UTHSC professor stresses importance of early detection of colorectal cancer
According to national statistics, more than 56,000 people in the United States die from colorectal cancer each year. Colorectal cancer is the second most common cause of cancer death in this country.
In response to these disturbing facts, former President Clinton proclaimed March to be National Colorectal Cancer Awareness Month. In his proclamation, Clinton said, "I encourage health care providers, advocacy groups, policymakers and concerned citizens across the country to help raise public awareness of the risks and methods of prevention of colorectal cancer and to use the power of our knowledge to defeat this silent disease."
Dr. J. Milburn Jessup, professor of surgery and chief of surgical oncology at the Health Science Center, is among the nationally recognized experts leading the fight against this deadly disease.
Last year, Dr. Jessup was one of several experts featured on a panel discussion about colorectal cancer at the American College of Surgeons' Annual Clinical Congress held at the Mayo Clinic in Rochester, Minn.
Dr. Jessup and his colleagues concluded from their discussion that although doctors agree early detection of colorectal cancer reduces the diseases' overall mortality rate, primary care physicians are not properly screening their patients.
On the other hand, many patients screened with the fecal-occult blood test (FOBT) whose test results are positive, elect not to go for more thorough follow-up screenings. What is needed is a combination of the FOBT followed by a colonoscopy when the FOBT results are positive.
Many patients resist undergoing the colonoscopy because of its invasive nature. Therefore, many doctors do not offer it to their patients.
Dr. Jessup said Dr. Gerald Dodd, chairman of radiology, and Dr. John Leyendecker, assistant professor, department of radiology, are developing ways to use a new method of screening called the virtual colonoscopy at the UTHSC and the University Hospital. The virtual colonoscopy, in which 3-D images are created by combining several CT scans, is not invasive like the traditional fiberoptic colonoscopy. Dr. Jessup believes that patients might be more willing to undergo this new method of screening because of its non-invasive nature.
For those who already have the disease, Dr. Jessup said that proper staging is vital to patient survival.
"Therapy and outcome are determined by the stage of the disease," Dr. Jessup said. "The risk of patient death is determined by the stage."
Dr. Jessup is working with the UTHSC Cancer Committee headed by Dr. Morton S. Kahlenberg, assistant professor of surgery, to foster the use of the College of American Pathologists staging protocols. The College of American Pathologists is the principal organization of board-certified pathologists serving more than 15,000 physicians and laboratory community members worldwide.
For patients with cancer that has developed into its later stages, Dr. Jessup said adjuvant chemotherapy in addition to surgery is needed. Adjuvant chemotherapy is the method of treating patients with chemotherapy after they have undergone surgery to remove all visible tumors. This is done to kill cancer cells that may have spread throughout the body from the primary tumor.
Dr. Jessup said that above all, educating physicians and patients about the importance of early detection is the key to reducing mortality rates.
"We must dispel the myth that colorectal cancer is a disease of the elderly," Dr. Jessup said. He indicated that many people younger than 50 get the disease due to genetic disorders. Dr. Kahlenberg and others in the department of surgery are promoting colonoscopy at age 50 in patients without risk factors. People with a family member who has had colorectal cancer, people who have had blood in the stool or after a bowel movement, or people with a past history of polyps or other bowel cancer are at increased risk and should start screening before age 50. People with family members who have had colorectal cancer or polyps should start 10 years before the family member had their first polyp or cancer.
For more information about colorectal cancer prevention and control, log on to www.cdc.gov/cancer/colorctl/colorect.htm.