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  1. #1
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    Many diagnosed with colorectal cancer too late despite availability of screening

    Many Canadians diagnosed with colorectal cancer too late despite availability of screening
    CBC News
    June 13, 2018

    'Every day I'm thankful that I get up,' says Ontario musician whose cancer was caught early

    Almost half of the colorectal cancers in Canada are discovered after they've already spread, even though most provinces and territories have screening programs that can catch it in early stages, according to new statistics released Wednesday.

    The report by the Canadian Cancer Society says about 29 per cent of colorectal cancers are diagnosed at stage 3, and 20 per cent are diagnosed at stage 4.

    One of the report's authors, epidemiologist Leah Smith, said early detection is key to boosting survival rates, but relatively few people seem to be taking advantage of organized screening programs, including an at-home stool test that can detect pre-cancerous signs.

    The five-year survival rate when diagnosed at stage 4 is less than 15 per cent. The rate increases to 90 per cent when colorectal cancer is found at stage 1.

    The Canadian Cancer Society recommends that everyone between the ages of 50 and 74 who are not at high risk for colorectal cancer should be screened every two years.

    People at higher risk (including those with a family or personal history of colon cancer, people who have had non-cancerous polyps in the colon or rectum or who have inflammatory bowel disease) may need to be tested more often and at an earlier age.

    "Early detection for this disease is key," said Smith, who is the society's senior manager of surveillance. "We have the tools available to detect these cancers earlier. Unfortunately, what we're also seeing is that participation in colorectal cancer screening is lower than we need it to be to really make a move on this cancer."

    Nine provinces and Yukon territory currently have organized colorectal cancer screening programs that use at-home stool tests, and plans are underway to develop programs in Nunavut and Quebec. Northwest Territories does not have an organized screening program but stool tests are available through hospitals and clinics.

    The tests are used to detect blood in the stool. If blood is found, then the person goes for followup tests, such as a colonoscopy or barium enema, so a doctor can check the colon and rectum.

    Smith said Canadians aged 50 to 74 years of age make up about one-third of the population and should do the stool screening, but researchers found less than 60 per cent of those eligible for the test are doing so.

    'How can you not do this?'
    Singer-songwriter Jeff Orson said that after he was diagnosed with stage 2 colorectal cancer, he began urging those around him to get tested.

    "How could you not go; how can you not do this? If it's in your family, especially, you're at risk, it's easily preventable," said the 56-year-old performer, based in Oakville, Ont.

    Orson said he was lucky to catch the cancer early when he went to his doctor complaining of feeling exhausted and losing sleep. Because he was in his 50s, he was sent for a stool test, which came back positive. That led to a colonoscopy, which revealed a tumour in his colon.

    "That was one of the most horrible things I ever heard in my life: 'You have cancer and we don't know what your future holds for you,"' he recalled.

    Surgeons removed 18 centimetres of his colon and Orson has been cancer-free for four years.

    Now he undergoes regular colonoscopies and blood tests and doesn't shy away from sharing his story on his website, and onstage during performances.

    "It's like a shadow, it never kind of leaves you," he said. "I don't dwell on it a lot but every day I'm thankful that I get up."

    stages-of-cancer-graphic-600x600.jpg

    Colorectal cancer is the second most commonly diagnosed cancer in Canada and the second leading cause of cancer death, after lung cancer.

    It is estimated that about one in 13 men and one in 16 women will be diagnosed with colorectal cancer during their lifetime.

    An estimated 26,800 Canadians were diagnosed with colorectal cancer in 2017, representing 13 per cent of all new cancer cases, while 9,400 Canadians died from the disease, representing 12 per cent of all cancer deaths.

    Simply put, fewer Canadians would die from this disease if more were screened, Smith said.

    She noted that more than 80 per cent of breast cancers are found at stage 1 or 2, likely due to screening. As a result, breast cancer survival rates are 87 per cent compared to lung cancer, which are closer to 17 per cent. About half of lung cancers are found at stage 4.

    "It really helps reinforce that connection between early detection and survival," Smith said.
    Wednesday's study was gathered in partnership with the Public Health Agency of Canada and Statistics Canada.

  2. #2
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    Re: Many diagnosed with colorectal cancer too late despite availability of screening

    I'd like to add my voice to this.

    My younger brother died from colon cancer about 6 years ago. He was in Stage 4 by the time he was diagnosed and despite aggressive treatment and some experimental treatment it was simply too late to save his life.

    I had been avoiding doing the stool sample test - partly just procrastination, partly not wanting to know (as irrational as that sounds), and partly because it just seemed really gross.

    My doctor also noted that the screening test, while recommended, did have a risk of false negatives (i.e., no blood in the stool detected). Given my new family history and the death of my brother, he instead sent me directly to the colonoscopy test and it was this that saved my life.

    The colonoscopy showed some polyps. A followup colonoscopy determined they were cancerous. I had stage 3 colon cancer.

    Surgery (a right hemi-colonectomy) followed by chemotherapy, while unpleasant and scary, saved my life.

    The difference between my situation and my brother's was that they caught and diagnosed mine earlier. It's as simple as that.

    Get tested, people.

    If you have any family history of cancer at all, especially cancers of the gastrointestinal system, get tested earlier. Just do it.

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    Re: Many diagnosed with colorectal cancer too late despite availability of screening

    Thanks for posting the article and especially for sharing your personal experience David.

    I also have been putting off my doctor’s yearly requests to do the home stool tests mainly because of the same reasons as you but also at first fear of a false positive due to blood thinners and hemorrhoid issues. But the last couple years constipation issues has made going the self test almost impossible since I’d have to do one sample bring it back within a week and get another kit and then another after.

    I was actually going to neglect telling my doc that the constipation is getting really bad when I see him Tuesday mainly out of fear of having to go through another colonoscopy as the one I had about 20 years ago was very painful. From what others have told me it should not be. But the fear remains. Also the stupid idea that if there is something wrong I’m afraid to find out. I also know that’s really dumb and irrational thinking.

    Weird but even after reading the article I still thought the same way but it’s you sharing your personal experience in detail that has convinced me I can no longer avoid it and will advise my doc that my situation is getting worse. Hopefully it’s just medication causing the problem but i guess better go through testing for nothing than find out too late that I should have been tested.
    “I impatiently await the day I finally become a patient man.” ~ Gary

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    Re: Many diagnosed with colorectal cancer too late despite availability of screening

    @GaryQ, was your previous colonoscopy done under sedation?

    I have heard stories about people who have had colonoscopies without sedation and that does not sound at all pleasant. But honestly, I have had many of them by now under sedation and most of the time I just go to sleep and feel nothing at all. Then I wake up to them telling me I'm done. There are no after effects other than drowsiness until the sedation wears off. You absolutely must have someone meet you at the hospital or clinic to take you home, though; they will not let you leave until you do.

    The unpleasant part is the preparation prior to the colonoscopy, which requires fasting and cleansing but I must say in the past year even that has improved with the use of different solutions.

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    Re: Many diagnosed with colorectal cancer too late despite availability of screening

    David, nope I was told that I had to be awake in order to notify him if I had any pain. Seems he was probably incompetent as the pain was worse than the worst cramps I’ve ever had. Then he would reduce the air pressure but wouldn’t take him more than a minute for me to be back in the same situation. The mild sedative just kept me numbed enough to not get up and beat the living daylights out of him. Oh and when he was trying to get past the corner to the cross section it felt like he was going to actually tear through my colon.

    Hence the fear. Being out of the city now makes it even more complicated getting there and back since I can’t drive home after. Guess that’s the least of my worries at the moment.
    “I impatiently await the day I finally become a patient man.” ~ Gary

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    Re: Many diagnosed with colorectal cancer too late despite availability of screening

    Well, remember that was 20 years ago and thankfully there have been many advances in medicine in the interim. I get two a year now as part of my followup and believe me even as a cancer survivor I would be balking if I had to go through what you went through. I really really really do not like pain!

    As to the transportation issue, do some research in advance. There are various volunteer and/or government funded agencies who will provide either free transportation or transportation at low cost to patients who require it.

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    Re: Many diagnosed with colorectal cancer too late despite availability of screening

    Oh thanks for reminding me of the “purge” I have to go through the night before. I remember that plastic gallon with powder I had to mix with water and drink the whole thing a glass at a time. Can’t remember if it was every 5 or 10 minutes. I remember how fast it started working and how hard it was to drink more once I had drank half of it. Oh the joyful memories
    “I impatiently await the day I finally become a patient man.” ~ Gary

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    Re: Many diagnosed with colorectal cancer too late despite availability of screening

    Colonoscopy i had was under sedation never felt anything i have not heard of being awake through this procedure Gary if you can find a doctor that will do your exam under sedation ok . I too have to put more effort in getting these test done as cancer runs so much in my family aunts twin even brother died of cancer. I was told every 10 yrs though for a repeat colonscopy but i have not done screen for it i lost the script to give to the lab and have not requested another from my doctor. Yes the cleansing of bowel was not fun i do not drink lots of fluid and that was alot to drink
    Words always stay inside ones soul

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    Re: Many diagnosed with colorectal cancer too late despite availability of screening

    @GaryQ it's not your typical planned relaxing evening, that's for sure.

    Try doing it with only half a colon. (Yes, that's right. I am officially just a semicolon, now. )

    But at least it doesn't last long and you can be reassured that it's the worst part. Plan a reward for afterwards. Coffee and Timbits for me.

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    Re: Many diagnosed with colorectal cancer too late despite availability of screening

    Quote Originally Posted by David Baxter View Post
    @GaryQ it's not your typical planned relaxing evening, that's for sure.

    Try doing it with only half a colon. (Yes, that's right. I am just a semicolon, now. )

    But at least it doesn't last long and you can be reassured that it's the worst part. Plan a reward for afterwards. Coffee and Timbits for me.
    Shouldn’t be laughing but that semicolon part was hilarious
    thanks for the suggestion of coffee and timbits! Then a “oh please, can we just make a quick stop at Harvey’s for a poutine? Pretty please? I promise if we go I’ll stop crying!”
    “I impatiently await the day I finally become a patient man.” ~ Gary

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