Colon conversations: New effort to raise awareness about threat of colorectal cancer

Raising awareness about colorectal cancer is a priority issue for the Cree Board of Health and Social Services of James Bay.

According to CBHSSJB statistics, the disease is now the most frequently diagnosed cancer in Eeyou Istchee, responsible for 12% of all new cancer cases. Since Eeyou Istchee’s population size is small, the number of new cases of cancer is generally low: on average there are three new cases per year. However, this number has been on the rise since the 1990s. Now Eeyou Istchee faces the same colorectal cancer risk as the rest of Quebec.

At that, colorectal cancer is also the second leading cause of cancer-related death in Eeyou Istchee, as three people now die from the disease every two years.

However, according to Dr. David Dannenbaum of the CBHSSJB, colorectal cancer is entirely treatable provided it is detected early on, and the only way to do that is by going for screening tests.

The problem here is that often people feel that getting these tests done can be embarrassing and disgusting because they involve a stool sample.

While diagnosing colorectal cancer will always require a colonoscopy, which is a procedure that needs to be conducted by a professional in a medical setting, there is now a new and easy test to see if a patient should go for a colonoscopy.

Known as a fecal immunochemical test (FIT), it requires examination of one’s feces.

According to Dannenbaum, the FIT simply requires a kit that will be provided by the local clinic. The patient receives a stick to collect a small sample of the fecal matter and then be placed in a plastic tube before being returned to the clinic.

Dannenbaum said the previous test required a patient to refrain from eating meat for three days and then collect three separate stools on three different days that had to be refrigerated. Those undergoing this test had a lot to manage, including the samples being near their food in their fridge.

While the FIT, which is going to be available throughout Eeyou Istchee as part of a provincial program, does not replace a colonoscopy, it is an indicator as to who should get one before the age of 50. All those aged 50 to 70 are recommended to have a colonoscopy, regardless as to whether there has been a family history of colon problems.

Just about everybody should be screened.

“When we screen for cancer, by definition you have no symptoms,” said Dannenbaum. “Everybody we speak to will say that their stomach doesn’t hurt, that their stools are normal and that they aren’t losing weight and so why would I screen for cancer if I feel great?”

But Dannenbaum says this is exactly the person who should be screened for cancer. “It is really important to mention that it is the person who feels great, is out playing hockey at the age of 65, is out in the bush and is doing well overall who should be screened because when you catch it this early it is 100% treatable.The FIT is also for people who are at low risk for colon cancer, for everybody.”

But, for those who actually do have a family history of colorectal cancer, it is recommended that they begin colonoscopy screenings 10 years prior to the age that their family member had it as a means of prevention.

 

One man’s story

For Ontario Regional Chief Stan Beardy, living a life on the go as head of his community and then handling the health portfolio at the Assembly of First Nations has meant a lifestyle that was less than healthy. He couldn’t always have three square meals a day or get as much sleep as he needed. After 10 years as Grand Chief of Nishnawbe Aski Nation, Beardy’s new job at the AFN hasn’t given him any more downtime than his previous position.

It was for that specific reason that Beardy was rigorous about getting tested and seeing his family doctor on a regular basis.

Last August, he went for a routine colonoscopy and here’s the story in his own words:

“When I woke up the doctor who was performing the test said that there was something that he wanted to tell me, that there was something in my colon and so they took some samples for a biopsy.

“I also had to go for a CT scan and then come back about two weeks later for the results as well as the results from the further blood work that they were doing because of this.

“On August 19, I went to the doctor as he had told me that he had the results. This was not my regular doctor but a specialist who had been performing the test on me. He said the test had come back and there was one area that was positive and it definitely was cancer and cancer cells on my colon.

“The doctor said it was in the very earliest of stages and it would be very helpful if I made the decision to have an operation to remove the two areas that looked suspicious – one was definitely positive, the other one could be as well. He said they wouldn’t know how bad it actually was until they went in. But they had figured from the CT scan and the blood work and photos that it could be in stage one.

“The turnaround time for me was very quick from the time I went in for a routine test to having cancer surgery. They did major surgery on me on September 10 and I was out of commission for four weeks.”

Beardy admits he was lucky because his cancer was caught early on so his treatment was simple. Had he been at home in the remote Muskrat Dam First Nation, it most likely wouldn’t have happened that way.

The problem with colorectal cancer is that symptoms often aren’t felt until years down the line, at which point it is much harder to treat.

In Beardy’s case, the doctors told him it would have taken about five or six years before he felt anything, at which point his cancer would have likely been stage four and possibly fatal.

It is for this reason that Beardy has started efforts to raise awareness about colorectal cancer among First Nations people, which includes finishing a video project with the AFN. In it, Beardy tells his story and talks about his community as well as access to medical care for those most in need of it, particularly Aboriginals in remote communities.

Launched on March 17, the video, Early Detection: The Path to a Good Life, can be viewed at www.tbrhsc.net/GoodLife.