Screening is the best defence against colorectal cancer

Mark Wilson didn’t have to have a medical degree to know that something was horribly wrong with him.

The blood in his stool said it all.

With a strong family history of colorectal cancer, Wilson assumed the worst and was prepared to fight. His first plan of attack – a colonoscopy to confirm his suspicions – would be one of the hardest battles to win.

That’s because Wilson was only 26 at the time and not a typical candidate for colorectal cancer. Without a family doctor, his only avenue was a walk-in clinic which left him with a diagnosis of hemorrhoids. What a blood test would have revealed was Lynch Syndrome, the most common hereditary form of colorectal cancer.

This form of cancer is often missed because the cases tend to develop more quickly and at younger ages. The syndrome also increases the risk of other cancers such as endometrial cancer in women. The unusual genetic sequence accounts for two to four per cent of cases of the disease.

With a family history of cancer as long as his arm, Wilson wasn’t satisfied with the clinic’s diagnosis.

“I knew it wasn’t that at all. I knew it was serious because the bleeding never stopped,” says Wilson. Nor did he. Wilson took a bold move and pushed the walk-in clinic to refer him for a colonoscopy.  The clinic set up a sigmoidoscopy with Dr. Michael Anderson, a cancer surgeon at Royal Victoria Hospital in Barrie and the Regional Lead, Surgical Oncology.

Wilson called Dr. Anderson and described his family history. Intrigued by the case, and the fact Wilson was so adamant it was cancer, Dr. Anderson moved ahead the sigmoidoscopy appointment to get Wilson screened.

“I knew after speaking with him, and looking at his family history, that I would find something,” says Dr. Anderson, who confirmed Wilson had Lynch Syndrome, as well as, a large tumour. Wilson had been right, and yet he was not prepared to hear the word ‘cancer.’

“Even though I expected it, just hearing the word ‘cancer’ blew me away. When Dr. Anderson was saying it, I could feel my heart beating faster. I kept it together until my girlfriend, Morgen, and I got to the car in the parking lot at RVH and then I just lost it.”

The tears would continue for this young man, as just a week after he received his cancer diagnosis his mother Eila passed away from endometrial cancer.

More determined than ever, Wilson accepted his pre-surgery treatment path including a five week stint of both chemotherapy and radiation in order to shrink the tumour. He wore an intravenous chemotherapy pump 24 hours a day and headed to a hospital in Toronto for radiation five days a week for five weeks, as radiation therapy was not yet available at RVH. Then there was surgery to remove the now shrunken tumour, followed by another round of eight chemotherapy treatments spread over 16 weeks at RVH.

In order to complete this treatment, Wilson had to put his whole life on hold. He had to leave his job as a carpenter and postpone proposing to Morgen in order to become consumed with one passion – beating colorectal cancer.

Dr. Anderson says catching it early meant the odds were on his side. “This cancer is the second leading cause of cancer deaths in Canada. In the early stages, this cancer is asymptomatic and by the time people experience a symptom, like rectal bleeding, the cancer is often advanced,” says Anderson. “In Ontario there are 8,300 new cases of colorectal cancer every year and almost half of those people will die simply because it was caught too late.”

However, colorectal cancer is totally preventable if people are screened early. What isn’t so easy is convincing people to be screened. The problem, as Dr. Anderson sees it, is that people wait for symptoms. Unfortunately, by that time it is often too late.  However, when detected early through regular screening, there is a 90 per cent chance of curing colorectal cancer.

According to ColonCancerCheck, the recommended screening method for average risk people aged 50 and over is the Fecal Occult Blood Test (FOBT). The FOBT kit tests for blood in stool. The presence of blood may be a sign of colorectal cancer.

The key to beating this cancer is screening. In addition to the Fecal Occult Blood Test another common test is a colonoscopy which is recommended for those who have a positive FOBT or those with an increased risk for colorectal cancer.

“A colonoscopy is simply a look inside the colon with a camera. The screening is a painless and forgettable experience. The only work for the patients is the homework. They have to drink a ton of laxatives, grab some good reading material and spend some time in the washroom.”

If polyps are detected during a colonoscopy Dr. Anderson will automatically remove them making the screening also a cure. On average, one in six people over the age of 50 have polyps and one in 70 have cancer. Screening is the best way to protect oneself from this deadly disease, but people can reduce their risk for colorectal cancer by eating a diet high in fruits, vegetables and fibre; quit smoking; limit the use of alcohol; be physically active every day and have regular physical checkups.

“All I have to say to the public is screen, screen, screen. Everyone over the age of 50 should be screened, as should people with a family history of colorectal cancer,” says Anderson.

Wilson has a stronger message.

“If you don’t want to go and get checked for yourself, then do it for the people who love you. Cancer is just as hard, if not harder, on your loved ones as it is for you,” says Wilson. “I honestly don’t know how I got through all that, along with my mother passing, but support from family and friends helped me push through. I believe in God and I asked for strength to get through whatever was thrown at me. I believe my prayers were answered.”

Now Wilson’s life is officially off the hold pattern. Nearly four years have passed since he was first diagnosed and he’s now back at work, cancer free and has a new outlook on life. Oh, and a wedding in the works. After contacting close family and friends to share that good news, Dr. Anderson was next on his list. “The best part of my job is that colorectal cancer is preventable. Mark was not far from being in real trouble. For me this is a real feel good story,” says Dr. Anderson. “My message is simple – get screened.”