Cancer Prevention and Screening
Colon (or colorectal) cancer is the second-leading cause of cancer deaths in this country, yet it lacks the visibility and awareness of many other types of cancer. It’s also highly curable if caught early enough, so the medical profession urges everyone of average risk to begin colon cancer screening at age fifty. African Americans, who are at higher risk (they tend to get it earlier and in a more aggressive form), should begin screening at age forty-five. Anyone with a family history of either benign polyps or colon cancer is also at risk; these groups should start screening five years earlier than the age the youngest relative was when affected, depending on how close the relation.
“All colon cancer, with rare exception, starts as a benign polyp,” says Dr. Susan Lepinksi, who practices gastroenterology at Meriter Hospital. “This is why we’re trying to do these screening exams to find early lesions that are benign polyps before they grow up to be cancers.”
The most common and effective screening tool is the colonoscopy, repeated every ten years provided no polyps are found. There is also a CT scan “virtual colonoscopy” that is commonly perceived as less invasive; however, Lepinski says it needs to be done more frequently (every five years as compared to ten), a tube still needs to be inserted to pump in air and you still have to do the preparatory cleansing. Another tool is the fecal occult blood test (FOBT), which detects blood in the stool that may not be visible to the naked eye. The FOBT might indicate polyps (some people unknowingly lose so much blood in their stool they develop anemia, not realizing the blood loss is from sloughing polyps) but false positives do occur. The FOBT must
be performed annually and is most effective when used in combination with a sigmoidoscopy.
“FOBT is effective only if patients are committed to following up a positive with a full colonoscopy,” cautions Lepinski.
Possible signs of colon cancer or precancerous polyps include abdominal pain and tenderness, blood in the stool, change in bowel habits and unexplained weight loss; however, in many cases of colon cancer, the patient has no symptoms at all. In addition to screening, possible preventive measures for colon cancer include eating a high-fiber, low-fat diet; taking aspirin and vitamin D supplements as guided by a physician; avoiding cigarettes and alcohol; and getting regular exercise.
Complementary Medicine and Cancer
At Group Health Cooperative of South Central Wisconsin, the Complementary Medicine program infuses every other department with a holistic perspective on both prevention and healing—especially when it comes to cancer. The Cancer Wellness Program aids members from diagnosis through treatment and into survivorship, and comp medicine plays a crucial role.
Ghadeer Alafifi, manager of the comp medicine department, is developing a new program aimed at cancer patients (as well as terminal patients who have other diseases or conditions) that will make comp medicine services even more accessible than they already are. At GHC-SCW, services such as acupuncture, craniosacral therapy, energy work, fibromyalgia consultations, massage therapy, mind-body therapy, naturopathy, homeopathy, Pilates, stress reduction, tai chi, wellness evaluation and yoga are already available to members at a 50 percent discount; with Alafifi’s new program, members with cancer may be eligible for these services free of charge or at an even more affordable cost. The program isn’t official yet, but Alafifi says it is clearly aligned with the patient-centered care GHC-SCW already offers.
“We just know and see how valuable complementary medicine is to patients who are undergoing cancer treatments,” says Alafifi. “This is not a replacement for medical treatments at all, but a way of helping patients cope with the treatment experience.”
Stanford University Hospital researchers suggest that massage reduces anxiety levels, relieves insomnia, eliminates nausea, eases depression, manages pain and reduces the need for medication. Exercise is similarly beneficial, but cancer patients undergoing treatment may feel run down and sapped of energy. GHC-SCW offers a broad spectrum of exercise options (for example, chair yoga and slow-paced tai chi, says Alafifi) while remaining sensitive to the special challenges and physical limitations some cancer patients face.
From a preventive perspective, “keeping your body healthy can lower the chance that you will get cancer,” says Alafifi. Her comp medicine staff offers “Kick the Habit” smoking cessation classes as well as two naturopathic doctors on hand to counsel members in using nutrition, supplements and herbs to maintain maximum health and help the body heal naturally. They also work with the dermatology department to facilitate skin cancer screening and education.
“Know your family history,” adds Alafifi, “and talk with your primary care provider to decide if and when to start regular cancer screening, and if genetic testing is right for you.”
- Maggie Ginsberg-Schutz