Colorectal cancer is one of the leading causes of death in the United States. In fact, research shows that it is the third-leading cause of cancer-related death in the United States, will result in over 53,000 fatalities in 2020, and will appear in almost 150,000 patients over that same time frame.
As with many health issues, knowledge of colorectal cancer means power: the power of early detection, treatment, and in some cases even prevention. You may worry that you or a loved one are at risk for developing colorectal cancer; or you may want to better understand certain aspects of this disease. If so, then the following information will likely prove to be very helpful to you, as it covers several frequently asked questions about this type of cancer.
What is Colorectal Cancer?
Colorectal cancer is a cancer that starts in the colon or rectum (the last part of the digestive tract).
It is important to note that the term “colorectal cancer” is actually a combination of colon cancer and rectal cancer. Colon cancer can start anywhere in the colon, whereas rectal cancer is confined to the rectum, or the last 5 inches of the colon. However, since these two cancers target the same general region of the body, they are usually referred to by the single phrase “colorectal cancer.”
What is the Colon?
The colon, also known as the large intestine, is a tube-like structure designed to remove fluid and salt nutrients from waste, temporarily store that waste, and then finally push it out of the body. Your colon is shaped like a little “n” with an entryway that connected to the small intestine and a discharge section (the rectum) that finally eliminates waste when you have a bowel movement. It has 5 basic parts:
The ascending colon
The transverse colon
The descending colon
The sigmoid colon
The rectum
How Does Colorectal Cancer Develop?
The majority of colorectal cancers start out as a polyp, or a small growth with a stalk that protrudes from the inner lining of the colon or rectal wall. There are two common kinds of polyps:
Hyperplastic polyps. These are usually benign and occur in areas where your body has repaired damaged tissue.
Adenomas. These polyps are generally considered pre-cancerous. Anywhere from one-third to one-half of people will develop at least one adenoma which, if not removed, could become cancerous over the course of 5 to 10 years.
What are the Signs and Symptoms of Colorectal Cancer?
One of the most daunting aspects of colorectal cancer is the fact that its symptoms may not appear until after the cancer has already progressed and spread. In addition, many common signs of colorectal cancer are the same symptoms that arise from less dangerous conditions, such as hemorrhoids or irritable bowel syndrome (IBS).
Symptoms of colorectal cancer may include:
Diarrhea, constipation, or narrowing of the stool (e.g. stool that is stringy or pencil-like) that lasts for several days
The sensation that you need to have a bowel movement even after you have one
Rectal bleeding
Blood in the stool, or extremely dark stool
Abdominal cramps
Fatigue
Unintended or sudden weight loss
Is Colorectal Cancer Hereditary?
Only 5% or so of colorectal cancers are considered to be hereditary. However, if close relatives such as parents, siblings, or children have been diagnosed with colorectal cancer, then your odds of also developing this cancer are 2 to 3 times higher than the average person.
5% of colorectal cancers are hereditaryIn addition, certain inherited conditions can increase the risk that you will develop colorectal cancer. These include Lynch syndrome and Familial adenomatous polyposis.
What is a Screening Colonoscopy, and When Should I Have One?
A screening colonoscopy is an outpatient procedure that is performed on sedated patients. In this procedure, a flexible scope equipped with a lighted camera is used to inspect the entire colon and rectum. During the operation, the surgeon will generally remove any polyps discovered in the colon. In order to prepare for the colonoscopy, the patient is typically instructed to only drink clear liquids like water and chicken broth the day before the procedure.
It is generally recommended that patients with an average risk of colorectal cancer should begin screening at 45 and (if no concerns are raised) to do so every 10 years thereafter. Of course, there are some exceptions to this guideline. For instance:
African Americans are usually at higher risk for colorectal cancer, and should thus begin screening earlier than age 45
Individuals with a family history of colorectal cancer should begin screening around age 40
Any other individuals at high risk (those with hereditary syndromes, IBS, etc.) should begin screening earlier than age 45, and should screen more frequently thereafter
Are There Other Ways to Detect Colorectal Cancer?
There are some alternative screening options besides the traditional colonoscopy. These include:
Flex sigmoidoscopy
Virtual colonoscopy
Stool testing
In the near future, researchers may also develop a blood test for colorectal cancer detection. It should be noted that if any of these tests come up positive for colorectal cancer markers, it is most likely that your attending physician will still recommend a traditional colonoscopy.
What is the Prognosis When Diagnosed with Colorectal Cancer?
The 5-year overall survival rate for patients diagnosed with colorectal cancer, regardless of the stage, is about 65%. When individuals are diagnosed with the disease in its early stages, that rate shoots up to 90%.
As of this writing, less than 65% of individuals over the age of 50 have had some form of colorectal screening. The National Colorectal Cancer Roundtable has the stated goal to drive that percentage up to 80%, which could prevent over 200,000 deaths within the next two decades.
Colorectal screening can save lives but only if people get screened. The best test is the one you will do.
Can I Prevent Colorectal Cancer?
There is no 100% guaranteed way to prevent colorectal cancer. Nevertheless, there are several things that you can do to reduce your risk of developing this disease. These include:
Engaging in 2 1/2 hours of moderate to strenuous physical exercise every week
Taking in adequate amounts of calcium, fiber, fruits and vegetables
Reducing your intake of red and processed meats
Limiting daily alcohol consumption (1 drink for women, 2 drinks for men)
Avoiding/quitting cigarettes and other forms of smoking
Working to maintain a healthy body mass index and weight
Even though colorectal cancer can be a scary prospect for many, if you know your family’s medical history, screen early, and cultivate a healthy lifestyle, then you will greatly reduce your risk of developing this harmful disease.
Arizona Oncology plays a major role in helping people throughout the state, and their families, win their battle against colorectal cancer by providing easy access to a full range of advanced cancer care services in a setting that allows patients to remain close to their homes and their support network of family and friends.
Originally written February 2018. Updated February 2020.
One breast cancer survivor’s story of turning a personal patient solution into a community solution
By: Lori McNeill
Sherri’s Story
“I was shocked.” This, perhaps not surprisingly, was Sherri Romanoski’s response to being told back in 2000, at the age of 48, that she had breast cancer.
“It hit me hard. I was full of fear,” said Sherri.
Along with that fear can sometimes come a sense of powerlessness—how do I combat a disease I don’t fully understand?—and a lot of questions. What’s my cancer treatment plan? How long will it take? What can I do outside of the doctor’s appointments right now to help make a positive difference? How do I tell my family? What do I share, if anything, at work? What do I do about side effects? How am I going to pay for all these medications?
How can someone like Sherri, someone newly diagnosed with cancer, find answers, and empower herself to not just cope but find support, learn to communicate with her doctors and her loved ones, move forward on this unexpected new journey, and even thrive?
Sherri took these questions and not only found answers for her own journey but answers she could share, through a non-profit program called Bag It.
But let’s go back to that first appointment of Sherri’s after her diagnosis …
“I was … surprised.”
“I was … surprised at how little information I was given along with my diagnosis,” commented Sherri. She describes the detail she received as incorporating two pieces of paper and a drawing, maybe a list of side effects. This didn’t seem like much to someone just diagnosed with a disease she didn’t see coming, didn’t fully understand, and requiring long-term treatments she didn’t completely comprehend yet.
As a Kindergarten teacher who also worked in the behavioral health field, however, Sherri was no stranger to finding solutions to challenges. She took a look at some resource bags she was putting together for her students’ parents and thought, “I need a bag.”
She added a three-ring binder to fill with questions and answers, and information and helpful resources relating to her cancer diagnosis and treatment. A binder that would keep all of the information she gathered and collected in and outside of her doctor’s office in one place, in one folder that she could carry with her, reference, and share as she saw fit with her support network.
Sherri created that binder for herself and asked a lot of questions of her Arizona Oncology cancer doctor.
“I felt empowered because I was asking the questions,” she said.
Sherri asked so many questions that during her last appointment following her last treatment she stood up and unrolled a long ream of attached computer paper (the type they used to have back in the day, with the holes punched in the sides and the green and white lines). “I just have a few more questions,” she joked.
The Bag It Story
“If it helped me, it could help someone else.”
Once Sherri finished her treatment, she thought about all of the other cancer patients in her community going through a similar journey. She thought about her binder, a bag full of educational information, questions and answers, treatment details, and more. “If it helped me, it could help someone else.” If it empowered her, it could empower someone else.
Sherri knew a lot of the educational information needed was out there, available from reputable sources like the American Cancer Society, the National Institutes of Health (NIH), and more. She gathered and organized the information she thought could be most helpful, but she didn’t just rely on her own experience. She showed the information to doctors and the Southern Arizona Nursing Society. She showed it to cancer survivor groups and support groups. This is how she made the initial decisions of which information would be included in the binder and the bag.
Then she spent two hours telling the office manager at the Arizona Oncology office that she had counted on for much of her treatment, why physicians distributing this free resource—these binders in a bag—could truly make a difference. Not only would Bag It provide patients with education and support resources, it would help physicians answer their patients many common questions in a place where patients could maintain and refer back to the information, even if they forgot what was said in the doctor’s office. Doctors often encourage cancer patients to bring someone with them to their office visits, so they have a second person to hear treatment information. The Bag It binder could help both the patient and caregiver remember personal health and history details and treatment instructions, track test results, and keep support contacts.
Arizona Oncology decided to give it a shot. The first bag featuring Sherri’s binder and information, the first Bag It, was distributed in July 2003. 75,309 bags have been distributed since, free of charge to cancer patients.
“I’m on my fourth binder,” says Sherri. “I take it to every appointment.”
Doctors are seeing the benefit of Bag It to cancer patients, as well.
Bag It supports the community, and the community supports Bag It.
“I’m going to tear up,” Sherri told Program Coordinator Joyce Palasek, when Joyce told her how one physician gives newly diagnosed patients the bag and binder with the hug that Sherri herself can’t give them, but admits she wants to in the opening letter in the binder.
The tears make sense. There’s a lot of work, thoughtfulness, determination, and love behind each Bag It bag and binder, yet Sherri knows the presentation by physicians and health care workers makes a tremendous difference, too. She and her team are very grateful for the support that keeps Bag It helping more and more patients across Arizona, and hopefully eventually across the nation.
It took 18 months to originally gather the materials for the binder, get reviews, and start a 501(c)(3) nonprofit organization. Sherri had a friend’s help and support from her oncologist at Arizona Oncology, both of whom were founding members of Bag It and on the board for many years.
Sherri also had the initial help of 25 people who, in hearing about the binder at a friend’s house, without even being asked, started writing checks to help make the project happen.
150 Bag It bags and binders were distributed each month, when they first started. They were put together on Sherri’s kitchen counter.
“It took a few years to get it into (doctor’s) offices,” Sherri said. The Bag It program started in Tucson, with Arizona Oncology offices, soon moved to other, rural communities, and finally into Phoenix. The binder information is also available in Spanish now.
Distribution grew, but the information that was readily available before became more controlled and limited and had to be ordered. Printing costs came into play. The Bag It team needed help with funding. They had to change their model.
The Bag It team didn’t shy from the challenge. They hold a fundraising hike in Tucson every November and a special fundraising event in Phoenix each spring. They encouraged the support of sponsors in the pharmaceutical and medical communities, and from community businesses. The Beacon Group works with the Bag It team to assemble the bags and volunteers are ambassadors for the bags at local events.
And they always keep in mind the Bag It purpose and look for ways to make it even more helpful to both patients and physicians.
The Work and the Love Behind Bag It Continues
The Bag It team, led by Executive Director Mindy Griffith and Program Coordinator Joyce Palacek, recently put even more research behind improving and perfecting the binders to provide the best patient experience. Once again, they talked to cancer survivors using the binders, doctors, and nurses. The results, seen in the 2019 Bag It bag and binder released just this month, are exciting. The bulk of the binder was slimmed down. Tabs divide information by function, rather than by stage of treatment: “My personal details”; “my test results”; “from my healthcare team”. Booklet information was condensed in some cases, to be more digestible for multiple audiences. Larger print makes the texts more readable. Vetted online resources are included. Binders are customizable by patients and their physicians. The result is a lighter weight binder still offering a plethora of educational materials, support resources, and simple tools for tracking and keeping information … it’s all in the bag.
“Mindy’s leadership has moved the Bag It program on to this new version, new logo and look, and it is truly an amazing endeavor,” said Sherri. “The result is outstanding. It is Mindy and the Bag It staff that have made this happen.”
And in every bag, is Sherri’s heartfelt letter. In every page of the binder is the commitment and dedication of a cancer survivor who once sat where many others sit, in a doctor’s office trying to absorb the shock of a diagnosis no one wants to hear; in the car on the way home fighting the fear of what’s to come; and surprised day in and day out by the seemingly unending questions that keep popping into one’s thoughts.
There are answers. There is support. There is power in knowledge. “Some days will be easier than others,” Sherri says in her opening letter in the binder, “just knowing that helps.”
And, it’s true, says Sherri … you are your own best advocate in your cancer journey. Bag It is her way, the team’s way, and one way many local physicians are helping every patient feel empowered and supported throughout their treatment and survivorship.
As for Sherri’s personal story, while she may be retired from teaching after 25 years, she continues to educate and empower cancer patients through Bag It and similar opportunities. She also spends time with her grandchildren. Cancer may have been a plot twist she didn’t see coming, but it’s only a piece of her much greater story and now her community’s story.
Cancer treatment continues to advance, and we’re proud to be at the forefront of it with our brand-new Halcyon Linac by Varian. This state-of-the-art radiotherapy system offers faster treatment in a spacious, patient-centered design, while incorporating volumetric modulated arc therapy (VMAT) to deliver a consistent radiation dose to tumors while minimizing the dose to healthy tissue.
Dr. Neil D’Souza is a radiation oncologist at our Goodyear location who has firsthand experience with this revolutionary machine. We asked him to share, in layman’s terms, exactly what makes the Halcyon Linac so special.
It’s fast
One of the most exciting features of the Halcyon are its reduced treatment times. “The system is likely the fastest available machine on the market,” Dr. D’Souza says. According to Varian, complex treatments that used to take 30 steps to deliver now only take nine. Besides less time spent on the table, the speed of the machine also means patients won’t have to hold their breath as long to minimize movement during treatments for tumors in the liver or lung, for example. When it comes to patient comfort, these improvements make a world of difference.
It’s accurate
The goal of radiation therapy is to deliver an appropriate dose of radiation to a cancerous tumor while minimizing exposure to healthy surrounding tissues. The Halcyon uses a type of radiation therapy known as volumetric modulated arc therapy (VMAT)–one of the newest forms of intensity modulated radiation therapy (IMRT) and the most accurate technology available.
Dr. D’Souza explains, “VMAT treats tumors using an ‘arc’ of fifty to eighty plus beams from many different angles, enabling the machine to shape the radiation dose directly for the target, reducing side effects. The Halcyon is the most efficient machine for this particular form of treatment.”
It’s comfortable
Let’s face it, radiation treatment can be scary. Varian took this into account when designing the machine, which looks a lot like a CT scanner, a piece of equipment many people are familiar and comfortable with. “Patients who have been treated on the Halcyon generally love the approachability, familiarity, and speed of the setup and treatment on this machine,” Dr. D’Souza says. The machine is also the quietest model yet.
The staff love it, too
Designed for ease of use by clinicians, the Halcyon gets a thumbs-up from the Arizona Oncology Goodyear staff as well. With built-in cone-beam CT image-guidance, the Halcyon allows the radiology team to “see” the tumor inside the patient at higher resolutions than ever before.
Says Dr. D’Souza, “The staff love the Halcyon because of its cutting-edge technology, speed of treatments, ease of setup, as well as the superior image-guidance capability which enables us to see the tumor well before the radiation is released from the machine.”
Leading Radiation Therapy in Goodyear, Arizona
Arizona Oncology is the only community-based cancer center in the West Valley to offer breast surgical oncology, radiation, and medical oncology all under one roof. The addition of the Halcyon Linac by Varian fits with our model of providing premier cancer care close to home.
Dr. D’Souza is pleased with the new acquisition and its performance so far: “Along with our very friendly team of therapists and assistants, I believe the new machine offers patients access to the most accurate and patient-friendly radiation treatment on this side of the metro.”
Jackie Dominguez had a very aggressive form of breast cancer, but with a multidisciplinary cancer care team who cared for her both physically and emotionally, she’s thriving with and beyond cancer.
“The doctor was kind enough to not make me wait for the results. I’ll never forget that,” Jackie said. “But he also said that it wasn’t a death sentence. He just reassured me that I wasn’t going to die from this.”
Jackie chose Arizona Oncology for treatment for her breast cancer. For most patients with breast cancer, surgery is the first step, and Jackie went to see an Arizona Oncology breast surgical oncologist in northern Arizona.
“Jackie came in with a very aggressive cancer,” her surgeon said. “She came in with multiple lymph nodes involved and the features of the cancer that make it very aggressive and difficult, sometimes, to treat.” Because of this, a chemotherapy-first approach was the best option for Jackie. “We were able to do that today with this comprehensive care that we offer.”
“I was referred from my gynecologist,” Jackie explained. “When I called her, she did tell me I needed to get with an oncologist first. So I made my appointment with Dr. Nagaiah, and that same day I went right over and I saw both of them the same day.”
Multidisciplinary Care
Comprehensive, multidisciplinary care is the cornerstone of Arizona Oncology’s approach to cancer treatment. We offer state-of-the-art chemotherapy, immunotherapy, radiation, and surgical treatments, all within one practice. Our multiple locations across the state ensure you receive the care you need close to home.
“Cancer care is evolving rapidly, and we at Arizona Oncology embrace new technology,” said Govardhanan Nagaiah, MD, medical oncologist and hematologist working out of our Goodyear office. “All of our patients get next generation sequencing, all of our patients have access to state-of-the-art clinical trials, all of our patients have access to state-of-the-art radiation oncology.”
The next generation sequencing Dr. Nagaiah is referring to is a form of genomic testing. Not to be confused with genetic testing, which looks at inherited traits that affect cancer risk, genomic tests look directly at tumor tissue to help determine the best way to treat a particular cancer. Arizona Oncology offers both.
Comprehensive Care
“It was life-changing because before I had cancer, my life was defined by my work,” Jackie said. “I wasn’t going to slow down, and I was not going to shift my priorities. I didn’t have a choice once I got breast cancer. I had to slow down, physically and mentally.”
Comprehensive cancer care includes caring for the patient as a whole, physically, mentally and emotionally. Our nurse navigators help coordinate appointments and streamline processes. Our social workers offer real-world support, education, and strategies for managing life with cancer.
Jackie appreciated the support she got from staff throughout her cancer care journey. They talked her through the entire process. She felt like she was in a safe space during a frightening time.
At Arizona Oncology, we understand that cancer is personal. We never lose sight of the fact that you are an individual going through one of the most difficult circumstances of your life. Our care is focused on getting you through this, so that cancer can become just a “blip” on your radar.
“I have a whole different perspective in life,” Jackie said. “Family and friends and my religion is the most important thing to me now.”
Of all the cancers, lung cancer is claiming the most lives of men and women every year in the United States. If you are a smoker, then it likely concerns you that smokers have the greatest risk of developing lung cancer according to the CDC. The good news though is that even after a lifetime of smoking, you can substantially reduce your risk of getting lung cancer if you stop smoking now. This article explores practical tips that can help you to quit smoking and as a result, reduce your lung cancer risk.
What Practical Steps Can Smokers Take to Reduce Their Lung Cancer Risk?
Go Cold Turkey or Cut Your Tobacco Consumption in Half
Eliminate the Smoking Temptations
Clean House
Develop Other New Habits
Be Mindful of Smoking Triggers
Rally Support
Treat Yourself
Go Cold Turkey or Cut Your Tobacco Consumption in Half
A study by the Journal of the American Medical Association found that although quitting smoking decreased lung cancer risk, there was also a benefit to cutting tobacco consumption in half. They found that there was a 27% decrease in lung cancer among those participants who reduced their smoking by 62%. JAMA also reported a 90% reduction in cancer risk for those who quit smoking before middle age. Therefore, for the greatest lung cancer risk reduction, you should quit today. But if you are not ready to go cold turkey just yet, then at least aim for reducing the amount you smoke daily while you work on making a plan for quitting in the coming days and weeks.
Eliminate the Smoking Temptations
Naturally, you need to eliminate every trace of the tobacco product you are trying to quit. That means, cleaning out drawers, nightstands, garage workspaces, any possible place that even one singular cigarette or cigar might be lurking. Even though you may want to prove your willpower by keeping a stray around, recognize that smoking is one of the toughest addictions that exists and there is no time to waste with testing the waters. If your significant other or housemate is a smoker and not interested in joining you in this endeavor, insist that they keep all smoking paraphernalia out of your sight and that smoking be done out of the house only.
Clean House
In addition to ridding yourself of all tobacco products, give yourself a fresh start by cleaning house. Over the years you may not realize the stench that smoking has left behind, in your home, on your clothes and in your car. As your sense of smell becomes sharper after quitting smoking, you may even become more sensitive to the smell of cigarettes on others. Depending on your time and finances you may consider cleaning your carpets, upholstery, curtains and even putting a fresh coat of paint on the walls. After investing in this clean start, it may make you think twice about reaching for that pack of cigarettes again.
Develop Other New Habits
Researchers debate on how long it actually takes to develop a new habit and it is commonly believed that you need at least two months to ingrain a new habit in your life. As you attempt to rid yourself of this old smoking habit, replace it with healthier and enjoyable activities. Think about the times of day that you feel the need to smoke and replace that old activity with a new one. Do not expect that this will be easy. The first few days to weeks are going to be the most challenging. But distracting yourself with a new healthier habit may help you to navigate this time. Instead of smoking you could try;
Playing a game on your phone
Calling or messaging a friend
Taking a walk or stroll
Go to the gym
Go shopping
Be Mindful of Smoking Triggers
Think ahead about potential triggers, what environments or times of day you feel the need to smoke? Is it first thing in the morning? Try to get out of the house or to walk around the block. Is it while on break with co-workers? Then aim to avoid those break area spots popular for smoke breaks and look to find another spot to take your breaks. Do you typically smoke while drinking coffee or having a beer. Substitute these potential triggers for other things while you work through the cravings.
Rally Support
Don’t go it alone. Tell your friends, family and co-workers about your efforts and include them on the progress you are making and challenges that you are experiencing. You may be surprised to learn of others who are trying to quit as well and be able to help one another. You may also consider joining Freedom From Smoking, an initiative by the American Lung Association that offers an online support group, group clinics, a helpline and more.
Treat Yourself
Calculate the expense and put it to paper, how much you will be saving by not smoking. CNN Money rates smoking as one of the biggest money wasters and estimates that many smokers spend on average $70 weekly or $280 a month on their habit. That comes to $3,360 a year. Imagine the ways you could spend that extra money on yourself. It might be a great incentive to save for that trip or cruise you’ve been dreaming of taking. Or this could be the perfect opportunity for you to get into that hobby or sport that your smoking habit and lungs could not tolerate before.
Don’t Give Up
Set backs are normal and will likely be part of your experience. Don’t use a relapse as an excuse to give up but learn from it. It is never a failure as long as you keep trying and don’t be afraid to talk about your feelings and frustrations with a trusted friend.
Quitting smoking will be one of the greatest gifts you can give yourself and to those that love you. Not only will you reduce your lung cancer risk but will also help your body to heal from other illnesses and protect yourself from other forms of cancer. At Arizona Oncology, our expert and compassionate oncologist are committed to helping you achieve the highest quality of life while you navigate your cancer treatment.
