March 09, 2007
Colon cancer survivor to promote awareness
DAVENPORT, IOWA - Judy Koehler was diligent about breast cancer screening. She had close friends and relatives with breast cancer. She was informed about breast cancer and understood the importance of mammography.
She made sure she got her mammogram on time each year, and she supported the Komen Quad Cities Race for the Cure.®
“I thought for sure that if I was ever going to have cancer, it would be breast cancer,’’ she said.
At age 50, a doctor suggested that it was time she had a colonoscopy. However, she had no family history and no symptoms of colon cancer. Her friends had not struggled with colon cancer. “I was so focused on preventing breast cancer that I just put off the colonoscopy,’’ she said.
Symptoms appear
Subconsciously, Koehler knew the value of routine screening tests and that she should undergo a colonoscopy, but instead she ignored her physician’s suggestion to have the test. What she couldn’t ignore however was one of the symptoms of colorectal cancer.
“I was going on vacation and had one of the symptoms and when I got back I had the colonoscopy,’’ she said.
Koehler was diagnosed with early-stage colon cancer. She had another colonoscopy in September 2005, surgery a month later and has since had rounds of chemotherapy and radiation at the Genesis Cancer Center and another surgical procedure at Genesis.
While she is now cancer-free, she wishes she had listened to her doctor earlier.
“I didn’t take colon cancer seriously enough. My best advice would be that if your doctors suggest you need to have a colonoscopy, get the colonoscopy,’’ said
Koehler, who is back at work full time in the Community and Economic Development office of the City of Davenport. “Most people who put off the procedure the way I did are not as lucky.’’
Koehler’s story is not uncommon. Too many people put off colonoscopies until they already have malignant polyps growing in their colon.
The National Cancer Institute estimates there will be 152,000 new cases of colon and rectal cancer in 2007. An estimated 52,180 will die of colon or rectal cancer.
During National Colorectal Cancer Awareness Month, Koehler is sharing her story of survival with City of Davenport employees. She and co-worker, Susanne Knutsen, have organized a blue star pin fundraiser, with proceeds going to the Genesis Cancer Center to be used to provide free fecal occult blood screening kits. City of Davenport employees who pay $5 for a blue star pin will be allowed to wear jeans to work on Friday, March 23.
The blue star, introduced in 2004, represents the memory of people whose lives were lost to colorectal cancer and has become a symbol of hope for a future free of colon cancer.
Polyps removed during colonoscopy
Screening and colonoscopy are the most effective ways to prevent colon cancer from developing. Most cases of the disease begin as non-cancerous polyps, which are growths on the lining of the colon and rectum. These polyps can become cancerous.
The polyps are removed during a colonoscopy. Approximately 90 percent of colorectal cancers and deaths are thought to be preventable.
“Colonoscopy utilizes a colonoscope, which is a thin, flexible maneuverable tube that has a video camera on its tip,” said Erling Larson III, M.D., Gastroenterology Associates. “We can use that instrument to examine and carefully inspect the lining of the colon, which is the large intestine. What we’re looking for are polyps, the precursor to most cases of colon cancer. Over time, polyps grow bigger, change character and become cancerous. So if we find those polyps and remove them, we’re not giving them a chance to become cancerous.”
In general, that growth — from small polyp to large polyp to cancer — takes years. If there are no risk factors other than age, experts currently recommend a routine colonoscopy every 10 years beginning at age 50.
“If a polyp is discovered, or there are other risk factors like a family history of polyps or cancer or other underlying diseases like colitis, then the frequency of follow-up needs to be more often,” Dr. Larson said. “Typically then, we would look at every 3-5 years.”
In most cases, it’s a lifestyle-related or genetic component that increases a person’s risk, he added. “Age, family history and high-fat and low-fiber diets are risk factors for polyps and cancer,” Dr. Larson said.
Free screening kit
Residents 50 years old or older, or those with other factors associated with an increased risk of colon cancer, are encouraged to pick up a free colon cancer testing kit in the Quad Cities during National Colorectal Cancer Awareness Month.
The kits are a screening tool, but are not considered to be an alternative to the much more accurate colonoscopy.
“We use the fecal occult blood test to check for hidden blood in the stool,” Dr. Larson said. “The test is very helpful when they’re positive. It indicates that something is likely bleeding within the intestinal tract and then we can go look for the cause. Sometimes that cause is a serious problem like colon cancer, so when the card is positive, we know we need to investigate.”
However, a negative test should not give people false assurance. Even serious problems in the colon don’t always cause bleeding.
“By all means, if there is a positive result from a fecal occult kit, the person should schedule an appointment with their physician,’’ Dr. Larson said. “But a negative result does not mean that a person should feel so confident that he or she puts off having a colonoscopy.
“Our concern is a false-negative test that causes someone to put off the more accurate colonoscopy.” Dr. Larson and his colleagues perform thousands of colonoscopies at the Center for Digestive Health in Bettendorf, a joint venture of Gastroenterology Associates, P.C. and Genesis Medical Center. “It works well for our patients,” he said. “It’s more efficient and more convenient than doing it at the hospital.”
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