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Katie Couric Reports On Colorectal Cancer

By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

As co-anchor of Today, Katie Couric keeps America informed every morning. Since colorectal cancer claimed the life of her husband, Jay Monahan, Couric has dedicated her life to making sure people stay informed about this very preventable cancer.

"Jay was just 41 when he was diagnosed, and it would have taken a very astute doctor to pick up on it being colorectal cancer early on," Couric states. "He was pretty much asymptomatic. He had no family history. You can be feeling perfectly fine - on top of the world physically - and still have colorectal cancer. One of the many difficult things about this disease is you often have no symptoms. You may not have blood in your stool, or have lost weight or your bowels habits may not have changed. But you could still have the disease."

While Couric tirelessly raises awareness about the disease, she also raises money for research as the co-founder of the National Colorectal Cancer Research Alliance, a program of the Entertainment Industry Foundation. This past spring Couric helped open the Jay Monahan Center for Gastrointestinal Health, a comprehensive cancer and wellness center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. 

"Clearly this is precisely the kind of center we wish had existed when Jay was diagnosed," Couric says. "It was very difficult to decipher the different medical jargon about treatment plans. It was a very lonely and isolating experience and very harrowing to go from one specialist to another. Having this comprehensive center full of compassionate caregivers all under one roof would have been a wonderful place for us to go. The opening was a bittersweet occasion, but the center is going to be incredibly helpful to thousands of families and what can be better than that?"

Not getting colorectal cancer in the first place.

Couric stresses that once you hit 40, it's time to start a dialogue about colorectal cancer with your doctor to determine your risk and whether you should begin colonoscopy screening earlier than recommended.

Unique cancer

Currently, the American Cancer Society recommends that average risk individuals begin screening at age 50, because 90% of colorectal cancer happens after that age. But unfortunately, fear and ignorance about colonoscopy screening prevent far too many Americans from getting examined. As a result, colorectal cancer is the second-leading cause of cancer deaths for Americans. While nearly 150,000 people will be diagnosed this year with the disease, more than 56,000 people will needlessly die of colorectal cancer in 2004.

"The unique thing about colon cancer screening is it leads to prevention," says Ernestine Hambrick, a colorectal surgeon and chairman and founder of the Stop Colon\Rectal Cancer Foundation. "If you get tested, you can prevent colon cancer. That does not happen with breast cancer or prostate cancer. The screening for these cancers leads to the earliest possible diagnosis but not to prevention."

Colon cancer begins as a little growth in the lining of the colon and rectum called a polyp. Not all polyps become cancer, but for all practical purposes all cancers begin as polyps.

"If you find and remove polyps, you prevent the cancer from ever getting started," Hambrick says. "You don't have to worry about being cured or finding it early. If we take it out, you don't get the cancer."

The gold standard for colorectal cancer screening is colonoscopy. Doctors insert a flexible, lighted tube with a camera into the rectum and up through the colon to view any possible cancers or polyps.

Couric broadcast her own colonoscopy on the Today show.

"I can think of some things I'd rather be doing than a colonoscopy, but I wanted to demystify the procedure and show people how it is done so they would know what to expect," Couric explains. "I think sometimes we imagine things to be much worse than it actually is. I figured if I could get it out there and take people on a personal journey through my colon they might be more relaxed when it came time to have their own procedure done."

Hambrick says people need to simply "get over it" when it comes to colorectal exams.

"It is time we got over this puritanical stuff about being violated and having someone putting this instrument up somewhere private and not talking about our colons and bowels because not talking about this is killing about 57,000 men and women a year," states Hambrick, who lost her brother to the disease. "No one has to die of this cancer and no one has to have it."

Getting personal

But it starts with getting screened when a person is feeling well, not sick.  It also greatly helps to know your risk factors, which include:

  • Family history of colon cancer or colon polyps
  • Personal history of colon cancer or colon polyps
  • Personal history of ulcerative colitis or Crohn's disease
  • Personal history of ovarian or uterine cancer

If people have one or more of these risk factors, it is recommended that screening begin at age 40 or 10 years before your relative was diagnosed with their cancer if they were less than age 50 or 55.

Certain lifestyle choices can increase your risk of colorectal cancer, including:

  • Lack of exercise - a strong correlation exists between inactivity and colon cancer
  • Obesity
  • High intake of red meat and animal fats
  • Low intake of fruits and vegetables
  • High intake of alcohol
  • Use of tobacco

But braving a colonoscopy is only part of the challenge for many Americans.  The cost can be even more frightening.

Many insurance companies do not cover colonoscopy screening which can typically cost around $1500. In fact, only 18 states require insurers to cover colorectal cancer screening compared to 47 states that require coverage for breast cancer screening, which kills about 17,000 fewer people annually.

EIF's NCCRA recently published the 2004 Colorectal Cancer Legislation Report Card to raise awareness about the disparities in colorectal cancer screening coverage. Information about how your state stacks up is available at EIF's NCCRA web site.

"My sister actually helped get legislation passed in Virginia to require insurance companies to cover colonoscopies for people 50 and older," Couric says. "It was the first state to do this and several states have followed suit. But obviously a lot more needs to be done."

In the meantime, Couric continues her advocacy work and urges everyone to educate themselves about colorectal cancer and getting screened.

"Getting a colonoscopy may not be on the top of your to-do list and it may not be the most fun you've ever had but compared to a diagnosis of advanced colorectal cancer getting screened is certainly much better," Couric says. "I don't want people to be full of regret and wish they had simply gotten screened. Not getting screened can rob you of your life and take you away from people you love prematurely."

For more information about the EIF/National Colorectal Cancer Research Alliance, click here.

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 7/5/2004  -  John Morgan & Stephen A. Shoop, M.D.
Reviewed: 7/5/2004  -  Donnica Moore, M.D.

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