7 minute read
ON THE BATTLEFIELD
By Donna Hurst
Colon and rectal surgeon Dr. Kelly Gilmore-Lynch is fighting to cure colorectal cancer with the same persistence and determination as when she pursued medical school. Gilmore-Lynch did not take the usual route through medical school, enlisting in the United States Army at age 17 where she served as a wire systems operator, executive secretary and legal specialist to help pay for college. “I wanted to go to college but didn’t have the means for it,” she says. Gilmore-Lynch quickly discovered that being a woman in the military was no easy task — she had to labor twice as hard as her male counterparts to gain respect. “I learned that the same skills I needed to excel in the military applied to the surgical arena as well,” she says.
During four years of enlistment, she became a certified paratrooper and won a host of commendations for tours of service and exemplary performance. Her perseverance paid off; she earned enough money to study biology and military science at Sam Houston State University. While in college,
she maintained her military connection, serving in the Reserves and participating in ROTC, where she became the first woman commander in the university’s history. Gilmore-Lynch re-entered the Army after college to serve as a medical service officer at Fort Hood and a treatment platoon leader when she was deployed to Saudi Arabia after the Gulf War. After discharge, her dream of medical school came true when she enrolled in the Universidad Autonoma de Guadalajara in Mexico and earned her medical degree. She completed her residency and a fellowship at the University of Texas Health Science Center. “It was a roundabout way to get here, but I wouldn’t change it for the world,” she says. “I attribute my success to the Army.”
Identifying a need
Gilmore-Lynch developed a particular interest in colon and rectal surgery after her general surgery rotation with Methodist colorectal surgeon Dr. H. Randolph Bailey. “I chose colon and rectal surgery because I felt like I could make a difference in multiple areas and realized there was a need for women colon and rectal surgeons,” she says. “Privacy is important, and having a female physician often helps women feel more at ease.” Surgery is a brutal field, she says, but due to her military training she had “thicker skin” and knew what had to be done. The wife and mother of two toddlers sees her future focus on women’s health, especially early prevention and detection of colon and rectal disorders. Only a small percentage of colorectal cancers are hereditary so Gilmore-Lynch stresses the importance of screening. “The majority of colorectal cancers (about 75 percent) are not hereditary, so don’t think you can’t get it if it doesn’t run in your family,” she says. “If it does run in the family, you need to be screened early.” Almost all colorectal cancer starts in glands in the lining of the colon and rectum. Although there is no single cause for colon cancer, Gilmore-Lynch says some studies indicate that a lowfiber diet that is high in red meat may be a factor in developing colon cancer. However, calcium supplementation and regular exercise are showing promise for helping prevent the disease. Nearly all colon cancers begin as noncancerous (benign) polyps, which slowly develop into cancer.
There may be no symptoms associated with colorectal cancer.
Warning signs can include: n Abdominal pain and tenderness in the lower abdomen n Blood in the stool n Diarrhea, constipation, or other change in bowel habits n Intestinal blockage n Narrow stools n Unexplained anemia n Weight loss with no known reason
Life-saving tests
According to the American Cancer Society, colorectal cancer is one of the leading causes of cancer-related deaths in the United States. The good news is early diagnosis often leads to a cure. That’s why screening is so important. A fecal occult blood test or FOBT may detect small amounts of blood in the stool, which can indicate colon cancer. However, this test is often negative in patients with colon cancer. Therefore, sigmoidoscopy (used to examine the lower portion of the colon) or colonoscopy (the only screening that can examine the entire colon) must be performed along with FOBT. “It is absolutely necessary for people to do the preparation correctly prior to colonoscopy to achieve good results,” Gilmore-Lynch explains. “If the colon isn’t completely clean, it diminishes the effect of the colonoscopy.” A colonoscopy proved to be a life-saving test for Dorothy McDonald, an 84-year-old patient of Dr. Bridget Fahy, a surgical oncologist at Methodist. Fahy performed a colon resection on McDonald after colorectal cancer was discovered during a colonoscopy. “I take a prescription blood thinner because I have a stent in my heart,” McDonald says. “I was passing a large amount of blood, which I thought could have been related to the blood thinner, but I knew something was wrong.” McDonald underwent a colonoscopy, which identified the tumor in her colon. She was then referred to Fahy for surgery. Fahy, who is an assistant professor of surgery with Weill Cornell Medical College, found that the cancer was contained — it hadn’t spread to nearby lymph nodes — and chemotherapy wasn’t needed. Knowing that McDonald was a cardiac patient, Methodist’s medical staff monitored her at all times during her stay and assigned a cardiac specialist to her. “Dr. Fahy kept me well-informed. I knew what was going on all the time,” McDonald says.
Lights, Camera… Chromoendoscopy
Methodist continues to expand its reach when it comes to colorectal cancer diagnostics and treatment. One leadingedge technology, chromoendoscopy, offers more intensive inspection than colonoscopy and helps to better detect flat lesions in some patients that colonoscopy may have missed. Chromoendoscopy involves applying stains or pigments topically to improve tissue localization, characterization or diagnosis during endoscopy. According to a study by the American Association for Cancer Research, chromoendoscopy detected more adenomas (benign polyps that can be precursors to cancer) and hyperplastic polyps (the most common benign polyps and aren’t considered to be precancerous) compared to colonoscopy using intensive inspection alone. “Globally, we’re moving more toward personalized medicine and trying to determine who will benefit from chemotherapy,” Fahy explains. “Molecular profiling of colorectal cancer helps oncologists know which therapies will be effective for a particular patient.” Molecular profiling allows pathologists to examine features of tumors removed from colorectal cancer patients. As a result, they can report their findings to the patient’s oncologist who can select the best chemotherapy treatment for the patient. “In addition, Methodist is a member of the Southwest Oncology Group, a regional cooperative group of researchers,” Fahy adds. “As a member of the group, Methodist will sponsor large, multicenter clinical trials for all types of cancer.” Cancer physicians will work collaboratively on projects and are in the process of determining which trials will begin at Methodist in the very near future. Fahy says, “The trials that will be open to our patients will expand our efforts in cancer prevention and treatment and help us understand cancer causes and risks even more.” n
Dr. Bridget Fahy
Patient Dorothy McDonald
To learn more about Methodist’s cancer services, visit www.methodisthealth.com/cancer or call 713-790-3333.
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Four Myths About Colorectal Cancer
MyTh: Colorectal cancer cannot be prevented.
TrUTh: In many cases, colorectal cancer can be prevented. Colorectal cancer almost always starts with a small growth called a polyp. If the polyp is found early, doctors can remove it and stop colorectal cancer before it starts. These tests can find polyps: double contrast barium enema, flexible sigmoidoscopy, colonoscopy or CT colonography (virtual colonoscopy). To help lower your chances of getting colorectal cancer n Maintain a healthy weight n Exercise n Limit your alcohol intake n Eat a diet with a lot of fruits and vegetables, whole grains, and less red or processed meat
MyTh: african-americans are not at risk for colorectal cancer.
TrUTh: African-American men and women are diagnosed with and die from colorectal cancer at higher rates than men and women of any other U.S. racial or ethnic group. The reason for this is not yet understood.
MyTh: age doesn’t matter when it comes to getting colorectal cancer.
TrUTh: More than 90 percent of colorectal cancer cases are in people age 50 and older. For this reason, the American Cancer Society recommends you start getting tested for the disease at age 50. People who are at a higher risk for colorectal cancer — such as those who have colon or rectal cancer in their families — may need to begin testing at a younger age. Talk to your doctor about when you should start getting tested.
MyTh: It’s better to avoid testing for colorectal cancer because it’s deadly anyway.
TrUTh: Colorectal cancer is often highly treatable. If it’s found and treated early (while it is small and before it has spread), the 5-year survival rate is about 90 percent. But because many people are not getting tested, only about four out of 10 are diagnosed at this early stage when treatment is most likely to be successful.
