Archive for March 18th, 2010

What is Colorectal Cancer?

Thursday, March 18th, 2010

Colorectal cancer (CRC) is the second leading cause of cancer mortality in North America, next to lung cancer. An estimated 6% of Canadians will develop CRC, half of whom will be asymptomatic until advanced stages of the disease emerge. CRC generally develops from benign adenomas, called polyps, which physicians can easily detect and remove during colonoscopy. It could take a polyp ten to fifteen years to develop into cancer. Screening for polyps and removing them during a colonoscopy can dramatically improve patient health outcomes, because when detected in its early stages, colorectal cancer is easily treated. Physicians diagnose close to 19,200 patients with CRC each year in Canada, and 8,400 will die from the disease.

Unfortunately, only 1 in 5 Canadians undergo the important screening process. The prospect of colonoscopy may be daunting to patients who recall “horror stories” of painful colonoscopies from a previous era, when equipment was larger and less flexible, and some are simply too embarrassed to think or talk about bowel related issues. Thankfully, modern technology has made colonoscopy a vastly more comfortable procedure to undergo, and it is now more socially acceptable to discuss medical issues such as bowel habits than in the past.

How is CRC detected?

Screening is a term that describes when doctors perform regular tests or examinations in people who do not have any signs of a disease. These individuals may be more likely to develop a disease because they have high risk factors. There is much debate over the extent to which screening of the general population for polyps or CRC needs to take place, and by what means.

In Canada, there are a number of screening tools available for your doctor to use to determine if you are progressing toward CRC. Researchers continue to find ways of detecting and predicting CRC that include studying a patient’s DNA for known genetic markers that place them at a higher risk of developing CRC. Some of the more common current tests are shown below along with the recommended interval for these tests to occur (shown in brackets) for all individuals over age 50 with no family history of CRC. Those with higher risk factors require screening that is more frequent.

Colonoscopy
During this procedure, a doctor inserts a thin flexible tube with a tiny camera into the colon through the rectum. The procedure usually takes place in an outpatient clinic, often located within a hospital. As with the sigmoidoscopy, while viewing the surface of the lining of the entire colon, the physician may take a small amount of tissue (biopsy) of specific areas that will later be examined in a laboratory or they may remove entire polyps on the spot. Light sedation makes the procedure more comfortable for the patient. (Every ten years)

Which Test Is For Me?

Of these common tests, colonoscopy is the most accurate means of detecting polyps or CRC and allows for the immediate removal of most polyps. Patients may choose to watch on a video screen. The procedure usually takes ten to twenty minutes. Recovery is quick and usually pain-free.

For IBD patients and others at high risk, a colonoscopy provides the greatest reassurance that his or her colon is free of cancer. Other tests to screen for CRC are less reliable but may be acceptable for those not considered to be at high risk. The intervals for the screening tests mentioned above are more frequent when there is greater risk. Your doctor will determine the appropriate interval for you.

Our American neighbours are encouraged by health policy makers to undergo colonoscopy regardless of their individual likelihood of developing CRC, but Canadian policy toward average risk patients is ambivalent, probably because we lack the capacity to perform the requisite number of colonoscopies. However, for individuals who have an above average risk of developing CRC, doctors recommend colonoscopy screening. Of course, individuals who notice blood in their stools or who have other bowel related symptoms should immediately report these to their physician.

Who Should Be Screened?

The Canadian Association of Gastroenterology and the Canadian Digestive Health Foundation Guidelines on Colon Cancer Screening recommend that:

  • People with chronic IBD (colonic Crohn’s disease or ulcerative colitis) should be screened every 1 to 2 years, once they have had the disease for 8 to 10 years.
  • Those with a first-degree relative with CRC (parent or sibling) diagnosed before age 60, or with multiple affected relatives, should be screened once every 5 years. The first screening should take place 10 years
  • Before the relative’s age of diagnosis or at age 40, whichever comes first.
  • Individuals with three or more affected relatives, or with a first degree relative affected before age 40, should be considered for genetic counselling and possibly genetic testing for specific hereditary diseases which dramatically increase the CRC risk and which may require much more intensive screening.
  • People with no risk factors should be considered for some form of screening beginning at age 50; this may be colonoscopy every 10 years, fecal occult blood testing every 1-2 years, or other options that may be discussed with their physician.
  • Remember, colonoscopy in expert hands is generally not painful. In fact, most patients report that the most unpleasant part of the procedure is the preparation. However, while it is true that the side effects of some preparation medications can be unpleasant, a newer product available might suit your tastes better.

UPDATE PART 1 AND THE SAGA CONTINUES

Thursday, March 18th, 2010

Diagnosis plus 3 months & 4 days

LOG ON TO RELAY FOR LIFE CANCER SITE , SEARCH FOR “EARTH ANGELS 1” AND SEE HOW WELL WE ARE DOING

March 17, 2010
Well, I am currently in chemo #4, of 12 treatments it is day 2 of 3, Nurse Vanessa is coming to the house to disconnect my (chemo to go) is what I have nick-named it. So far, very little side effects which I am so grateful for.

I travel to London every other Tues to get chemo treatments. This will go on for 6 more months and at that time I will be re-assessed to see what happens from that point, whether it be more chemo or radiation or whatever? I am in a chemo chair ( I call it my Lazy-Girl chair ) and get hooked up to the I.V pole (I call him Slim Jim) for approx. 4 hours with a few drug cocktails. First in line is the anti-nausea stuff, followed by a few other drugs. Once they have flowed through me, the nurse will connect the final drug that is hooked up to my chest through the port-a-catheter that is inside my chest above my right breast. It is no longer painful when they poke me with the needle to set things up. The final drug is on a continuous feed through a pump that looks much like a large baby bottle. This drug will feed into me for another 46 hours but the nice part is that this is all done at home and I just carry around the pump/bottle in a fanny pack and carry on life as usual. This is why I call it “chemo to go”. I make the nurses laugh with my nicknames, but I find it much easier to make others laugh and keep things light, it makes me feel better too.

The cancer clinic is kind of like a factory, I had no idea how many people are affected and fighting. It’s sad to say I am just another number in this unlucky lottery. Fuck cancer, is all I can say. (sorry if I offend anyone but I am pissed off.)

I truly think that all the boosts that my friends and family and strangers have given me since my diagnosis, is doing the trick. I am not one to worry, but I have to admit that before chemo started on Feb 2, I had some pretty long nights thinking the worst case scenario which included being above a toilet and being sick in bed for 6 months. Now I know that was totally unnecessary, I have been very, very lucky.

I am getting around as I normally do, maybe a bit slower because I do get tired/weak at times but not too often, only when I over-exert myself. I am my own worst enemy. I only get nauseas on chemo days and my appetite is normal. I have pretty much given up on junk food, but do indulge from time to time. I am eating healthy food choices and even gave up pop and coffee. I still crave this daily, but I am told it’s not good for me, so I listen.

I know everyone is curious and worried how I feel. Here is the scoop:

  • sore scalp, feels like I’m wearing a pony tail too tight
  • red faced only on chemo days
  • voice gets strange like a sore throat
  • saying things backwards (chemo brain)
  • poor concentration
  • my hair is thinning daily, but not coming out in chunks, the doc says I shouldn’t go bald, just thin out (Rick & I have a wig picked out that we both like plus I can borrow all of C.J.’s bandanas (our dog’s) if this becomes a necessity.

That’s pretty much it for side effects, nothing I can’t handle, and I am actually quite grateful that they are very minor. Nice trade off for mouth sores, diarrhea, etc, which I am supposed to get, but it hasn’t happened yet, so I am going to keep doing what I have been doing and keep that nasty stuff at bay.

The Cancer Society office here in Chatham asked me to be a model in their upcoming “Celebrate Life Fashion Show” fundraiser. I graciously accepted, although I am honestly very, very nervous. I am only good at dog-walks, not the cat-walk. I don’t like being the center of attention, but it’s for a great cause, and it brings awareness in the spotlight so I am going to “put my big girl panties” on and do it. If you are interested in attending the event, tickets are $35 each. It’s held a Club Lentinas in Chatham, with food, silent auction, etc. I am told it is a feel good night. Just what we all need. Just let me know if you wish to attend so I can reserve seats ahead of time. Event date is Wed: April 21

The “Relay for Life” has become my new job. My “Earth Angels” teams are doing very well. Since I have some many people that have stepped up to help fundraise and walk the 12 hour relay that the cancer Society has split the team up to 10 people per team so now we have EARTH ANGELS 1 , 2 , 3 , 4 and now EARTH ANGELS 5, FIVE TEAMS AND COUNTING NICE. I am so very, very honoured by so many of my family and friends that have joined the team. It’s not too late if you want to join as the event isn’t until June, call or email me if you are interested. I am here to assist, just say so. It’s been a nice distraction for me and keeps me positive and motivated. I can’t wait until that night when my Earth Angels are all with me. I don’t know if I will be around for next year’s relay so I am making the absolute best of this year. I am so excited !

I will write soon to provide another update.

Just want to thank each and everyone of you for caring, for your support and love, etc. You are what keeps me wanting to fight and I don’t plan on giving up any time soon.

Very special thank you to Rick (my Rock), for surprising me with my very own web site to keep in touch with all of you. I love you and appreciate you more than you can ever, ever know.

Much love to each & everyone of you reading this, be good to those you love and make sure they know it.

Hugs, Karrie