Thursday, September 11, 2008
My health-o.k.
I realize I didn't post since all the tests I had. I think when I have to face my fears, I need to reach out more. The tests results all came back that I was still cancer-free. So I am relieved, of course. I did have a bone density scan and the results of that indicated I some bone-thinning in my neck. Other than taking calcium with vitamin D, nothing else is recommended at this time. I do wonder if some of this was an effect of the chemo, as it can be a side effect.
Follow-up Lacking
An article that was on cnn.com:
Study: Many colon cancer patients not followed up properly
Story Highlights
- 40 percent of study patients got all advised doctor visits, blood tests and screens
- Older patients, African-Americans, those with other health issues got less follow-up
- Colorectal cancer expected to be diagnosed in 149,000 Americans this year
NEW YORK (AP) -- Many colon cancer patients aren't getting the screenings recommended after surgery to make sure the disease hasn't returned, new research shows.Only about 40 percent of the 4,426 older patients in the study got all the doctor visits, blood tests and the colonoscopy advised in the three years after cancer surgery, according to the results released Monday by the journal Cancer.
While nearly all made the doctor visits and almost three-quarters got a colonoscopy, many didn't get the blood tests that can signal a return of colon cancer, according to the researchers at University Hospitals Case Medical Center in Cleveland, Ohio.
Whether doctors didn't offer the tests or patients failed to get them isn't known, said Dr. Gregory Cooper, who led the study. He said perhaps the follow-up care was being provided by doctors who aren't specialists and who aren't familiar with the guidelines.
"I would probably put most of the blame on the providers," said Cooper, a gastroenterologist at the hospital.
Colorectal cancer will be diagnosed in an estimated 149,000 Americans this year. Survival after five years varies from 90 percent for cancer that hasn't spread to 10 percent for advanced cases.
Cooper and his colleagues used a federal database of cancer cases and Medicare records for patients to see whether the guidelines were being followed. They focused on those 66 and older with less advanced cancer who had surgery that could cure them.
Patients were tracked for three years, beginning six months after surgery. When the study began in 2000, the minimum guidelines called for at least two doctor visits a year, twice yearly blood tests for two years and a colonoscopy within three years. Cooper said a colonoscopy is now recommended in the first year.
Overall, 60 percent of the patients didn't meet the guidelines. Of those who did, more than half actually got advanced medical scans such as CT scans and PET scans that are not recommended for routine screening. The scans could have been done because of signs or symptoms of a recurrence but the researchers said they suspect they were done for routine follow-up.
There was less screening among older age groups, African-Americans and those with other health problems.
"Quite honestly, I'm sorry to say, I'm not surprised about the findings," said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, which funded the study. Despite advanced medical technology, "our ability to deliver the recommended care to patients has left something to be desired."With the information resources available today, he said patients can take an active role in their follow-up care and make sure that they are getting the screenings they need.
Study: Many colon cancer patients not followed up properly
Story Highlights
- 40 percent of study patients got all advised doctor visits, blood tests and screens
- Older patients, African-Americans, those with other health issues got less follow-up
- Colorectal cancer expected to be diagnosed in 149,000 Americans this year
NEW YORK (AP) -- Many colon cancer patients aren't getting the screenings recommended after surgery to make sure the disease hasn't returned, new research shows.Only about 40 percent of the 4,426 older patients in the study got all the doctor visits, blood tests and the colonoscopy advised in the three years after cancer surgery, according to the results released Monday by the journal Cancer.
While nearly all made the doctor visits and almost three-quarters got a colonoscopy, many didn't get the blood tests that can signal a return of colon cancer, according to the researchers at University Hospitals Case Medical Center in Cleveland, Ohio.
Whether doctors didn't offer the tests or patients failed to get them isn't known, said Dr. Gregory Cooper, who led the study. He said perhaps the follow-up care was being provided by doctors who aren't specialists and who aren't familiar with the guidelines.
"I would probably put most of the blame on the providers," said Cooper, a gastroenterologist at the hospital.
Colorectal cancer will be diagnosed in an estimated 149,000 Americans this year. Survival after five years varies from 90 percent for cancer that hasn't spread to 10 percent for advanced cases.
Cooper and his colleagues used a federal database of cancer cases and Medicare records for patients to see whether the guidelines were being followed. They focused on those 66 and older with less advanced cancer who had surgery that could cure them.
Patients were tracked for three years, beginning six months after surgery. When the study began in 2000, the minimum guidelines called for at least two doctor visits a year, twice yearly blood tests for two years and a colonoscopy within three years. Cooper said a colonoscopy is now recommended in the first year.
Overall, 60 percent of the patients didn't meet the guidelines. Of those who did, more than half actually got advanced medical scans such as CT scans and PET scans that are not recommended for routine screening. The scans could have been done because of signs or symptoms of a recurrence but the researchers said they suspect they were done for routine follow-up.
There was less screening among older age groups, African-Americans and those with other health problems.
"Quite honestly, I'm sorry to say, I'm not surprised about the findings," said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, which funded the study. Despite advanced medical technology, "our ability to deliver the recommended care to patients has left something to be desired."With the information resources available today, he said patients can take an active role in their follow-up care and make sure that they are getting the screenings they need.
Hereditary cancer?
http://misc.medscape.com/pi/editorial/dmeflash/2008/17063/nccn-cancerriskevaluation.pdf - This article provides the guideline for patient referrals for genetic counseling for cancer - breast and ovarian are on page 1; colorectal is on page 2. Specifically, for colorectal cancer:
RED FLAGS:
- Personal history of early-age-onset colorectal cancer (< 50 years of age)
- Personal or family history of multiple colorectal carcinomas
- Personal or family history of polyposis (> 10 adenomas) in the same individual
- Personal history or family history of more than 1 hereditary non-polyposis colorectal cancer
(HNPCC)-related cancer (eg, colon and uterine cancer) in the same individual
- Personal history of an HNPCC-related cancer and:
o One or more first-degree relative with HNPCC-related cancer prior to age 50
o Two or more first- or second-degree relatives with an HNPCC-related cancer
diagnosed at any age
- Personal or family history of a hereditary syndrome associated with cancer (eg, HNPCC,
FAP, MYH-associated polyposis, Peutz-Jeghers syndrome, juvenile polyposis) with or
without a known mutation
-HNPCC (also known as Lynch syndrome)-related cancers include: Colorectal; Endometrial; Ovarian; Duodenal/small bowel; Stomach; Sebaceous adenomas or sebaceous carcinomas; Ureteral/Renal pelvis; Hepatobiliary/pancreatic; and Brain tumors (particularly glioblastomas)
DEFINITIONS
First-degree relative: parent, sibling, child
Second-degree relative: aunt, uncle, niece, nephew, grandparents
Third-degree relative: first cousin, great aunts, great uncles
RED FLAGS:
- Personal history of early-age-onset colorectal cancer (< 50 years of age)
- Personal or family history of multiple colorectal carcinomas
- Personal or family history of polyposis (> 10 adenomas) in the same individual
- Personal history or family history of more than 1 hereditary non-polyposis colorectal cancer
(HNPCC)-related cancer (eg, colon and uterine cancer) in the same individual
- Personal history of an HNPCC-related cancer and:
o One or more first-degree relative with HNPCC-related cancer prior to age 50
o Two or more first- or second-degree relatives with an HNPCC-related cancer
diagnosed at any age
- Personal or family history of a hereditary syndrome associated with cancer (eg, HNPCC,
FAP, MYH-associated polyposis, Peutz-Jeghers syndrome, juvenile polyposis) with or
without a known mutation
-HNPCC (also known as Lynch syndrome)-related cancers include: Colorectal; Endometrial; Ovarian; Duodenal/small bowel; Stomach; Sebaceous adenomas or sebaceous carcinomas; Ureteral/Renal pelvis; Hepatobiliary/pancreatic; and Brain tumors (particularly glioblastomas)
DEFINITIONS
First-degree relative: parent, sibling, child
Second-degree relative: aunt, uncle, niece, nephew, grandparents
Third-degree relative: first cousin, great aunts, great uncles
Friday, August 8, 2008
Clean Endoscopy
I'm just now fully awake from the procedure yesterday. Because it was both a colonoscopy and upper GI endoscopy, I had double the normal sedative, so I would be out during the procedures. If it weren't for the prep before, these tests would be nothing. I was just really tired.
The endoscopy was totally clean. The CT scan I had showed a "masslike tissue in the stomach". I spoke to a friend, who is a radiologist. He said that the new CT machines scan so quickly, that it often happens that a stomach contraction (can happen when your body is digesting the barium you drink) will show up as a blur or a masslike tissue. He said that often the technician will catch it at the time and re-run that part to be sure. I'm glad to know my cancer center is using the latest machines and I was scheduled for the upper GI endoscopy in November, anyway.
As for the colonoscopy, six small polyps removed. Need to wait for the biopsy results. I had six benign ones removed last year and just to be on the safe side as six more grew, will do a colonoscopy next year, as well.
Yes, I cried before lying on the table waiting for the procedure to start thinking about if I had a relapse or another health problem to deal with.
The endoscopy was totally clean. The CT scan I had showed a "masslike tissue in the stomach". I spoke to a friend, who is a radiologist. He said that the new CT machines scan so quickly, that it often happens that a stomach contraction (can happen when your body is digesting the barium you drink) will show up as a blur or a masslike tissue. He said that often the technician will catch it at the time and re-run that part to be sure. I'm glad to know my cancer center is using the latest machines and I was scheduled for the upper GI endoscopy in November, anyway.
As for the colonoscopy, six small polyps removed. Need to wait for the biopsy results. I had six benign ones removed last year and just to be on the safe side as six more grew, will do a colonoscopy next year, as well.
Yes, I cried before lying on the table waiting for the procedure to start thinking about if I had a relapse or another health problem to deal with.
Fighting Cancer Book
http://www.blochcancer.org/fighting/chap1.html - This is an on-line book that, although a bit dated (1988), the messages are still important. Topics include physician-patient communication, medical treatments, diet, and exercise.
Wednesday, August 6, 2008
Fears
I go for an endoscopy and colonscopy tomorrow, as a result of the yearly, guideline CT scan that was done last month. A masslike tissue was seen in the anterior of the stomach. My husband's cousin is a radiologist and I had him look at the scan results. He said that the newer CT machines work very quickly and it is not uncommon for a muscle contraction (which happens since you drink the barium) to show up blurred. Usually, if the technician catches it, then they just re-run the test at that time. In this case, to be safe, the endoscopy is needed. Since I was scheduled for on in November, it is only bringing it in by a couple of months - so not too much extra effort.
I remember, however, that when I read the report and was discussing it with the oncologist - the man I trust and feel safe around - although he said similar things, I believed he was sugar-coating the news. I think my fear was so great, I couldn't be soothed. I felt better after getting the opinion a second time, but am still nervous about tomorrow.
I also accompanied my friend who has rectal cancer to her surgical appointment. The surgeon strongly recommended the full surgery - which would result in a colostemy bag, but she was adament about not having one and so will have surgery next Tuesday to remove what they can. My fear for her turned into anger at the disease. We were talking after the appointment in the appointment room and she suggested we go somewhere else so they could have the room back. I responded that I didn't care what they wanted, this was about what she needed. She said she couldn't allow herself to get angry, as it takes her to place of self-blame for not having the screening sooner. I figure that cancer happens to a lot of people and why is not known. Just like all other good health practices people should do so.
I remember, however, that when I read the report and was discussing it with the oncologist - the man I trust and feel safe around - although he said similar things, I believed he was sugar-coating the news. I think my fear was so great, I couldn't be soothed. I felt better after getting the opinion a second time, but am still nervous about tomorrow.
I also accompanied my friend who has rectal cancer to her surgical appointment. The surgeon strongly recommended the full surgery - which would result in a colostemy bag, but she was adament about not having one and so will have surgery next Tuesday to remove what they can. My fear for her turned into anger at the disease. We were talking after the appointment in the appointment room and she suggested we go somewhere else so they could have the room back. I responded that I didn't care what they wanted, this was about what she needed. She said she couldn't allow herself to get angry, as it takes her to place of self-blame for not having the screening sooner. I figure that cancer happens to a lot of people and why is not known. Just like all other good health practices people should do so.
Diagnosing Cancer
I went with a friend for her oncology appointment a couple of weeks ago and just now posting. My friend was diagnosed with rectal cancer few months ago and completed 5-6 weeks of radiation and chemo. She had an endoscopy/ultrasound last week and the appointment was to discuss the results and next steps. The biopsy they took from this procedure indicated no cancerous cells – a good sign, but not necessarily enough to base a final treatment plan on. So the next step is for a surgeon to remove the entire tumor (or as much as they can without going into the wall – basically a colonoscopy where they remove more of the tumor) and have it analyzed.
I post this, not to tell my friend’s story, but to blog my reactions. I have known some of these things, but having a bit of distance – i.e., not me – allowed me an additional perspective. My first reaction is how capricious and non-precise diagnosing cancer is, as if the treatment wasn’t bad enough. They have tests, but they are basically indicators. If they find cancer in the tests, then you have it, but if the tests are clean, it doesn’t mean you are clean. The term – No Evidence of Disease – is about all they can really tell you. So, the CT scans and blood draws and even limited or what the oncologist referred to as “frozen” biopsies are not definitive. It makes me angry and scared. I think about my friend who is having to decide on surgery that would impact her quality of life substantially on something she may or may not need.
My second reaction was to the oncologist. My friend goes to a medical center other than the one I go to and I experienced the same caring and expertise I have experienced with my treatment. I know some people’s experiences and incidents have not had positive, but many more have been positive than have not. I think this is a positive sign that oncology is aware of the “human” side of things. Her oncologist talked more in everyday terms – like referring to radiation as “frying the person”. I found this very helpful in understanding the complex issues of cancer and treatment. At times, though, it was confusing, because a term would be used loosely, that would result in frustration to understand what was being said. An example, were the terms resection and excision, which he used interchangeably. I (and my friend) had thought resection was when they cut through the colon wall and reconnected you.
I post this, not to tell my friend’s story, but to blog my reactions. I have known some of these things, but having a bit of distance – i.e., not me – allowed me an additional perspective. My first reaction is how capricious and non-precise diagnosing cancer is, as if the treatment wasn’t bad enough. They have tests, but they are basically indicators. If they find cancer in the tests, then you have it, but if the tests are clean, it doesn’t mean you are clean. The term – No Evidence of Disease – is about all they can really tell you. So, the CT scans and blood draws and even limited or what the oncologist referred to as “frozen” biopsies are not definitive. It makes me angry and scared. I think about my friend who is having to decide on surgery that would impact her quality of life substantially on something she may or may not need.
My second reaction was to the oncologist. My friend goes to a medical center other than the one I go to and I experienced the same caring and expertise I have experienced with my treatment. I know some people’s experiences and incidents have not had positive, but many more have been positive than have not. I think this is a positive sign that oncology is aware of the “human” side of things. Her oncologist talked more in everyday terms – like referring to radiation as “frying the person”. I found this very helpful in understanding the complex issues of cancer and treatment. At times, though, it was confusing, because a term would be used loosely, that would result in frustration to understand what was being said. An example, were the terms resection and excision, which he used interchangeably. I (and my friend) had thought resection was when they cut through the colon wall and reconnected you.
Saturday, July 26, 2008
Stomach Tumor
I had my one year CT scan earlier this month and a tissue-like mass was identified in the anterior of the stomach. My oncologist indicated that colon cancer metastisis does not usually present itself in the stomach and stomach cancer is rare. I am scheduled for an upper endoscopy (which I was to have in November) August 8, as a result. I have no other symptoms and the rest of the CT scan was clear of cancer.
It is difficult for my mind to stay in the present and just wait and see. I jump to in the implications – surgery, more chemo. It seems so unfair. I’m scared. It’s not quite as intense as the first time I got diagnosed, however. Maybe once to face your own mortality, you accept it more or maybe you just learn better coping skills.
It is difficult for my mind to stay in the present and just wait and see. I jump to in the implications – surgery, more chemo. It seems so unfair. I’m scared. It’s not quite as intense as the first time I got diagnosed, however. Maybe once to face your own mortality, you accept it more or maybe you just learn better coping skills.
Tuesday, July 1, 2008
CT Radiation
An article by Catherine Guthrie in Time magazine: "...researchers behind two recent studies that sound the alarm about the increased cancer risk associated with multiple CT scans... physicians ... evaluated the medical-imaging records of 1,243 randomly selected patients to calculate just how much radiation each patient had sustained in the past five years. Although CT scans were the biggest source of radiation, other offenders included X-rays and mammograms. The results of the study, presented in May at the annual conference of the Society for Academic Emergency Medicine, were disturbing: the average patient had received 45 millisieverts (mSv) of radiation. (The typical chest X-ray dispatches 0.02 mSv of radiation.) And 12% of patients had gotten more than twice that amount - 100 mSv or more. "Our focus is to bring awareness to the fact that people are getting large doses of radiation and it's not innocuous," says Timothy Bullard, the study's lead author and chief medical officer at Orlando Regional Medical Center."
Wednesday, June 18, 2008
Red's Benign Tumor
My two-year old dog, Red has a cyst-like bump on her ear. Last week, it looked like a pimple and today it had grown and was a bit bloody. I took her to the vet. My other dog, Blue, plays with Red by grabbing her ear and I assumed it was just a small infection that would need antibiotics. However, when I got to the vet, the vet wanted to do a biopsy - actually a needle aspiration of it. She then examined the slide, while I held Red's ear to clot the bleeding from the biopsy. I was sitting in the same office, actually, as when they took my previous dog, Cashew, to get X-rayed and then told me the news about her cancer. I kept thinking about that and I wished I had brought Red in last week. It was difficult.
It turns out it is benign and quite common in dogs under two. Her breed is not known for it, but the vet has seen it before. It usually clears up on its own, so no additional medical care is necessary. I will bring her back in two months to make sure it has cleared up and if it hasn't they will cut it out, while it is still same. Red was so brave. I held Blue on the table so she could be there with her. I think Red was scared of the attention and procedure, in general, but except for a small whine didn't seem to care about the needle going into her.
I, of course, am glad she is o.k., but it brings back the reality of my upcoming six month tests.
It turns out it is benign and quite common in dogs under two. Her breed is not known for it, but the vet has seen it before. It usually clears up on its own, so no additional medical care is necessary. I will bring her back in two months to make sure it has cleared up and if it hasn't they will cut it out, while it is still same. Red was so brave. I held Blue on the table so she could be there with her. I think Red was scared of the attention and procedure, in general, but except for a small whine didn't seem to care about the needle going into her.
I, of course, am glad she is o.k., but it brings back the reality of my upcoming six month tests.
Sunday, June 8, 2008
Colonoscopy Preps
About four months ago, I posted on colonclub.com a query about colonoscopy preps. The usual responses were forthcoming about the unpleasantness of the experience without any real good suggestions, until today. Someone indicated there was a new prep - Pico Salex - which was reasonable tasting. Usually GI doctor's have a preference, but I plan to inquire for next one in a few months.
EndoNurse Magazine, online, a publication for gastrointestinal nurses, has technical information on bowel preparation and clinical studies about effectiveness and patient tolerance including a 2006 Bowel Prep Update, Which Bowel Preps are Best for Your Patients,- http://www.endonurse.com/articles/bowel_preps/586_661feat2.html and Bowel Preps: the Current and Future Outlook.- http://www.endonurse.com/articles/bowel_preps/586_561feat1.html
EndoNurse Magazine, online, a publication for gastrointestinal nurses, has technical information on bowel preparation and clinical studies about effectiveness and patient tolerance including a 2006 Bowel Prep Update, Which Bowel Preps are Best for Your Patients,- http://www.endonurse.com/articles/bowel_preps/586_661feat2.html and Bowel Preps: the Current and Future Outlook.- http://www.endonurse.com/articles/bowel_preps/586_561feat1.html
Relay for Life
From the American Cancer Society Website: Relay For Life is a fun-filled overnight event designed to celebrate survivorship and raise money for research and programs of your American Cancer Society. During the event, teams of people gather at schools, fairgrounds, or parks and take turns walking or running laps. Each team tries to keep at least one team member on the track at all times. Visit www.relayforlife.org for up-to-date information.
The one for my city was held on Saturday, May 31. I did not join a group, but went on my own. It was amazing!!! It was held at the local high school track. There were tents pitched everywhere! The majority of people there were teens/young adults, enjoying being able to stay out all night. The message of courage was everywhere. To remember someone, you could write/color on a white bag. A candle was place inside the bag and lined the track. On the stadium bleachers, the word HOPE was spelled out with the bags. At night, all the candles were lit and you walked around the track reading each bag and seeing HOPE. It was very poignant.
The one for my city was held on Saturday, May 31. I did not join a group, but went on my own. It was amazing!!! It was held at the local high school track. There were tents pitched everywhere! The majority of people there were teens/young adults, enjoying being able to stay out all night. The message of courage was everywhere. To remember someone, you could write/color on a white bag. A candle was place inside the bag and lined the track. On the stadium bleachers, the word HOPE was spelled out with the bags. At night, all the candles were lit and you walked around the track reading each bag and seeing HOPE. It was very poignant.
Thursday, May 15, 2008
Angel
I went to a funeral yesterday for someone who I had known - albeit briefly - through a colon support group. Her name was Angel, which is appropriate. There were pictures of her from her life before the colon cancer and to see someone young (she was 31) and vibrant was particularly hard. One of the people paying respects read a poem that talked about thinking of death as an adventure, not something to be feared. I liked that sentiment. Her oncologist also spoke and said how she had touched his life. She would often refer to him as her "boyfriend", but could never replace the love of her life - her husband. He was mentioned by several people and the person I have spoken to more. He was a real fighter for her. I had not realized that at first her insurance company declined the cancer treatment expenses, indicating it was a pre-existing condition. It required they hire a lawyer to fight it. They won, but what a difficult battle to go through. One of the speakers indicated that Angel would often talk about issues in the marriage - buying a house, cleaning, etc. - but never once had an issue that she had married the wrong person. It was a wonderful testament to love.
It is natural to think about the other person, as well as yourself in these situations. I reflected that my next set of tests are coming in July and I am a bit afraid. I am glad that I have an oncologist who I feel is competent as well as understanding.
It is natural to think about the other person, as well as yourself in these situations. I reflected that my next set of tests are coming in July and I am a bit afraid. I am glad that I have an oncologist who I feel is competent as well as understanding.
Insurance Commissioner
I joined the American Cancer Society Action Network, which is the political arm of the ACS. They are the organization I was involved with over the past year or so that got funding for under and un-insured colonoscopies and an insurance mandate to cover routine colonoscopies. Washington state is starting to address the need for better healthcare coverage. Several proposals are being floated for ballot vote this November. All are flawed, but anything that provides better access for people is good. I was invited to a small meeting with the insurance commissioner, Mike Kreidler, where he reviewed and wanted input for his proposal - basically an "umbrella liability" coverage for all state residents to be funded by a payroll tax. Anything over $10,000 would be covered by the state, so employers and non-covered people would have limited financial exposure and/or could buy cheaper coverage as it would only be for $10,000. There were some points not totally worked out, but I liked the idea of the plan. Website for this proposal is: http://www.insurance.wa.gov/consumers/reform/index.shtml
Saturday, May 3, 2008
Personalized Chemotherapy
Article Date: 03 May 2008 - 0:00 PDT - Can a blood test improve treatment outcomes for colorectal cancer patients? Recently published studies indicate that personalized chemotherapy dose management -- measuring drug levels in patients' blood and adjusting them for optimal dosing -- can substantially reduce severe toxicity and improve efficacy in colorectal cancer. http://www.medicalnewstoday.com/articles/106152.php
Catching Up
I haven't posted in a while. I guess as I get more time between me and the cancer treatment, I have learned to integrate all the fears and emotions. My outlets for dealing with the disease have taken more of a form of helping others.
I have two friends, who sadly, have been diagnosed - one with rectal and one with colon cancer. I've been touched by this. I also realize that although rectal and colon cancer may have the same characteristics under the microscope, they are treated very differently. My friend will be undergoing chemo and radiation prior to surgery. Her concern about the surgery is that she may end up permanently having a bag and is considering the quality of her life. One on hand I want to tell her she must have to increase her odds and on the other hand totally relate to the prospect of having a constant and quite inconvenient reminder. I know for me, I focused on the having a port installed as the worse thing that can happen. Its odd how our minds connect to something.
My other friend has No Evidence of Cancer and her CEA during chemo has gone down from 50+ to just under 5. This is very good, but I still worry a bit. Under 5, is considered "normal" by the testing labs, but as I understand it under 2.5 is normal for non-smokers. She had quite a few challenges with the chemo, but continued to work. She is a real fighter.
I have also become an "ambassador" for the American Cancer Society. It is the political activist arm of the ACS. Two of the activities I have participated in at a local level were the passages of bills by the state to cover un and under-insured people for colonoscopies, as well making insurance companies cover routine colon screenings.
I have two friends, who sadly, have been diagnosed - one with rectal and one with colon cancer. I've been touched by this. I also realize that although rectal and colon cancer may have the same characteristics under the microscope, they are treated very differently. My friend will be undergoing chemo and radiation prior to surgery. Her concern about the surgery is that she may end up permanently having a bag and is considering the quality of her life. One on hand I want to tell her she must have to increase her odds and on the other hand totally relate to the prospect of having a constant and quite inconvenient reminder. I know for me, I focused on the having a port installed as the worse thing that can happen. Its odd how our minds connect to something.
My other friend has No Evidence of Cancer and her CEA during chemo has gone down from 50+ to just under 5. This is very good, but I still worry a bit. Under 5, is considered "normal" by the testing labs, but as I understand it under 2.5 is normal for non-smokers. She had quite a few challenges with the chemo, but continued to work. She is a real fighter.
I have also become an "ambassador" for the American Cancer Society. It is the political activist arm of the ACS. Two of the activities I have participated in at a local level were the passages of bills by the state to cover un and under-insured people for colonoscopies, as well making insurance companies cover routine colon screenings.
Friday, March 21, 2008
Flat lesions
from the web site: http://www.medicinenet.com/script/main/art.asp?articlekey=87641
---------------- While the majority of colon cancers were thought to develop from polyps, a new study challenges that assumption and points out that so-called non-polypoid (flat or depressed) lesions in the colon are also likely to turn into cancer. A study in the March 5 issue of the Journal of the American Medical Association reports that such lesions were present in almost 10 percent of people screened for the study, and that these lesions were 10 times more likely to be cancerous than polyps were. ... Generally, non-polypoid lesions can be removed at the time of a colonoscopy. If the center where you have your colonscopy done doesn't have the expertise yet, you may have to undergo a second procedure to have the lesion removed.
---------------- While the majority of colon cancers were thought to develop from polyps, a new study challenges that assumption and points out that so-called non-polypoid (flat or depressed) lesions in the colon are also likely to turn into cancer. A study in the March 5 issue of the Journal of the American Medical Association reports that such lesions were present in almost 10 percent of people screened for the study, and that these lesions were 10 times more likely to be cancerous than polyps were. ... Generally, non-polypoid lesions can be removed at the time of a colonoscopy. If the center where you have your colonscopy done doesn't have the expertise yet, you may have to undergo a second procedure to have the lesion removed.
Wednesday, February 6, 2008
Lost
I still feel like I'm "lost" about the direction I want in my life. A friend of mine whose parents have cancer shared the following reflection: "I didn't understand what you meant before by difficulty in moving on with your life, but now that I have seen what both of my parents have gone through, I now understand a little better. In the movies, when a person thinks they're going to die, they often try to accomplish all their missing dreams, such as portrayed in the "Bucket List" movie. In real life, my experience is that people get preoccupied with death and become stuck in what they should do." I think I may be preoccupied, as are many of the survivors I know. Some deal it with by activism with the disease, some be being depressed. Me, it's this lost feeling.
I go to the eye doctor today, for a routine exam, and just this "I don't want to go" feeling. I think one gets doctored out. Perhaps, that is why people get preoccupied, because it is always in the back of your mind. There is always another test to do. Any medical procedure - even if it is not cancer related - is a reminder. I had my mammogram last week and it was normal, but while I was there my mind wandered to scenario of having cancer - the surgery, the chemo.
I go to the eye doctor today, for a routine exam, and just this "I don't want to go" feeling. I think one gets doctored out. Perhaps, that is why people get preoccupied, because it is always in the back of your mind. There is always another test to do. Any medical procedure - even if it is not cancer related - is a reminder. I had my mammogram last week and it was normal, but while I was there my mind wandered to scenario of having cancer - the surgery, the chemo.
Tuesday, January 22, 2008
Cancer Free
My CEA level (the blood marker which indicates cancer) is still low and the thyroid ultrasound indicated no change - i.e. nothing cancerous. It's interesting how quickly the fear sets in. While I was having the ultrasound, I thought about what I had cancer. Would I have surgery? Would I have chemo? Or would I just want a good quality of life as long as I could? After getting the results, I was just so happy. I don't have to go back for the next cancer check until July.
Dealing with the Unknown
I have my standard three month check-up with the oncologist today. I went in last week for the blood draw, so the results can be known for my visit. I also go in for another ultrasound on my thyroid. I see the doctor for that next week. I feel fine and healthy, but there is always this scare that the cancer may come back or that I'll need more medical procedures. I guess that is why I am writing a blog entry after so long. Somehow expressing your fear helps me deal with it.
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