Fight Colorectal Cancer

WHAS11 in Louisville, KY will present Catching a Killer: Steps to Preventing Colon Cancer on Tuesday, March 11 from 7 to 8 pm.  Hosted by Rachel Platt, the live show will let viewers call in and ask questions of doctors and nurses about preventing colorectal cancer through screening.

Kentucky State Auditor, Crit Luallen, former University of Kentucky basketball head coach Joe B. Hall, and former Louisville Cardinal basketball star Lancaster Gordon will share their personal experiences with colon cancer during the show.

• Catching a Killer:  Steps to Preventing Colon Cancer
• Tuesday, March 11, 7 to 8 pm
• WHAS, Channel 11
• Louisville, KY

The program is presented in collaboration with the Colon Cancer Prevention Project

The mission of the Colon Cancer Prevention Project is to eliminate preventable colon cancer death and suffering by increasing screening rates through education, advocacy and health systems improvement in Kentucky and surrounding communities.

MARCH IS NATIONAL COLORECTAL CANCER PREVENTION MONTH

Colorectal Cancer is Preventable, Treatable, and Beatable

Suzanne Lindley, who has lived with advanced colon cancer for nine years, is featured in the current issue of All You magazine.

Writing her own story, Suzanne says, “Cancer makes me thankful for every moment.”

Told nine years ago that she had colon cancer that could not be treated and that she had at most six months to live, Suzanne despaired at first. Then, discovering an Internet support list, she met another patient with stage IV colon cancer who told her that she shouldn’t be planning her death, but finding a doctor who would give her some hope. She writes that she owes her life to Shelly Weiler, who told her that he wouldn’t die without a fight and neither should she.

Since then she’s been in active treatment almost constantly, finding new treatments as old ones failed. She moved to the country where she could have horses to ride and a special life with her daughters and husband.

She says that cancer has been a journey of self-discovery for her.

I’ve changed a lot since my diagnosis, and I think it’s simply because I’m thankful for every moment. Early on, we decided to stay in the country, and we’ve been so happy here. We know everyone in our town, and I even ran a café for a year. Before cancer, I used to be timid and afraid. Now we saddle up the horses when the moon is full and ride down to the lake.

She’s come to realize the power that her cancer story has to inspire change and to help others. She writes,

I’ve become aware of the power my experience has to create change. I’ve told my story more than a dozen times in Congress to help lobby for cancer research and treatment funding, and I’m now involved in several advocacy groups. Knowing that I’ve given people new avenues for hope has made the time I spend living even more meaningful. Meanwhile, I’ll continue to ride horses, dance, fight and hope for the cure around the next corner.”

March is Colorectal Cancer Awareness Month

By Nancy Roach, Chair, C3 Board of Directors

C3 has submitted comment to the Food and Drug Administration (FDA) Oncology Drug Advisory Committee (ODAC), recommending that FDA implement a Special Restriction Distribution Program for Erythropoiesis Stimulating Agents (ESAs), to maximize patient safety and ensure the rapid collection of patient information.

ESAs, better known under brand names, Procrit, Epogen and Aranesp, were approved by the Food and Drug Administration (FDA) to reduce the need for blood transfusions and have been used widely to aid with chemotherapy-induced anemia. Research results have indicated that higher doses of ESAs could actually cause a patient’s cancer to grow faster, and increase mortality, pointing out the need for future research to nail down the risk/benefit ratio of ESA use.

C3, in partnership with other advocacy organizations, has been working with FDA and ESA manufacturers (Amgen and Johnson & Johnson) to ensure that patients are helped, not harmed, by these supportive care drugs.

ODAC will be meeting on March 13, 2008 to discuss new research findings, future research plans and the current clinical situation. Carlea Bauman, C3 President, will speak during the open public hearing. In addition, C3 has submitted comments identifying questions such as:

• What is the plan for answering the question of whether ESAs have a tumor-promoting effect?
• What is the plan for answering the question of whether ESAs provide patient benefit when dosed according to the FDA label?
• What is the appropriate clinical use of ESAs pending the answers to these questions?

Ultimately, C3 recommends that ESA use be closely monitored, similar to the way that thalidomide use is monitored.

For additional information, see:

• www.ESAFacts.org presented by the Marti Nelson Cancer Foundation
• Briefing information from the May 10, 2007 ODAC meeting

Disclosure: C3 believes in fully disclosing sources of financial support, per our disclosure policy which can be viewed here. In 2006 and 2007, C3 received funding from Amgen in the form of a charitable donation. Since the May 2007 Oncology Drug Advisory Committee (ODAC) meeting, C3 has met with Amgen and Johnson & Johnson (J&J) to increase our understanding of these issues and express our concerns. J&J held a meeting on February 19, 2008 in Washington, DC, and paid the travel expenses of a C3 Board member so that she could attend the meeting.

March is here!  And we’re taking time to focus on colorectal cancer — prevention, screening, research, what’s new and what must be done to wipe out this disease that kills nearly 50,000 Americans each year and more than 630,000 people around the world.

We’ll run and walk this month, hold seminars, go to meetings, put stories on TV, talk to Congress.  Some of us will have a colonoscopy or do a fecal occult blood test.

We’ll wear blue bracelets and pin the Blue Star of Hope on our shirt collars.

We’ll be hopeful because we are making progress and sad because too many of our friends are dying.  We’ll remember colorectal cancer fighters who aren’t here this March.

What can we do during this month?

Get screened if we’re not screened and get our families and friends screened. 

Work to get slipping funding for colorectal cancer research restored and increased.  Research cures cancer!

Pull down the financial barriers to colorectal cancer screening so that every Butt is Covered.

Welcome to March.  Spread the word.

Aetna announced on February 27 that they would delay a proposed change in insurance coverage for the services of a anesthesiologist for monitored anesthesia care (MAC) during routine upper and lower endoscopic procedures including colonoscopy.

The policy was to go into effect on April 1.

The new policy, announced in late December, would have continued to cover moderate sedation administered by the physician doing the procedure but would only pay for deeper sedation via monitored anesthesia care for high-risk patients. 

According to a Aetna press release,

Aetna will now delay implementation until patient-friendly alternatives – which will not require the added expense of an anesthesiologist – are approved by the Food and Drug Administration (FDA) and available in the marketplace.

Aetna expects that new devices and sedatives, now being reviewed by the FDA, will be available in late summer and will provide patient experiences similar to those delivered with MAC.  However, they will be able to be administered by the treating doctor and won’t require an additional anesthesiologist.

Troyen A. Brennan, M.D., Aetna’s chief medical officer, said,

Once these new options are available in the marketplace, we will move forward with our policy. Aetna considers the health of our members, and their access to preventive screenings and affordable quality health care, top priorities. Our goal is to improve the consistency of care delivered to our members nationally, align that care with the best evidence available and remove unnecessary costs from the health care system. These are worthwhile goals that should be shared by the medical community, and we will continue to work with care providers to achieve them.

He also said,

We have determined that in those few markets where monitored anesthesia care (MAC) has become the routine approach to sedation, implementation of our policy on April 1 would inconvenience our members in those markets and potentially depress cancer screening rates in the short term.

Media coverage of the proposed policy has been confusing and frightening for patients potentially leading to reduced screening rates for colorectal cancer.  It was not always clear that moderate sedation — drugs to relax patients and relieve pain — would still be available for all colonoscopies.  Patients with a medical condition that required deeper sedation administered by an anesthesiologist would also have that covered under the new policy.  However, anesthesiologist care would not be routine.

One sedative drug Diprivan® (propofol) has been part of this controversy.  The drug induces sedation rapidly and patients recover from it quickly and are able to leave the recovery area sooner.  However, its FDA approved label says,

For general anesthesia or monitored anesthesia care (MAC) sedation, DIPRIVAN^® Injectable Emulsion should be administered only by persons trained in the administration of general anesthesia and not involved in the conduct of the surgical/diagnostic procedure.

Thus the need for an anesthesiologist if Diprivan is used during colonoscopy.

The American Gastroenterological Society announced that they commend Aetna on the decision to delay implementation of the policy,

The AGA Institute commends Aetna for listening to our concerns. Aetna will now delay implementation until patient-friendly alternatives for sedation — which will not require an anesthesiologist — are approved by the FDA.

What this means for patients

People insured by Aetna having screening colonoscopies will continue to be able to have monitored anesthesia care using drugs that require an anesthesiologist after April 1 whether or not they are high-risk.

Not all upper endoscopies and colonoscopies use MAC for sedation.  Moderate sedation using drugs that make you sleepy and relaxed and manage pain will continue to be available for you as it was before.

You should discuss what sedation is going to be used for your colonoscopy and whether an anesthesiologist will be present with your gastroenterologist before your test.

If you believe that you have an need for deep sedation because of your age, prior colonoscopy experience, past surgeries, or other medical reason talk to the gastroenterologist about using an anesthesiologist to monitor your care.

In any event, sedation to make patients comfortable during colonoscopy is available and is routinely used. No one need fear colonoscopy because of unnecessary pain.

People who have had a colonoscopy can help reduce deaths from colorectal cancer by assuring their friends and family who have not been screened that colonoscopy is not painful.