Today there are more than 1 million survivors of colon and rectal cancer in the United States, probably 600,000 to 700,000 with no sign of cancer.

And we are grateful for their courage and persistence and for all the people that have made more cures and longer survival possible.

The National Coalition for Cancer Survivorship defines  someone as a cancer survivor from the time of diagnosis and for the balance of life.

Some survivors are still being treated for cancer, others are no longer being treated by still have active disease.  Finally Post-Treatment or Long-Term Survivors have completed their treatment and have no signs of cancer.

Very often close family and friends who are touched by the cancer experience count themselves as survivors as well.

For a healthy survivorship, remember that most people with colorectal cancer will die of something else — hopefully after a long life.  So,

• Maintain a healthy weight.  Not only will that protect you against further cancers, it will reduce risk of cardiovascular disease and diabetes.
• Don’t smoke and keep your alcohol intake moderate.
• Get at least 30 minutes of moderate to vigorous exercise at least five days a week.  45 minutes is better.
• If your post-treatment colon and rectum allow it, eat more plant-based foods, whole grains, fruits, vegetables, and beans.  Limit red meat and avoid processed meat altogether.
• Have regular screenings for other cancers.  Follow your survivorship plan for the right schedule of colorectal cancer screening after treatment ends.
• Get a flu shot every year and talk to your doctor about other vaccinations you may need as an adult, especially if you are over 65.
• Be sure that you get a written Survivorship Plan from your doctor at the end of your active cancer treatment.

Finally, the Surgeon General has declared this Thanksgiving Day Family Health History Day. As families gather, it’s a perfect time to talk about what diseases might run in a family and get information to create My Family Health History Portrait. You can begin it online, save it so you can add more information as you learn it, and print it out for other family members.

You can find more survivorship information on Fight Colorectal Cancer’s Patient Pages.

Among the nearly 12 million US cancer survivors, there are 1.1 million who have been diagnosed with colon or rectal cancer.

The number of all US cancer survivors has increased steadily from about 3.8 million in 1971 to 9.8 million in 2001 to 11.7 million in 2007.

More than half of survivors had colorectal, breast, or prostate cancer.

Individuals are considered cancer survivors from the time of diagnosis through the balance of their lives.

As of January 1, 2007:

• 64.8 percent of survivors had lived 5 years of more since their diagnosis.
• 1.1 million of the 11.7 million had lived more than 25 years.
• 59.5 percent were 65 years old or older.
• 54.3 percent were female, 45.7 percent male.

Most common cancer diagnoses were

• female breast: 22.1 percent of all survivors,
• prostate: 19.4 percent.
• colorectal: 9.5 percent.

People in the United States diagnosed with cancer:

• In 1971 there were 3 million cancer survivors, 1.5 percent of the US population.
• By 2001, the number of survivors had increased to 9.8 million, 3.5 percent of people in the US.
• In 2007, survivors grew to 11.7 million, 3.9 percent of population.

Almost all survivors were over 40 in 2007

• 59.5 % were 65 and older.
• 35.2 % were 40 to 60.
• 4.5 % were 20 to 39.
• less than 1 % were 19 or younger.
• of the young survivors under 20, 1/3 had been diagnosed with leukemia.

SOURCE: Centers for Disease Control, Morbidity and Mortality Weekly Report, Volume 60, Number 9, pages 269-272.

Despite guidelines calling for a colonoscopy a year after surgery for colon or rectal cancer, less than half of patients have had one 14 months after colorectal surgery intended to cure their cancer.

A study of stage I, II, and III colorectal cancer patients in the United States found that only 49 percent had received the recommended colonoscopy.

Currently follow-up guidelines call for a surveillance colonoscopy to look for local cancer recurrence or new polyps or cancers a year after surgery.  If that exam is normal, another colonoscopy is called for three years later and then every five years. 

Researchers talked to 1,400 colorectal cancer survivors in the Cancer Care Outcomes Research and Surveillance (CanCORS) study and examined their medical records.  Patients in the study had been diagnosed with colon or rectal cancer between 2003 and 2005.  They all had surgery for stage I, II, or III colorectal cancer and were alive 14 months later.

CanCORS includes lung and colorectal cancer patients in a collaborative study including four geographic areas across the United States, 15 Veterans Administration sites, and 5 members of the Cancer Research Network, a network of managed care organizations designated by the National Cancer Institute to conduct research on cancer prevention and control.

Patients were more likely to have received a surveillance colonoscopy by 14 months after surgery if they:

• had colon versus rectal cancer.
• were seen by a medical oncologist.
• saw a primary care provider in the year after their cancer diagnosis.
• had stage I versus stage III cancer.
• had no other serious medical conditions.

Rates varied significantly depending on the site where care was received from 37 percent to 57 percent.  It was lowest in managed care organizations.

The study authors considered whether or not there was confusion as to who should order a follow-up colonoscopy.  They wrote,

With the often fragmented care of cancer survivors, it may be unclear who is responsible for ensuring adherence to colonoscopy guidelines. Oncologists, primary care providers, and other providers involved in the care of CRC survivors must communicate with each other about their separate responsibilities for detecting second primary cancers.

They said that it is important to know if colorectal cancer survivors are receiving a survivorship plan, as recommended by the Institute of Medicine, whether they understand it, and whether they are sharing it with their primary care providers.

In conclusion, Talya Salz and the study team wrote,

Despite guidelines, more than half of CRC survivors did not receive surveillance colonoscopy within 14 months of surgery, with substantial variation by site of care. The association of primary care visits and adjuvant chemotherapy use suggests that access to care following surgery affects cancer surveillance.

SOURCE: Salz et al., BMC Health Services Research, Volume 10, September 1, 2010.

What This Means for Patients

A colonoscopy a year after surgery is important for stage I, II, and III colon and rectal cancer patients. It can detect a local recurrence at the site of the surgery and, perhaps, a new polyp at other places within the colon.  People who have had one colorectal cancer are at higher risk for another one.

Post cancer surgery surveillance guidelines call for a colonoscopy at 1 year, and — if normal — 3 years later and then at 5 year intervals.

If polyps are found or if the patient has Lynch syndrome, more frequent exams are necessary.

If, for some reason, the entire colon wasn’t examined with a colonoscopy before surgery, a colonoscopy to clear all polyps should be done 3 to 6 months after surgery.  This might happen if there was an obstruction in the colon and the scope couldn’t reach beyond it.

Make sure that your doctors are aware of the need for colonoscopies after your colorectal cancer surgery and that you get prompt referrals for them.  Ask for a written survivorship plan when you finish treatment, whether that is after surgery or chemotherapy.

Are you a woman with cancer who wants to work but you worry that your resume needs to be tuned up or your makeup fine-tuned?

Spend an evening with Cancer and Careers starting at 6 pm on July 14th at the W Hotel in Washington and get

• Resume makeovers, interview tips and career coaching from Cancer and Careers
• Self-instruction on facial massage and makeup application techniques with Shiseido beauty experts
• Relaxation and wellness tips from SELF Magazine

When?

• July 14, 2010
• 6:00 pm

Where?

• W Hotel
• 515 15th Street NW
• Washington, DC 20004

RSVP

• cancerandcareers@cew.org or call 646-929-8095

There will be refreshments and valet parking is free.

Cancer and Careers provides information and coaching for working women with cancer and their employers, family members, and co-workers about balancing cancer and work.

Close to three million children in the United States live with parents who have had cancer, half a million with parents in the early stages of treatment and recovery.

One in five adults recently diagnosed with cancer reported having a child under 18 living with them.

Most were women, married, and under the age of 50.

Using the United States National Health Interview Survey (NHIS) between 2000 and 2007 and population information, researchers estimated that 2.85 million children lived with parents who were cancer survivors. 562,000 of those children had parents whose cancer had been diagnosed within the past two years.

One third of the children (30.6 percent) were under the age of 6 when their parents first learned they had cancer, and another third (33.4 percent) were born after the diagnosis.

Overall, 1.58 million adult cancer survivors live with their minor children in the United States.

In the NHIS sample survivors were primarily:

• female (78.9%)
• married (69.8%)
• younger than age 50 years (85.8%)

Writing in an early online view of Cancer, Kathryn E. Weaver, PhD, MPH and her colleagues concluded,

There is a large population of families for whom cancer may pose special challenges and for whom assessment of needs and referral to resources are essential.

SOURCE: Weaver et al, Cancer, Early View, online June 28, 2010.

If you have completed your colorectal cancer treatment within the past two years, researchers at the University of Texas need your help.

Led by Nynikka Palmer, a doctoral student at the University of Texas School of Public Health, a study will explore the goals and plans colorectal cancer survivors have for their health after their treatment is over.

Learn more about the survey or sign up.

In order to participate, colorectal cancer survivors must:

• be a colorectal cancer survivor (includes colon, rectal and anal cancers),
• have completed cancer treatment within the past two years (0-24 months since last treatment),
• be currently disease-free, and
• have been 18 years or older when diagnosed with colorectal cancer

Study Background

There is limited cancer survivorship research exploring colorectal cancer patients who have successfully completed cancer treatment. The end of cancer treatment is an opportunity to help cancer patients resolve post-treatment issues and make healthy lifestyle changes. However, we do not know what is important to colorectal cancer survivors once they finish treatment. We want to know the goals you have for your health, so that we can develop new programs and provide resources to help colorectal cancer survivors move forward after treatment.

This is a one-time survey.  You can stop it at any time you wish.

You should read and consider the online informed consent before agreeing to take part.

The research has been reviewed and approved by the Committee for the Protection of Human Subjects (CPHS) of the University of Texas Health Science Center at Houston.

NOTE:  C3 is not conducting this study.  If you have questions about it or whether you might be eligible contact Nynikka Palmer, at 713-500-9789, or by email at Nynikka.Palmer@uth.tmc.edu.

Put on those sneakers and take a walk!

Today is National Start Walking Day.  Not only can regular walking reduce risk for heart disease, it can be part of an exercise program to prevent colorectal cancer and support survivorship.

Thirty minutes of walking at a moderate pace has been shown to reduce risk of getting colorectal cancer.  Plus exercise after surgery for stage III colon cancer reduced the chances of its coming back.

The National Heart, Lung, and Blood Institute suggests starting slow by walking for 30 minutes three days a week.

All adults should set a long-term goal to accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days of the week. This regimen can be adapted to other forms of physical activity, but walking is particularly attractive because of its safety and accessibility.

They also point out that you can combine several short periods of exercise during the day.

Start walking!

You may know this already, but we have now more proof that physically activity reduces significantly your risk of tumor recurrence.

The study conducted by Dr. Jeffrey Meyerhardt from the Dana Farber Cancer Institute began in January 1986, included 668 men who’d been treated for stage I, stage II or stage III colon cancer that had not spread (nonmetastatic cancer).

Every two years, the men were sent questionnaires that asked them about any new cancer and disease diagnoses, as well as their physical activity. A metabolic equivalent task (MET) score was matched to each type of physical activity, with exercises that burned more energy receiving higher MET scores.

During the study period, which ended in January 2006, 258 of the participants died, including 88 who died from colon cancer. The results show that men who were physically active after diagnosis of nonmetastatic colorectal cancer experienced a significantly decreased risk of colorectal cancer-specific death, as well as death from any cause. This benefit was independent of age, disease stage, body mass index and tumor location and from the pre-diagnosis physical activity.

This manuscript was published in the Archives of Internal Medicine on December 14. These data show that physical activity will help in your fight against colon cancer for anyone.

Turn off your TV and start exercising.

Nancy Kerrigan

After the football and the turkey, tune in Kaleidoscope on Thanksgiving.  C3 is part of the show!

Featuring cancer survivors Dorothy Hamill, Scott Hamilton, and Olivia Newton-John, Kaleidoscope focuses on women and cancer, raising awareness of how cancer affects women and providing strength to triumph over it.

Taped before an audience almost entirely of cancer survivors, Kaleidoscope will air at 4 p.m. EST, Thursday, November 26, Thanksgiving Day on FOX.

Watch for the more than 200 C3 cancer survivors and their families who were at the taping in the Verizon Center.

Dorothy Hamill, a breast cancer survivor, skates to music sung by Olivia Newton-John, another survivor.

Newton-John and David Foster will sing Hope is Always Here, a song written by children with cancer as part of the Purple Songs Can Fly project.

Others stars include Grammy-winner David Foster, Olympic ice-skating champions Kristi Yamaguchi and Nancy Kerrigan, and children from Purple Songs Can Fly.

Performing for Kaleidoscope, Scott Hamilton is back on television ice, skating for the first time since his diagnosis with testicular cancer and treatment for a brain tumor.  He talks about his cancer, being back skating, and Kaleidoscope with Good Day New York:

Disclosure: C3 receives funding from sanofi-aventis in the form of unrestricted educational grants. C3 has ultimate authority over website content.

Kimberly and Cecil

Kimberly Wright and Cecil Bradstreet  are being married on December 26, a date they chose because it falls in a free week between Kimberly’s tenth and eleventh chemotherapy treatments.

They won a holiday dream wedding from WIS-TV in Columbia, South Carolina, chosen by online voters.  Cecil wrote their story for the WIS contest as a surprise for Kimberly who was diagnosed with stage III colon cancer during emergency surgery on July 1.

The wedding includes a reception at the historic Mitchell House and Gardens in Lexington, South Carolina, along with a wedding cake, flowers, candles, and a champagne toast.  Part of the prize is a wedding planner who will take over the details, freeing up Kimberly to focus on getting well. Cecil didn’t want her to have to worry.

Writing about Kimberly’s diagnosis and treatment, Cecil said,

Two weeks ago our lives changed forever.  Kimberly was diagnosed with Stage 3 colon cancer.  She had the tumor removed along with about 2 feet of her colon.  There were 6 lymph nodes that were positive, but the PET scan showed no other signs of cancer in the body.  She will now endure 16 treatments of chemotherapy over the next 32 weeks.  We have a tremendous support system that has been a wonderful foundation for us.  After questions and tears we are ready to fight this and she is going to prevail.  Our future plans are to beat this and move on in our lives and have a family.

Congratulations Kimberly and Cecil. Much health and happiness in your future together.