Monday, November 12, 2012

My Story - Heather Keogh

 
 

Posted by Barbara Armstrong Green
Welcome. Please take a moment to read this important letter from Heather about how Susie's Cause may have saved her life. The folks at Susie's Cause encourage you to check in with your doctor if you suspect there's something wrong.  And don't be afraid to get a second opinion even if you're not scheduled for colon cancer screening yet.
 
Dear David Cohan,
Back in February 2009 (I was 39 at the time), I had what turned out to be my first symptom of colon cancer. This caused me to do what most of us do today…self-diagnose through internet MD. That is when I first saw Susie’s Story. Of course, I dismissed that this could possibly be my ailment, but our life similarities stuck in my head - around the same age, also a mother of two young children. I was from Florida, but now living in Maryland.
 
At that time, I dismissed my symptom and moved on, but her life story was always in my head. A few months later, the symptom resurfaced and I actually discussed it with my internist. Unfortunately, she also dismissed it, figuring it was nothing to worry about.
 
Then, actually on my 40th birthday, the symptom returned, and I decided to see a GI doctor. He suggested a colonoscopy, just to be sure, which led to my diagnosis in October 2009. I was lucky to be considered an early diagnosis, stage 2A, and so far I have remained cancer free.
 
I wanted to share this with you, as you may not realize the ways in which your foundation is able to reach people and help save lives. I would be happy to offer my assistance if you have any needs locally. Thank you, for continuing her cause and helping to prevent others from suffering.

Warm regards,
Heather

To learn about colon cancer symptoms, click on the Susie's Cause web site's About Colon Cancer tab.  Please leave a comment below. We welcome people to tell their stories.
 
 

 

With My Girls June 2012
 

With Hubby Above and Family Below



 

Medical Disclaimer

The information presented on the Susan Cohan Colon Cancer web site is solely intended to provide you with information that will help educate you on the importance of diet, exercise and regular cancer screening in maintaining a healthy lifestyle. Adopting these habits is an individual choice and one that should only be made after consultation with your health care professional. No information provided on this Web site or otherwise offered is intended to replace or in any way modify the advice of your health care professional. 

Monday, November 05, 2012

What You Need to Know about Vitamin D


 
Posted by Barbara Armstrong Green
Welcome. Vitamin D is something I never paid much attention to.  That’s the sunshine vitamin, I thought.  All I have to do is walk outside for a while and I'm covered. And besides, I can also get Vitamin D from various food sources such as fish, eggs, fortified milk, and cod liver oil.

But it turns out to be more complicated than that. I'm paying attention now and so should you.

According to  Dr. Joel Fuhrman, board certified family physician and New York Times bestselling author of Super  Immunity, "Vitamin D can provide powerful cancer protection. Yet Vitamin D insufficiency is common among Americans overall but more prevalent among African Americans. A recent review of the literature suggests that Vitamin D insufficiency is a key contributor to cancer survival disparities that exist between African Americans and white Americans (darker skin is less efficient at producing vitamin D in response to UV rays).

A striking part of this literature review is the comprehensive summary of the existing data on vitamin D status and cancer survival. The authors present a long list of studies reporting that Vitamin D adequacy is associated with reduced risk of death in all cancers combined, breast, colorectal, lung, and prostate cancer, leukemia and lymphomas.”
Click the Prevention Tab on our web site to read Dr. Fuhrman's entire article.

The author, Dr. Joel Fuhrman is a #1 New York Times bestselling author and board certified family physician specializing in lifestyle and nutritional medicine. His new book Super Immunity discusses how to naturally strengthen the immune system against everything from the common cold to cancer


Medical Disclaimer

The information presented on the Susan Cohan Colon Cancer web site is solely intended to provide you with information that will help educate you on the importance of diet, exercise and regular cancer screening in maintaining a healthy lifestyle. Adopting these habits is an individual choice and one that should only be made after consultation with your health care professional. No information provided on this Web site or otherwise offered is intended to replace or in any way modify the advice of your health care professional.


Friday, November 02, 2012

FDA Approves Two New Colorectal Cancer Treatments


The U.S. Food and Drug Administration (FDA) has approved the following two new treatments for advanced colon cancer, Stivarga  and Zaltrap.

Stivarga Approved in September 2012
In September the FDA approved Stivarga to treat patients with colorectal cancer that has progressed after treatment and spread to other parts of the body. Stivarga blocks several enzymes that promote cancer growth.

According to the Centers for Disease Control and Prevention, colorectal cancer is the second most common cancer affecting both men and in women and the second cause of cancer death in men and in women in the United States. The National Institutes of Health estimates 143,460 Americans will be diagnosed with colorectal cancer, and 51,690 will die from the disease in 2012.

The new drug was reviewed under the FDA’s priority review program that provides an expedited six-month review for drugs that offer major advances in treatment or that provide treatment when no adequate therapy exists, according to the FDA news release on the new treatment. Stivarga is being released one month ahead of schedule.

“Stivarga is the latest colorectal cancer treatment to demonstrate an ability to extend patients’ lives and is the second drug approved for patients with colorectal cancer in the past two months,” said Richard Pazdur, M.D., director of the Office of Hematology and Oncology Products in FDA’s Center for Drug Evaluation and Research.

The safety and effectiveness of Stivarga were evaluated in a single clinical study of 760 patients with previously treated metastatic colorectal cancer. Patients were randomly assigned to receive Stivarga or placebo in addition to “best supportive care” BSC. Patients received treatment until their cancers progressed or side effects became unacceptable, according to the FDA.

The FDA reported study results that showed patients treated with Stivarga plus BSC lived a median of 6.4 months compared to a median of five months in patients treated with placebo plus BSC. Results also showed patients treated with Stivarga plus BSC experienced a delay in tumor growth for a median of two months compared to a median of 1.7 months in patients receiving placebo plus BSC.

Stivarga has been approved with an alert to patients and health care professionals that severe and fatal liver toxicity occurred in patients treated with Stivarga during clinical studies. The most common side effects reported in patients treated with Stivarga include weakness or fatigue, loss of appetite, hand-food syndrome, diarrhea, mouth sores, weight loss, infection, high blood pressure, and changes in voice volume or quality.

Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.

Stivarga was developed by Onyx Pharmaceuticals Inc. and by Bayer HealthCare Pharmaceuticals.

Source: The U.S. Food and Drug Administration

Zaltrap Approved August 2012
The U.S. Food and Drug Administration (FDA) approved a new treatment called Zaltrap for use in combination with a chemotherapy regimen to treat adults with colorectal cancer. Zaltrap inhibits the blood supply to tumors. It is intended for patients whose cancer has spread to other parts of the body (metastatic) and whose tumors are resistant to or progressed after the commonly used chemotherapy regimen, FOLFIRI. 

“This approval demonstrates the benefits of adding a biological agent, Zaltrap, to a commonly used chemotherapy drug regimen, FOLFIRI,” said Richard Pazdur, M.D., director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research. “An improvement in median survival time was noted with the addition of Zaltrap to FOLFIRI, accompanied by an improvement in response rate and a delay in tumor progression and growth,” according to the FDA.
Zaltrap’s safety and effectiveness was evaluated in a randomized clinical study of 1,226 patients with metastatic colorectal cancer whose cancer grew while receiving oxaliplatin-based combination chemotherapy, or whose cancer was removed by surgery but returned within six months after receiving oxaliplatin-based combination chemotherapy for post-surgery (adjuvant) treatment. Participants received treatment until their cancer progressed or side effects became unacceptable.
The study was designed to measure overall survival, or the length of time a patient lived. Patients who were assigned to receive the Zaltrap plus FOLFIRI combination lived an average of 13.5 months compared to an average of 12 months for those receiving FOLFIRI plus placebo. A reduction in tumor size occurred in 20 percent of patients receiving the Zaltrap plus FOLFIRI combination versus 11 percent for those receiving FOLFIRI plus placebo. In addition, the clinical trial demonstrated an improvement in progression-free survival, or the time a patient lived without the cancer progressing. The progression-free survival for patients receiving the Zaltrap plus FOLFIRI combination was 6.9 months compared with 4.7 months for those receiving FOLFIRI plus placebo.

Zaltrap is being approved with an alert to patients and health care professionals that the drug can cause severe and sometimes fatal bleeding, including gastrointestinal bleeding and the development of holes in the gastrointestinal tract. Zaltrap can also make it more difficult for wounds to heal. The most common side effects observed in patients receiving Zaltrap plus FOLFIRI were decreased white blood cell count, diarrhea, mouth ulcers, fatigue, high blood pressure, increased amount of protein in the urine, weight loss, decreased appetite, abdominal pain, and headache.
Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
Zaltrap was developed by Sanofi and Regeneron Pharmaceuticals, Inc.

Colorectal Cancer Prevention and Risk





Posted by Barbara Armstrong Green
Welcome. If you have had the chance to read the “My Story” post about my sister Susan’s battle with colon cancer, you may know that Susan died of colon cancer when she was 59, after a four-year battle. How could someone so seemingly healthy and vibrant be growing a silent killer in her colon and not know it? 

Colorectal cancer, which may begin in either the colon or the rectum, is the second leading cause of death from cancer in the United States.  What makes this even more tragic is that colon cancer is one of the most preventable cancers.  

If I only knew then what I know now, my sister Sue might still be alive.  As Sue’s cancer advanced and she realized that she would not beat this, Sue - ever the big sister - focused on how to turn her personal tragedy into an opportunity to save her two sisters from a similar fate.  She wanted to make sure that my sister Peggy and I (as well as other loved ones) would take steps to protect ourselves by getting screened.
We all want to have healthy lives and healthy families but how do we manage it? How do we make the daily choices that may protect us and our families from cancer? Fortunately, the National Cancer Institute has done our homework for us with a list of preventions and risks that we should all be aware of.  Some risk factors, such as smoking may be avoidable. Others, such as inheriting certain genes, may not. Avoiding risk factors and increasing protective factors may help prevent cancer, according to the National Cancer Institute.
Below is a list of protective factors that decrease the risk of colorectal cancer:
  • Physical activity: Regular physical exercise
  • Aspirin: Taking aspirin every day for at least 5 years decreases the risk of colorectal cancer and the risk of death from colorectal cancer. But aspirin may increase the risk of bleeding in the stomach, intestines, or brain.
  • Hormone replacement therapy (HRT): Studies have shown that hormone replacement therapy (HRT) that includes both estrogen and progesterone lowers the risk of colon cancer in postmenopausal women. HRT with estrogen alone does not lower the risk. However, hormone use increases the risk of breast cancer, heart disease, and blood clots.
  • Polyp  removal: Removing colorectal polyps that are larger than one centimeter (cm) may lower the risk of colorectal cancer. It is not known if removing smaller polyps lowers the risk of colorectal cancer.  The possible harms of polyp removal during colonoscopy or sigmoidoscopy include a tear in the wall of the colon and bleeding.

Below is a list of risk factors that increase the risk of colorectal cancer:
  • Age: The risk of colorectal cancer increases after age 50.
  • Family history of colorectal cancer: Having a parent, brother, sister, or child with colorectal cancer doubles a person’s risk of colorectal cancer.
  • Personal history: Having a personal history of inflammatory bowel disease increases the risk of colorectal cancer.
  • Inherited risk: The risk of colorectal cancer is increased when certain gene changes are inherited.
  • Alcohol: Drinking three or more alcoholic beverages per day increases the risk of colorectal cancer. Drinking alcohol is also linked to the risk of forming large colorectal benign tumors.
  • Cigarette smoking: Cigarette smoking is linked to an increased risk of colorectal cancer and death from colorectal cancer.
  • Obesity: Obesity is linked to an increased risk of colorectal cancer and death from colorectal cancer.
Please take a few moments to comment on this blog and return to the Susie's Cause web site to learn more about protecting yourself and your family from this devastating disease.

Source: National Cancer Institute at the National Institutes of Health

 

Medical Disclaimer 

The information presented on the Susan Cohan Colon Cancer web site is solely intended to provide you with information that will help educate you on the importance of diet, exercise and regular cancer screening in maintaining a healthy lifestyle. Adopting these habits is an individual choice and one that should only be made after consultation with your health care professional. No information provided on this Web site or otherwise offered is intended to replace or in any way modify the advice of your health care professional.







Thursday, November 01, 2012

My Story - Barbara Armstrong Green





Posted by Barbara Armstrong Green
Welcome to the National Colon Cancer Foundation’s Blog.  My name is Barbara Armstrong Green, blog manager.  I suspect that you are here for the same reason I am.  We have had a close encounter with colon cancer. My encounter came eight years ago, the summer of 2004.  My sister, Susan Armstrong Goglia, then 55, was enjoying a relaxing vacation at Ocean City with her husband Michael Goglia, who is my brother-in-law and the web master for this site. 

Coincidentally, my husband Charlie and I were entertaining friends at Bethany Beach at the same time.  It was a perfect weekend. We were so blessed. Then the phone rang.  And my vibrant sister Sue told me she was in terrible pain and had been to the hospital for some sort of blockage. 

The next time I saw Mike and Sue and our sister Peggy was several days later just before Sue was about to have surgery.  Family and friends gathered in the hospital waiting room to support us. After what seemed like an eternity, the surgeon walked over to us and broke the news that it was indeed colon cancer and that it had broken through the colon wall.  We just looked at the surgeon, trying to comprehend what he had just said and what it meant for Sue.  After a stunned silence, one of our family members quietly turned to the surgeon and said, “That doesn’t sound good.”
Sue was diagnosed with stage three colon cancer – stage three! – I didn’t even know what that meant.  I had never heard of stages of cancer.  I had just seen Sue a few weeks ago.  Her only complaint was a little lower back pain.  Who doesn’t have that on occasion?
My beloved sister Sue, an elementary teacher and principal, who touched the lives of countless children, died at the age of 59, after a four-year battle with colon cancer. She left a husband, daughter, son, five grandchildren, two sisters, and too many other devoted family members and friends to list here.  What makes this even more tragic is that colon cancer is one of the most preventable cancers.

We hope that you will use this blog to share your stories and comments with one another and learn together. Also check out our web pages, which have a lot of information you might find helpful.

Our family loves to get together.
Three Sisters (from left) Barbara, Peggy & Susan

Family beach day at Bethany Beach
Team Furtub participants at the Annual 5K Run and Family Walk in Towson, MD

Please leave a comment.  We welcome people to tell their stories. Don’t forget to click back to the Susie’s Cause web site for more information on colon cancer.


Medical Disclaimer

The information presented on the Susan Cohan Colon Cancer web site is solely intended to provide
you with information that will help educate you on the importance of diet, exercise and regular
cancer screening in maintaining a healthy lifestyle. Adopting these habits is an individual choice
and one that should only be made after consultation with your health care professional. No
information provided on this Web site or otherwise is intended to replace or in any way modify
the advice of your health care professional.

 

 
 









Friday, February 19, 2010

Dr. Fuhrman will be contributing to our website!

Allow us to introduce Dr. Fuhrman and his insights…


In response to the numerous requests for information and an equal amount of requests for a Healthy Living Section on our site, the Foundation has enlisted the nutritional and lifestyle expertise of Dr. Joel Fuhrman. On a personal note, as Executive Vice President of the Foundation, I have read Dr. Fuhrman's books and subscribed to his website, which provides an online forum with Dr. Fuhrman to ask him questions directly in real-time. I also ordered some of his wonderful products. In fact, after just 8 weeks of following his program, I’ve lost 20 pounds, experienced extraordinary results in reducing my total cholesterol levels from 214 to 155, and I’ve achieved a overall nutritional balance.


After having the pleasure of meeting with Dr. Fuhrman personally, we are confident that he is the best individual to assist the Colon Cancer Foundation in providing to our followers the most current information on health, nutrition, and colon cancer prevention. Dr. Fuhrman has agreed to contribute on a regular basis with important updates on nutrition and health. You can view his website at www.drfuhrman.com


Joel Fuhrman M.D. is a board-certified family physician and one of the country’s leading nutritional medicine experts. He speaks to audiences at conferences and events throughout the United States and Canada. He is a frequent guest speaker at hospital grand rounds and has lectured at benefits for the American Heart Association and the U.S. Olympic Team. Dr. Fuhrman has appeared in hundreds of magazines, radio, and television shows including: Good Morning America, The Today Show, Good Day New York, America’s Talking, TV Food Network, CNN, Oprah & Friends, and the Discovery Channel.

His best-selling book, Eat To Live: The Revolutionary Formula for Fast and Sustained Weight Loss, published by Little Brown & Co. in 2003, has gone through 17 printings and several foreign language translations. The book describes Dr. Fuhrman’s high nutrient eating style that is the safest and most effective way to permanently lose weight and prevent and reverse disease.

Dr. Fuhrman’s most recent release, Eat For Health guides the reader through a gradual transition to increase the level of micronutrients in their diet, while losing the addictive and psychological dependencies of unhealthy foods. His other books include Disease Proof Your Child: Feeding Kids Right, Cholesterol Protection for Life, and Fasting and Eating For Health.

Dr. Fuhrman is a graduate of the University of Pennsylvania, School of Medicine. He is widely published in medical journals such as the University of Pennsylvania Journal of Orthopedics and Alternative Therapies in Health and Medicine, as well as consumer publications such as Readers Digest, NJ Savvy Living, Mothering Magazine and Health Science.

Dr. Fuhrman is the Medical Director of the Eat Right America Foundation, a non-profit organization dedicated to educating Americans about the connection between appropriate food choices and long term health. He is a member of the Board of Directors of the National Health Association and the American College of Lifestyle Medicine. He sits on the advisory panel of The Physicians Committee for Responsible Medicine and is a diplomat of the American Academy of Family Physicians. Dr. Fuhrman is also the Chair of Nutritional Excellence for the Nutrition for Wellness Foundation in East Hampton, NY. Dr. Fuhrman’s corporate wellness program offers corporations an interventional strategy for their employees to prevent and reverse disease while lowering company’s health care expenditures. His other corporate experiences include a position on the PwC Health and Performance Advisory Panel at PricewaterhouseCoopers. Joel Fuhrman is a former world class figure skater and was a member of the United States International and World Figure Skating Team. In 1973, he won Second Place in the United States National Pairs Championships. In the World Professional Pairs Skating Championships in Jaca, Spain in 1976, he placed third.

More and more research continues to prove that proper diet, exercise, and nutritional supplements can be of great value in the prevention of many diseases and specifically Colon Cancer. With that knowledge we are proud to provide you Dr. Fuhrman’s insight and will continue to provide the latest information on achieving and maintaining a healthy lifestyle.

Your generosity will continue to enable our foundation to continue its mission to eradicate Colon Cancer as a life threatening disease. Please visit the donations section of our website and help us to reach our goals. For assistance please call our National headquarters at 410-244-1778. As always, you can reach me at bobby@coloncancerfoundation.org.

Susie’s Cause
ColonCancerFoundation.org
201NorthCharlesStreet
Suite2404
Baltimore, Maryland 21201

Monday, January 11, 2010

Dr Stein's Chronicles


The Daily Grind

I recently saw a patient diagnosed with colon cancer. She was relatively healthy, and she was referred to me for a laparoscopic colon resection. I did what I always do. I spoke to her about the risks and benefits of surgery. I discussed what she can expect after surgery, from pain to bowel function. I discussed how we determine her pathologic stage and if she would need chemotherapy. Afterwards, she told me she was also seeking a second opinion and had the appointment already scheduled at a different institution. I told her, as I tell every patient, that I firmly believe my role is to help everyone who comes through my door, and that she has to be comfortable with and trust her surgeon, whether it was me or someone else.

She asked me all the usual questions – laparoscopic vs. open surgery, complications, and how many surgeries have I done, what are my results – and I gave her all my answers. She called me this past Monday morning and told me she was going with the other surgeon and his institution.I wished her the best and that was that.

Yet it gnawed at me for the rest of the day. Did I do something wrong? Did I not spend enough time with her? Did I make her wait too long in the waiting room? Did I not engender enough trust? Should I have done something different? Could I have done something better? Did I fail to help her?

It is inevitable that at some point in time each and every one of us asks the question “Am I doing a good job? Am I doing something worthwhile?” In healthcare, many people enter the field to do something special and to help make people better. In truth, most people enter a chosen area of work because they enjoy it, it stimulates them, and they like the people or lifestyle.

We are extremely excited when start on a new path – whether it is work, exercise or a hobby.We try to excel at what we do – whether it is trying a case, selling a product, cleaning a floor, running on the treadmill or programming a computer. However, as time marches on, the novelty and excitement wear off and we are faced with a daily grind. We become cogs in a wheel, and are unable to generate excitement and enthusiasm for our daily vocations. This is true in medicine as well.

After years of training, we enter practice, and treat thousands of people over the course of a few years. Yet it becomes a routine, tedious, mundane – no more novelty and excitement. Where am I going with this? No, I do not believe I am having a midlife crisis (my wife may disagree), nor am I planning on a career change, but I have started asking myself some tough questions - Am I doing everything I can to provide the best care? Am I staying on top of new research and developments in my field?

I recently read the book Better by Atul Gawande. The basic message is that to make yourself better than average, you need to be able to look in the mirror, critique yourself and implement a change. Whether it is a vocational issue or simply a lifestyle issue (I do need to eat more fiber……) we all have room to improve. It is how we deal with these day to day issues in our lives that will truly define us.

As the New Year begins – I am hopeful that we will all strive to choose an aspect of our lives that we can critique, improve upon and ultimately become better for it.









Thursday, October 29, 2009

COLON CANCER SCREENING MADE FASHIONABLE AT AARP’S VEGAS@50+

Fashion designer and colon cancer survivor Carmen Marc Valvo to encourage screening and early detection


The Venetian

Sands Expo and Convention Center, Hall C 3355 Las Vegas Boulevard South

Thursday, October 22, 2009 from 12:30 – 1:30 PM

As more than 30,000 people gather in Las Vegas for AARP's national annual meeting October 22-24, 2009 organizers have invited renowned fashion designer and colon cancer survivor Carmen Marc Valvo and a representative of the national nonprofit Susie’s Cause to alert attendees about the importance of colon cancer screening and their options for early detection. Carmen will also host a fashion show featuring some of his most beautiful designs. Carmen’s feature session is being sponsored by Quidel Corporation, manufacturer of the QuickVue® iFOB (immunochemical Fecal Occult Blood) test.

Colonoscopies can be costly for the uninsured and the 2009 Colorectal Cancer Legislation Report Card indicates that many states still do not require insurance companies to cover preventative screenings. While there is not a replacement for a colonoscopy, consumers need to be aware of potential lower cost screening alternatives recommended by the American Cancer Society and other organizations. This includes a yearly fecal immunochemical test also known as FIT, an at-home screening test available through healthcare providers that detects blood in stool which can be an indicator of colorectal cancer.

Carmen Marc Valvo, renowned fashion designer and colon cancer survivor. Carmen's designs, which are currently staples at Neiman Marcus, Saks Fifth Avenue and Bloomingdales, have been worn by some of the world's most recognized women, including Katie Couric, Kate Winslet, Vanessa Williams, and Catherine Zeta-Jones.

COLORECTAL CANCER FACTS:

The American Cancer Society estimates that in 2009, almost 150,000 people will be diagnosed with colorectal cancer and almost 50,000 people will die of this disease. Cancer of the colon and rectum combined are the third most common type of cancer and second leading cause of cancer deaths in the United States. The majority of these cancers and deaths can be prevented through early screening and detection.

ABOUT SUSIE’S CAUSE:

Susie’s Cause is a nonprofit foundation that educates the public about the benefits of colorectal cancer screening. Susie’s Cause advocates screening if you are over 50 and are at average risk for colorectal cancer, and over 40 if you have a family history of colorectal cancer.

ABOUT QUIDEL CORPORATION:

Quidel Corporation serves to enhance the health and well being of people around the globe through the discovery, development, manufacturing and marketing of rapid diagnostic solutions at the point of care in infectious diseases and reproductive and gastrointestinal health.

Friday, September 25, 2009

Second Annual Golf Classic

We are still accepting foursomes and sponsors for the Second Annual Susie’s Cause Charity Golf Classic to be held on Monday October 5, 2009. The tournament will be held in Frederick, Maryland at The Clustered Spires Golf Course and we are proud to announce that Kendel Ehrlich is the Honorary Chairwoman of this year’s Classic.

Join PGA Golfers Woody Austin and John Rollins and the many corporations and individuals showing their support for our work in eliminating colon cancer as the second leading cause of cancer deaths in men and women. Take part in this fun event or come out and cheer on the golfers as they shoot their way into Golf
Classic glory.

View all the details in our registration packet:
Registration Packet

Wednesday, September 09, 2009

A Woman's Strength and Courage

We wanted to take this opportunity to share with you one of the most moving letters we have received since we began Susie's Cause. It is a great reminder of all of the women that are touched by Colon Cancer and the tremendous strength and character that so of many these women possess. It is another wonderful testimony to the human spirit and the love and support that are all around us. We are very proud of our leading Board member Dr. Howard Berg for his role in Stacy's care and guidance. Most of all it reminds us of the work ahead of us to continue to educate the public and remove the stigmas of this dreaded disease.


Hello,

My name is Stacy Arthur and here is my story. I was diagnosed with rectal cancer 18 months ago and I am currently in remission. Rectal cancer is not glamorous. In fact, it is rather embarrassing because of the body parts involved and the tests and probes required for diagnosis and treatment. I have decided to reveal my painful ordeal to hopefully increase awareness of this disease. I want to thank the numerous medical personnel who provided me with such quality care. It is also a testament that you can win the battle against this nasty disease.

My life was pretty close to perfect on my 37th birthday in March 2008. A few days later on March 27, 2008, I was blindsided when I began to hemorrhage rectally after a nice dinner with my family. My five year old son was home and could not be left unattended. I calmly called my mother around 9:45 p.m. and asked her to pick me up and drive me to the ER. She and my step-father arrived and drove me to the hospital. Upon my arrival, I felt a great need to use the bathroom and before I could make it there, I passed out onto the lobby floor and blood clots the size of steaks began seeping through my pants. I was immediately taken back for treatment and started to receive blood transfusions. I was told that I had lost 3/4 of my blood and was extremely lucky to be alive. As each transfusion entered my body, it was quickly expelled. I believe I received four transfusions before the hemorrhaging began to subside. It took some time but I was finally transferred to the ICU around 1:30 a.m. I had a lovely nurse who saw the terror in my eyes and stayed with me most of the night. She did her best to assure me that the bleeding was not likely to be cancer related. Several other conditions can cause severe bleeding and with my age and lack of symptoms, cancer was the least likely diagnosis. Apparently, the rectum is very venous and severe bleeding can be common. With the bleeding stopped at least temporarily, the plan was to send me for a colonoscopy as soon as a space was available. Around 2:30 p.m. on March 28th 2008, I was taken down for my colonoscopy. The test took little time and the next thing I knew, I was waking up in recovery. When the doctor came to visit me in recovery, my mother asked him if it was cancer. She let him know that she was aware pathology reports were needed for true confirmation but with his experience, he should have a pretty good idea if it was cancer. He sadly shook his head and let us know that his experience lead him to believe that the mass was cancerous. Shortly after, I was transferred back to ICU with my mind racing but surprisingly, I felt rather well physically. The next couple of days passed with lightning speed and I was soon transferred to a medical/surgical unit. Dr. Jeffrey Alexander, my primary care physician of more than 15 years came to visit. He sympathetically explained my situation and told me that I would need to have a team of specialists assembled quickly. I don't know how he did it, but within 30 minutes, I was introduced to my oncologist, radiation oncologist, and three colo-rectal surgeons from the same practice. Dr. Howard Berg was the last to speak to me. He in no way sugar coated my situation. He let me know what I was up against and what steps I needed to do NOW! At the time I felt he was a little abrasive but I have come to admire him tremendously and appreciate his honesty however harsh it may be. The next two days were packed with diagnostic tests. I later learned that the Cancer Board of Maryland was meeting on Friday and the physicians wanted results back so my case could be presented during the assembly. I'm still not sure but I took that to mean that the top cancer physicians in Maryland would agree to the best plan of treatment after case review and discussions.

Pathology reports confirmed that I had a seven centimeter tumor in my lower rectum and treatment needed to be started immediately. The cancer had spread to 3 lymph nodes and had also invaded my vaginal wall. I believe the cancer was categorized as Stage III/IV because although it had spread, no major organs were involved. After my release from the hospital, my treatments began almost immediately. Initially, I visited Dr. Jason Citron for radiation treatments five days a week for five weeks. During week one and week five, I also visited my Oncologist, Dr. Richard Huslig for chemotherapy. Radiation was quite painful but I survived. Once the radiation was completed, I was given five weeks to allow the swelling to subside during which time I felt rather well. I have never really asked "Why Me?" but one thing does upset me. My doctors believe that this tumor was slow growing and had probably been present for several years. I was on fertility drugs for eight months and saw my GYN on a regular basis. Had she done a rectal exam this tumor most likely would have been discovered but rectal exams are typically done on women over 40. Having said that, I have also had some very reputable doctors tell me that this tumor was so large that it could have been detected during a vaginal exam.

On July 8th 2008, I was admitted to the hospital to undergo my major surgery not completely sure what to expect. I was however confident that I had the greatest group of surgeons working together to perform the surgery. I fondly referred to them as the A-Team. Dr. Berg and his partner Dr. Akbari were present for the colo-rectal piece. Dr. Neil Rosenshein who is a fantastic GYN Oncologist was on hand to perform the hysterectomy. Dr. Jeffrey Schreiber was the plastic surgeon who had the chore of putting me back together. At the beginning of the surgery, there was some hope that my rectum could be salvaged and I would only need a temporary colostomy. My surgery lasted about 8 hours and I was overwhelmed with joy when I opened my eyes for the first time and realized that I had made it through surgery. Many people were standing around me and I immediately had an uncanny feeling that there was bad news. Everyone smiled and kissed me and said how well I had done and I quickly asked "What is the bad news?" My gut feeling was right and I was informed that I had a permanent colostomy and my rectum was completely removed and replaced with a skin graft.

Using clinical terms, I underwent a total bilateral hysterectomy, bilateral salpingo-oophorectomy, partial distal vaginectomy as well as sigmoid colon resection with proctectomy, and abdominal perineal resection with a vaginoperineal reconstruction. In my words, I had a total hysterectomy, the cancerous mass and 20 some lymph nodes were removed (the mass and three original lymph nodes that were cancerous prior to radiation came back non-cancerous) Portions of my vaginal wall, my pelvic floor, my rectum and anus were removed. Muscles were removed from my abdomen and were attached to make a new pelvic floor and vagina. A skin graft was also removed from my abdomen and sewn over my bottom. I may have mixed up some medical mumbo jumbo but that is the basic picture.

As the anesthesia wore off, I was transferred to ICU in agonizing pain where I remained for eight long days, flat on my back with nothing to eat or drink. I was having constant hot flashes and despite the thermostat reading in the low sixties, I was still hot. Noise drove me insane and even though my eyes were closed, I was aware of everything going on around me. I did have one scare in the ICU where my heartbeat went out of control but that was soon regulated. On the 9th day, I was moved to a regular room but was still in agonizing pain and very paranoid. After my surgery, I was placed on a Fentanyl drip and it wasn't until it was discontinued did I realize my body did not respond favorably to that drug. Once I was able to take oral medication for pain, I was a little more relaxed and in control. I suffered a complication during my surgery and woke up only to find that my left leg was paralyzed. I could not do anything for myself. I was unsure if I would ever feel better.

I was still hospitalized on my son's 5th birthday. This was the absolute worst day of my life! Not the hemorrhage, diagnosis, pain or paralysis could compare to the feeling I had when he walked into my room and saw me with tubes everywhere on his very special birthday. We had presents, balloons and cake but he trembled when he got near me and kept asking to leave. I was so devastated to see him so scared. He was the reason I had been fighting so hard. I have a locket with his picture that is actually displayed on the outside. I wore this locket to every doctor's appointment and pointed out that dying was not an option for me because I had this son to raise. His 6th birthday just passed and I made sure it was extra special. He was allowed to have two parties and I am so incredibly thankful to be here to share it with him.

I was discharged on July 19th. The pain was still unbearable. My husband had to carry me upstairs and I needed help with everything. I had a large swollen open wound on my backside. I had a home health nurse and physical therapist come every day to pack my wounds and work to just get me out of bed. Then there was the issue of the ostomy bag to get used to. The bags have to be cut and placed just right so waste does not spill all over you. I had several drains left in to collect fluid which were awkward and painful. There were times when I couldn't imagine a time when I would not be in pain. Slowly, I began to regain my strength and made strides in baby steps. I was soon able to walk with a walker. It did take two months before I was somewhat able to manage to get around independently.

I was finally encouraged by my progress and then had to begin chemotherapy on Sept. 9th 2008. I was given oxaliplatin over several hours on a Monday and left with a fannie pack of 5FU that flowed through my veins until that Wednesday. So every other week, I was hooked to chemo for three days. Half way through my treatment, the oxaliplatin was causing permanent neuropathy in my hands and feet. I was then changed to Camptosar still in conjunction with the 5FU. I also received Neulasta shots to boost my immune system. My chemotherapy was finally finished on February 11, 2009.

While most of my story sounds quite gloomy, now I would like to give some insight to some positive outcomes of my illness:

FIRST AND FOREMOST - I AM ALIVE AND GET TO SPEND TIME WITH MY SON!

I am usually able to drive and have resumed working although it is a shorter work week making me somewhat independent.

My husband has stood by me during good times and bad. He carried me up and down the steps when I first came home and slept on the floor in the hallway with his head in my room my first few days home.

My family and friends have shown unwavering support. I have received over 150 cards, flowers, and meals.

I talk to my mother every day and she showed how much I meant to her when she took me for most of my treatments.

If you look, you can see beauty in life every day.

Material things are not important and can be replaced where people can't.

My mother-in-law was a tremendous support when I was diagnosed. She spent her time with me or took my son on special trips. She came to be a good friend to me. Unfortunately she was diagnosed with colon cancer on 10/1/08 and died 3/9/09. I cherish the time I spent with her and really miss her especially after we had grown close.

I would say that we are more closely bonded with all of our family members after this ordeal.

The staff from my place of employment have shown genuine concern for me over the months.

Coming so close to death has made me realize how much living I have left to do.


The anniversary of my surgery really forced me to do some soul searching. For a few weeks, I found myself depressed. During my fight, I never stopped to feel sorry for myself. I always had a hurdle that had to be crossed. Until recently I had no time to dwell on my experience and was always in fighting mode. I gained a considerable amount of weight following chemotherapy. I am very greatful to say that today I am cancer free. One thing that I didn't realize is that there are still complications that arise even though the cancer is in remission. I still suffer from fatigue as well as muscle,,joint, and bone pain. I still have a least four appointments a week for follow-up. I just hope to find a "New Normal"

I had the pleasure of speaking to Susie's dad recently and I hope that I can contribute to this cause. Make no mistake that I feel extremely lucky to be here and anyone that should find themselves faced with a medical such as mine, there is light at the end of the tunnel.


IT REALLY IS A BLESSING TO BE ALIVE!



Stacy Arthur

Sunday, August 30, 2009

Dr. Stein's Chronicles

Colon Cleansing and CAM

Cleaning colons is apparently the rage of the 21st century. Celebrities, friends and TV talk show hosts are all discussing it, but is it a healthy thing to do? Are there truly pounds of waste backed up in that colon that has accumulated over the past 20 years? The answer to the first question is maybe, the answer to the second question is an emphatic NO! The theories behind a build-up of waste were debunked in the early 1900s. The concept was called auto-intoxication, the idea that poisons in the stool built up over time and caused disease.

This theory was disproved more than a century ago. Yet it seems so logical that people say it must be true. When one truly understands how miraculous the human body is you realize that these theories make no sense. The body is designed to not waste anything - in fact our waste - the stool, contains the nutritional components that keep the colon healthy! Bacteria in our colon help our body modify the waste so it is usable for the cells in the colon lining, known as the mucosa. Repeated cleansing actually traumatizes the colon lining and may lead to problems such as colon ulcers, bleeding and perforation.

So why the obsession? It is true that most of Western Societies have an element of constipation, but this is mostly do to a lack of fiber intake. If we all took in the recommended dose of dietary fiber, and drank enough water, we would eliminate constipation, diverticular disease and symptomatic hemorrhoids. So if colon cleansing means taking high-dose fiber products, I have no problems with it. For a full review on colon cleansing feel free to go to http://www.betterbowel.com/articles/the-truth-about-colon-cleansing - an article I wrote a year ago.

Much of the publicity for colon cleansing comes from sources in alternative medicine. We have learned over the years that there is much value in understanding herbal remedies, and many of them work. Witch hazel is used for hemorrhoids, and is also the active ingredient in Preparation H (sorry - I can talk about this stuff for days). So how do you figure out what is reliable and what is pure fiction? You need to find resources for complementary alternative medicine.

So what is complementary alternative medicine, affectionately called CAM? Nobody seems to know. On the one hand, the Institute of Medicine defines it as follows: "Complementary and Alternative Medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed."

I am not sure that helps - I did not understand that definition at all. The bottom line is CAM is what you make of it. It varies between people, religions, cities and countries. In some countries, CAM programs are run by medical physicians. In the United States, CAM has traditionally been independent of Medical Doctors. Many Naturopathic Physicians obtain degrees for Alternative Medicine via web based programs. The question is simply how one can decide if their CAM practitioner is well trained and understands the complementary nature of traditional medicine and alternative therapies.

Modern medicine has needed to embrace and understand the nature of alternative therapies and for most of the 20th century has failed to do so. Recently, academic medical centers have begun incorporating alternative therapies into their healthcare delivery systems.
My simple advice is to only use those CAM Centers affiliated with Medical Schools and Hospitals, such as the University of Maryland’s Center. This may help weed out alternative therapies that really have no basis in science or medicine, such as colon cleansing enemas. Did I mention colon cleansing enemas are a load of..........waste?

Wednesday, August 12, 2009

Dr. Stein's Chronicles

An aspirin a day to keep colon cancer away!
The media has been buzzing about newly published data on the use of aspirin in patients with colon and rectal cancer. Since the 1980s, the genetic mechanism of colorectal cancer development has been known. Colon cells, called colonocytes, take a "hit" to one of their genes. The cells begin to grow abnormally, and they form disorganized tissue which can become a polyp. A second "hit" makes the cells even more irregular, and the polyp turns into a cancer. Although admittedly, this is a simplified version of the genetic mechanism, these are the genetic steps required for the development of cancer. Why does it happen to some people and not others?

The human body is complex. There is an interaction between a person’s immune system, the environment and genetics. These complex interactions are what determines who will develop cancer and who will not. We have known for some time about something called the inflammatory response. Basically, an increased inflammatory response may actually worsen injury – think keloid formation – the body tries so hard to heal it forms bigger scars as the cells grow more.

This response is mediated by a protein called Cox-2. This protein is stimulated during an inflammatory response, and Cox-2 also stimulates cellular growth. That is why the inflammatory response also promotes colon polyp and colon cancer growth – Cox-2 causes these cells to multiply at a faster rate.

This pathway has been extensively studied in patients with abdominal obesity (the metabolic syndrome), and the increased risk of colon cancer and polyps may be due in part to the increased production of Cox-2. Inhibiting Cox-2 has been studied for many years as a way to decrease cellular growth and reduce cancer risk.

Aspirin and NSAIDs (nonsteroidal anti-inflammatory drugs) decrease the inflammatory response and they inhibit Cox-II. That is why they are effective as pain relievers. The pain from an injury is due to the inflammatory response. This is also why aspirin benefits patients with coronary artery disease and heart attacks, as it decreases the injury to the blood vessels that supply the heart.

There have been prior studies in the New England Journal of Medicine and other journals showing aspirin use decreases polyp formation and may also reduce the risk of colon cancer. The study in this week’s JAMA showed that even after a diagnosis of colon cancer, aspirin use reduces the risk of dying from non-metastatic colon cancer by almost one third.

There are some caveats. Firstly, the aspirin used was full strength and not a baby aspirin, so there is the risk of side effects such as bleeding and GI problems. Second, not every colon cancer is caused by Cox-2, so the benefit is limited to those cancers that express the Cox-2 protein. That being said, I routinely recommend a daily aspirin to all of my patients that have had polyps or colorectal cancer. This study at least re-enforces this aspect of my practice, and tells us that an aspirin a day can keep some colorectal problems away.



Wednesday, August 05, 2009

Dr. Stein's Chronicles

The Beginning


As I am now entering the world of the blogosphere, I cannot help but to think back to chronicle the events that brought me here. It was a cold night in December, 2004 (I really do not remember if it was cold or in December but it sounded good) and my cellphone rang. It was one of my patients who had undergone a laparoscopic right colon resection for a large polyp in the cecum and appendix. He was a few months out from surgery and he was doing great. He asked me if I was willing to speak with a colleague of his who was trying to get a foundation off the ground. I said sure.............. my life would never be the same.



I spoke with Bobby Smith and became involved in Susie's Cause. Together we designed websites, established the mission and I was fortunate enough to meet David Cohan. His passionate and articulate plea that no one desrved to die from colon cancer and suffer like his daughter had resonated within me. It was then I decided I would do everything I can to help this fledgling foundation grow. It was soon afterwards that we decided to combine interactive learning with the energy of teenagers, and the concept of The Save Our Parents Program was born.


Throughout the United States, Canada and Puerto Rico The Save Our Parents Program has galvanised teens to educate their parents and loved ones about screening for colorectal cancer. Featured on the news and on morning shows, this program placed a unique stamp on Susie's Cause, and with each successful program, Susie's Cause repuation as a grass roots organziation that gets involved at the patient level has grown.


In the coming months, as a blogger for Susie's Cause, I will attempt to provide important or interesting information related to GI Health. Although alot of the information will be related to Colon and Rectal Cancer, I will discuss other topics as well. Even for me, there is a limit as to how often I can write about the colon.