Watch Kate Murphy on Lifetime TV Sunday morning

On Sunday March 9th, Leeza Gibbons’ Health Corner airing on the Lifetime network will feature an episode about the cancer “no one wants to talk about.” No one, except our own Kate Murphy who was interviewed for a segment on the show highlighting the advancements in screening for the disease.

Says Kate on the segment entitled, “Meet a 25-Year Cancer Survivor:”

“I think one of the one most important things that hasn’t changed in 25 years is how frightening that diagnosis is going to be to somebody,” says Kate. But with better screening, surgery, chemo and prevention, there are many good stories from patients with colorectal cancer.

Watch the entire episode on Lifetime TV Sunday morning at 9:30 a.m./8:30 a.m. Central.

Posted by Judi Sohn on March 7th, 2008
Posted in: Research & Treatment News | 1 Comment »

Dr. Heinz-Josef Lenz uses weblog to provide colorectal cancer information

Dr. Heinz-Josef Lenz has taken a unique approach to providing colorectal cancer information to patients and consumers.  He writes a weblog on the Revolution Health site, regularly updating it with current information.

Not only does the blog provide information for the public, it’s a resource for Dr. Lenz’s colorectal cancer patients, answering common questions that they have for him.

Dr. Lenz is an oncologist and researcher at the University of Southern California/Norris Colorectal Cancer Center and Associate Professor of Medicine in the Keck School of Medicine at USC. 

Recent posts to Dr. Lenz’s blog include information on how fruits and vegetables can fight colorectal cancer, small changes that can be symptoms of colorectal cancer, and a new molecular test that can help doctors personalize colorectal cancer treatment.

Readers can subscribe to the blog via RSS and also receive email alerts when a new article is posted.

March is National Colorectal Cancer Awareness Month

Colorectal Cancer is Preventable, Treatable, and Beatable

Posted by Kate Murphy on March 7th, 2008
Posted in: Research & Treatment News | 2 Comments »

Colon Cancer Challenge in New York City on March 9

The fifth annual New York Colon Cancer Challenge will be held in Central Park in New York City on March 9, 2008. 

Two races and a remembrance walk will highlight colon cancer awareness, prevention, advocacy, and research.

Race start times:

• 4 Mile Run:  9 a.m.
• 15K (9.3 miles) Run: 10:15 a.m.
• 1.7 mile Remembrance and Prevention Walk:  10:15 a.m.

Basic race and walk information includes maps of the starting points.

Although online registration is closed, people can easily register for any of the three events on March 9th in Central Park prior to the event at the registration tent on Center Road (mid-park at approximately 69th Street)

Funds raised during the Colon Cancer Challenge will benefit Partners in Prevention and the Colon Cancer Alliance.

March is National Colorectal Cancer Awareness Month

Colorectal Cancer is Preventable, Treatable, and Beatable

Posted by Kate Murphy on March 7th, 2008
Posted in: Research & Treatment News | No Comments »

Updated colorectal screening guidelines add new tests

Joint updated  colorectal cancer screening guidelines to find colon and rectal cancer early and to detect precancerous polyps (adenomas) were published yesterday by the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology.  Removing adenomatous polyps before they become malignant can prevent colorectal cancer.

For the first time, screening tests are grouped into two categories:

• Tests that detect adenomatous polyps and cancer.
• Tests that primarily detect cancer.

Two additional tests were added to recommended screening tests for average risk men and women:

• Stool DNA (sDNA) testing was added to the tests that primarily detect cancer.
• CTC or virtual colonoscopy, is now included in tests that detect polyps and cancer.

The expert panel that developed the new guidelines emphasized their opinion that colorectal cancer prevention should be the primary goal of screening.

Testing Options for the Early Detection of Colorectal Cancer and Adenomatous Polyps for Asymptomatic Adults Aged 50 Years and Older

Tests that Detect Adenomatous Polyps and Cancer

• Flexible sigmoidoscopy every 5 years
• Colonoscopy every 10 years
• Double-contrast barium enema every 5 years
• Computed tomographic colonography every 5 years

Tests that Primarily Detect Cancer

• Annual guaiac-based fecal occult blood test with high test sensitivity for cancer
• Annual fecal immunohistochemical test with high test sensitivity for cancer
• Stool DNA test with high sensitivity for cancer, interval uncertain.

The guidelines are a consensus of experts from

• American Cancer Society
• US Multi-Society Task Force on Colorectal Cancer
  • American College of Gastroenterology
  • American Gastroenterological Association
  • American Society for Gastrointestinal Endoscopy.
• American College of Radiology

The panel reviewed previously known and new evidence for effectiveness and safety of methods to test for colorectal cancer and the adenomatous polyps that lead to it.  They weighed risks and benefits for each method before coming to consensus on the updated recommendations.

In dividing test methods between those that primarily detect cancer and those able to find precancerous polyps, the expert panel emphasized the importance of cancer prevention:

It is the strong opinion of this expert panel that colon cancer prevention should be the primary goal of CRC screening.

Tests that are designed to detect both early cancer and adenomatous polyps should be encouraged if resources are available and patients are willing to undergo an invasive test.

These tests include the partial or full structural exams mentioned above. These tests require bowel preparation and an office or hospital visit and have various levels of risk to patients. These tests also have limitations, greater patient requirements for successful completion, and potential harms.

Significant positive findings on FSIG, DCBE, and CTC require follow-up colonoscopy.

However, they recognized that some people may not want to undergo invasive tests requiring bowel preparation, may prefer a test that they can do privately at home, or may not have access to preventive tests because of lack of insurance coverage or local resources.  In those situations, patients and doctors should understand that fecal tests that primarily detect cancer:

• Are less likely to prevent cancer compared with the invasive tests.
• Must be repeated at regular intervals to be effective.
• An invasive test (colonoscopy) will be necessary if a fecal test is abnormal.

C3 Colorectal Cancer Coalition Founding Member and Research Advocate Pamela McAllister,PhD participated in the development of the updated guidelines as a member of the American Cancer Society Colorectal Cancer Advisory Group.

Bernard Levin, MD, Professor Emeritus at the University of Texas MD Anderson Cancer Center in Houston was the lead author of the paper that appears in CA: A Cancer Journal for Clinicians, Gastroenterology, and Radiology.

Posted by Kate Murphy on March 6th, 2008
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Flat colon lesions different from polyps are more common and dangerous than previously believed

While most colon neoplasms (adenomas) appear as polyps protruding into the space inside the colon, some lie flat against the colon wall or are even slightly depressed.  A study reported in the Journal of the American Medical Association reports that flat or nonpolypoid colorectal neoplasms (NP-CRNs) are more common that previously believed.

In addition, the flat or depressed lesions were almost ten times as likely to contain cancer than the polyps that protruded.

NP-CRNs are difficult to detect during colonoscopies because they appear very similar to surrounding tissue.  Depressed NP-CRNs that sink into the colon lining are especially hard to find and are the most dangerous.

For the study reported in JAMA,  four specially trained endoscopists at a Veterans Affairs hospital out-patient program in California sprayed the colon with a special blue dye that made the flat lesions easier to see. Over a year’s time, they performed more than 1,800 routine colonoscopies trying to identify how often nonpolypoid colorectal neoplasms occurred.

Patients in the study included a screening group who were having routine colorectal cancer screening, a surveillance group who had a personal or family history of colorectal adenomas or cancer, and a group of people with symptoms of colorectal cancer.  There were about 600 in each group, almost all men with an average age of 64.

Nonpolypoid colorectal neoplasms were found in 170 people, about ten percent of the entire group.   They were more common in the surveillance group where more than 15 percent had a NP-CRN.  About 6 percent of the screening and symptoms groups also had NP-CRNs. 

Roy M. Soetikno, MD, MS and his colleagues wrote,

In this group of veteran patients, NP-CRNs were relatively common lesions diagnosed during routine colonoscopy and had a greater association with carcinoma compared with polypoid neoplasms, irrespective of size.

Three years later, follow-up colonoscopies were done in 68 percent of the 580 patients who were recommended to have one according to guidelines. In those 393 patients, 12 advanced adenomas and 1 new cancer were found, significantly lower percentages than similar studies without the new techniques.

Gastroenterologists doing the colonoscopies for the study developed new skills for recognizing NP-CRN’s by working with leading Japanese endoscopy centers who were already finding and describing NP-CRN’s.  Videos of colonoscopies helped the doctors see changes in color, blood vessels, and colon wall that were characteristic of these lesions. 

In 2000, it became routine practice for doctors in the VA unit where the study was done to use a carmine-indigo spray during colonoscopy when they suspected a NP-CRN.  When they found a lesion, they removed and biopsied it using the endoscope.

Although colonoscopy and removal of polyps prevents many cancers from ever developing, between 0.3 percent and 0.9 percent of patients will develop an interval cancer within the three years after a colonoscopy.  These may be due to missed lesions, incomplete removal of polyps, or fast-growing cancers.  However, the research team believes that NP-CRN’s may also contribute to interval cancers and identifying and removing them may prevent more colorectal cancer.

The above image shows a NP-CRN (the slightly raised area along the right edge of the first and second pictures) before and after indigo dye was applied.  The third picture is after the position of the colonoscope was changed.  (Images courtesy of the Journal of the American Medical Association)

SOURCE:  Soetikno et al. Journal of the American Medical Association, Volume 299, Number 9, March 5, 2008.

Additional articles about the study and the accompanying editorial appear in Time and the New York Times.

Posted by Kate Murphy on March 5th, 2008
Posted in: Research & Treatment News | No Comments »