A CALL TO RETURN TO REGULAR SCREENINGS The pandemic interrupted many health screenings—with serious consequences. A colorectal surgeon at CBMC explains why it’s imperative to get back on schedule for these tests and preventive screenings. Post-surgery, Dr. Gilder and Gang’s oncologist, The COVID-19 pandemic has upended many aspects Michael Scoppetuolo, M.D., medical director of The of our lives, including normal health care. In the past Cancer Center at CBMC, determined that Gang did two years, many people have cancelled important not need any further treatments, but will be evaluated elective procedures, which has led to a substantial regularly for any changes. decline in cancer screening, according to the American Gang, a marathon runner who’s in “very good shape,” Cancer Society (ACS). “We’re seeing a lot of bad things resulting from COVID Dr. Gilder says, quickly regained his strength and, just six weeks later, was back to his normal running routine not allowing us to find things early,” when cancer is and training for his seventh marathon in Philadelphia most easily and successfully treated, says Mark Gilder, this November—just one year since surgery. Now cancerM.D., a colorectal surgeon affiliated with Cooperman free, Gang says it’s important to “listen to your body. Barnabas Medical Center (CBMC) and a member of You know yourself better than anyone else. If you have a the RWJBarnabas Health Medical Group. “We lost a problem, take action.” lot of ground with prevention. We were doing a At 39, Gang was not a candidate for regular pretty good job, but now we have to kind of screening; had he been, the test may have reinvent the wheel a bit, and get back to caught his disease in its earliest stages before prevention.” it became cancerous. There are several Gilder notes that, in his specialty, options for testing, according to the ACS, screening guidelines have changed including stool-based tests, DNA testing recently. In the past, regular screening and imaging tests. But the gold standard is for colorectal cancer typically started colonoscopy, a minimally invasive procedure at age 50 for those at average risk that allows the surgeon to see inside the for the disease. Now, most health colon and rectum and remove any growths, organizations, like the American Cancer called polyps, to test for signs that they could Society, the American Society of Colon become cancerous. and Rectal Surgeons and the Centers Mark Gilder, M.D. Dr. Gilder adds that some insurance for Disease Control and Prevention, put companies have not been quick to update the starting age at 45 for average-risk their coverage to meet the new 45-and-older individuals. (See risk categories at right.) recommendations, and initially may not cover the Early detection can make a world of difference. expenses of the screening. “This is a situation where, Take the case of Gang (he prefers to use one name), clearly, lives are saved, but unfortunately some insurance a 39-year-old who started having abdominal pain companies are delaying this. It’s very frustrating for all of and irregular bowel movements. Three different us [in his field],” he says. If a patient’s insurance initially gastrointestinal specialists misdiagnosed him with denies coverage, his team can try to authorize it on a diverticulitis and treated him with antibiotics. When case-by-case basis. Gang’s symptoms persisted, he was referred to Dr. Dr. Gilder’s final word is to take the screening Gilder, who suspected an abnormal growth and guidelines seriously. The preparations needed are much recommended that Gang get a colonoscopy. The easier and more flexible to accommodate one’s work procedure confirmed he had an obstructive mass, and requirements, the sedation required is minimal, there a biopsy found that it was cancerous. Six days later, is no pain and the recovery is quick. Most importantly, on November 16, 2021, Dr. Gilder performed surgery to screening saves lives. remove the tumor.
ACS GUIDELINES
The American Cancer Society recommends that people at average risk of colorectal cancer start regular screening at age 45. People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75. For people ages 76 through 85, the decision to be screened should be based on a person’s preferences, life expectancy, overall health and prior screening history. People over the age of 85 should no longer get colorectal cancer screening. For screening, people are considered to be at average risk if they do not have: • A personal history of colorectal cancer or certain types of polyps. • A family history of colorectal cancer. • A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease). • A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary nonpolyposis colon cancer or HNPCC). • A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer. Those at higher risk may need to begin screening earlier. Talk to your doctor to assess your risk and screening schedule.
To learn more about colorectal cancer treatment or to make an appointment, go to 973.322.0250 or rwjbh.org/colonscreening. CBMC, together with Rutgers Cancer Institute of New Jersey, is the state’s only NCI-designated Comprehensive Cancer Center. MSXHEALTHANDLIFE.COM
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