In recent months, the American Cancer Society (ACS) unveiled new guidelines recommending doctors to begin screening for colorectal cancer starting at age 45. Colorectal cancer includes all cancers of the colon and rectum. Prior to this updated recommendation, physicians were advised to begin screening patients at age 50.
Recent research has shown alarming trends in the U.S. where more people are developing colorectal cancer at a younger age.
Perhaps no one understands this better than Pikeville Medical Center (PMC) Certified Surgical First Assistant, Vanessa Crum, who had her own close-call with colon cancer at the age of 44.
In March of 2016, Crum began experiencing abnormal rectal bleeding and acute abdominal pain. She consulted PMC General Surgeon, Amy Johnson, MD, about her symptoms. She recommended Crum have a colonoscopy right away.
During the procedure, Dr. Johnson discovered over 100 polyps inside of her colon. This finding is not typical for anyone at any age. Dr. Johnson removed 17 polyps in different areas of the colon, specifically the one she suspected was causing the bleeding.
The polyps were sent to the PMC Pathology department to be tested for cancer.
Crum’s official diagnosis was tubulovillous adenoma. It is regarded as one of the more dangerous diseases of the gastrointestinal tract. These types of polyps can develop into cancer within eight to 10 years.
“There was no way to determine how long the polyps had been there, but many of them were precancerous,” Crum explained. “It is scary to think about how close I was to cancer. If I had waited or ignored my symptoms, I might be sitting in a chemo chair right now.”
Due to the location of her polyps, Crum made an appointment with Sadie Hutson, PhD, RN, WHNP-BC, and genetics counselor at the Pikeville Medical Leonard Lawson Cancer Center.
“Genetic testing looks for specific inherited changes in a person’s genes and helps to estimate one’s chance of developing cancer over their lifetime. It is done using a simple blood test,” explained Hutson. “This testing helps individuals learn more about their own risk of cancer, and also the risk of cancer for those who are biologically related to them, such as parents, siblings and children.”
Hutson said that genetic testing helps patients gain helpful information about cancer risks. If an individual has genetic testing and learns that they carry a genetic change associated with hereditary cancer, they are provided with evidence-based strategies to help reduce their risk of cancer. This helps empower individuals to make more informed choices about their health.
“Two weeks later, my test results confirmed that I had a rare, recessive gene malformation called MUTYH Associated Polyposis,” explained Crum. “I also found out that not only did I have a nearly 100 percent chance of getting colon cancer, but I was in a high-risk category for esophageal, gastric, kidney, uterine, breast, duodenal, thyroid and ovarian cancers, as well as mandibular osteoma.”
Part of Crum’s treatment included a subtotal colectomy, performed in January 2018. This procedure removed the affected part of her colon. This step was necessary because there was no way to safely remove all the polyps. While polyp removal is a routine procedure, extracting them in large numbers can increase the chance of perforating the colon, which is very dangerous.
“I feel very lucky to work in health care because it makes me more aware of my body and overall health,” said Crum. “People have to be diligent about their health and make time for themselves to keep their screening appointments. I was guilty of that, too. All I worried about was work and my son.”
This gene mutation was not discovered until 2008. She now participates in a case study as part of a national registry and logs all her tests and data. She hopes they will discover something from her case that will help someone years from now. She says it will all be worth it if she can help prevent just one person from going through everything she has gone through.
Crum has made a conscious choice to be in better health. She quit smoking and has prioritized her own health above all else. She understands her elevated cancer risk and takes time to keep her screening appointments each year. Crum recommends that everyone else do the same.
“Listen to your inner voice. It will tell you if something isn’t right,” urged Crum. “Get screened for things, because it’s more important than you realize. For me, it all started with that colonoscopy.”
In the U.S., colorectal cancer is the second leading cause of cancer-related death among cancers that affect both men and women according to the Center for Disease Control and Prevention (CDC).
The ACS recommends that people with an average risk of colorectal cancer ages 45 and older undergo annual, noninvasive fecal tests and other tests, including imaging of the colon and colonoscopies, every five to 10 years.
This can be done with either a test that looks for signs of cancer in a person’s stool (a stool-based test), or with an exam that looks at the colon and rectum (a visual exam).
Most cancers in stage one, at their most survivable, have no symptoms. If you are not screening for them, you will not detect them.
See your family doctor or nurse practitioner and talk about your health concerns. For more information about the services offered at PMC call 606-430-3500 or browse this site.
