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Colon Cancer, A Silent Killer

Screening is key for women and men

July 29, 2008
By Rodrigo B. Erlich, MD

 
 

In 2002, Susan Cohan Kasdas was 42 and the mother of two elementary school children when she found out she had advanced-stage colon cancer. The beautiful, dynamic blonde had told her family back in Baltimore that she had been having stomach pains, but her doctors in Florida told her not to worry. It was nothing.

It was not nothing. The pain got so bad that Susan checked herself into the hospital, where a large tumor was found in her colon. She called her father, hysterical, saying she had only a few months to live.

Susan lived for two more years, through multiple rounds of chemotherapy and several operations. I was one of her doctors. She flew to Baltimore for treatment but tried to spend as much time at home in Florida as possible. Her family took care of her to the end.

That Susan died so young is a tragedy. Her death is especially tragic because colon cancer is 90 percent preventable with proper screening. The most common symptom is no symptom at all. By the time Susie started having symptoms, she was very, very sick.

Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in men and in women in the United States. The American Cancer Society estimated that about 112,340 new cases of colon cancer (55,290 men and 57,050 women) and 41,420 cases of rectal cancer (23,840 men and 17,580 women) would be diagnosed in 2007.

Colorectal cancer is the second-leading cause of cancer-related deaths in the U.S. and is expected to have caused 52,180 deaths (26,000 men and 26,180 women) in 2007. Breast cancer kills approximately 40,000 American women each year.

Some more statistics — very important ones: Less than 40 percent of people who should be screened have been. And more than one-third of colorectal cancer deaths could be prevented if people over 50 had regular screening tests.

Who should be screened? The American Cancer Society recommends that Caucasian men and women be screened regularly for colon cancer beginning at age 50. African-Americans should be screened regularly after age 45. Death rates from colorectal cancer are about 30 percent higher in African-Americans than in Caucasians.

People should talk to their doctor about starting colorectal screening earlier and/or more often if they have any of these RISK FACTORS:

  • A personal history of colorectal cancer or adenomatous polyps.
  • A strong family history of colorectal cancer or polyps in a first-degree relative younger than 60 or in two first-degree relatives of any age.
  • A personal history of chronic inflammatory bowel disease.
  • A family history of a hereditary colorectal cancer syndrome.

What are the screening options? The American Cancer Society recommends that both men and women follow one of these FIVE TESTING SCHEDULES:

  • Yearly fecal occult blood test (FOBT) or fecal immunochemical test (FIT).
  • Flexible sigmoidoscopy every five years.
  • Yearly FOBT or FIT, plus flexible sigmoidoscopy every five years.
  • Double-contrast barium enema every five years.
  • Colonoscopy every 10 years.
  • All positive tests should be followed up with colonoscopy.

Susan Cohan Kasdas vowed to educate others about colon cancer. She insisted that her brother and two sisters be tested and, sure enough, her sisters’ tests revealed precancerous polyps, which were removed. She could very well have saved their lives.

After Susan’s death, her family established the Susan Cohan Kasdas Colon Cancer Foundation. Known as Susie’s Cause, the Baltimore-based nonprofit strives to eliminate colon cancer as a life-threatening disease through educational programs focused on prevention, early screening and detection, as well as aggressive therapeutic intervention.

The foundation has established the Save Our Parents Program, an interactive mini-medical school designed to educate high school and college students about colorectal cancer, with the idea that they will in turn teach their parents about the benefits of early screening and healthy diet and lifestyle choices.

There is some good news. Recent statistics show that the number of Americans who died of cancer has dropped since 2003. The biggest drop was in colorectal cancer.

Be smart: Get screened. Remember, colon cancer can be cured when it is caught early.

Visit the Susie’s Cause website at www.coloncancerfoundation.org.

RODRIGO B. ERLICH, MD, is the director of the Solid Tumor Program at the Alvin and Lois Lapidus Cancer Institute at Sinai Hospital. He is also the director of the GI Cancer Multidisciplinary Clinic at Sinai Cancer Institute.

 
 
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