Helping keep cancer in check

Dr. Jay Zimmerman, left, and Dr. Gary Sinensky, right, both gave a presentation at the Colorectal Cancer Awareness Month Seminar Tuesday at St. Mary’s Healthcare Carondelet Pavilion. (The Leader-Herald/ Briana O’Hara)

AMSTERDAM — When it comes to the leading causes of cancer deaths, Colorectal cancer is the second following breast cancer, yet it is one of the most preventable cancers. Symptoms of colorectal cancer are unintentional weight loss, blood in stool and changes in bowel habits.

With March as Colorectal cancer awareness month, The Cancer Services Program of Fulton, Montgomery and Schenectady Counties hosted a Colorectal Cancer Awareness Month seminar on Tuesday at the St. Mary’s Healthcare Carondelet Pavilion. There to speak on the signs and symptoms of colorectal cancer as well as how the cancer can be preventable were St. Mary’s Healthcare gastroenterologists Dr. Gary Sinensky and Dr. Jay Zimmerman.

Giving the opening remarks to the seminar was CEO and President of St. Mary’s Healthcare, Victor Giulianelli.

Giulianelli mentioned the 80 percentile which is the National Colorectal Center Round Table initiative to have 80 percent of Americans age 50 and older to be regularly screened for colon cancer.

“Screening, which leads to early detection which leads to diagnosis and treatment [have] generally better outcomes,” Giulianelli said.

Giulianelli said proceeding to the start of the Cancer Services Program, the service area had one of the highest mortality rates of any service area in New York. They then applied for the Cancer Services grant and were designated as the cancer service program by New York State Department of Health for Montgomery, Fulton and Schenectady counties. “This designation included funding for cancer screening detection, diagnosis and eventually treatment specifically [for] the uninsured and underserved,” Giulianelli said.

Dr. Zimmerman took the floor to give a presentation on signs and risk factors of colorectal cancer. Although colorectal cancer is the second leading cause of cancer deaths, it is one of the most preventable. Unlike other cancers, colorectal cancer starts as a pre-cancerous growth called a polyp. “If we remove the polyp we can prevent the cancer from ever forming,” Dr. Zimmerman said. “This is one of those preventable cancers, but takes a procedure, when you feel well, in order to do that because there are no symptoms of polyps.”

Zimmerman said there are two main types of polyps which are hyerplastic and adenomas. He said the hyerplastic polyps are more benign, reactive, the non-cancerous type. Adenomas polyps are when left with time can become cancerous and are the type to be removed.

Two of the main risk factors of colorectal cancer are family history and age. Zimmerman said someone the age of 50 and older are more at risk of colorectal. He said there are also environmental risk factors as well. Zimmerman said patients in Asia are less likely to get colorectal cancer and within three years of moving to the U.S., their incidence rates go up. “So clearly there is something in the environment addition to genetics,” he said.

Zimmerman then spoke about the several different ways to screen for colorectal cancer including fecal occult blood testing, fecal immunochemical testing, CT colonography, flexible sigmoidoscopy and colonoscopy.

“The best thing about colonoscopy is it’s diagnostic, but also treats the patient because we can remove the polyp right on the spot,” Zimmerman said.

Zimmerman said the symptoms of colorectal cancer are changes in bowel habits, unintentional weight loss and blood in stool. He said if a patient isn’t at the age of 50 and there isn’t family history of cancer, some other risk factors could include diabetes, alcohol abuse, smoking, obesity, lack of physical activity, increase of red meat and meats excessively cooked.

Dr. Sinensky then spoke about screenings for colorectal cancer, their prices, when and what age to get a screening and how often to get screened.

“Colon cancer is very prevalent and we need to do something to decrease the instance of colon cancer to detect it earlier and to prevent it,” Sinensky said.

Sinensky said the best test for colorectal cancer is the colonoscopy. He said even when patients use the other screenings that Zimmerman mentioned, patients still end up getting the colonoscopy. He said the tests such as the Cologuard can get expensive. With the Cologuard cost can range up to $750. “The problem is you have to have one every three years, it’s not enough to do it once,” Sinensky said. “Over a 10-year period you’ll be spending close to $2,000.” He said one-third of patients who use the Cologuard end up needing the colonoscopy, so all together they would have spent $3,000.

When it comes to when and what age to get screened, Sinensky said anyone over the age of 50 should get screened. However, there are other factors that lead patients to get screened at an earlier age. He said if there is history of colorectal cancer in the family, then screening should start at the age of 40 or 10 years before the family member had cancer. If someone’s mom had colorectal cancer at 45 then family members should get screened at 35. “The idea for colonoscopy is not to detect cancer, the idea is to detect polyps, take the polyps out and you don’t get colon cancer,” Sinensky said.

The age of when patients should stop getting a screened colonoscopy is 85. Sinensky said it also depends on the patients physical health conditions.

The frequency of getting a colonoscopy also depends on age and family history of colorectal cancer. Sinensky said it is recommended to get a colonoscopy every 10 years if there is no family history and if there weren’t any polyps found. If a polyp is found patients are in high-risk category and should get screened after five years and if a patient has several polyps are in a higher risk category and should get screened after three years of their first colonoscopy. “The recommendation is if you’ve had colon cancer, you should have another colonoscopy somewhere between six months to a year after the surgery,” Sinensky said.

For any questions and to see if someone is eligible for a free screening for either breast cancer, cervical cancer or colon cancer at the Fulton, Montgomery and Schenectady Cancer Services Program can call (518) 841-3726.

By Paul Wager

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