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Managing colon cancer with diet, exercise

December 08, 2008

By SAM MCMANIS

Sacramento Bee

He came to dread Octobers. When the leaves turned and the calendar flipped over to the 10th month, it was time again for Steve Abrams to have his yearly colonoscopy.

As a longtime colitis sufferer, Abrams knew he was at extremely high risk for colon cancer, so he dutifully complied with his doctor's edict to have a yearly colonoscopy.

It wasn't the exam itself he dreaded - though, to be honest, it's not a lot of fun - but rather the wait to know whether this would be the year doctors would find something.

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"I figured I'm not going to worry about it the other 11 months of the year, because worrying about it causes additional stress on the body," Abrams says. "And being symptom-free, I never thought about it until October. Then, I'd have to wait five days for the call from the doctor to say everything is OK."

And for 20 years, it was.

Abrams, 45, controlled his chronic colitis through medication and went about his business coaching freshman football at a high school and working for the legislative counsel of California.

Until October 2007.

"October 22, to be exact," he says. "It's funny how you remember those dates."

The diagnosis was colon cancer. Abrams was told by his specialist, Dr. John Roe, to have immediate surgery to remove his colon and rectum. Abrams begged for a three-week reprieve until after prep-football season.

In the time before surgery, Abrams had a lot of time to think. He admits to feeling like a "walking zombie" at times.

"I wasn't in shock, because I knew it could happen, but I wanted it to be delayed so I could get my boys raised," he says. "I also was relieved, knowing what I was dealing with now. It was hovering over my head for 20 years."

Roe says that chronic colitis patients have a 1-in-10 chance of getting colon cancer after 20 years. After 30 years, the risk rises to 1-in-3.

Abrams didn't wait and fret before surgery. He took action, learning all he could about colon cancer and contacting the American Cancer Society to be placed with a mentor who had survived the same surgery. And, as a former linebacker for the Sacramento State football team in the mid-1980s, he decided to "train" for the operation.

"I'd work out (at the gym) twice a day to get as much stamina to handle the surgery as I could," Abrams says. "I wanted to prepare my body for the trauma."

In December, when Roe removed Abrams' colon and rectum in a seven-hour procedure, they found an inch-long tumor. They connected a portion of his upper intestine to his sphincter muscle, which would ultimately serve as the way to expel waste. For the short term, though, he wore a colostomy bag.

The good news was that the cancer had not spread to other organs or Abrams' lymph nodes.

"It's amazing that in October 2006, there was no signs of cancer and a year later it's over an inch tumor," Abrams says. "I had no discomfort or bleeding. There was no way I would've known. So the yearly test actually saved my life."

Post-operation, what Abrams did to improve the quality of his life quickly hastened his recovery.

With 42 staples in his stomach and a colostomy bag on his right side, Abrams nonetheless forced himself out of bed a week after the surgery to work out at his gym.

"I was incredibly weak," he recalls. "My muscles atrophied so much. I lost 23 pounds the first week. I told that to the doctor and he said, 'Yeah, while you were in there, we shaved off a bit of belly fat.' My friends laughed and said, 'You got a free liposuction.' "

That first day on the treadmill remains seared into Abrams' memory.

"I pushed '1' on the treadmill, which is almost not moving, and walked 10 minutes," he says. "It made me feel better to move my body and be out in a social atmosphere. Every day, I increased it five minutes. I worked up until I could do it with elevation. As my strength returned, I added more weights and jogged on the treadmill. In three weeks, I started running."

Roe says exercise, before and after an operation, hastens healing.

"The risk of complications, such as blood clots and pneumonia, is much lower if you're ambulatory," Roe says.

In January, Abrams had to return for more invasive surgery, this time to remove the colostomy bag. That was a setback to getting in shape - "I lost fitness again" - but by March he was well enough to go surfing and kayaking in Hawaii with his new wife, Carla. His children are from a previous marriage.

His lunchtime regimen now involves running a mile from work to a club in downtown Sacramento, where he does circuit weight training, then running back.

There still are challenges. He cannot sleep through the night because he needs to go to the bathroom every few hours. His diet is restricted - no spicy or fibrous foods, no red meat - and portion sizes are reduced.

"I go to work, coach football and come home at 8 (o'clock) and am exhausted," he says. "There are days when I get down - maybe because I don't sleep much. But I just need to remind myself every day is a blessing that I'm still here."

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