Colon Cancer Awareness by Omaha World-Herald

FACES THE

OF COLON CANCER MARCH IS COLON CANCER AWARENESS MONTH • • •

What you need to know. Page 2 Three tell their stories. Pages 4-5 Superfoods for colon health. Pages 6-7

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SPECIAL SECTION FEBRUARY 26, 2017

SUNDAY, FEBRUARY 26, 2017

OMAHA WORLD-HERALD

Keeping colorectal cancer at bay By Maggie O’Brien

COLON CANCER AWARENESS MONTH This publication was produced by the Omaha World-Herald as a sponsored message for the Great Plains Colon Cancer Task Force. Project editor Chris Christen, 402444-1094, chris.christen@owh.com Deputy project editor Howard K. Marcus, 402-444-1397, howard. marcus@owh.com Designer Kiley Cruse Copy editor Kim Carpenter Writer Maggie O’Brien On the cover: Nebraskans and Iowans affected by colon cancer. Clockwise from top left: Cheryl Ferguson and family, Kelly Arkfeld with husband Mike Arkfeld, Chris Snowardt, Laurie Earnest-Little, Nancy Paul with daughter Katie, Amanda Troutman, Keisha Holloway, Shawn McCann and his wife Dianne McCann, Summer Peterson, Stephen Monroe and Julie Klug. Photos provided by the Great Plains Colon Cancer Task Force. For special section advertising information, contact dan.matuella@ owh.com.

WHEN TO GET A COLONOSCOPY

WORLD-HERALD CORRESPONDENT

Fifty is the magic number. That’s the age doctors recommend for beginning regular colon cancer screenings. The exception is for people with a family history of colon cancer. A physician might recommend that first screening at a much younger age. The most common — and preferred — test is colonoscopy, which examines the large intestine for suspicious cell clusters or polyps. In colon cancer, healthy cells in the large intestine become damaged, and errors develop in their DNA. The damaged cells then divide and accumulate to form tumors in the colon. Nationwide, an estimated 96,000 new cases of colon cancer will be diagnosed Dr. Alan this year while colon cancer deaths are Thorson estimated to reach 40,000, according to the American Cancer Society. About 840 Nebraskans will be among those diagnosed, and about 330 will be among colon cancer’s victims, according to Dr. Alan Thorson, a colon and rectal surgeon with Colon and Rectal Surgery Inc. and Colonoscopy Center Inc. The good news, he said, is that colon cancer has been on a steady decline nationally and locally over the last decade. He credits colon cancer awareness campaigns for helping to improve the numbers. Screening, he said, is the best prevention because it allows cancer to be caught early, and even stopped before it starts. Colonoscopy is recommended every 10 years, beginning at age 50 for many people. The examination can detect colorectal polyps that need to be removed. “It doesn’t spread very quickly,” Thorson said of colon

» If someone in your family — a parent or sibling, for example — has been diagnosed with colon cancer, you should have your first colonoscopy 10 years before the age they were when their cancer was detected. » If there is no history of colon cancer in your family, get your first colonoscopy at 50. If no polyps are found, repeat every 10 years. » For an African-American with no family history of colon cancer, that first screening should take place at age 45. Source: Guidelines of the American College of Gastroenterology

cancer. “It can take five to 10 years for a polyp to become cancerous. It gives us a lead time to find a polyp and take it out. That’s the goal.” Most people dread a colonoscopy because of the preparation required the day before, including consumption of a liquid that evacuates the colon and allows doctors to get clear views of it with a tiny camera. But properly completing the prep is how doctors can use colonoscopy to spot small colon cancers while they are treatable, before they spread to other parts of the body. People should have the tests regularly until they reach age 75 or so, Thorson said. After that, it depends. “I tell my patients that after 75, they should assess their overall health when they decide whether or not to continue screening,” Thorson said. “If they are remaining healthy and active with a life expectancy of at least five years, they may choose to continue screening. I don’t use a strict age cutoff.”

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Myth vs. fact: Now you know what doc knows Being smart about diagnosis, prevention can save your life By Maggie O’Brien // WORLD-HERALD CORRESPONDENT With any disease or condition, there are myths and there are facts. Dr. Josh Evans, a gastroenterologist with Midwest Gastrointestinal Associates in Omaha, sets the record straight on colon cancer, one of the leading causes of cancer death in the United States.

Myth: Periodic colon cleanses keep excess waste from sticking to the wall of the colon and releasing toxins that develop into cancer cells and precancerous polyps. Fact: There is no scientific evidence backing claims that certain herbs, foods or liquids consumed to flush the colon actually prevent or slow colorectal cancer. In Evans’ opinion, such routines are a waste of time and money. Myth: A colonoscopy is just a cancer screening. Fact: A colonoscopy is much more than a cancer screening. It not only detects colon cancer, it finds and removes precancerous polyps before they can become deadly. A colonoscopy is the most effective way to protect yourself from dying of colon cancer. Doctors recommend regular colonoscopies beginning at age 50, or earlier if there is a family history of the disease.

HOW TO PROTECT YOUR COLON HEALTH » Maintain a healthy weight. » Be phyically active. » Eat 2½+ cups of vegetables and fruits daily. » Choose whole grains over refined grain products. » Limit red meat and processed meat in your diet. » Limit alcoholic drinks to one daily for women, two for men. » Never use tobacco. » Get regular colonoscopies after age 50. Source: American Cancer Society

Myth: Only people with a family history of colon cancer are susceptible to the disease. Fact: Anyone can get colorectal cancer. Evans said in his practice, one in seven patients under age 50 diagnosed with colon cancer have no family history. African-Americans with no family history are especially prone to the disease. They are diagnosed and die from colorectal cancer at higher rates than individuals of other racial groups. Why remains a mystery to researchers. Myth: Colon cancer has no symptoms. Fact: Rectal bleeding — which can be a sign of precancerous or malignant polyps — is often attributed to hemorrhoids and sometimes ignored. Changes in bowel movements, including ongoing diarrhea or constipation, also are symptoms. Be diligent, Evans said. See a doctor if anything looks or feels strange.

A R E G I O N A L R E F E R R A L C E N T E R F O R C O L O N A N D R E C TA L S U R G E R Y W I T H A N AT I O N A L A N D I N T E R N AT I O N A L R E P U TAT I O N

Celebra ng 98 years of con nuous service in the delivery of expert surgical care for colon and rectal diseases to the Omaha community. We provide state of the art care for colon and rectal diseases including laparoscopic and robotic surgery, complete surgical care for colon and rectal cancer, inflammatory bowel disease, diverticulitis, fecal incontinence and hemorrhoids.

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Lauren Sullivan with her husband, Justin, at the Boxer 500. mother, Karen Coffey, who died of colon cancer at age 52.

Don’t chance it, lucky triathlete says S cott Hazuka considers his colon cancer story a lesson for those who might dismiss a strange health issue as a fluke that will go away on its own. Though Hazuka, 40, didn’t have colon cancer, he was close to it. A married father of a 12-year-old and a 9-yearold, Hazuka is a former triathlete who began noticing blood in his stool in his mid-30s. Doctors told him the cause was an anal fissure that would go away on its own. But the bleeding continued. Hazuka was about to start a new fitness plan and scheduled a physical to make sure everything was in check. His primary care physician noticed hemorrhoids and suggested a colonoscopy to make sure there wasn’t any other internal bleeding, or something besides hemorrhoids causing the rectal bleeding. Hazuka went to the colonoscopy appointement without much fear. His father, who is in his 70s, had had a few polyps removed, but there otherwise was no family history. Besides, Hazuka was a decade younger than the recommended age for beginning regular screenings for colorectal cancer. “If you had a checksheet for colon cancer, most everything about me would not have been on that list,” Hazuka said. “Everything led me to believe that I had hemorrhoids.”

During the colonoscopy, Hazuka’s doctor found and removed a colorectal polyp that was more than an inch-and-a-half in size. Such polyps often turn cancerous, and Hazuka’s doctor told him he was certain to have developed cancer if he had waited to have the colonoscopy. “I woke up, and my wife and my dad were looking at me like, ‘You are one lucky sucker,’ ” Hazuka said. “It had the makings of becoming pretty bad had I even waited a couple more months.” Hazuka is feeling great. The blood in his stool is gone. He’s making his health an even bigger priority and is grateful to be around for his wife, Kristy, and Natalie and Halle. “Something like this changes you a little,” he said. Hazuka will have another colonoscopy later this year. From there, he’ll do whatever his doctor recommends. He said he tells friends to pay attention to anything about their bodies that seems off, no matter how scary it might seem. “If you have symptoms, don’t be an idiot and put it off,” Hazuka said. “When you have a problem, get it taken care of for yourself and your Scott Hazuka with his wife, Kristy, and daughters Natalie and Halle. family.”

OMaHa WOrLd-HeraLd

Mom put it off; daughter now advocates for early screenings

The couple attend the event each year in memory of Lauren’s

aren Coffey would often experience abdominal pain so fierce it made her double over. “I remember her standing in the kitchen and having to take a minute to catch her breath,” Lauren Sullivan recalled of her mother. Coffey, a real estate attorney, had suffered from the pain for months but didn’t see a doctor. She didn’t believe it was anything serious. “She put it off, like most of us do,” her daughter said. “She just didn’t want to take the time.” But in 2004, a middle-of-the-night visit to the emergency room brought with it the news that Sullivan and her family were stunned to hear: Coffey had stage IV colon cancer. The wife and mother of three began chemotherapy, but the cancer soon spread to her liver. Coffey died about a year after being diagnosed. She was 52. Sullivan, of Papillion, was a teenager. Lauren Now 29, she is a passionate advocate for Sullivan colon cancer awareness and early diagnosis. She believes there is hope for colon cancer survival if the disease is found before it spreads to other parts of the body. As far as Sullivan is aware, Coffey never had a colonoscopy.

The Centers for Disease Control and Prevention recommends that adults have a colorectal cancer screening every year after their 50th birthday, continuing until age 75. Sullivan, who works in marketing and sales at Union Pacific, is a member of the company’s colon cancer task force. The group sets up a booth at work and Karen hands out information on testing and its Coffey impact on survival rates each March during Colon Cancer Awareness Month. Sullivan also raises money and participates in the Boxer 500 Run & Walk, an annual event at Papillion’s Werner Park that promotes colorectal cancer awareness. Sullivan and her husband, Justin, create “Karen Coffey” stickers for the event. Sullivan said writing her mom’s name makes her feel close, even after all these years. Coffey didn’t get to see her daughter go to prom, graduate from high school or leave for college. Experiencing those milestones alone hurt — but advocacy helped her handle the grief, Sullivan said. “You’re sad for a long time. But then you get over the hump. You now have a memory that makes you happy rather than sad.”

Fit and trim and surprised by cancer

eople often told 68-year-old Mardee Brechwald that she looked 40. The Omaha woman took care of herself, and it showed. “All of my friends were like, ‘Mardee, you are the healthiest person in my life,’ ” Brechwald said, who has undergone regular colonoscopies since her 50th birthday. “I’m in shape, and I have always eaten right.” So Brechwald and her friends were flabbergasted last year when she was diagnosed with Mardee stage II colon cancer. Brechwald “I was like, ‘What?’ ” Brechwald recalled. “There is no family history for any type of cancer at all. I’m not a candidate. But there I was.” Brechwald’s cancer journey started with a sinus infection. In December 2014, a doctor pre-

scribed an antibiotic. And then she began having bouts of diarrhea, sometimes 20 to 30 times a day. It was attributed to a Clostridium difficile infection, also known as C. diff. The condition can be triggered when antibiotics kill off healthy bacteria that keeps a person’s gut in check. After the C. diff had been treated, she continued having symptoms. Her primary care physician recommended seeing a colorectal surgeon, who told her that she had an internal hemorrhoid and should come back to have it checked. Brechwald almost didn’t return, but the avid knitter had made her doctor a pair of mittens. So she went back. In March 2016, the surgeon did a biopsy of the hemorrhoid and found cancer. Her treatment, which began March 31, involved seven weeks of radiation and two rounds of chemotherapy. She was hospitalized three times during treatment, including a 10-day stint

in intensive care for second-degree radiation burns. She also developed medication-related pancreatitis and had painful sores in her mouth from the chemotherapy. But she made it through, thanks in large part to the support of friends who helped her with groceries and cleaning. She and her friends also knitted together, which was soothing. In August, Brechwald received a clean bill of health. After owning a fabric store for 17 years, Brechwald now has a part-time job. She sees her doctor every three months for checkups and is optimistic that her cancer is gone for good. She recently signed up for “A Time to Heal,” a series that helps cancer survivors adjust to life after treatment. “I think every cancer patient has fear every time they go in to see their doctor,” Brechwald said. “But you try to be as positive as you can. I’m happy right now.”

SUNDAY, FEBRUARY 26, 2017

OMAHA WORLD-HERALD

SUPERFOODS

BE KIND TO YOUR DIGESTIVE TRACT AND YOUR COLON BENEFITS, TOO By Maggie O’Brien // WORLD-HERALD CORRESPONDENT

Save your own behind. GET SCREENED LIKE THEY DID.

Most physicians and nutritionists agree: A healthy lifestyle is important in cancer prevention, and colon cancer is no exception. Some studies have indicated that calcium and vitamin D can prevent colon cancer. Others have found that pomegranates contain two substances that have the potential to fight colon cancer. Certain “superfoods” can help move food through the digestive tract, which ultimately can help keep the colon healthy, experts say. Many of these foods can be found in your refrigerator and are likely already part of your healthy diet. Lezlie Haddad, a registered dietitian with Hy-Vee cited the American Cancer Society’s recommendation of a diet filled with plant-based foods that limits processed and red meats. The following superfoods also can encourage overall digestive health and help prevent colon cancer.

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Fiber

SUNDAY, FEBRUARY 26, 2017

Fiber keeps your digestive system running smoothly by helping bulk your stools and move waste through the intestines. Just remember to increase your water intake when increasing fiber intake. Sources of good fiber are whole grains, fruits and vegetables, fiber-rich beans (black, edamame, pinto, etc.), legumes (lentils, chickpeas), nuts and seeds, and psyllium. In laboratory tests, University of Michigan researchers have found that black and navy beans reduced colon cancer.

Antioxidants

Many foods contain antioxidants, especially fruits and vegetables. Antioxidants include beta-carotene (found in fruits, vegetables and whole grains), selenium (found in Brazil nuts and walnuts), vitamin C and vitamin E. All berries are packed with cancer-fighting phytonutrients. In particular, blueberries and black raspberries have huge anticancer benefits.

Spices and herbs

Healthy spices and herbs include ginger, coriander, cumin, turmeric, fennel seeds, cardamom and black pepper. They aid in digestion and add flavor to healthy foods. Garlic is a natural colon cancer fighter. The Iowa Women’s Health Study has found that women with the highest amounts of garlic in their diets had half the risk of colon cancer compared to women who didn’t include as much garlic in their daily meals.

Probiotics

Probiotics are helpful bacteria that benefit your digestive system. Though good bacteria are naturally found in your body, you can lose them during an illness or after a round of antibiotics. Probiotics can replace lost good bacteria and help balance good and bad bacteria to keep the body functioning properly. Sources of probiotics include yogurt with active cultures, kefir and supplements taken under a doctor’s supervision.

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