because it can spread to the liver and lungs, and patients are still able to have a long quality of life with surgery or chemotherapy— unlike other diagnoses, such as pancreatic cancer.
“It’s weird because doesn’t that seem incongruous, that it’s the number two cancer death? People don’t discover it until it’s really, really late and they aren’t getting screened,” Murrell said. When colon cancer is found in later stages after metastasizing to multiple organs, it’s too late, he said.
For young patients ages 40 to 50, like Kay, a colon cancer diagnosis is both a gift and a curse because while they have cancer, their young age helps in their ability to fight it and tolerate chemotherapy and surgery.
“[Patients] try to give up, but with this there is actually a reason to be hopeful,” Murrell said.
Getting over the fear
The number one factor that prevents individuals from going through a colonoscopy isn’t the process itself— during which patients are given a sedative— it’s the preparation the day before that requires cleaning out the bowels. Traditionally, the chemical concoctions prescribed taste unpleasant, but Murrell has his patients use a mix of Miralax and Gatorade.
“I always tell individuals and my own patients, you never want to die from fear and you never want to die from embarrassment,” he said. “It still angers me that this is the number two killer of men and women because it’s really preventable in terms of diet and in terms of getting appropriate screening. It shouldn’t be this way.”
Murrell emphasized the need for patients to be their own advocates. If you’re not getting what you feel like you need, don’t push your doctor around, but educate yourself; if you have a colonoscopy and they find a polyp, tell your family and children about it, he said.
“I try to get patients to talk about [colorectal cancer] around the dinner table. In the 1980s, breast was a ‘bad’ word and now there’s such a big push to talk about it,” he said.
“So many people do have in mind that it’s just an older person problem or for people who have terrible health habits, but that’s not necessarily the case and it’s kind of a good thing that it happened to me in that it might help others be aware and not be scared of having a colonoscopy,” Kay said. “It’s not fun and games but you don’t even know about the procedure when it’s happening.”
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