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Colorectal cancer - early detection is best protection

January 18, 1999

Early detectionBy KATE COLEMAN / Staff Writer

right: RIC DUGAN / staff photographer

below: RICHARD T. MEAGHER / staff photographer




Harold Grossnickle's grandfather died of colorectal cancer, and his mother, now 87, survived it.

Grossnickle, a resident of Smithsburg, has survived it twice. The first time, he was 23, years away from the age at which the American Cancer Society recommends screening.

[cont. from lifestyle]

He was having "awful" stomach pains, and tests revealed a spot the size of a penny on his colon. He had a section of his large intestine taken out and had no problems for several years.

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In 1987, when Grossnickle was 48, his doctor gave him a screening test for blood in the stool. He had been having some problems that he figured were hemorrhoids - something he says many truck drivers have.

Further testing revealed a malignant polyp - a growth on the intestine wall. Grossnickle opted for a colostomy - surgery that creates an opening in the abdomen through which solid body wastes pass - rather than other surgery or radiation treatment.

Now 59, Grossnickle admits that he didn't keep up with regular checkups. He advises people to have the screening tests.

In the United States, colorectal cancer the third most frequently diagnosed cancer and the third leading cause of cancer death. The American Cancer Society estimated that 131,600 new cases of colon and rectal cancer would be diagnosed in 1998. An estimated 56,500 men and women were expected to die from it last year.

Among those in the news who were diagnosed in recent years were Eric Davis, the former Baltimore Orioles outfielder; New York Yankees outfielder Darryl Strawberry; and Jay Monahan, Katie Couric's husband, who died of the disease.

"Early detection is your best protection," says Carol Antoniewicz, an oncology counselor at John R. Marsh Cancer Center at Robinwood Medical Center in Hagerstown. She encourages people to have regular checkups and to make sure that their doctors are doing the cancer screenings.

Bettiejean GroutAbout nine years ago, Bettiejean Grout of Hagerstown attended a seminar on colorectal cancer at Washington County Hospital. She always had trouble with her bowels and constipation and thought it would be a good idea to hear what the speaker had to say. At the end of the program, fecal occult blood screening test kits were handed out.

Grout followed through with the home testing, and within a week, she received a letter from the lab encouraging her to see a doctor. X-rays showed a mass in her colon. Surgery removed it and a foot of her large intestine, and six months of chemotherapy followed.

She had a bout with cancer at other sites a couple of years ago. Grout, now 77, goes "religiously" for checkups every six months.

American Cancer Society recommends that all men and women 50 years old and older be screened for colorectal cancer. Options include a fecal occult blood test every year and flexible sigmoidoscopy every five years, or colonoscopy every 10 years, or double-contrast barium enema every five to 10 years.

A rectal exam should be done at the same time as sigmoidoscopy, colonoscopy or double-contrast barium enema. People at risk for colorectal cancer should talk to their doctor about a different testing schedule.

Risk factors include a personal or family history of colorectal cancer or polyps and inflammatory bowel diseases. If your parent, grandparent, sibling or your child had it, you are at risk. In successive generations, colorectal cancer tends to occur earlier, says Dr. Frederic H. Kass, director of John R. Marsh Cancer Center. If your father developed it at age 60, you would be at risk at a younger age.

Physical inactivity, a high-fat and/or low-fiber diet and an inadequate intake of fruits and vegetables also are possible risk factors, according to American Cancer Society.

Screening tests are not perfect. Blood in the stool can be caused by something else, and cancer doesn't always bleed, Kass says.

But this simple test is absolutely better than nothing, he said, and there's some evidence showing that the number of deaths has gone down, and that's due in part to screening, Kass says.




-- What are the tests and how do they work?

-- Information Resources

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