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Increased Risk of CRC in Patients With Slow-Transit Constipation

Slow-transit constipation (STC) is reported to occur in 15-30% of people in the U.S. The most widely accepted definition of STC is two or fewer bowel movements per week or straining at stool more than 25% of the time. Research continues to point to STC as a risk factor for colorectal cancer (CRC).

A study published in 2020 that looked at 2,165 patients (median age 54 years), found that the cumulative probability of CRC was 0.2% 5 years after STC diagnosis and 0.4% 10 years after STC diagnosis. This was not significantly different (p=0.575) than among those without STC diagnosis. However, this may be due to the small number of patients (5) who were diagnosed with CRC.

Although the authors of the 2020 study did not find a significant difference among those with and without STC diagnosis, it is well established that STC increases CRC risk. Gurérin et al. in their 2014 study of over 100,000 patients identified a statistically significant risk of CRC among those with STC:

  • 56% higher for CRC
  • 260% higher for benign neoplasm
  • 256% higher for benign neoplasm in colon
  • 262% higher for anal and rectal polyps

Current management options for STC range from dietary counseling, pharmacological therapy, and surgery. 

While the etiology of STC remains unclear, there is increasing evidence that it is caused by an imbalance in the gut microbiome. Zhang et al. in their 2021 review published in Gastroenterology Report found that gut microbiota may play a major role in modulating colonic motility, secretion, and absorption. However, there is still much research needed to understand how the gut microbiome modulates movement of fecal matter through the small intestine and colon.

Conversations about the role of the gut microbiome in CRC development were a part of the Early-Age Onset Colorectal Cancer Summit held by the Colon Cancer Foundation in May 2022.

 

Gargi Patel is a Colon Cancer Prevention Intern with the Colon Cancer Foundation.

 

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Study Found that Cigarette Smoking May Increase the Risk of Colorectal Cancer Incidence In a Japanese Population

A study conducted by researchers in Japan found that cigarette smoking may increase the risk of colorectal cancer (CRC) incidence in a Japanese population While smoking has been associated with an increased risk of CRC among Western populations, it has not been investigated as a risk factor in Asian populations prior to this study, according to the authors.

 

Statistics show that 60% of CRC cases occur in developed countries and CRC incidence continues to increase rapidly in Asia. Specifically, Japan experienced an increase in cases from 1978 to 1993 and has remained stable since then but is still among the top 10 countries with the highest incidence of CRC. A separate Japanese study found a gender-based difference in CRC incidence, with men being more susceptible to rectal cancer and women being more susceptible to colon cancer:

 

Colon cancer:

  • Men: 65.7%
  • Women: 75.4%

Rectal cancer:

  • Men: 34.3%
  • Women: 27.0%

 

It is hypothesized that environmental and lifestyle factors, such as smoking, can increase the risk of CRC. In Japan, for instance, 80% of men and 20% of women were smokers in the 1950s. However, a significant reduction was observed in smoking rates by 2017: only 32% of men and 9% of women were smokers. The age-standardized CRC incidence rate was 22.2 in 1978 and 38.9 in 2018.

 

Tobacco use can cause many different cancers, including mouth, larynx, lung, kidney, liver, and many more . In 2014, the U.S. Surgeon General’s report added CRC to the list of tobacco-related cancers. However, there are some issues with this:

  • Evidence supporting the claim that the use of tobacco is associated with the development of colon cancer has been derived mainly from Western populations while data from Asian populations are conflicting. More research is needed on this association in Asian populations.
  • Meta-analysis by geographic region did not find a significant association between smoking and CRC in Asian studies

The Japanese study aimed to investigate the correlation of smoking and CRC incidence in Asian populations.

 

Researchers used original data from major cohort studies performed by the Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan. The following criteria  were used when examining these studies for this analysis:

 

  • Population-based cohort studies conducted in Japan
  • Studies initiated between the mid-1980s and mid-1990s
  • Studies with more than 30,000 participants
  • Studies that acquired information on health-related lifestyles
  • Studies that followed the incidence of CRC

 

A self-administered questionnaire at the baseline survey determined if each participant was a smoker and classified them into one of three groups: never smoker, former smoker, or current smoker. Participants were followed-up for CRC incidence from the baseline study until the date of CRC diagnosis, migration out of the study area, death or the end of follow-up, whichever was first. The end of the follow-up period was between December 31, 1992 and December 31, 2014.

 

The study found that men who were ever, current or former smokers had a statistically significant higher risk of CRC than never smokers. Ever and current smoking increased the risk of both colon and rectal cancer, while former smokers had an increased risk of colon cancer.

Women who were ever, current or former smokers did not have an increased risk of CRC, but a significantly greater risk of distal colon cancer. Women who were heavily exposed to smoking had an increased risk of CRC.

 

Colon cancer is one of the most preventable diseases through screening methods and avoiding risk factors such as smoking , obesity, and poor diet. The American Cancer Society recommends getting screened at age 45 or younger if you have a family history of CRC.

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Diet and Nutrition to Prevent Colon Cancer

You can help significantly decrease your chances of colorectal cancer through proactive action related to your diet.

Maintaining a Healthy Weight Helps Prevent Colon Cancer

One of the best things you can do is to get yourself to a healthy weight and maintain it within a designated range. By maintaining a healthy weight you won’t just be proactively protecting yourself from colon cancer, you’ll also be making an investment in your overall health.

What to Eat to Beat Colon Cancer and Help Prevent it

Some of the best foods to be eating to lower your chances of contracting colon cancer include, chicken, fish, fruits, and whole grains.

Foods that you should avoid eating in excess include red meats and anything that is rich in refined sugars.

The Link Between Obesity and Colon Cancer

A strong link has been identified between obesity and colon cancer. Diet choices have a profound impact on how susceptible you are to contracting colon cancer.

It’s important to remember that making healthy choices with what you eat and how much affects much more than your susceptibility to contracting colon cancer. Your diet affects your overall health. It’s also important to remember that portion size is just as important as the food that you choose to eat. You can eat red meat without increasing your chance of getting colon cancer if you do it in moderation.

Someone who enjoys a steak every couple of weeks or so for dinner with a salad is not going to have a particularly high risk of getting colon cancer. Conversely, someone who eats steak, pork, sausage, and bacon in large quantities every single day or even every other day, will greatly increase their chances of having colon cancer.

Eating red meats in small amounts and in limited frequency is perfectly fine. No one needs to be panicking about eating a steak every now and again. No matter what you eat, your portion size is vital. Larger portion sizes are unhealthy and will put weight on fast.

You shouldn’t commit to a healthy diet just to decrease your chances of contracting colon cancer, you should want to eat healthy to feel better about yourself and increase your overall health. If you exercise and maintain a healthy diet, you won’t just be limiting your chances of getting colon cancer. You will feel better, and eliminate your susceptibility to countless other health problems.

How Does a Poor Diet Increase Your Chances of Contracting Colon Cancer?

Some of you might be wondering exactly how a poor diet increases your chances of contracting colon cancer. Obviously foods that are rich in fats aren’t good for you, but why does such delicious food have to make you more susceptible to such a horrible disease?

Studies have shown that when mice were fed a diet consisting of foods that were high in fats, they exhibited aggressive cell growth of stem-like cells that encourage mutation. This aggressive cell growth is typically coupled with the development of cancerous tumors along the intestine.

The unfortunate mice who were tested offer us invaluable insights into the factors that affect one’s chances of developing colon cancer. Their sacrifice, while trivial compared to the totality of scientific inquiry, is significant and it can save lives, human lives.

Further Recommendations

With so much information out there on the internet, it can be difficult to distinguish genuinely useful information from inaccurate drivel. For example, fiber supplements and antioxidant vitamins do not reduce one’s chances of having colon cancer, nor does it affect polyps.

Calcium, on the other hand, does have an effect on polyps and helps reduce polyp recurrence. Another thing that can help you is regular exercise. If you’re going to make the effort to maintain a healthy diet, you should double down and add exercise to the mix.

By exercising, eating healthy, and consuming the recommended amount of calcium, you can reduce your chances of contracting colon cancer significantly. Although these lifestyle changes can give you much better odds, it’s still imperative that you schedule regular screenings. If you aren’t being screened for colon cancer, you can still contract if and all of your efforts will be for naught, especially if it isn’t detected early on, hence the importance of regular screenings.

 

 

 

 

 

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COVID-19 Doesn’t Stop for Colorectal Cancer

Seventeen organizations from across the globe – who individually have made a significant impact in the fight to end colorectal cancer – are joining together in solidarity #atadistance to let their collective communities know that even in the wake of a global pandemic they are unified in and fiercely committed to saving, improving, and extending the lives of millions at risk for or living with the world’s third cancer killer.
‎#InThisTogether‎, #AllInThisTogether

On Tuesday, June 9th, these organizations will collectively celebrate and lift up the over 4.6 million colorectal cancer survivors around the world and reach out to the thousands who are newly diagnosed every day to offer a message of hope.

Colorectal cancer hasn’t stopped for COVID-19. “We know patients and caregivers affected by this disease need our support now more than ever.”Cindy Borassi, Colon Cancer Foundation, “And, we are here to help those most affected by CRC navigate cancer in the weeks and months to come.”

 AliveAndKickn                                                          Aliveandkickn.org

Beat Liver Tumors                                                    beatlivertumors.org

Blue Hat Foundation                                                bluehatbowtie.org

Colorectal Cancer Canada                                      colorectalcancercanada.com

Colon Cancer Coalition                                            coloncancercoalition.org

Colon Cancer Foundation                                       coloncancerfoundation.org

Colon Cancer Prevention Project                           coloncancerpreventionproject.org/

Colon Cancer Stars                                                  colonstars.org

Colorectal Cancer Alliance                                      ccalliance.org

Colontown                                                                 colontown.org

Fight Colorectal Cancer                                           fightcrc.org

GI Cancers Alliance                                                  GICancersAlliance.org

Michael’s Mission                                                     michaelsmission.org

Minnesota Colorectal Cancer Research Foundation  minnesotacolorectal.org

The Raymond Foundation                                       TheRaymondFoundation.org

The Colon Club                                                         colonclub.org

The Gloria Borges WunderGlo Foundation    wunderglofoundation.org

 

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2020 Global Colon Cancer Challenge

The 2020 Challenge has gone virtual during this unprecedented time. By going virtual you can still raise awareness and fund colorectal cancer research sorely needs now more than ever.  Our goal is to collectively take 1.8 million steps a day (representing 1.8 Million diagnoses per year). This will enable us to cover 41,672 miles OR ~ 83 Million steps! Most importantly we hope each of you will join us in meeting the American Heart Association’s recommended 10,000 steps per day. Let’s “Take Action Together To Defeat Colorectal Cancer!” Sign up today!

Learn why Sanjay and his family are participating in the 2020 Virtual Challenge.

The bery family did it’s own virtual event in Harry Dunham their local park in Basking Ridge, New Jersey. The kids ran 5 k and seema/ Sanjay walked 3.2 k, wearing their Colon Cancer Challenge. 2020 was the 12th year that Bery Colon Cancer Helpers participated in this Challenge — the locations have varied over the years from Central Park, Citi Field, Randall’s Island, and now Harry Dunham park.

After each Challenge the BCCH (bery colon cancer helpers) would go to a le Pain Quoitden ( a Belgium cafe chain ) in Manhattan for tartine lunch. We replicated that by creating our own le pain quoitden in our own kitchen (do not miss the cookbook in the 4th picture) and making our own open-faced tar-tine. Donate today. 

 

If you are interested in fundraising, signing up or becoming a sponsor of the Global Colon Cancer Challenge please follow the links below.

We are extremely excited to continue the legacy of the physical Colon Cancer Challenge by going virtual this year. Next year the physical Colon Cancer Challenge will return stronger than ever! In the meantime please stay safe and help us reach our goal of 1.8 million steps per day.

 

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What Causes Colon Cancer?

Predicting when or if colon cancer will develop is not possible, but predicting due to high risk factors can save lives. Early detection through screening can prevent cancer and keep it at a treatable stage.

General Causes

 While many different factors can lead to colon cancer, the exact cause is unknown. Being aware of the factors and whether or not you are at a higher risk can help save your life.

Age

All though the majority of colon cancer cases are  found in people aged 45 and up, there is an increase in colorectal cancer cases in those under 45. The risk is higher as you age. Screening starts at age 50 and continues for the next 25 years.

Overweigh

 Years of obesity can also increase your chances of developing colon cancer.

Inflammatory Bowel Disease (IBD)

 If you have ever had ulcerative colitis or Crohn’s disease, these diseases can increase your chances of developing colorectal cancer.

Type II Diabetes

 Not only can diabetes increase your risk for colon cancer it can also have an effect on your prognosis.

 Lifestyle

 The way you live can also increase your chances of developing colon cancer.

Diet

Overeating, carrying extra weight and the types of foods you eat can contribute not only to poor health but to colon and other types of cancers. Not only the food but also the way they are prepared.

Avoid red meat and any types of processed meats, like deli meat, hot dogs, and all types of red meat. Avoid eating burnt meat or other foods and try to avoid grilling, frying, and broiling meats.

Try to increase fresh fruits and vegetables, more plant-based foods, and avoid dairy, all processed foods, and sweets.

Smoking and Drinking

Cigarettes are one of the worst things you can do to damage your health. Combine it with excessive drinking, you increase your health risks and your cancer risks.

Exercise

Try to stay active, even walking in the evening or to work, taking the stairs or some type of stationary exercise equipment in the home can help with your overall health and keep cancer risks lowered.

Even for those with mobility concerns, you can find exercises you can do online or from books and magazines.

Genetics

The same way we can inherit a strong chin or a good head of hair, we can also inherit bad genes. If there has been colorectal cancer in your family, then your doctor will likely recommend you get screened earlier.

Inherited syndromes can also be a factor that increases your chances of developing colon cancer. The two most common are familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC).

Your ethnic background can also be a factor. African Americans have the highest incidence of colorectal cancer in the United States. Ashkenazi Jews also have a higher risk of developing the disease.

If you have no other risks, yet are in one of those ethnic groups you should consider getting a screening earlier than the normal recommendation.

Prevention

Taking care of your health is important, in particular, as we age. Taking plenty of exercise doesn’t mean you have to run a marathon. It just means getting off the couch or out of your desk chair regularly.

Try walking to work or part of the way home, if possible. Take the stairs when possible and invest in a bike, either stationary or mobile.

Our diets are one of the biggest ways we can prevent disease and poor health. It is all tied together, our diets, the amount we eat, what we eat, plus the impact on our bodies and the environment.

Eating a diet high in fiber, low in fat and avoiding meat can increase your health, your life expectancy and give you much more energy and a more enjoyable lifestyle.

Try to avoid stress. It is not always easy and some stresses in our lives are unavoidable, but avoid the ones you can and find other ways of coping with stress other than turning to carbs, smoking, and alcohol.

Relaxing with yoga, a warm bath before bed, and turning off all your devices can make a big difference. Getting a good night’s sleep can help start your day and it plays a big part in our overall health.

Consider a walk after a big meal, to help move it through your body. Even a walk after a stressful day at work can drop your stress and blood pressure considerably.

Worrying about family, money, your job is going to happen, to try to avoid stressing about things you have no control over. Turn off the news and your social media before you go to bed.

Try reading, relaxing, stretching, and listening to soft music with low lighting. Don’t overeat, stop smoking, eat more fiber, and take care of yourself. Colon cancer can be detected early, but there is no reason you should encourage it along.

 

 

 

 

 

 

 

 

 

 

 

 

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What is Advanced Colon Cancer?

Colon cancer develops in stages. Depending on what stage the cancer is at will determine the type of treatment you will receive. Once tested and diagnosed, the doctor will know what stage it is at.

Stages of Colon Cancer

 While it is considered the 4 stages it begins at zero.

Stage 0

 This is the earliest stage of colon cancer. The discovery of polyps, or abnormal cells is found in the inside lining of the rectum or colon. These polyps have not yet spread to other parts of the body and may or may not be cancerous.

Stage 1

In this stage, the cells have attached themselves to the walls of the intestine. They have moved through the  mucosa (the inner lining) and into the submucosa. There may be a chance they have entered the muscle. But there is no evidence the cancer has spread to lymph nodes or other organs.

Stage 2

 The next stage of colon cancer is more dire and can be divided into 3 other categories.

Stage 2A means it has moved to the outermost layer of the colon or rectum, but has not grown through it. It has not reached nearby organs or lymph nodes, and has not spread to other, more distant organs.

Stage 2B means that the cancer has grown through all the layers of the colon or rectum, but has not yet spread to the lymph nodes or other organs.

Stage 2C indicates that the cancer has now grown through all the layers of the intestine but has also grown into nearby organs or tissues. It also means that it has not spread to the lymph nodes or other distant organs.

Stage 3

 Stage 3 colon cancer is also divided into 3 sub categories.

The first stage of stage 3 has the cancer spread into at least 3 lymph nodes and possibly the muscles.

The second category of stage 3 will mean the cancer has grown into or through the outermost layer of the colon or rectum and may have also spread into nearby organs or other tissues. It has not yet spread to distant organs.

When colon cancer is determined at the third stage of stage three, the cancer has now spread into the next closest organs.

Stage 4

Stage 4 colon cancer is also called advanced  colon cancer. It means the cancer has now reached other organs like the lungs or liver.

There are several ways this cancer can metastasize. It may or may affect the lymph nodes, and it doesn’t always grow through the wall of the colon or rectum.

There are different categories for advanced colon cancer. It will depend on how many organs it has reached and whether it is in the lymph nodes or just the original tumor.

 

Treatment for Advanced Colon Cancer

 Treating a patient with advanced colon cancer will depend on several other factors. Age, medical condition, overall health, medications the patient is taking and the potential side effects and risks involved.

 Depending on how many organs are affected by the cancer, there may be surgery to remove tumors, organs and surrounding tissue. The lymph nodes may also be removed, damaged and healthy parts of the colon and rectum.

It may result in the patient also having to have a colonoscopy. This is a small opening done surgically so the colon can be connected to the abdominal surface.

This will provide a pathway for waste to exit the body. This waste is collected in a pouch worn by the patient. It may be temporary, it may be permanent. It will depend on the individual and their own situation.

Aftercare can include chemo or radiation therapy or medications. The recovery will depend on when the cancer was found and the patient’s health and age.

In many cases, the patients may move to palliative care. This will help the patient cope with the effects of colon cancer. This can be at home, in the hospital or a long-term care facility. It is meant to improve the quality of life.

It does not always mean end-of-life care, however advanced colon cancer survival rate is not promising. Once it has reached the other vital organs, it lowers the life expectancy considerably.

 

Get Screened

 If you have a history of cancer in your family, if you have a sedentary lifestyle, are overweight, smoke or have type 2 diabetes, you should consider getting screened before the recommended age.

Talk to your healthcare provider about the variety of tests available and take charge of your health. It is difficult to recover once your colon cancer has reached the advanced stage.

Testing and taking control of your own health is the best way to prevent all types of illnesses and diseases that are otherwise preventable. Cancer is not always preventable, but there is no need to invite it in.

 

 

 

 

 

 

 

 

 

 

 

 

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Colon Cancer Caregivers

If you or a loved one is living with colon cancer or in recovery from treatment, you know how difficult it can be. It can also make a drastic difference in the patient’s recovery.

Their involvement can vary, depending on many factors. Mostly, it will depend on the stage of colon cancer, the patient’s age and health and what they need. The caregiver will come in many forms, as well.

 

Support From Family

One of the best ways a caregiver can help their patient is giving them emotional support. Being diagnosed with cancer is a frightening notion and many of us have no idea what to do.

It’s important for all family members to provide emotional support, if available. Often, just someone to listen to them talk about what they are going through can ease a lot of fears.

It can be a lot of work, but family should be involved in helping the patient make decisions, accompany them to doctor appointments and to ask how they are getting on.

The day-to-day little things will go a lot smoother with emotional support. They don’t want to feel alone and it helps to have someone there to hear what the doctors have said, just to make sure it was all understood.

 

Professional Support

 For those patients who need a lot more care than just a ride to the doctor or an ear to chew, you will likely need professional care. Advance stage cancer will require a lot more than most of us are capable of, nor should we be.

Depending on your situation, you will likely require a caregiver to come into the home. They know all about what needs to be done and are highly trained to take care of your loved one.

They can administer medications, change dressings, check surgery sites, give them baths, help with physical therapy and so much more. It is too much of a burden to take on as a family member.

The truth is, many patients will be more comfortable with a professional. While you provide the emotional support they need, the professionals will take care of the rest.

Patients can feel like they are asking too much from you, and often, don’t want you to be the one caring for them. They are feeling vulnerable and dependant and that shouldn’ come down to you.

 

In Care

 If your patient requires more medical care than you can provide, you may need to consider a care facility. Long or short term facilities are designed especially for these situations.

This will depend on how advanced the cancer is, if you are looking at end of life care and if your insurance or budget will allow this type of care. They will receive all the care they need and it takes the burden off of you.

Doctors, nurses, therapists and also people who are also going through the same things can be a great comfort for the patient. They don’t feel like they are depending on you and cause you to miss out on anything.

Being in a care facility with like-minded people who have had the same experiences can be very liberating for people, in particular, for people who are having trouble coping with the cancer, the treatment and the prognoses.

 

Care For Life

 The caregiver, whether it is a family member or a community nurse, plays a vital part in the patient’s recovery and overall disposition. No one wants to be in this situation, but it doesn’t stop it from happening.

Support through all the stages of colon cancer are important. Even getting someone to the doctor to get screened can be difficult for some people. But, they won’t cope if you don’t.

Stay positive but be honest. It is a difficult situation for everyone involved, but the patient most. They will be scared and have a lot of questions. Encourage them to seek the best treatment that is recommended by their medical professional and stay with them through all of it.

 

Cope The Best You Can

It will be a big adjustment for everyone in their life, and a rapid one. As a caregiver in the family, it is fine for you to be angry, stressed, frustrated and scared.

But don’t blame the patient. Avoid the ‘I told you so’ routine, as that will not help anyone. People heal faster if they are not stressed and worried. Even if you have a professional caregiver, you can still play a huge part in their recovery.

Make them healthy meals, let them vent and express themselves. Do nice things that will cheer them up and just be there when they need it.  It is a difficult time for everyone. Just be there in whatever capacity you can to make them as happy and comfortable as possible.

 

 

 

 

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2020 Colon Cancer Challenge Goes Global

The 2020 Challenge has gone virtual during this unprecedented time. By going virtual you can still raise awareness and funds colorectal cancer research sorely needs now more than ever.  Our goal is to collectively take 1.8 million steps a day (representing 1.8 Million diagnoses per year). This will enable us to cover 41,672 miles OR ~ 83 Million steps! Most importantly we hope each of you will join us in meeting the American Heart Association’s recommended 10,000 steps per day. Let’s “Take Action Together To Defeat Colorectal Cancer!” Sign up today!

 

 

Sign up today!

If you are interested in fundraising or becoming a sponsor of the Global Colon Cancer Challenge please follow the links below.

We are extremely excited to continue the legacy of the physical Colon Cancer Challenge by going virtual this year. Next year the physical Colon Cancer Challenge will return stronger than ever! In the meantime please stay safe and help us reach our goal of 1.8 million steps per day.

 

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Coronavirus Pandemic Colonoscopy

The Coronavirus pandemic has many Americans putting life on hold, bracing for the new normal that is social distancing and staying home during these uncertain times. For many the pandemic has also delayed lifesaving screenings as the Centers for Disease Control and Prevention (CDC) has urged patients to delay any elective surgeries or procedures at this time such as your routine colonoscopy. According to the American Cancer Society, Dr. Rich Wender, Chief Cancer Control Officer for the ACS, stated:

“The American Cancer Society recommends that no one should go to a health care facility for routine cancer screening at this time…Remember, these screening tests save lives. When restrictions lift, it’s important to reschedule any screening test that you’re due to receive…Getting back on track with cancer screening should be a high priority.”

These recommendations have affected those seeking routine colonoscopies, which the American Cancer Society recommends that people at average risk* of colorectal cancer start regular screening at age 45, and every 10 years thereafter. Even with a family history of colorectal cancer or previous instances of cancer and/or polyps, colonoscopies in these instances would still be considered elective non-urgent procedures. Upcoming procedures would need to be rescheduled for the future. Some surveillance colonoscopy could be a higher priority and may need to be performed.

*For screening, people are considered to be at average risk if they do not have:
A personal history of colorectal cancer or certain types of polyps
A family history of colorectal cancer
A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer

 

For the latest information related to the Coronavirus pandemic please visit the CDC website.

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