Medically underserved residents of three Georgia counties will be able to get a free screening colonoscopy thanks to a collaborative effort developed by the Magnolia Foundation and the Northwest Georgia Regional Cancer Coalition.

Financially eligible people from 50 to 69 in Chattooga, Floyd, Gordon and Polk counties without insurance coverage to pay for screening can apply through their local county health department.  Younger people at higher risk for colorectal cancer because of a family or personal medical history are also included.

Health department staff will forward eligibility forms to the Northwest Georgia Regional Cancer Coalition.  Numbers to reach health departments:

• Chattooga County Health Department: 706-857-3471
• Floyd County Health Department: 706-295-6316
• Gordon County Health Department: 706-624-1444
• Polk County Health Department: 770-749-2253

Colonoscopies will be provided at Gordon Hospital, Floyd Medical Center and Redmond Regional Medical Center.

Physicians from Harbin Clinic Gastroenterology and Rome Gastroenterology Associates have agreed to provide colonoscopies at no charge to qualified patients referred through the pilot program.  If biopsies are necessary,  pathologists from Southeastern Pathology will prepare and analyze slides without their usual fee.

If cancer is found during the exam, patients will be referred to Patient Navigators, Inc. for help finding medical coverage for treatment.

The pilot project is part of an effort funded by the Georgia Department of Human Resources to improve colorectal cancer screening in the counties covered by the Northwest Georgia Regional Cancer Coalition.  The Coalition, in collaboration with Morehouse School of Medicine, has trained six facilitators from Chattooga, Floyd and Polk Counties to raise screening awareness.

The Magnolia Foundation was organized as a 501 (c) 3 not-for-profit organization to fund colonoscopies, preps, and medicines necessary for free screenings.

Lisa Smith, founder of the Magnolia Foundation, whose mother died of colorectal cancer said,

Three of our primary goals are to remove barriers blocking access to colorectal-cancer-screening services, increase participation in recommended screenings for colorectal cancer and improve area screening rates by the year 2012. This pilot program will help accomplish all three.

There is an article in the Rome News-Tribune about the collaborative effort.

In studies reported this week  fewer specialists managing colorectal cancer were found in US counties with large African American populations, older adults with cancer had significantly worse physical and mental health, and palliative sedation at the end of life did not hasten death.

In other headlines, colorectal cancer screening for the uninsured will begin on July 1 in Minnesota, and if screening reveals cancer, treatment will be covered under the Minnesota Medical Assistance program.  The FDA warned consumers not to use Zicam nasal gel or swabs to avoid loss of smell, and doctors advised patients on long-term Xeloda therapy to carry a letter from their oncologist explaining possible loss of fingerprints if they travel internationally.

Research Reports

• Communities with large percentages of African Americans have less access to the doctors critical to colon and rectal cancer care. Analyzing data from the HHS Area Resource File, researchers discovered that as the percentage of African Americans in individual US counties increases, the numbers of gastroenterologists, radiation oncologists, and colorectal cancer surgeons decreases.  Awori J. Hayanga, MD wrote in the June 2009 Archives of Surgery, “Increasing numbers of minority patients in counties is accompanied by a differential access to specialists. This may affect the likelihood of a patient to receive appropriate care.”
• Measuring health-related quality of life, older adults with most cancers, except melanoma and endometrial cancer, have poorer physical health than matched over 65 controls.  However, only older cancer patients with lung, colorectal, and prostate cancer had significant reductions in mental health.  Bruce Reeve and his team linked data from the Medicare Health Outcomes Survey (MHOS) and NCI SEER cancer registry to determine how a cancer diagnosis affects both physical and mental health and quality of life. They reported their results online June 9, 2009 in the Journal of the National Cancer Institute. A JNCI Memo to the Media has more information about the study.
• Palliative sedation given to manage severe symptoms at the end of life does not reduce survival time when compared to patients treated with standard hospice protocols, according to a study in the July Annals of Oncology. The study resolves some ethical questions of using sedation for unmanageble end-of-life pain even if it might hasten death.  Dr. M. Martoni wrote, “Palliative sedation therapy does not shorten life when used to relieve refractory symptoms and does not need the doctrine of double effect to justify its use from an ethical point of view.”

Other Headlines

• On July 1, 2009, with funds from an increased tobacco tax, the Minnesota Colorectal Cancer Prevention Act will provide screening for uninsured and underinsured residents of Minnesota. Program participants must have family incomes less than 250 percent of poverty and be over 50 or at high risk of colon cancer.  If cancer is found during screening, patients will be covered by Medical Assistance for their treatment. The American Cancer Society recognized state representative Maria Ruud, a nurse practitioner, as Legislator of the Year for her leadership in writing the legislation and getting it passed.
• On June 16, 2009 the FDA warned consumers to stop using and throw away intranasal Zicam Cold Remedy Nasal Gel and Zicam Cold Remedy Swabs. The zinc-containing  products have been linked to a loss of the sense of smell, for many people with the first use.  Zicam Cold Remedy Swabs, Kid Size has been discontinued, but the FDA is concerned that some people may still have it in their homes.  Because children may not report loss of a sense of smell, the FDA is particularly concerned with the use of zinc in the noses of children.  The FDA has sent a warning letter to Matrixx Initiatives telling them that these products cannot be marketed without FDA approval.
• Hand-foot syndrome side effects from Xeloda® (capecitabine) may cause loss of fingerprints with long-term use.  The July 2009 Annals of Oncology reports on a case of a man with head and neck cancer who took oral Xeloda for over three years as maintenance therapy.  He was detained trying to enter the United States because his fingerprints could not be detected.  In a letter to the editor of Annals, doctors say that patients on long-term capecitabine therapy should be warned about the possibility of fingerprint loss and carry a letter from their oncologist explaining the situation.  They point out that it is unclear how soon fingerprint loss may occur.

A reminder that free colonoscopies for Connecticut residents without insurance or whose insurance doesn’t pay for colonoscopy screening ends on June 29.

The program is a collaboration between the Connecticut Department of Health, the Community Health Center Association of Connecticut, and participating gastroenterologists.

Connecticut residents between the ages of 50 and 64 can contact one of the participating community health centers to schedule a test.

A new type of drug was successful in helping patients with cancer cachexia regain muscle and strength, and counting circulating tumor cells helped predict survival for people with advanced colorectal cancer.

Free colonoscopies are available through a Connecticut program, the FDA and FTC warn the public to be wary of websites or ads promising treatments for 2009 H1N1 influenza, and people in remote areas of Arizona were able to have CT colonoscopy screening with teleradiology.

Research Reports

• Ostarine or GTx-024, the first of a new drug class called selective androgen receptor modulators (SARMS) increased lean muscle mass in patients with cancer cachexia. Patients were also stronger, as shown by improved performance on a stair climbing task.  They didn’t gain weight because fat tissue was replaced with muscle.   Cancer cachexia or wasting causes significant weight loss and reduced lean muscle leaving patients tired, weak, and with little appetite.  Merely eating more — or trying to eat more — doesn’t help patients gain weight or strength.  In the study, nearly 160 patients were randomized to a placebo or two different strengths of ostarine.  Before beginning the trial, patients with a number of different cancers had lost an average of almost ten percent of their body weight.  There was no difference in serious side effects among the three groups.  Read more about the study in a news release from GTx, the company developing the drug.
• The number of circulating tumor cells (CTCs) can predict both how long it will take for colorectal cancer to get worse (progression-free interval) and overall survival time.  Both progression-free interval (PFS) and overall survival (OS) were shorter when three or more CTCs were found in the blood.  Those with fewer than three CTC  had median PFS of 7.8 months compared to 4.4 months for those with three or more. Overall survival was 20.6 months with fewer than three CTCs compared to 9.4 months for three or more.  The study, led by Dr. S.J. Cohen, was published in Annals of Oncology in advance online March 26,2009.

Other Headlines

• Connecticut has a free screening colonoscopy program for the uninsured and people whose insurance doesn’t cover screening colonoscopy. Working with the Community Health Center Association of Connecticut, the University of Connecticut, and gastroenterologists statewide, the program refers Connecticut residents, ages 50 through 64, for colonoscopy screening and follow-up.  Find telephone numbers of participating community health centers.
• Teleradiology is helping bring virtual colonoscopy to remote areas of Arizona.  While physicians and equipment for optical colonoscopy screening often is not available in rural areas, CT colonography can be performed by technologists and information be uploaded to a workstation and interpreted by an off-site radiologist.  During a study at the University of Arizona, 86 patients were screened with CT colonography in two rural health centers. Radiologist Arnold Friedman, MD, FACR, who led the study, reported its results at the American Roentgen Ray Society meeting in Boston
• The FDA and the Federal Trade Commission warn consumers against websites or products that offer to prevent, treat, or cure the 2009 H1N1 influenza virus.   FTC Chairman Jon Leibowitz said, “The last thing any consumer needs right now is to be conned by someone selling fraudulent flu remedies. The FTC will act swiftly against companies that resort to deceptive advertising.” The FDA provides information about buying medicine online and has a web page dedicated to influenza information, including H1N1 updates.

Dylan Cappel

The Strides for Life Colon Cancer Foundation is planning their Sixth Annual Cocktail Party and Silent Auction on Friday, May 8, 2009 from 7 pm to 11 pm at the Kohl Mansion in Burlingame, CA.

Dancing will feature Martini Straight Up.

Funds raised during the evening support the Bottoms Up Colonoscopy Program which provides colonoscopy screening, follow-up, and colon cancer treatment for uninsured people in the San Francisco Bay area.

Strides for Life was established in memory of Dylan Cappel, who died of colon cancer at the age of 23 while training for a spot on the US Olympic Rowing Team.

Tickets are $60 and can be purchased online on the Strides for Life website or reservations can be sent to:

• Strides for Life Colon Cancer Foundation
• P.O. Box 4225
• Burlingame CA 94011