Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=109231
Story Retrieval Date: 11/24/2014 9:00:35 AM CST
While mammograms and PSA tests offer early detection of breast and prostate cancers, colon cancer can actually be prevented by proper screening.
Colonoscopy screening detects pre-cancerous polyps that can be removed as part of the procedure to prevent colon cancer.
But horror stories and fear of diagnosis still discourage people from getting screened despite the benefits.
“The overall screening rate is probably a little over 50 percent,” said Dr. Ernestine Hambrick. “If you raise that to 60 percent, you could drop the death rate by 80 percent. That would be 40,000 lives this year. That’s quite an impact.” She answers basic questions about colon cancer.
Who should be screened for colon cancer?
Adults with no close family history of colon cancer should get a colonoscopy at the age of 50. If you are at higher risk, you should start screening at 40, or 10 years less than the age of diagnosis in your relative with colon cancer. Pre-cancerous polyps are estimated to develop into cancer slowly over 10 years, so a negative test means you don’t need another until you’re 60.
Hambrick pointed out that studies have shown that African-Americans are diagnosed with more advanced colon cancer and it’s more aggressive. Because of this, they are advised to start being screened at 45.
What are the screening methods for colon cancer?
The gold standard for screening is a colonoscopy. The procedure allows the physician to find pre-cancerous polyps and remove them before they ever become cancerous, as well as to identify early lesions. It’s performed under mild sedation to make the patient more comfortable and a study showed that patients felt less invasive tests were actually more uncomfortable than a colonoscopy.
How do you get a colonoscopy when you turn 50 (or younger if you’re at higher risk)?
Your primary care physician should be able to refer you to a gastroenterologist to perform the colonoscopy.
What are the options for the uninsured or low-income individuals?
Colonoscopies are covered by Medicare, but with the first test recommended at age 50 that leaves some people without a good screening option.
“That’s a major problem,” said Hambrick.
She sees a fecal occult blood test as an inexpensive, though not ideal, alternative. The test uses a stool sample to check for blood, which may be an indicator of cancer. It’s inexpensive enough that most people could afford to pay for it out-of-pocket. The bigger challenge would be having a “safety net” in place for patients with positive tests to receive follow-up care, according to Hambrick. Although colonoscopies are expensive, she feels that finding ways to provide screening to everyone is just basic financial sense.
“It’s infinitely cheaper to pay for screening than treatment for cancer.”
Dr. Ernestine Hambrick was a talented colorectal surgeon with a successful private practice when she reinvented herself as an activist championing the cause of preventative screening for colon cancer.
Her inspiration hit close to home: she had lost her brother to the disease.
Now, with screening rates climbing and deaths from colon cancer dropping, she’s reinventing herself again at the age of 67, hoping to pursue both the art of medicine and the art of photography.
“The goal was to get prevention on the screen of life, to make it become just part of life that you get screened for colon cancer and that you behave yourself with your eating,” said Hambrick, nestled in her apartment overlooking Oak Street Beach on a cold, bright day.
“That’s clearly happening now. The numbers of people dying are being reduced. It’s terribly wonderful and fulfilling to be able to say I had a significant part in this,” she said.
As a medical student at the University of Illinois College of Medicine in Chicago, Hambrick naturally gravitated to surgery. She was bored on her medical rounds, and during her time in pediatrics, “I got every disease those little critters had,” she said. She went on to a general surgery residency and colorectal surgery fellowship at Cook County Hospital.
“I liked that you could actually fix [patients] and make them well.”
That appeal, combined with Hambrick’s talent for colorectal surgery, led her to become the first board-certified female colorectal surgeon in the country in 1973. She taught at Cook County Hospital and formed her own private practice a few years later.
In 1993, Hambrick’s only brother died of colon cancer at the age of 55. A scientific paper published a year later showed that if you found and removed pre-cancerous polyps during a colonoscopy, you could prevent colon cancer from developing.
“As the study proved to be true, it appeared to me that people were dying who didn’t need to be,” she said.
Hambrick formed the STOP Colon/Rectal Cancer Foundation in 1997 to raise awareness of the importance of screening and spread the word that colon cancer is a preventable disease. She left her practice in 1998 to devote all of her time and energy to the cause.
“That was something I needed to do. I loved being a surgeon, I love surgery, I love the patients, the office,” she said. It became clear that I needed to do this other thing because it didn’t exist.”
One of the most important projects STOP initiated was publication of a brochure with information about colon cancer and how to pursue screening. It was translated into French, Spanish and Portuguese, and can be downloaded at www.coloncancerprevention.org.
Hambrick soon was asked to join the national Colorectal Cancer Roundtable, a group partnering different professional organizations including the American Cancer Society and Centers for Disease Control and Prevention. They all worked together to increase colon cancer screening.
Today, Hambrick feels that she and other champions of screening for colon cancer have made a difference. Due to her success, she has decided to bring STOP to an end.
“[Screening has] become part of the paradigm,” Hambrick said. “There are few people in the country who haven’t heard about it, but not enough are being tested. There’s still work to be done, but I don’t have to do it.
“I can continue to have a role, and that would be to continue to speak about it and give presentations. I do it well and I like doing it.”
Hambrick also has plans to continue to travel and pursue her love of photography, both of which are evident in the framed pictures on her walls and exotic knick-knacks scattered around the apartment.
She photographs the beach from her wide living room windows regularly and is interested in publishing her work in a book. Such whimsical pursuits seem to be a just reward for her important life’s work, which has given the surgeon and educator a sense of accomplishment.
“I don’t feel like I have to do anything else.” She pauses. “I’ve never verbalized that before. What a great way to feel about your life.”