Hospital Addresses Many Patients’ Reluctance to Having the Life-Saving Procedure, Stresses Importance of Early Detection to Survive Colorectal Cancer
By Stephen K. Peeples 
Colorectal cancer is the second leading cause of cancer deaths in the United States, killing upwards of 50,000 people year, according to the Centers for Disease Control .
And a 2012 study of Santa Clarita Valley colon cancer patients by the Cancer Committee at Henry Mayo Newhall Memorial Hospital confirmed what doctors and nurses had long suspected.
Many patients who arrived at Henry Mayo already showing symptoms of colon cancer, had skipped, for one reason or another, the routine colonoscopy cancer screening the American Cancer Society recommends for people at age 50.
“That’s really scary, because the difference between having (colorectal cancer) diagnosed routinely and finding it after you present with symptoms is years of life lost, to be quite frank,” said Gail Oliphant, R.N., Henry Mayo’s Performance Improvement Coordinator, and Quality Improvement Coordinator for the hospital’s cancer program.
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The veteran registered nurse has worked at Henry Mayo for 31 years, and now coordinates efforts to improve care for all cancer patients at Henry Mayo. The American College of Surgeons Commissions on Cancer in Chicago has accredited the hospital’s high-quality research-based, evidence-based cancer program every three years since July 1987.
What is Colorectal Cancer, and How Does a Colonoscopy Work?
Colon and rectal cancer strike the lower digestive system, from the rectum up to the large intestine, and mostly affect people older than 50. Sufferers have symptoms including varying combinations of pain, nausea, vomiting, diarrhea, constipation, anemia and bleeding. In some cases, there are no symptoms at all in early stages.
A colonoscopy is a visual inspection of the interior of the colon using a lighted fiber-optic scope with tiny camera inserted in the rectum. It remains the best way to detect and remove pre-cancerous or cancerous polyps or abnormal growths on the rectal and lower intestinal walls without far more invasive surgery.
"Polyps that tend to grow in the colon, if left to themselves, very frequently turn cancerous," Oliphant said. "So the routine colonoscopy can take care of those polyps. They just put a little wire loop around it and pull, and it just snips it right off. It’s non-invasive. That’s the procedure."
In a nutshell, she said, the preparation and fasting (to clean out the colon and provide the clearest images) is not as much of a hassle as it used to be. Now, just before starting the procedure, the patient is given a light short-term sedative, so the patient hardly notices when the mini-cam is inserted in his or her anus.
“We reassure patients they’re not really aware at that point,” Oliphant said. “That’s usually a big relief to them.”
In most cases, the exam takes 15-30 minutes, and the sedative wears off soon after. Patients should not drive right away, so you must have a family member or friend take you to and from your appointment. You can stop fasting and eat whatever you like right away, and resume your daily life within a few hours.
Colonoscopy Leads to Better Colon Cancer Survival Odds
If undetected, and colorectal cancer cells move into the body’s abdominal walls and beyond, odds of a successful outcome – i.e., survival -- drop dramatically.
Yet despite its value in early colorectal cancer detection, a colonoscopy remains an unpopular medical procedure, a major reason almost a third of Americans older than 50 have never had one .
Seeing evidence of the same trend in the Santa Clarita Valley communities it serves is why Henry Mayo’s Cancer Committee started its 2012 survey.
First, they aggregated and studied the most recent local data -- 53 “unique” cases of colorectal cancer diagnosed at Henry Mayo in 2010-2011.
By “unique cases,” Oliphant said, “We didn’t look at them…if they had two different cancers, only colorectal. What we found was alarming. Of our 53 patients, only 15 percent of them had their cancer diagnosed during a routine colonoscopy screening.”
Of that 15 percent, early detection of colon cancer by colonoscopy gave the patients survivability odds of between 74 percent and 93 percent.
“That’s not bad,” Oliphant said.
Patients who had never had a colonoscopy did not fare as well.
“The survivability of the other 85 percent of the patients that didn’t get a diagnosis until they presented with symptoms shifted down to more like 60 percent, because most of them were being diagnosed later, when the cancer was already at Stage I or beyond,” she said.
“Again, it clearly showed us that years of life are being lost because of poor compliance with routine colonoscopy screenings,” she said.
Henry Mayo’s Efforts to Boost Colonoscopy Compliance
Poor compliance is hardly surprising, but the oncology doctors and staff at Henry Mayo are working hard to improve it, mainly through outreach and education to demystify the process and debunk some of horror stories people have come to association wsith colonoscopies.
During their study, Henry Mayo’s Cancer Committee researched the reasons why many Americans don’t get routine colonoscopies starting at age 45 or 50, and every five or 10 years thereafter as warranted, to keep an eye out for early symptoms or colorectal cancer, even when their doctors recommend the procedure.
The reasons respondents cited varied from community to community, but chief among them were fear of the procedure, embarrassment because of the private part of the body involved, inadequate or no insurance coverage, or the people simply did not want to take the time.
Survey Results: Santa Clarita Residents Too Busy for Colonoscopy
"But that represented a huge group, and we wanted to know what causes Santa Clarita citizens in particular to not be compliant," Oliphant said. "So we developed an online survey with a research company that helped us make sure we were asking the right questions, to find out why (people) didn’t get a colonoscopy when their doctor recommended it. And what we found out was surprising.
"For the Santa Clarita community, it’s because they just don’t take the time," she said. "People here feel like they’re too busy. And when we looked to see which group in Santa Clarita was the least compliant, again, we were really surprised to find out that it's women 50 and older."
Henry Mayo Urges SCV Locals to Make Time for Routine Colonoscopy
In response, Henry Mayo’s Cancer Committee developed a team to reach out and attempt to educate members of the Santa Clarita Valley community, especially women 50 and older, of the life-saving value of colonoscopy.
“We developed some ideas, things like outreach at the Relay for Life (cancer fundraiser) last May, with the Mega-Colon (giant walk-through colon display),” Oliphant said. “We asked people to pledge that if they’re told to get a colonoscopy, they will. And if they’re too young, we ask them to pledge to encourage somebody they love who’s 45 and older to get a colonoscopy if it’s recommended.”
In the weeks and months ahead, she said, “We have physicians and nurses and community members who will be speaking out about their experience with colonoscopy and cancer, and how that one day (having a colonoscopy) can save a life.”
"We all need to have it done, and it’s embarrassing, it’s inconvenient, but one day can mean years of life," she said. "We think that’s a really good trade for a little bit of time and inconvenience, and we hope to get that message out. That’s our campaign, and we’re very passionate and proud of it. We hope it makes an impact.”
Call 661-253-8888 or visit www.henrymayo.com  for more information about Henry Mayo’s colorectal cancer prevention and treatment.
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A Colonoscopy Can Add Years To Your Life Says Henry Mayo Cancer Expert
Article: A Colonoscopy Can Add Years To Your Life Says Henry Mayo Cancer Expert 
Source: Santa Clarita News
Author: Stephen Peeples