Colorectal cancer: Symptoms, screening and treatment, plus one family's story

'We miss him terribly'
Before dawn on June 17, 2007 – Father’s Day – my beloved Tony slipped away in his sleep. He left this world quietly, knowing the boys were safe and sound in their bedrooms down the hall and I was curled up right next to him.  We miss him terribly.

I have made it my mission to raise awareness about colorectal cancer. I've already included links to patient groups and cancer associations on my blog (www.onedayatatime-rar.blogspot.com).
 
Richard, Mathieu and I were part of a team proudly wearing T-shirts with Tony's photo on the front at the Terry Fox Run last September. When the boys are older, I hope to devote more time to the fight against cancer.

Tony left an important legacy – his unbelievably positive spin on life.  When I worry about Mathieu, I know Tony would say that he is a brave, resilient little boy. He would also say that thanks to an early diagnosis, Mathieu will have a long, normal life. And Tony would urge me to be grateful that Richard didn't inherit the disease too. Looking at the future in that bright light, I know we will be just fine.

Screening
With proper screening and early diagnosis, most cases of colorectal cancer can be prevented or successfully treated, says Dr. Steven Gallinger, professor of surgery at University Health Network and Mount Sinai Hospital in Toronto and a member of the medical advisory board of the Colorectal Cancer Association of Canada. "You could theoretically prevent 90 per cent of all colorectal-cancer-related deaths with proper screening of people over the age of 50," he says. 

The Canadian Cancer Society and the Canadian Task Force on Preventative Health Care recommend that people over 50 who are at average risk for colorectal cancer be screened every two years using fecal occult blood testing (FOBT). (Men and women with no personal or family history of colorectal cancer or inherited syndromes like familial adenomatous polyposis, and who don't suffer from inflammatory bowel disease, are considered at average risk.)

FOBT involves sending stool samples to a laboratory to be examined for traces of blood. Blood in the stool doesn't necessarily mean a cancer diagnosis, but it is an indication that further testing is required.

A sigmoidoscopy or colonoscopy is also recommended every 10 years. During a sigmoidoscopy, a physician uses a soft, bendable tube to examine the rectum and lower part of the colon. For a colonoscopy, a doctor can examine the rectum and entire colon. Polyps can be removed and biopsies taken during both these screening tests. Almost all colorectal cancers start as noncancerous polyps that can be removed before they become malignant.

Stats
• Last year, 20,800 Canadians were diagnosed with colorectal cancer and 8,700 died from it.  
• Every week, 400 Canadians are diagnosed with colorectal cancer.
• Colorectal cancer is the second-leading cause of cancer-related deaths in the country.
• Only 23 per cent of Canadians at average risk are tested within the recommended time frame, according to one recent study. Reluctance to discuss bowel habits, economics and a shortage of trained doctors are possible reasons why so few Canadians get screened. However, the Canadian Association for Colorectal Cancer is also working with other cancer associations to persuade governments to establish screening programs in each province.
• Familial adenomatous polyposis, the kind of cancer that took the life of my husband, Tony, accounts for one per cent of all colorectal cancers and affects one in 10,000 people.

Read more:
• When a family member is ill or dying
• Foods that fight cancer
• How to help a friend with cancer

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