By Linda Farkas
October is the “pink” month. Pink is everywhere for breast cancer. Major cities light up pink fountains, pink skyscrapers, and even “real men” (football players) wear pink for breast cancer (BC). Kudos to breast cancer awareness for hitting a home run through their campaigns, which can be measured in action. This success can be seen with increased mammography screening up to 70.2%, depending on a woman’s insurance. (ACS, Surveillance Research 2016).
Other than the “Get your Butt in Gear”, or the Traveling Colossal Colon, colorectal cancer (CRC) awareness is silent. Why? Is it sexier to talk about breasts, than colons, rectums, colostomies and stool? CRC screening compliance does not fare as well. By any modality- guaiac cards, sigmoidoscopy, colonoscopy, and barium enemas it still hovers around 50%. (2009 NCQA data-reflecting 2003-2008 data)
So every March (let’s face it –every day) I use CRC Awareness to my advantage as I counsel my patients.
Women are the easiest to mobilize for CRC screening, as they are often the medical decision makers of family units. While CRC is the 3rd most common cancer, it is the 2nd most common cause of cancer death. Our diligence about breast health should be equal to that for colon health. Forty-seven percent of all inflicted with CRC are women. Therefore, it is equally important to promote screening for themselves as well as the men in their lives: husbands, fathers, brothers, sons, and friends.
Testing may be as infrequent as every 10 years versus yearly mammograms. However, I stress that while mammography finds cancers early, colonoscopy PREVENTS cancer. Testing is therapeutic at that same visit, as polyps are removed to prevent progression to cancer and subsequent surgery. The STOP CRC Foundation, founded by the first woman boarded in colorectal surgery, Dr. Ernestine Hambrick, had the best message for the public: Do the Test. Find the Polyp. Skip the Cancer!
One obstacle to screening is the “prep”. I remind my patients of a multitude of preps on the market that are not always a four liter jug. Having gone through the prep myself, I can now give advice on mixing Miralax in a variety of clear fluids to prevent taste fatigue. Baby wipes and butt cream are also helpful!
Still there are those that are firmly resistant to screening due to factors like time, courage, or dignity. Another acceptable screening option would be to take home three hemoccult cards. Any screening is better than none.
While we advocate for our patients, we as physicians need to have these discussions with our own families. I think over the years I have “shamed” all my family members and in-laws to be tested lest they succumb to CRC with a known colorectal surgeon in the family! What-ever- it –takes!
Last but not least, we have to think of ourselves.
The airplane industry has always been ahead of the health industry. They are the founders of the check list take-off that many hospitals have just begun to incorporate. Also, remember the takeoff message? “In the event of … an oxygen mask will automatically appear. If travelling with someonewho needs assistance, secure your mask first, and then assist the other person” Why? Because if you become hypoxic before you can help others, then the two of you succumb to hypoxia. Likewise, as physicians, if we do not take care of ourselves, then we fail to care for others. We are not invincible or immune to disease. It saddens me each time as I hear about fellow colorectal surgeons who have succumbed to CRC, and never had their scope. They were so busy caring for others they forgot their own self-care. I silently applaud surgeons who realize the importance of their own screenings and find creative ways to get their own scopes done, even in their busy schedules.
While CRC awareness month is becoming more known, I doubt it will ever reach the awareness of BC: blue city fountains, sky rises, and football shoes. Still, we must do our part to prevent the 2nd most common cancer death in ourselves, loved ones, and patients. I had my colonoscopy in 2014. When did you get yours, or when will you schedule yours?
Dr. Linda Farkas is the first Chief of the Division of Colon & Rectal Surgery at UC Davis. She received her medical degree from Loyola University Chicago Stritch School of medicine, and received her following training from University of Illinois/Cook County Hospital. and has been in practice for 26 years and proud to have had the opportunity to operate with Ernestine Hambrick, the first woman to be boarded in Colon & Rectal Surgery.
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