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Show WedThursFri, May 8-10, 2002 The Park Record B-11 Payback is Sweet fragrant decadent soft succulent HERE'S TO YOUR HEALTH by Joan Jacobson Colorectal cancer: It's epidemic in the United States - 1'- I was honored to be invited to a recent conference in Park City. Dialogue for Action: Impacting Colorectal Cancer in Utah was sponsored by the American Cancer Society and the Utah Comprehensive Cancer Control Initiative. The Huntsman Cancer Center, University of Utah College of Nursing, St. Mark's Hospital Cancer Support Center and a host of other concerned healthcare-related healthcare-related Utah agencies sponsored the event. Lest you think this summit was simply a "provincial" discussion, the latest discoveries in treatments, treat-ments, screening procedures, national and state statistics and prevention strategies were presented pre-sented by experts in the field including Dr. Robert Fletcher, professor Harvard Medical School, an internist and an epidemiologist. epi-demiologist. Dr. Randall Burt, professor of Medicine at the University of Utah, senior director direc-tor for Prevention and Outreach at the Huntsman Cancer Center, and chief to the Department of Gastroenterology at the University Health Sciences Center also was a presenter. Other experts such at Charles Wiggins, Ph.D., an epidemiologist epi-demiologist and director of the Utah Cancer Registry were also heard. The question of colon cancer is not just a Utah problem, but is occurring in epidemic proportions throughout the country, according to Dr. Burt. Colon cancer is the second sec-ond most common cause of cancer death. The lifetime risk is six per cent - about one in 17 - and 93 percent per-cent of the cases occur in individuals individu-als over 50 years old. Only 33 percent per-cent of the cases are inherited or genetic. It is projected, in 2(X)2, that 148.3(H) cases of colon cancer will be discovered and 56.600 will die as a result. According to Wiggins, rates are lower in Utah. It is predicted pre-dicted that 700 people will be diagnosed diag-nosed and 300 will die because of colon cancer. Sadly, because there are dismal percentages of individuals who are screened for colon cancer, this preventable pre-ventable type of cancer is going undetected. Early detection is the key for dealing with this and other types of cancer. The Utah Department of Health reports that less than one-third of Utahns over 50 were screened for colon cancer, lower than the national average. Everyone who reaches age 50 should be screened, preferably with a colonoscopy, to detect adenomas or polyps. Early stage adenomas can be visualized with a camera that is built into the colonoscope and then removed with a snare that is attached to the end of the camera. In this instance, the removal of the early stage adenoma prevents it from becoming cancerous. It can take as much as 15 years for a cancer can-cer to develop from a small polyp. Just imagine how early detection and removal of small early-stage polyps can prevent the anguish of cancer. When cancer of the bowel occurs because early screening was not performed the treatment consists con-sists of surgical removal of the cancer, can-cer, radiation and chemotherapy. Even then, there is no guarantee MESSIAHS NATURAL WOOD FINISHES A "Hocky Mountain Tough" Protects, conditions and enhances the natural beauty of wood. ON 5ALE NOW! (luulilv llUlllt IlliOl 111 01-463-1779 3232 5.400 E..5LC www.wilsonspaint.com that the patient's life will be saved because the cancer may have spread to other organs. Granted, colonoscopy is not a pleasant event with preparation consisting of awful cleansing drinks, and possible enemas ene-mas to clean the bowel. An intravenous intra-venous sedative is usually given during the procedure. But, being uncomfortable for a day or so beats the alternative. Dr. Burt says that if you have no genetic or inherited disease you have a six percent chance of developing devel-oping colon cancer over a lifetime. doscopy. a viewing of only the low est part of the bowel because 70 percent per-cent of polyps are found in this area, and it is a relatively inexpensive procedure. This is in lieu of the $2,(XK)-plus for a colonoscopy that examines the entire colon and would be able to detect the other 30 percent of polyps that have formed above the sigmoid portion of the colon. The decision should be left up to each individual with the counsel coun-sel of the physician. Individuals w ith family history are a different story. They should begin the screening Interestingly, if a first-degree relative has had polyps you may have twice the usual risk for developing develop-ing colon cancer. As always diet, exercise, a low-fat high-fiber diet, and being a non-smoker all are risk reducers. " Joan Jacobson With a first degree relative (parent, sibling, or child) with colon cancer, you are two to three times more likely to develop the disease yourself. your-self. If both parents have colon cancer, can-cer, you are three to six times more likely to develop colon cancer. If you have a second- or third-degree relative (grandparents and aunts) your risk is one and a half the normal nor-mal risk. Interestingly, if a first-degree first-degree relative has had polyps you may have twice the usual risk for developing colon cancer. As always diet, exercise, a low-fat, high-fiber diet, and being a non-smoker all are risk reducers. Dr. Fletcher reported that colorectal col-orectal cancer is the second leading cause of cancer deaths in the United States. He discussed the costs associated asso-ciated with colorectal cancer screening. screen-ing. It was only in 1999 that Medicare coverage began for colorectal col-orectal screening in indiv iduals over 65 years old. He explained that the cancer screening guidelines are complex and often inconsistent. It may be that this has delayed some individuals from getting screened because their physicians have not recommended the appropriate methods. Dr. Fletcher explained that a person with an average risk should have a fecal occult blood test (FOBT) annually. However, for individuals over 50 the story is even murkier. Some physicians and HMOs are opting for a sigmoi- process when they turn 40 years old. Dr. Fletcher clarified some of the confusion regarding two new and exciting screening methods that are being developed. Several months ago I wrote about the virtual virtu-al colonoscopy. This procedure is still under development, although many clinicians are using the procedure proce-dure because patients are demanding demand-ing this less invasive and less costly screening method. In this method, patients are asked to eat lightly the day before the procedure and drink a small drink. Then they receive a CT scan of the abdomen with a computer enhanced program that enables visualization inside the entire colon. This allows the examiner exam-iner to see behind any polyps that may be found. One such computer program claims to be able to discount dis-count any fecal material that may be in the colon. However, Drs. Fletcher and Burt are warning that the data are not sufficient to sanction sanc-tion this method until the studies on the reliability of the virtual colonoscopy are completed. The results must be judged by a jury of peers and published in professional journals. The doctors do not expect virtual colonoscopy to become a standard screening for at least five years. This method will be less invasive and distasteful leading more individuals to make colon cancer screening an important aspect of their health maintenance. mainte-nance. Another exciting development in colorectal screening is the new DNA testing of fecal specimens from individuals who have genetic genet-ic or inherited risk factors for colon cancer. These tests are now possible because of the mapping of the human genome and will most certainly save lives. In conclusion. Dr. Fletcher says that colorectal screening is cost effective in that early detection, on average, will save $25,000 per person, per-son, not to mention saving a life. That's medical economics for you. Other nuances discussed are that patients expect doctors to recommend recom-mend screening. If they develop cancer and screening is not provided provid-ed they may sue their physicians. Colorectal screening will benefit individuals as they age, making medical costs lower and longevity higher. Park City resident Joan Jacobson, PhD, RN, is an adjunct professor for the University of Utah College of Nursing. 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