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Community Connections: Brittney Waldrop

Brittney Waldrop 32, female, patient

How did you discover your diagnosis? How old were you at the time? Did you have symptoms? 

I was 31 years young when diagnosed. I went in for my first ever colonoscopy and they found one polyp that was cancerous. I had symptoms for about 5 years, but they were unfortunately overlooked by many doctors. I experienced extreme exhaustion; I could drink 8 cups of coffee a day and still go to sleep! I also occasionally had bloody stools, but they were bright red instead of the black they tell you to look for. Doctors kept saying that it was just hemorrhoids but didn’t look into it any further. If they did, maybe I wouldn’t be stage 4 at this point! It could’ve been caught sooner!

 

Did you have any prior knowledge about colon cancer before you were diagnosed? For instance, did you know about the symptoms and factors that lead to a higher risk of CRC? Did you know your family history?

I did not know anything and I do not have a family history of colon cancer.

 

Has your experience impacted your lifestyle? If so, what are some changes you’ve made?

Yes, it made me realize that life is short, and to live each day to the fullest! I’m weaker than I used to be, so I’ve been slowly trying to build my strength back up as well. 

 

It’s great that you’ve been taking the steps to regain your strength! Is there anything specific that you’ve been doing for this?

I have been walking, riding my stationary bike, reading my daily religion book, stretching and taking wheatgrass shots daily!

 

Is there someone or something that you have leaned on for support during this time?

Facebook support groups, my family & friends, and the hospital that I received care from.

 

What advice would you give to others who are experiencing the same situation as you?

Breathe, it’s going to be okay!

 

For more information related to colon cancer contact us today: www.coloncancerfoundation.org

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New Indiana Law Requires Insurance to Cover Colon Cancer Screenings at the Age of 45

A new law passed during the Indiana General Assembly’s 2020 session now requires insurance companies to cover colonoscopies at age 45 instead of the previously recommended 50. The law comes two years after the American Cancer Society modified their guidelines for colon cancer screenings.

In a study published in 2017 by the Journal of the National Cancer Institute, researchers found that from the mid-1980s through 2013, colorectal cancer incidence rates in adults age 55 years and older were declining while incidence rates for adults between the ages of 20 and 49 were increasing. It is speculated that the increase in colorectal cancer incidents in young adults is attributed to the fact that screenings were previously not recommended for those under 50.

Implications

It is estimated that there will be around 104,000 newly diagnosed cases of colon cancer and around 43,000 new cases of rectal cancer in the United States in 2020. Almost 18,000 of these cases are estimated to be diagnosed in adults younger than 50. The American Cancer Society estimates that among these numbers, 3,410 will be Indiana residents. Inspired by these statistics, the new Indiana law allows for cases to be diagnosed at an earlier age since screenings are now covered for those 45 years and older. Rep. Brad Barrett, who drafted the law, emphasized its benefits by explaining that insurance costs could potentially decrease if people are diagnosed at an early stage since “the cost of treatment will be less than if it had been caught at a later stage.” The five-year survival rate for colorectal cancer that has been detected early is 90%.

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Pembrolizumab Approved as First-Line for MSI-H/dMMR Metastatic CRC

At the virtual American Society of Clinical Oncology (ASCO) annual meeting in May/June 2020, promising results from the interim analysis of phase 3 data from the KEYNOTE-177 trial were presented during the plenary session. First-line treatment of a subset of patients with metastatic colorectal cancer (mCRC) with the immunotherapy drug pembrolizumab doubled the median progression-free survival (PFS) compared to patients treated with standard-of-care chemotherapy. This has now led to an FDA approval for the drug.

Trial Results

KEYNOTE-177 was designed as a global, multicenter, open-label, active-controlled, randomized trial that compared treatment of 307 previously untreated patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) mCRC. Mismatch repair is an inherent property of cells that allows them to correct DNA replication errors, and dMMR cell lack this process, resulting in mutations in the DNA. dMMR cells with alterations in short, repetitive DNA sequences are called MSI-H.  Patients were randomized to receive first-line pembrolizumab alone at 200 mg every 3 weeks for up to 2 years or investigator’s choice chemotherapy: FOLFOX (fluorouracil [5-FU], leucovorin, and oxaliplatin) or FOLFIRI (5-FU, leucovorin, and irinotecan) every 2 weeks, with or without bevacizumab or cetuximab.

This was a crossover trial, meaning patients on chemotherapy could cross over to receive pembrolizumab for up to 35 cycles if their disease had progressed. Primary end points were PFS and overall survival (OS); objective response rate (ORR) was the secondary endpoint.

Median PFS was 16.5 months in the pembrolizumab group and 8.2 months in the chemotherapy group. Pembrolizumab showed a 40% reduction in the risk of disease progression (P=0.0002); PFS rates were 55% vs 37% for pembrolizumab vs chemotherapy, respectively, at 12 months, and 48% vs 19%, respectively, at 24 months. ORR were 43.8% and 33.1%, respectively. While the median duration of response was 10.6 months for chemotherapy (2.8-37.5 months), it had not been reached with pembrolizumab (2.3-41.4 months). Complete responses were achieved in 11.1% and 3.9% patients receiving pembrolizumab vs chemotherapy, partial responses were achieved in 32.7% vs 29.2%, respectively.

Only 22% of patients in the pembrolizumab arm had treatment-related adverse events (TRAEs) compared to 66% in the chemotherapy arm. One TRAE death was reported in the chemotherapy arm.

The study is ongoing and OS data are expected to be presented at a later time.

FDA Approval

The above results have led to the FDA approval of pembrolizumab in previously untreated patients with MSI-H/dMMR mCRC. Importantly, this is the first immunotherapy to receive FDA-approval as first line of care in this patient population.

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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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Colon Cancer Immunotherapy

Many therapies have been proposed in the continuous fight against colon cancer. Some of these therapies have proven to be more effective than others. One of the more promising therapies for treating colon cancer is immunotherapy. It is a much more holistic approach than many other treatment methods and helps the patient’s body fight cancer on its own. Here is what you should know about the benefits and challenges of treating colon cancer with immunotherapy.

In 2019, an estimated 100,000 of new cases of colon cancer emerged. Numbers like that might not seem like a lot, but when you start looking at the big picture, say, 100,000 cases of colon cancer per year, you can see a trend of 1,000,000 cases in ten years. One hundred thousand might seem trivial, but a million people is like the population of a small country, and when you look at the mortality rates, the picture gets even more interesting.

This is why colon cancer awareness is so important. Do yourself and your loved ones a favor and start talking about your family history and get screened. Prevention is crucial, and being proactive is the key to prevention. One of the best things you can do for yourself aside from committing to regular screenings is to learn more about the most effective treatments. One of the most intriguing treatment methodologies to date is immunotherapy.

What to Know About colon Cancer Prevention and Immunotherapy

Most immunotherapy methodologies focus on leveraging the patient’s own body to actively seek out, identify, and destroy cancer cells. It works by empowering your own immune system and helping it root out any cancer cells before they cause you any more trouble.

Immunotherapy has displayed impressive success rates when used to treat certain types of cancer including a type of lung cancer and skin cancer. Less is known about immunotherapy’s potential to combat colon cancer.

For those who are afflicted with colon cancer, immunotherapy shows the most promise to patients who exhibit something called mismatch repair deficiency. Patients with mismatch repair deficiency are prone to abnormal rates of mutations including the types of cells that contribute to colon cancer.

This serves to highlight the importance of knowing more about your genetics. Some people are afraid to investigate their genetic predisposition because of the fear of actually being predisposed. No one wants to hear that they are genetically susceptible to contracting colon cancer. As difficult to hear as it may be, information is your best friend in these situations. If you’re genetically predisposed to getting colon cancer, you can focus on prevention to decrease your chances of contracting the disease.

Is Immunotherapy Right for You?

One thing that you should know about immunotherapy is that it’s widely considered to be the last line of defense, or offense, depending on how you look at it. Chemotherapy and surgery are the two most commonly used treatment options. They are used at both to combat colon cancer in both the early and late stages of the disease. It’s only when both surgery and chemotherapy have failed that immunotherapy comes into play.

When colon cancer is caught relatively early, surgery has a fairly high success rate as a treatment. When other treatments have failed, immunotherapy is typically used. There is a lot to learn about immunotherapy and a lot more developments underway. One day, immunotherapy may be considered to be a much more promising treatment.

 

 

 

 

 

 

 

 

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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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