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Doctors urge screenings in effort to catch deadly disease

Dr. Johnny Green, of Kitsap ColoRectal Surgery, explains that during colonoscopies he performs at the Olympic Ambulatory Surgery Center in East Bremerton, the anesthetic machine, in the background, keeps patients in very deep sedation. - Photo by Valentina Petrova
Dr. Johnny Green, of Kitsap ColoRectal Surgery, explains that during colonoscopies he performs at the Olympic Ambulatory Surgery Center in East Bremerton, the anesthetic machine, in the background, keeps patients in very deep sedation.
— image credit: Photo by Valentina Petrova

Polyp Man became a television star in 2002 as the American Cancer Society’s mascot for a colon cancer prevention campaign.

Four years later, in time for National Colorectal Cancer Awareness Month, the tomato-red glob that is Polyp Man, gave a rare appearance March 4 at Costco.

Barbara Otto, clinical educator for oncology at Harrison Medical Center, said the famous mascot accompanied her and several doctors and nurses on a four-hour quest to educate shoppers at the Silverdale store about the disease.

“People don’t want to talk about colorectal stuff,” she said.

Yet, she estimated about 200 people stopped by to do just that on a Saturday as they were out shopping.

The American Cancer Society has been running advertisements for a few weeks now encouraging people to get screened.

Washington ranks 17th in the nation with nearly 55 percent of white, non-hispanic adults ages 50 and older having had a recent colorectal cancer screening test, according to 2001-02 data in an American Cancer Society report from 2005.

The state leads the nation in the number of African American adults screened at about 65 percent, which is a group affected by the disease more often, who have had a recent test.

That’s no cause for loosening up the campaign, though.

“Even today in 2006 colon cancer, if it is not found early, has a 40 to 60 percent mortality rate,” said Dr. Johnny Green, surgeon of Kitsap ColoRectal Surgery.

If detected in the earliest stage, colorectal cancer has a 90 percent survival rate. With regular screening every five to 10 years, starting at the age of 50 for men and women at average risk, the cancer is practically preventable.

But despite increased awareness in recent years, less than 40 percent of colorectal cancers are found early enough for the patient to have the best chances for recovery, Otto said.

“There are no reliable early symptoms,” said Green, Harrison’s liaison to the American College of Surgeons’ Commission on Cancer. “By the time you have symptoms, it’s usually a big bad cancer.

“Most colon cancers spend many years as benign polyps,” Green explained.

If found at that stage they can be removed and cancer can be avoided, he added.

Nobody knows that better than Leonard Vaughan.

The 71-year-old Port Orchard resident did not know his family’s history of cancer and thought he had nothing to worry about.

“My primary physician had been advising me to get a colonoscopy for a couple of years now and I’ve been putting it off,” Vaughan said.

Besides, he was not a big fan of tests, especially one that’s so invasive.

“I’m not one for medical procedures,” he said. “I shy away from whatever I can.”

About nine weeks ago, however, upon a referral from his doctor, Vaughan made an appointment with Green. Vaughan was going to finally get his physician off his back.

“I thought I’d go into it and they won’t find anything and my doctors would be happy,” he said.

Green performed the colonoscopy on a Monday.

“Lo and behold, he discovered a growth,” Vaughan said.

Usually, polyps found with a colonoscopy can be removed right then, but this one was too large.

Two days later, Vaughan went in for surgery. Relief followed shortly when the polyp turned out to be benign.

Vaughan spent two days after the surgery at Harrison and went home afterwards. Now he is almost back to full strength.

“I’d advise anybody over 50 to have it,” he said. “If you wait until you have some of the symptoms ... the surgery is much more worrisome.”

The screening procedure Vaughan went in for is surgeons’ test of choice, Green said. It is the most expensive and most invasive procedure, but a colonoscopy allows physicians to view the entire colon and to remove any polyps they find. It can cost about $400, according to the American Cancer Society. Otto said some insurance plans may not cover a colonoscopy. But although it can miss some polyps, it is more reliable than other tests.

The procedure also has gained a bad reputation, mostly because of the notorious bowel preparation.

“You’re trying to visualize the colon and the only way to visualize it is to have it empty,” Otto said.

The day before colonoscopy can be unpleasant, but it is better than the alternative, says Vaughan. Upon doctor’s orders, drinking a special liquid or taking oral laxatives will cleanse the colon and rectum.

“That’s a day of fasting and spending time in the bathroom,” Vaughan said.

The full bowel preparation, however, is necessary for another test as well — the barium enema, which is a fancy X-ray with air and dye injected into the bowel through the rectum. Doctors can see the entire colon, but if they find any polyps, a colonoscopy will have to follow to remove them.

Another option is the Flexible Sigmoidoscopy, where a short tube is inserted into the rectum. Only a third of the colon is viewed, however.

“And you’re wide awake to enjoy the whole thing,” Green said.

Another established screening method is a Fecal Occult Blood Test, the cheapest option at around $20, it also is less reliable and must be done every year.

Any test is better than no test, Otto says, because colorectal cancer is the third most common cancer for men and women — right behind lung and prostate/breast cancers. Colorectal cancer also is the second leading cancer death for men and the third leading cancer death for women.

“A lot of people think it’s a man’s disease,” Otto said. “It’s an equal opportunity predator.”

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