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NATIONAL olorectal Cancer ROUNDTABLE White House Event on New Efforts to Promote Colon Cancer Prevention September 10, 1998 PHOTOCOPY PRESERVATION c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE FOR IMMEDIATE RELEASE Contact: Carole Anikis (301) 941-2626 Founding Organizations: American Cancer Society HILLARY RODHAM CLINTON HOSTS WHITE HOUSE EVENT TO Centers for Disease Control and Prevention PROMOTE PREVENTION, EARLY DETECTION OF COLORECTAL CANCER Member Organizations: Agency for Healthcare Policy and Research First Lady Joins National Colorectal Cancer Roundtable In Urging Alliance of Community Americans Over 50 to Get Tested Health Plans American Academy of Family Physicians American College of WASHINGTON, DC (September 10, 1998) - Today at the White House, First Gastroenterology Lady Hillary Rodham Clinton announced her support for raising awareness of American College of Physicians colorectal cancer and unveiled new efforts to promote the prevention and American College of Radiology early detection of the disease. Joining Mrs. Clinton at the event were American Digestive Health Foundation Secretary of the Department of Health and Human Services Donna Shalala, American Gastroenterological co-anchor of NBC's "Today" show Katie Couric, National Colorectal Cancer Association Roundtable Chair Bernard Levin, MD, and Good Housekeeping Editor-in- American Medical Association Chief Ellen Levine. More than 50,000 Americans die each year from American Medical colorectal cancer, which is preventable and even curable when detected early. Women's Association Men and women over the age of 50 are at risk for developing this disease. American Society of Colon and Rectal Surgeons American Society for In urging age 50 and older Americans to be screened for colorectal cancer, Gastrointestinal Endoscopy Mrs. Clinton said, "You can prevent colon cancer, even beat it. In fact, if Association of State and Territorial Directors of Health cancer is found early enough, the patient has more than a 90 percent chance of Promotion and Public Health survival." Dr. Levin, echoing Mrs. Clinton's comments, said, "widespread Education Digestive Diseases screening for colorectal cancer could reduce the death rate from this killer by National Coalition over 50 percent. There is no other disease about which we can make this Collaborative Group of the claim." Americas on Inherited Colorectal Cancer Memorial Sloan-Kettering To underscore their efforts, Mrs. Clinton, who at the event was made Cancer Center Honorary Chair of the National Colorectal Cancer Roundtable, unveiled National Cancer Institute survey results and several new initiatives to help spread the word about the National Caucus and Center on Black Aged, Inc. importance of colorectal cancer prevention and early detection. STOP Colorectal Cancer Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center Results of National Survey Results of a national colorectal cancer awareness survey, commissioned by the Roundtable (a coalition of medical professional, consumer advocacy, and voluntary organizations) and conducted by the Gallup Organization, were released at the White House event (see news release on survey results). The survey found that nearly 50 percent of people over age 50 - the age group considered at highest risk for developing colorectal cancer - have never been screened for the disease. Of those people, most reported that no medical professional had ever recommended a screening test for colorectal cancer. Public Service Announcements Dr. Levin unveiled a new public service announcement (PSA) campaign, sponsored by the Roundtable and featuring the First Lady. In the television, print, and radio PSAs, shown during the event, Mrs. Clinton urges all Americans over the age of 50 to be screened for colorectal cancer, a test that could save their lives. The print PSA will appear in the January issue of Good Housekeeping. The PSAs will be distributed nationally via satellite broadcast and mailings to public service directors across the country. The PSAs also will receive additional distribution and visibility through the grassroots efforts of the National Colorectal Cancer Roundtable members (see Roundtable fact sheet for list of members). Colorectal Cancer Chat Room As a member of the Roundtable, the American Digestive Health FoundationˢM's Digestive Health Initiative debuted its Internet chat room on colorectal cancer located at www.gastro.org/adhf.html. This public to public chat room will allow consumers, colorectal cancer patients, family members, survivors, and people at high risk for the disease to engage in live, real time discussions of the many issues related to colorectal cancer. Each month, the chat room will feature a guest expert, beginning with actress and colorectal cancer survivor Barbara Barrie, co-star of the NBC sitcom "Suddenly Susan" and author of the 1997 book Second Act: Life After Colostomy and Other Adventures. On September 11th, from 1 p.m. - 2 p.m. EDT, Ms. Barrie will appear in the chat room live to discuss her personal experience as a colorectal cancer survivor. In addition, Ms. Barrie will respond to questions posted on the chat room's message board during the month of September. Private Sector Partnerships In its efforts to spread the word about the importance of colorectal cancer prevention and early detection, the Roundtable sought and secured partnerships with members of private industry, which were announced at the White House event. In her remarks, Mrs. Clinton recognized the following companies for the activities they will undertake to raise awareness about the importance of colon cancer prevention and screening among their employees and customers (see Private Sector Partnerships fact sheet for details on individual company activities): American Airlines American Greetings Corporation / National Association of Chain Drugstores Beckman Coulter, Inc. / SmithKline Diagnostics, Inc. Bristol Myers Squibb Oncology / Better Health Foundation Eli Lilly and Company General Motors Corporation Kellogg Company National Association of Chain Drugstores Olympus America Inc. Zeneca Pharmaceuticals ### c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE FOR IMMEDIATE RELEASE Contact: Carole Anikis (301) 941-2626 Founding Organizations: American Cancer Society SURVEY SHOWS NEARLY HALF OF AMERICANS AT RISK FOR Centers for Disease Control and Prevention COLON CANCER ARE NOT BEING SCREENED Member Organizations Large Number Report That Physicians Are Not Recommending Tests Agency for Healthcare Policy and Research Alliance of Community WASHINGTON, DC (September 10, 1998) - Survey results released today at Health Plans a White House event on new efforts to promote colorectal cancer prevention American Academy of Family Physicians reveal that nearly half of all adults aged 50 and older -the age group American College of considered at highest risk for developing colorectal cancer -have not been Gastroenterology screened for the disease. The White House event was hosted by First Lady American College of Physicians Hillary Rodham Clinton, who announced her support for raising awareness of American College of Radiology colorectal cancer and unveiled new efforts to promote the prevention and American Digestive Health Foundation early detection of the disease. Colorectal cancer, also known as colon cancer, American Gastroenterological kills more than 50,000 Americans each year, even though it is preventable and Association curable when detected early. American Medical Association American Medical Women's Association The survey, conducted for the National Colorectal Cancer Roundtable by the American Society of Colon Gallup Organization, underscores the need for new national initiatives and Rectal Surgeons promoting colorectal cancer prevention and early detection. One of the most American Society for alarming findings is that most of the 47 percent of people over 50 not being Gastrointestinal Endoscopy screened for colorectal cancer reported that no medical professional had ever Association of State and Territorial Directors of Health recommended screening. Promotion and Public Health Education Digestive Diseases "Physicians must make testing for colorectal cancer a part of their medical National Coalition practices," said Roundtable Chair Bernard Levin, MD, vice president for Collaborative Group of the Americas on Inherited Colorectal Cancer Prevention at the M.D. Anderson Cancer Center in Houston. "I have Cancer spent too much of my professional career delivering bad news to people Memorial Sloan-Kettering whose lives and health could have been saved if they had been screened for Cancer Center National Cancer Institute this preventable disease." National Caucus and Center on Black Aged. Inc. Although colorectal cancer occurs with almost equal frequency in men and STOP Colorectal Cancer women, the survey found that women aged 50 and older are less likely than Foundation men in this same age group to undergo screening (49 percent of women University of Minnesota Cancer Center reported not having been screened versus 36 percent of men). Dramatic University of Texas differences were also seen between whites and non-whites. Among survey M.D. Anderson Cancer Center respondents, 44 percent of whites reported not having had any of the three tests - fecal occult blood tests, flexible sigmoidoscopy, barium x-ray - compared to 56 percent of non-whites. The majority of adults surveyed seem to believe that early detection can save lives; however, when asked what they could do to help prevent colorectal cancer, fewer than half cited regular screening tests. Even fewer mentioned dietary changes, such as eating a high-fiber diet (21 percent), or general references to diet (20 percent). A sizable minority (22 percent) could not name anything a person might do to help prevent colorectal cancer. Asked to estimate their own chances for developing colorectal cancer, one in five adults (20 percent) believe they are very likely to develop cancer of the colon or rectum. Another 35 percent say it is somewhat likely they will develop the disease. A small proportion - one percent - reported they already have colon or rectal cancer. Sixteen percent could not estimate their chances of getting colorectal cancer. The Gallup Organization conducted telephone interviews from August 11 through August 23, 1998, with a national sample of 1,062 adults aged 50 or older, to examine the knowledge and experience of adults with testing for colorectal cancer. ### The National Colorectal Cancer Roundtable is a coalition of medical professional, consumer advocacy, and voluntary organizations committed to raising awareness about the prevention and early detection of colorectal cancer. NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE The Facts About Colorectal Cancer What is Colorectal Cancer? Founding Organizations: American Cancer Society Almost all cases of colorectal cancer, also referred to as colon cancer, Centers for Disease Control and Prevention begin with the development of benign colonic polyps. Polyps form when cells lining the colon grow, divide and reproduce in an Member Organizations unhealthy, disorderly way, producing a growth. Agency for Healthcare Policy and Research These polyps can be cancerous, invading the colon wall and surrounding Alliance of Community blood vessels, and spreading to other parts of the body. Health Plans American Academy of Colorectal cancer frequently begins without symptoms. Family Physicians American College of What Causes Colorectal Cancer? Gastroenterology American College of Physicians The exact causes of colorectal cancer are unknown, but the disease American College of Radiology appears to be caused by both inherited and lifestyle factors. American Digestive Health Foundation Diets high in fat and low in fruits and vegetables - such as those that American Gastroenterological include red meat, fried foods and high-fat dairy products - may increase Association the risk of colorectal cancer. American Medical Association Lifestyle factors -such as cigarette smoking, a sedentary lifestyle, and American Medical Women's Association obesity - also may increase the risk of developing the disease. American Society of Colon Genetic factors may determine a person's susceptibility to the disease, and Rectal Surgeons whereas dietary and other lifestyle factors may determine which at-risk American Society for Gastrointestinal Endoscopy individuals actually go on to develop the disease. Association of State and Territorial Directors of Health How Common is Colorectal Cancer? Promotion and Public Health Education Digestive Diseases National Coalition Colorectal cancer is the second leading cancer killer in the United States, and the third most common cancer overall. Collaborative Group of the Americas on Inherited Colorectal This year, more than 50,000 Americans will die from colorectal cancer Cancer Memorial Sloan-Kettering and approximately 131,600 new cases will be diagnosed. Cancer Center Eighty to 90 million Americans (approximately 25 percent of the US National Cancer Institute population) are considered at risk because of age or other factors. National Caucus and Center on Black Aged, Inc. More women over the age of 75 die from colorectal cancer than from STOP Colorectal Cancer breast cancer. Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center Who Is At Risk? Men and women aged 50 and older are at almost equal risk of developing colorectal cancer. Those who have a personal or family history of colorectal neoplasia (cancer or polyps) are at high risk of developing the disease. Anyone who has a personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn's disease, is also at high risk. Although the incidence of colorectal cancer appears to be the same among all racial groups, survival rates seem to be lower for African-Americans. How Can You Prevent Colorectal Cancer? Know your family history. See your doctor for yearly screenings if you are aged 50 or older. Maintain a diet low in animal fat and high in fruits, vegetables and fiber. Exercise regularly. Prevent obesity. Avoid cigarette smoking. What You Need To Know ... Early detection saves lives - colorectal cancer is preventable, even curable when detected early. If colorectal cancer is found early enough, the patient has more than a 90 percent chance of survival. Colorectal cancer screenings are safe and effective and are now covered by Medicare and an increasing number of other health providers. Several screening methods can be used to detect polyps before they become cancerous, such as fecal occult blood test, colonoscopy, flexible sigmoidoscopy and barium x-ray. These tests also can detect cancer in its early stages. ### BERNARD LEVIN, MD Gastroenterologist Bernard Levin, MD, currently is professor of medicine and vice president for cancer prevention at University of Texas M.D. Anderson Cancer Center in Houston, Texas. Prior to his fourteen years at M.D. Anderson, Dr. Levin was associate professor of medicine and attending physician at University of Chicago Hospital and Clinics. For the American Digestive Health FoundationˢM (ADHFSM), Dr. Levin serves as co-chair of the Digestive Health Initiative® Colorectal Cancer Education Campaign. He also is chair of the American Cancer Society's National Advisory Task Force on Colorectal Cancer and recently was appointed as chair of the National Colorectal Cancer Roundtable. Affiliated with a number of professional organizations, Dr. Levin is a member of the American Gastroenterological Association and a fellow of the American College of Physicians. He participates as a consultant to the National Cancer Institute. Dr. Levin has written extensively for distinguished medical publications including Journal of the National Cancer Institute, Gastroenterology, the International Journal of Cancer, Cancer and Science. A graduate of the University of Witwatersrand in Johannesburg, South Africa, Dr. Levin completed fellowships in gastroenterology and biochemistry in pathology at the University of Chicago. FIRST LADY HILLARY RODHAM CLINTON PROMOTES COLON CANCER AWARENESS AND PREVENTION September 10, 1998 Today, at the White House, the First Lady will announce a series of initiatives to raise awareness about colon cancer. She will announce a new research grant to fight colon cancer, release a survey reporting that many Americans do not receive appropriate screening for this disease, unveil a new public service announcement to promote prevention, and announce new public and private sector partnerships to raise awareness. The First Lady will be joined by Katie Couric, NBC "Today Show" Anchor; Ellen Levine, Editor-in-Chief of "Good Housekeeping" Magazine; Dr. Bernard Levin, a colon cancer specialist and chair of the National Colorectal Cancer Roundtable; and Secretary Shalala. Colon Cancer - A Preventable Killer. Colon cancer is the number one non-tobacco-related cancer killer, with more than 50,000 Americans dying each year from the disease. For both men and women, it is the third most common cancer, and 130,000 Americans contract the disease each year. Men and women over the age of 50 have the greatest risk of developing colorectal cancer. However, it is preventable and curable when detected early; in fact, a patient whose cancer is detected early has more than a 90 percent chance of survival. Raising awareness about colon cancer and the importance of screening can save lives. New Grant to Fund Colon Cancer Research. The First Lady will announce a new $8 million grant by the National Institutes of Health to the Seattle Gastrointestinal Program Project for research aimed at preventing, diagnosing and treating colon cancer. The grant will help scientists better determine who is at risk for colon cancer and will test new strategies to reduce their cancer risk. The grant will also be used to develop more sensitive and precise ways of screening colon cancer than those available today. New Survey Demonstrates Need for Greater Need for Colon Cancer Awareness. The First Lady will release a survey finding that nearly 50 percent of men and women over the age of 50 of those at highest risk for colon cancer have never been screened. Forty-seven percent of those not tested reported that no medical professional had ever recommended that they be screened for colon cancer. Although colon cancer occurs with almost equal frequency in men and women over the age of 50, 49 percent of women reported not having been screened compared to 36 percent of men. Dramatic differences were also present between whites and non- whites. Forty-four percent of whites reported not having taken any of the three tests used for screening, as opposed to 56 percent of non-whites. While most of the adults surveyed believed that early detection could save lives, few were aware that screening and dietary changes could help prevent the onset of colorectal cancer. This national survey was conducted by the Gallup Organization. A New Media Campaign: With its October issue, "Good Housekeeping" Magazine is initiating a year-long colon cancer awareness campaign. The October issue will contain a major medical report on what women can do to protect themselves from colon cancer. In addition, NBC's "Today Show" will present a week-long in-depth series, "Confronting Colon Cancer," that will offer a comprehensive look at this preventable disease. New Partnership Between Public and Private Sector. The First Lady will also announce the creation of the National Colorectal Cancer Roundtable -- unprecedented private and public sector partnership to promote greater awareness of colon cancer. Group members include the Centers for Disease Control, the American Cancer Society, the American Digestive Health Foundation. Raising Awareness through a New Public Service Announcement. A new public service announcement featuring the First Lady will be unveiled urging all Americans over the age of 50 to be screened for colorectal cancer. NBC will air the PSA, and the print version will appear in the January issue of Good Housekeeping. The PSA will also be distributed nationally. New Internet Site to Answer Questions on Colon Cancer. The First Lady will also announce a new Internet chatroom that will allow consumers, patients, family members, survivors, and people at high risk for the disease to engage in live discussions of issues relating to colorectal cancer. Doctors and other experts will be available on line to answer questions about this disease. The website address is www.gastro.org/adhf.html and it will be sponsored by the American Digestive Health Foundation, a member of the Colorectal Cancer Roundtable. New Private Sector Commitments to Raise Awareness: The First Lady will also announce new private sector commitments to promote colon cancer awareness, by bringing attention to the importance of prevention and early detection. Commitments include: American Airlines will publish the public service announcement on colon cancer in its in- flight magazine, where it may reach approximately two million travelers in the U.S. and abroad. The Kellogg Company USA will promote colorectal cancer prevention and early detection by printing public service messages on five million packages of All Bran and Bran Buds cereal boxes. American Greetings will create an insert for prescriptions that promotes prevention and early detection of colorectal cancer. The National Association of Chain Drug Stores will distribute the insert to all of its pharmacies and pharmacists. Bristol-Meyers Squibb Oncology has provided a $100,000 grant to the Better Health Foundation to develop a colorectal cancer workplace awareness program that it will initiate at all of its work sites, and send to companies all around the country. Olympus America, Inc., will sponsor an education program on colon cancer that will be sent to the administrators of retirement communities all across the country. General Motors will publish an article in its newsletter to encourage its two million employees to research information relating to preventing, detecting and understanding colorectal cancer. Other private industries included in the partnership are Smith Kline Diagnostics, Eli Lilly and Company, and Zeneca Pharmaceuticals, all of whom have committed to raise awareness among their thousands of employees about colon cancer. Things To Do "I feel fine." "My schedule is too hectic." 7:00 Tennis Staff Meeting 9:00 Colon Cancer Test "I'm only 50." 11:00 Dry Cleaning MAKE THE TIME TO GET 12:30 1:45 Lunch w/ Rita A TEST THAT COULD SAVE 3:00 Conference Call YOUR LIFE. Colon cancer is the second-leading cancer killer and every- one aged 50 and older is at risk. More than 50,000 Americans will die from colon cancer and 131,600 new cases will be diagnosed this year. Colon cancer is an equal-opportunity disease that affects both women and men. This silent killer frequently begins without symptoms and those with a family history are at even greater risk. THE GOOD NEWS IS: Colon cancer is preventable-even curable when detected early. In fact, if cancer is found early enough, the patient has more than a 90 percent chance of survival. Colon cancer screenings are safe and effective and are now covered by Medicare and an increasing number of other health providers. There's even a test that can be used in the privacy of your own home. Talk to your doctor about getting tested. "You can prevent colon cancer, even beat it." HILLARY RODHAM CLINTON NATIONAL olorectal Cancer ROUNDTABLE SPONSORED BY THE NATIONAL COLORECTAL CANCER ROUNDTABLE FOR MORE INFORMATION, CALL THE AMERICAN CANCER SOCIETY AT 1-800-ACS-2345 TV PSAs The National Colorectal Cancer Roundtable NATIONAL 1599 Clinon Road NE Atlanta, GA 30329-4251 :60/:30/:15 olorectal "Hillary Rodham Clinton on Colon Cancer" ancer ROUNDTABLE MEMBERS OF THE NATIONAL Dear Public Service Director: COLORECTAL CANCER ROUNDTABLE Imagine having most a deadly disease cancer that rarely in the women produces United and symptoms buttal men risk. This Agency for Healthcare Policy & Research Alliance of Community Health Plans the cancer equal second frequency is a silent and killer everyone that Americans affects over will the age die diagnosed. from of 50 colorectal is at can- American Academy of Family Physicians year, more nearly than 131,600 50,000 new cases will be American Cancer Society American College of Gastroenterology cer and colorectal cancer is preventable, and the dis- There even American College of Physicians The Bood news detected The 800 when detected ease good news is that could about death which rate we by can more make than this 50 percent. claim. American College of Radiology American Digestive Health Foundation American Gastroenterological Association is First Colorectal orectal screened. no Lady other cancer Hillary disease As an and urging everyone over the Clinton has joined the information, deadly the age National air disease about of this 50 we PSA to col- and get need as American Medical Association American Medical Women's Association American Society for Gastrointestinal Endoscopy American Society of Colon and Rectal Surgeons Association of State & Territorial Directors of Health your the frequently benefits help in as when of spreading possible. screening. viewers 1 We over 50 are do to Promotion & Public Health Education Centers for Disease Control & Prevention schedule it Collaborative Group of the Americas on Inherited Colorectal Cancer Sincerely, Digestive Diseases National Coalition Slamin Memorial Sloan-Kettering Cancer Center National Cancer Institute National Caucus & Center on Black Aged, Inc. Bernard Levin, National M.D. Colorectal Prevention Cancer Roundtable STOP Colorectal Cancer Foundation Chairman, President for Cancer Center University of Minnesota Cancer Center Vice M.D. Anderson Cancer University of Texas M.D. Anderson Cancer Center 1ST WOMAN: Okay, who's up for lunch? 2ND WOMAN: Oh yeah. It's just a colon 3RD WOMAN: I'm supposed to get screened 2ND WOMAN: Oh, sorry. I've got to take cancer test. too, but I don't have the time my husband to the doctor. 4TH WOMAN: But he's so young. 3RD WOMAN: Is everything okay? Orly fifty-two. MAKE THE TIME TO get A TEST THAT could SAVE YOUR LIFE. Call the American Cancer Society 1-800-ACS-2345 ancer Hillary Rodham Clinton HILLARY RODHAM CLINTON: Colon can- But you can beat it if it's detected early. ANNCR: Call 1-800-ACS-2345. cer kills over 50,000 people a year and So if you're fifty or older please get tested. strikes women nearly as offen as men It can save your life. c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE Colorectal Cancer Public Service Announcements Featuring First Lady Hillary Rodham Clinton Founding Organizations: American Cancer Society WHAT: Television, print, and radio public service announcements (PSAs) Centers for Disease Control on the importance of screening to prevent and detect colorectal and Prevention cancer. Television and radio PSAs are available in :15, :30 and :60 Member Organizations: formats. The print PSA is available in a variety of dimensions. Agency for Healthcare Policy and Research Alliance of Community WHO: The PSAs feature First Lady Hillary Rodham Clinton urging all Health Plans Americans over the age of 50 to see their doctors about getting American Academy of screened for colorectal cancer. The PSAs are sponsored by the Family Physicians National Colorectal Cancer Roundtable, a coalition of medical American College of Gastroenterology professional, consumer advocacy, and voluntary organizations, American College of Physicians committed to raising awareness about the prevention and early American College of Radiology detection of colorectal cancer (see Roundtable fact sheet). American Digestive Health Foundation WHY: 50,000 Americans die every year from colorectal cancer, the American Gastroenterological Association second leading cancer killer, and the disease affects women nearly American Medical Association as often as men. Everyone aged 50 and older is at risk for American Medical developing colorectal cancer, and those with a family history are at Women's Association even greater risk. However, colorectal cancer is preventable, even American Society of Colon and Rectal Surgeons curable, when detected early. In fact, widespread screening for American Society for colorectal cancer could reduce the death rate by over 50 percent. Gastrointestinal Endoscopy There is no other disease about which we can make this claim. Association of State and Territorial Directors of Health Everyone 50 and older should see his or her doctor about getting Promotion and Public Health screened for colorectal cancer. Education Digestive Diseases National Coalition WHERE: The television PSAs will be available via satellite broadcast on the Collaborative Group of the following days: Americas on Inherited Colorectal Cancer Memorial Sloan-Kettering Thursday, September 10th Friday, September 11th Cancer Center 7:30pm to 7:45pm EDT 1:00pm to 1:15pm EDT National Cancer Institute Satellite GE1, Transponder 1 Satellite Telestar 4, Transponder 23 National Caucus and Center on Black Aged. Inc. Downlink 3720 Downlink 4160 STOP Colorectal Cancer Audio on 6.2 and 6.8 Audio on 6.2 and 6.8 Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center The PSAs will be widely distributed to television, radio and print public service directors across the country. A nationally distributed trade publication for television PSA directors will feature Mrs. Clinton's PSAs in the September issue, and the PSAs also will be distributed through the grassroots efforts of the member organizations of the National Colorectal Cancer Roundtable. For copies of the television, radio or print PSAs, contact Bill Goodwill at (703) 426-0881. ### c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE Roundtable Member Organization Launches Chat Room on Colorectal Cancer www.gastro.org/adhf.html Founding Organizations: American Cancer Society Centers for Disease Control and Prevention On September 10th, 1998, the American Digestive Health FoundationSM's (ADHFSM) Digestive Health Initiative (DHI) will debut its Internet chat Member Organizations: room on colorectal cancer. Located at www.gastro.org/adhf.html, this public Agency for Healthcare Policy and Research to public chat room will allow consumers, colorectal cancer patients, family Alliance of Community members, survivors, and people at high risk for developing the disease to Health Plans engage in live, real-time discussions of the many issues related to colorectal American Academy of Family Physicians cancer. At this same electronic location, the DHI also will offer a colorectal American College of cancer message board, on which participants can post questions, answers, Gastroenterology information about resources, and topics for discussion concerning this disease. American College of Physicians American College of Radiology In addition to the address above, the chat room can be accessed through the American Digestive home pages of the three ADHF member societies: Health Foundation American Gastroenterological Association American Gastroenterological Association: www.gastro.org American Medical Association American Society for Gastrointestinal Endoscopy: www.asge.org American Medical Women's Association American Association for the Study of Liver Diseases: American Society of Colon www.hepar-sfgh.ucsf.edu and Rectal Surgeons American Society for "Guest of the Month" Feature Gastrointestinal Endoscopy Each month, the DHI colorectal cancer chat room will feature a guest expert. Association of State and Territorial Directors of Health These guest experts, drawn from the medical, patient support, and cancer Promotion and Public Health Education survivor communities, will be scheduled to appear live in the chat room to Digestive Diseases discuss their personal and professional experiences with colorectal cancer. National Coalition Throughout the month, the guest experts will also respond to questions and Collaborative Group of the Americas on Inherited Colorectal topics of discussion posted on the message board. Cancer Memorial Sloan-Kettering Cancer Center September's live guest will be actress and colorectal cancer survivor Barbara National Cancer Institute Barrie, co-star of the NBC sitcom "Suddenly Susan" and author of the 1997 National Caucus and Center book Second Act: Life After Colostomy and Other Adventures. Ms. Barrie on Black Aged, Inc. will participate live in the chat room on September 11th from 1 p.m. to 2 p.m. STOP Colorectal Cancer EDT to discuss her personal experience and will respond to inquiries on the Foundation University of Minnesota message board during the month of September. Dr. Bernard Levin, vice Cancer Center president for Cancer Prevention at the M.D. Anderson Cancer Center in University of Texas Houston and chair of the National Colorectal Cancer Roundtable, also M.D. Anderson Cancer Center will be available during the last two weeks of September to respond to message board questions and comments. See the opening page of the chat room for information on future guest experts. The American Digestive Health Foundation is a cooperative effort of the American Gastroenterological Association, the American Society for Gastrointestinal Endoscopy, and the American Association for the Study of Liver Diseases. The ADHF promotes digestive health for all Americans by supporting educational initiatives and research into the causes, prevention, diagnosis, treatment and cure of digestive and liver diseases. The ADHF funds basic research, clinical research, and investigations into prevention strategies, and has established four interdependent initiatives to advance its digestive health agenda. ### * National Colorectal Cancer Roundtable member. c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE The National Colorectal Cancer Roundtable Founding Organizations: The National Colorectal Cancer Roundtable is a coalition of medical American Cancer Society professional, consumer advocacy and voluntary organizations, committed to Centers for Disease Control and Prevention raising awareness about the prevention and early detection of colorectal cancer. The Roundtable's ongoing mission is to reduce the incidence of and Member Organizations: mortality from this disease by achieving screening rates for colorectal cancer Agency for Healthcare Policy and Research that are equivalent to screening rates for other cancers (currently four out of Alliance of Community five people*). Health Plans American Academy of Colorectal cancer is the second leading cancer killer in the US, causing the Family Physicians American College of deaths of more than 50,000 Americans every year. Men and women over the Gastroenterology age of 50, and those with a family history of colorectal cancer, are most at risk American College of Physicians for developing this disease. American College of Radiology American Digestive To advance its major objectives, the Roundtable has set the following goals: Health Foundation American Gastroenterological Association Develop a national strategic plan for the early detection and control of American Medical Association colorectal cancer. American Medical Advocate for key policy issues that will help reduce colorectal cancer Women's Association American Society of Colon rates. and Rectal Surgeons Identify research needs and potential barriers to reducing colorectal cancer American Society for rates, and recommend solutions. Gastrointestinal Endoscopy Develop and sustain partnerships to enhance efforts in the prevention and Association of State and Territorial Directors of Health early detection of colorectal cancer. Promotion and Public Health Education Monitor progress in disease reduction efforts and participation in Digestive Diseases screening. National Coalition Produce periodic reports on the current state of colorectal cancer control, Collaborative Group of the Americas on Inherited Colorectal and progress towards national objectives. Cancer Memorial Sloan-Kettering Cancer Center For more information on the National Colorectal Cancer Roundtable, call Dr. National Cancer Institute Gabriel Feldman at the American Cancer Society, (404) 329-7504. National Caucus and Center on Black Aged. Inc. STOP Colorectal Cancer ### Foundation University of Minnesota Cancer Center * Breast and cervical cancers. University of Texas M.D. Anderson Cancer Center Member Organizations of the National Colorectal Cancer Roundtable Agency for Healthcare Policy and Research Alliance of Community Health Plans American Academy of Family Physicians American Cancer Society American College of Gastroenterology American College of Physicians American College of Radiology American Digestive Health FoundationSM American Gastroenterological Association American Medical Association American Medical Women's Association American Society of Colon and Rectal Surgeons American Society for Gastrointestinal Endoscopy Association of State and Territorial Directors of Health Promotion and Public Health Education Centers for Disease Control and Prevention Collaborative Group of the Americas on Inherited Colorectal Cancer Digestive Diseases National Coalition Memorial Sloan-Kettering Cancer Center National Cancer Institute National Caucus and Center on Black Aged, Inc. STOP Colorectal Cancer Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE National Colorectal Cancer Roundtable Private Industry Partnerships Promoting Awareness of Colorectal Cancer Prevention and Detection Founding Organizations: American Cancer Society The National Colorectal Cancer Roundtable, a coalition of medical Centers for Disease Control and Prevention professional, consumer advocacy and voluntary organizations, has developed partnerships with private industry to raise awareness of the importance of Member Organizations: colorectal cancer prevention and early detection. These national companies, Agency for Healthcare Policy and Research with their powerful reach, have committed to activities that will educate Alliance of Community hundreds of thousands of Americans over the age of 50 about the importance Health Plans of getting screened for colorectal cancer, the nation's second leading cancer American Academy of Family Physicians killer. American College of Gastroenterology American Airlines American College of Physicians American Airlines will publish First Lady Hillary Rodham Clinton's public American College of Radiology service announcement on colon cancer in its in-flight magazine, American American Digestive Health Foundation Way, reaching approximately two million air travelers in the US and around American Gastroenterological the world. In addition, American Airlines' in-house medical staff will provide Association free colorectal cancer screening cards to more than 200,000 American Medical Association employees, spouses and retirees. American Medical Women's Association American Society of Colon American Greetings Corporation / National Association of Chain Drugstores and Rectal Surgeons American Greetings will create a prescription insert reflecting National American Society for Colorectal Cancer Roundtable messages about prevention and early detection. Gastrointestinal Endoscopy The National Association of Chain Drugstores will distribute the insert to its Association of State and Territorial Directors of Health 30,000 chain pharmacies and 90,000 chain pharmacists. Beginning in early Promotion and Public Health Education 1999, individuals having prescriptions filled at participating drugstores and Digestive Diseases pharmacies will receive the insert in their prescription bags. National Coalition Collaborative Group of the Beckman Coulter, Inc. / SmithKline Diagnostics. Inc. Americas on Inherited Colorectal Cancer Beckman Coulter/SKD will publish First Lady Hillary Rodham Clinton's Memorial Skoan-Kettering public service announcement on colorectal cancer through the company Cancer Center intranet and in-house publication, Beckman Coulter Life, reaching more than National Cancer Institute 10,000 employees worldwide. SKD-trained representatives and an in-house National Caucus and Center on Black Aged, Inc. support staff of 50 will promote the message about screening for colorectal STOP Colorectal Cancer cancer by making themselves, and SKD's Basic Training TM Patient Education Foundation Program, available to National Colorectal Cancer Roundtable participants and University of Minnesota Cancer Center partners. University of Texas M.D. Anderson Cancer Center Bristol-Myers Squibb Oncology / Better Health Foundation Bristol-Myers Squibb Oncology has provided an initial $100,000 grant to the Better Health Foundation to develop a colorectal cancer workplace awareness program that companies nationwide can adopt at no cost. Bristol-Myers Squibb Oncology will initiate the program at all of its work sites. Eli Lilly and Company Eli Lilly will conduct a new employee education campaign to increase awareness about the prevention of colon cancer through regular screenings. The campaign will reach more than 31,000 Lilly employees worldwide and their families using the public service materials developed by the National Colorectal Cancer Roundtable, as well as educational materials created by the company's employee health services department in cooperation with corporate communications. Lilly will inform employees through a number of venues, including publications and its in-house television network. General Motors Corporation General Motors will publish an article on the importance of colorectal cancer prevention and early detection in its newsletter, Feelin' Good, which is distributed to 1.5 million employees, retirees, and families. The article will encourage employees to access the audio-tapes General Motors has in its Audio Health Library on colorectal cancer risk factors, early detection guidelines, signs and symptoms, and treatment, and will encourage enrollees in the corporation's wellness program to discuss any colorectal cancer questions or symptoms with registered nurses available through a toll-free number. The article also will contain information on how readers can access General Motors' web site information on the prevention and early detection of colorectal cancer, and will encourage employees to read the information on the disease contained in their wellness program self-care manuals. Kellogg Company Kellogg will promote colorectal cancer prevention and early detection messages to a variety of audiences, including: consumers via five million packages of Kellogg's All Bran and Bran Buds; 5,000 hospital health care sites; 5,000 health care professionals; 500 retailers; and to its thousands of employees and retirees through its publication, The Kellogg News. In addition, Kellogg Company will provide in-store consumer education messages in 12,000 stores, as well as information on the Internet generating approximately five million "hits" per month. Olympus America Inc. Olympus America will sponsor and videotape a "Colorectal Cancer Education -What Everyone Needs to Know" program which will be open to employees, family members and the general public. Olympus will initiate a direct mailing to the administrators of retirement communities across the country, offering copies of the videotaped program at no cost, and will show the videotaped program at the five Olympus Service Center branches in Atlanta, Cleveland, Chicago, Dallas, and Long Beach. The program will be held at Olympus America headquarters in Melville, NY, or at a local medical university, and will be repeated at Olympus' repair and distribution facility in San Jose, CA. A panel of leading experts will speak about the problem of colorectal cancer, as well as solutions, including preventive measures, nutrition, and screening. The program will be promoted through a direct mail piece and internal Olympus Bulletin. Zeneca Pharmaceuticals Zeneca will offer to all employees over the age of 40 a new educational session on nutrition and its role in colorectal cancer, as well as a new session on the importance of screening women for colorectal cancer. In addition, a new work-site guide for detection/screening for colorectal cancer will be issued for customer use. ### NATIONAL olorectal Cancer ROUNDTABLE White House Event on New Efforts to Promote Colon Cancer Prevention September 10, 1998 PHOTOCOPY PRESERVATION c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE FOR IMMEDIATE RELEASE Contact: Carole Anikis (301) 941-2626 Founding Organizations: American Cancer Society HILLARY RODHAM CLINTON HOSTS WHITE HOUSE EVENT TO Centers for Disease Control and Prevention PROMOTE PREVENTION, EARLY DETECTION OF COLORECTAL CANCER Member Organizations: Agency for Healthcare Policy and Research First Lady Joins National Colorectal Cancer Roundtable In Urging Alliance of Community Americans Over 50 to Get Tested Health Plans American Academy of Family Physicians American College of WASHINGTON, DC (September 10, 1998) - Today at the White House, First Gastroenterology Lady Hillary Rodham Clinton announced her support for raising awareness of American College of Physicians colorectal cancer and unveiled new efforts to promote the prevention and American College of Radiology early detection of the disease. Joining Mrs. Clinton at the event were American Digestive Health Foundation Secretary of the Department of Health and Human Services Donna Shalala, American Gastroenterological co-anchor of NBC's "Today" show Katie Couric, National Colorectal Cancer Association Roundtable Chair Bernard Levin, MD, and Good Housekeeping Editor-in- American Medical Association Chief Ellen Levine. More than 50,000 Americans die each year from American Medical colorectal cancer, which is preventable and even curable when detected early. Women's Association American Society of Colon Men and women over the age of 50 are at risk for developing this disease. and Rectal Surgeons American Society for In urging age 50 and older Americans to be screened for colorectal cancer, Gastrointestinal Endoscopy Mrs. Clinton said, "You can prevent colon cancer, even beat it. In fact, if Association of State and Territorial Directors of Health cancer is found early enough, the patient has more than a 90 percent chance of Promotion and Public Health Education survival." Dr. Levin, echoing Mrs. Clinton's comments, said, "widespread Digestive Diseases screening for colorectal cancer could reduce the death rate from this killer by National Coalition over 50 percent. There is no other disease about which we can make this Collaborative Group of the claim." Americas on Inherited Colorectal Cancer Memorial Sloan-Kettering To underscore their efforts, Mrs. Clinton, who at the event was made Cancer Center Honorary Chair of the National Colorectal Cancer Roundtable, unveiled National Cancer Institute survey results and several new initiatives to help spread the word about the National Caucus and Center on Black Aged, Inc. importance of colorectal cancer prevention and early detection. STOP Colorectal Cancer Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center Results of National Survey Results of a national colorectal cancer awareness survey, commissioned by the Roundtable (a coalition of medical professional, consumer advocacy, and voluntary organizations) and conducted by the Gallup Organization, were released at the White House event (see news release on survey results). The survey found that nearly 50 percent of people over age 50 - the age group considered at highest risk for developing colorectal cancer - - have never been screened for the disease. Of those people, most reported that no medical professional had ever recommended a screening test for colorectal cancer. Public Service Announcements Dr. Levin unveiled a new public service announcement (PSA) campaign, sponsored by the Roundtable and featuring the First Lady. In the television, print, and radio PSAs, shown during the event, Mrs. Clinton urges all Americans over the age of 50 to be screened for colorectal cancer, a test that could save their lives. The print PSA will appear in the January issue of Good Housekeeping. The PSAs will be distributed nationally via satellite broadcast and mailings to public service directors across the country. The PSAs also will receive additional distribution and visibility through the grassroots efforts of the National Colorectal Cancer Roundtable members (see Roundtable fact sheet for list of members). Colorectal Cancer Chat Room As a member of the Roundtable, the American Digestive Health FoundationˢM Digestive Health Initiative debuted its Internet chat room on colorectal cancer located at www.gastro.org/adhf.html. This public to public chat room will allow consumers, colorectal cancer patients, family members, survivors, and people at high risk for the disease to engage in live, real time discussions of the many issues related to colorectal cancer. Each month, the chat room will feature a guest expert, beginning with actress and colorectal cancer survivor Barbara Barrie, co-star of the NBC sitcom "Suddenly Susan" and author of the 1997 book Second Act: Life After Colostomy and Other Adventures. On September 11th, from 1 p.m. - 2 p.m. EDT, Ms. Barrie will appear in the chat room live to discuss her personal experience as a colorectal cancer survivor. In addition, Ms. Barrie will respond to questions posted on the chat room's message board during the month of September. Private Sector Partnerships In its efforts to spread the word about the importance of colorectal cancer prevention and early detection, the Roundtable sought and secured partnerships with members of private industry, which were announced at the White House event. In her remarks, Mrs. Clinton recognized the following companies for the activities they will undertake to raise awareness about the importance of colon cancer prevention and screening among their employees and customers (see Private Sector Partnerships fact sheet for details on individual company activities): American Airlines American Greetings Corporation / National Association of Chain Drugstores Beckman Coulter, Inc. / SmithKline Diagnostics, Inc. Bristol Myers Squibb Oncology / Better Health Foundation Eli Lilly and Company General Motors Corporation Kellogg Company National Association of Chain Drugstores Olympus America Inc. Zeneca Pharmaceuticals ### c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE FOR IMMEDIATE RELEASE Contact: Carole Anikis (301) 941-2626 Founding Organizations: American Cancer Society SURVEY SHOWS NEARLY HALF OF AMERICANS AT RISK FOR Centers for Disease Control and Prevention COLON CANCER ARE NOT BEING SCREENED Member Organizations: Large Number Report That Physicians Are Not Recommending Tests Agency for Healthcare Policy and Research Alliance of Community WASHINGTON, DC (September 10, 1998) - Survey results released today at Health Plans a White House event on new efforts to promote colorectal cancer prevention American Academy of Family Physicians reveal that nearly half of all adults aged 50 and older -the age group American College of considered at highest risk for developing colorectal cancer -have not been Gastroenterology screened for the disease. The White House event was hosted by First Lady American College of Physicians Hillary Rodham Clinton, who announced her support for raising awareness of American College of Radiology colorectal cancer and unveiled new efforts to promote the prevention and American Digestive Health Foundation early detection of the disease. Colorectal cancer, also known as colon cancer, American Gastroenterological kills more than 50,000 Americans each year, even though it is preventable and Association curable when detected early. American Medical Association American Medical Women's Association The survey, conducted for the National Colorectal Cancer Roundtable by the American Society of Colon Gallup Organization, underscores the need for new national initiatives and Rectal Surgeons promoting colorectal cancer prevention and early detection. One of the most American Society for alarming findings is that most of the 47 percent of people over 50 not being Gastrointestinal Endoscopy screened for colorectal cancer reported that no medical professional had ever Association of State and Territorial Directors of Health recommended screening. Promotion and Public Health Education Digestive Diseases "Physicians must make testing for colorectal cancer a part of their medical National Coalition practices," said Roundtable Chair Bernard Levin, MD, vice president for Collaborative Group of the Cancer Prevention at the M.D. Anderson Cancer Center in Houston. "I have Americas on Inherited Colorectal Cancer spent too much of my professional career delivering bad news to people Memorial Sloan-Kettering whose lives and health could have been saved if they had been screened for Cancer Center National Cancer Institute this preventable disease." National Caucus and Center on Black Aged. Inc. Although colorectal cancer occurs with almost equal frequency in men and STOP Colorectal Cancer women, the survey found that women aged 50 and older are less likely than Foundation men in this same age group to undergo screening (49 percent of women University of Minnesota Cancer Center reported not having been screened versus 36 percent of men). Dramatic University of Texas differences were also seen between whites and non-whites. Among survey M.D. Anderson Cancer Center respondents, 44 percent of whites reported not having had any of the three tests - fecal occult blood tests, flexible sigmoidoscopy, barium x-ray - compared to 56 percent of non-whites. The majority of adults surveyed seem to believe that early detection can save lives; however, when asked what they could do to help prevent colorectal cancer, fewer than half cited regular screening tests. Even fewer mentioned dietary changes, such as eating a high-fiber diet (21 percent), or general references to diet (20 percent). A sizable minority (22 percent) could not name anything a person might do to help prevent colorectal cancer. Asked to estimate their own chances for developing colorectal cancer, one in five adults (20 percent) believe they are very likely to develop cancer of the colon or rectum. Another 35 percent say it is somewhat likely they will develop the disease. A small proportion - one percent - reported they already have colon or rectal cancer. Sixteen percent could not estimate their chances of getting colorectal cancer. The Gallup Organization conducted telephone interviews from August 11 through August 23, 1998, with a national sample of 1,062 adults aged 50 or older, to examine the knowledge and experience of adults with testing for colorectal cancer. ### The National Colorectal Cancer Roundtable is a coalition of medical professional, consumer advocacy, and voluntary organizations committed to raising awareness about the prevention and early detection of colorectal cancer. c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE The Facts About Colorectal Cancer What is Colorectal Cancer? Founding Organizations: American Cancer Society Almost all cases of colorectal cancer, also referred to as colon cancer, Centers for Disease Control and Prevention begin with the development of benign colonic polyps. Polyps form when cells lining the colon grow, divide and reproduce in an Member Organizations: unhealthy, disorderly way, producing a growth. Agency for Healthcare Policy and Research These polyps can be cancerous, invading the colon wall and surrounding Alliance of Community blood vessels, and spreading to other parts of the body. Health Plans Colorectal cancer frequently begins without symptoms. American Academy of Family Physicians American College of What Causes Colorectal Cancer? Gastroenterology American College of Physicians The exact causes of colorectal cancer are unknown, but the disease American College of Radiology appears to be caused by both inherited and lifestyle factors. American Digestive Health Foundation Diets high in fat and low in fruits and vegetables - such as those that American Gastroenterological include red meat, fried foods and high-fat dairy products - - may increase Association the risk of colorectal cancer. American Medical Association Lifestyle factors -such as cigarette smoking, a sedentary lifestyle, and American Medical Women's Association obesity - - also may increase the risk of developing the disease. American Society of Colon Genetic factors may determine a person's susceptibility to the disease, and Rectal Surgeons whereas dietary and other lifestyle factors may determine which at-risk American Society for Gastrointestinal Endoscopy individuals actually go on to develop the disease. Association of State and Territorial Directors of Health How Common is Colorectal Cancer? Promotion and Public Health Education Digestive Diseases Colorectal cancer is the second leading cancer killer in the United States, National Coalition and the third most common cancer overall. Collaborative Group of the Americas on Inherited Colorectal This year, more than 50,000 Americans will die from colorectal cancer Cancer Memorial Sloan-Kettering and approximately 131,600 new cases will be diagnosed. Cancer Center Eighty to 90 million Americans (approximately 25 percent of the US National Cancer Institute population) are considered at risk because of age or other factors. National Caucus and Center on Black Aged. Inc. More women over the age of 75 die from colorectal cancer than from STOP Colorectal Cancer breast cancer. Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center Who Is At Risk? Men and women aged 50 and older are at almost equal risk of developing colorectal cancer. Those who have a personal or family history of colorectal neoplasia (cancer or polyps) are at high risk of developing the disease. Anyone who has a personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn's disease, is also at high risk. Although the incidence of colorectal cancer appears to be the same among all racial groups, survival rates seem to be lower for African-Americans. How Can You Prevent Colorectal Cancer? Know your family history. See your doctor for yearly screenings if you are aged 50 or older. Maintain a diet low in animal fat and high in fruits, vegetables and fiber. Exercise regularly. Prevent obesity. Avoid cigarette smoking. What You Need To Know ... Early detection saves lives - colorectal cancer is preventable, even curable when detected early. If colorectal cancer is found early enough, the patient has more than a 90 percent chance of survival. Colorectal cancer screenings are safe and effective and are now covered by Medicare and an increasing number of other health providers. Several screening methods can be used to detect polyps before they become cancerous, such as fecal occult blood test, colonoscopy, flexible sigmoidoscopy and barium x-ray. These tests also can detect cancer in its early stages. ### BERNARD LEVIN, MD Gastroenterologist Bernard Levin, MD, currently is professor of medicine and vice president for cancer prevention at University of Texas M.D. Anderson Cancer Center in Houston, Texas. Prior to his fourteen years at M.D. Anderson, Dr. Levin was associate professor of medicine and attending physician at University of Chicago Hospital and Clinics. For the American Digestive Health Foundationˢᵗ (ADHFSM), Dr. Levin serves as co-chair of the Digestive Health Initiative® Colorectal Cancer Education Campaign. He also is chair of the American Cancer Society's National Advisory Task Force on Colorectal Cancer and recently was appointed as chair of the National Colorectal Cancer Roundtable. Affiliated with a number of professional organizations, Dr. Levin is a member of the American Gastroenterological Association and a fellow of the American College of Physicians. He participates as a consultant to the National Cancer Institute. Dr. Levin has written extensively for distinguished medical publications including Journal of the National Cancer Institute, Gastroenterology, the International Journal of Cancer, Cancer and Science. A graduate of the University of Witwatersrand in Johannesburg, South Africa, Dr. Levin completed fellowships in gastroenterology and biochemistry in pathology at the University of Chicago. FIRST LADY HILLARY RODHAM CLINTON PROMOTES COLON CANCER AWARENESS AND PREVENTION September 10, 1998 Today, at the White House, the First Lady will announce a series of initiatives to raise awareness about colon cancer. She will announce a new research grant to fight colon cancer, release a survey reporting that many Americans do not receive appropriate screening for this disease, unveil a new public service announcement to promote prevention, and announce new public and private sector partnerships to raise awareness. The First Lady will be joined by Katie Couric, NBC "Today Show" Anchor; Ellen Levine, Editor-in-Chief of "Good Housekeeping" Magazine; Dr. Bernard Levin, a colon cancer specialist and chair of the National Colorectal Cancer Roundtable; and Secretary Shalala. Colon Cancer - A Preventable Killer. Colon cancer is the number one non-tobacco-related cancer killer, with more than 50,000 Americans dying each year from the disease. For both men and women, it is the third most common cancer, and 130,000 Americans contract the disease each year. Men and women over the age of 50 have the greatest risk of developing colorectal cancer. However, it is preventable and curable when detected early; in fact, a patient whose cancer is detected early has more than a 90 percent chance of survival. Raising awareness about colon cancer and the importance of screening can save lives. New Grant to Fund Colon Cancer Research. The First Lady will announce a new $8 million grant by the National Institutes of Health to the Seattle Gastrointestinal Program Project for research aimed at preventing, diagnosing and treating colon cancer. The grant will help scientists better determine who is at risk for colon cancer and will test new strategies to reduce their cancer risk. The grant will also be used to develop more sensitive and precise ways of screening colon cancer than those available today. New Survey Demonstrates Need for Greater Need for Colon Cancer Awareness. The First Lady will release a survey finding that nearly 50 percent of men and women over the age of 50 -- of those at highest risk for colon cancer have never been screened. Forty-seven percent of those not tested reported that no medical professional had ever recommended that they be screened for colon cancer. Although colon cancer occurs with almost equal frequency in men and women over the age of 50, 49 percent of women reported not having been screened compared to 36 percent of men. Dramatic differences were also present between whites and non- whites. Forty-four percent of whites reported not having taken any of the three tests used for screening, as opposed to 56 percent of non-whites. While most of the adults surveyed believed that early detection could save lives, few were aware that screening and dietary changes could help prevent the onset of colorectal cancer. This national survey was conducted by the Gallup Organization. A New Media Campaign: With its October issue, "Good Housekeeping" Magazine is initiating a year-long colon cancer awareness campaign. The October issue will contain a major medical report on what women can do to protect themselves from colon cancer. In addition, NBC's "Today Show" will present a week-long in-depth series, "Confronting Colon Cancer," that will offer a comprehensive look at this preventable disease. New Partnership Between Public and Private Sector. The First Lady will also announce the creation of the National Colorectal Cancer Roundtable unprecedented private and public sector partnership to promote greater awareness of colon cancer. Group members include the Centers for Disease Control, the American Cancer Society, the American Digestive Health Foundation. Raising Awareness through a New Public Service Announcement. A new public service announcement featuring the First Lady will be unveiled urging all Americans over the age of 50 to be screened for colorectal cancer. NBC will air the PSA, and the print version will appear in the January issue of Good Housekeeping. The PSA will also be distributed nationally. New Internet Site to Answer Questions on Colon Cancer. The First Lady will also announce a new Internet chatroom that will allow consumers, patients, family members, survivors, and people at high risk for the disease to engage in live discussions of issues relating to colorectal cancer. Doctors and other experts will be available on line to answer questions about this disease. The website address is www.gastro.org/adhf.html, and it will be sponsored by the American Digestive Health Foundation, a member of the Colorectal Cancer Roundtable. New Private Sector Commitments to Raise Awareness: The First Lady will also announce new private sector commitments to promote colon cancer awareness, by bringing attention to the importance of prevention and early detection. Commitments include: American Airlines will publish the public service announcement on colon cancer in its in- flight magazine, where it may reach approximately two million travelers in the U.S. and abroad. The Kellogg Company USA will promote colorectal cancer prevention and early detection by printing public service messages on five million packages of All Bran and Bran Buds cereal boxes. American Greetings will create an insert for prescriptions that promotes prevention and early detection of colorectal cancer. The National Association of Chain Drug Stores will distribute the insert to all of its pharmacies and pharmacists. Bristol-Meyers Squibb Oncology has provided a $100,000 grant to the Better Health Foundation to develop a colorectal cancer workplace awareness program that it will initiate at all of its work sites, and send to companies all around the country. Olympus America, Inc., will sponsor an education program on colon cancer that will be sent to the administrators of retirement communities all across the country. General Motors will publish an article in its newsletter to encourage its two million employees to research information relating to preventing, detecting and understanding colorectal cancer. Other private industries included in the partnership are Smith Kline Diagnostics, Eli Lilly and Company, and Zeneca Pharmaceuticals, all of whom have committed to raise awareness among their thousands of employees about colon cancer. OCTOBER 1998 $1.95 Win Good CONTEST! Wardrobe Gained Back KITCHEN Those Pounds? MAKEOVERS Lose Them For Good Great Looks You Can AIR BAG DANGERS Afford How To Keep Your Family Saf Do You Talk To Yourself? When It Helps INTERVIEW BEST EVER Katie's Wish PASTA RECIPES Speaking out in her husband's memory...what she KIDS' HEALTH desperately wants you to know Update on Unsafe Medicines, New Vaccines, and More http://goodhousekeeping.com 10 PLUS: Other stories of courage. 08345 And real hope in the 0 754714 o $1.95 battle to beat colon cancer. GOOD HOUSEKEEPING october Katie's Crusade Still coming to terms with her husband's death from colon cancer, the Today show's Katie Couric is speaking out in his memory. What she wants you to know could save your life. BY JOANNA POWELL 124 In her handsome corner office at New York City's Rockefeller young ages. At least 13,000 new cases Center, Katie Couric is trying to get on with her life. Dressed each year involve people under 50. Does having lost a loved one to cancer in a baby-blue tailored suit and heavy makeup from her make you terrified of developing the morning duties as cohost of NBC's Today show, she's both disease yourself? poised and funny as she gives a rare interview. First, she Terrified is probably too strong a word. But it certainly makes me feel vulnera- takes time for a bit of girl talk about shoes. Then she turns ble. My husband was trim, healthy, had serious as the subject moves to her recent loss. never smoked a cigarette. It makes me feel vulnerable for everyone, not just for Despite her courageous front, Katie's myself. It's very frightening. voice cracks often during our conversa- How did you keep going after Jay's death? tion, and her eyes well up with tears. It As hard as it is for everybody who faces a has been just a few months since the tragedy in their lives, you really don't death of her husband, TV legal analyst have much of a choice. You can stay in Jay Monahan, who at 42, lost a swift, bed every day, or for weeks or months at a brutal fight with colon cancer. As a new- time, or you can just keep going. Children ly single mother with two small children force you to keep going. You don't have (Ellie, 7, and Carrie, 2½), Katie is still the luxury of putting your head in the reeling from the shock. sand. My children are a tremendous But in her search for solace, she has source of comfort, tremendously motivat- found some touchstones. In one corner ing for me. Because I have responsibili- of her office there is a small antique ties. It's not just financial. It's being there chest of drawers that was a birthday gift for them because they are children. from her husband the year before he How was Jay's cancer discovered? died. Once a scientist's display cabinet, He was already very sick when doctors it is filled with delicate eggs of various diagnosed it in April 1997. He had no wild birds. Even though some of the symptoms. Jay was tired, but we thought eggs have already broken, Katie has it was because he was flying back and protectively made a handwritten sign forth to California for his job [as a TV that reads FRAGILE and taped it to the Katie with husband Jay in 1995. legal analyst]. And we had two small chil- top of the chest. "I'm just so afraid it "We had no idea dren bringing every bug in America into might get damaged," she says. "It the house. We had no idea what was means so much to me." what was going on in going on in his body. This cancer is so What also means a lot to Katie is her decision to turn her grief into action-by his body. This cancer insidious. What are the lessons to be learned? launching a fight to raise awareness is so insidious." For one, that there are often very few about colon cancer. It is to that end that symptoms until it's too late. I'm not say- she is anchoring a five-part series about ish about it. It might cost you your life. ing everyone in America is walking the disease on the Today show from For the Today show's series on colon can- around with colon cancer, but everyone September 14 to 18. And it is why, for cer, we interviewed a Yale-educated doc- needs to know that it is a possibility. And this interview, she agreed to talk inti- tor who was going to give a talk on colon they need to rule it out. The only way to mately about her loss-and her ongoing cancer at the Yale Club in New York be really safe is to be tested. I'd like for effort to understand it. City. He was asked to change the subject people to become more aware of Joanna Powell: You've been very private of his talk to make it more palatable. Peo- colonoscopy, an exam that allows a doctor since your husband died. Why are you ple educated at a university like Yale can- to check the colon for abnormalities, and speaking out now? not deal with colon cancer? I just couldn't to decide with their doctors whether one Katie Couric: Colon cancer has taken a believe it. is huge personal toll on my life. Now I'd What do you want people to be especially Do you think there's anything doctors like to help educate others about this dis- aware of? know now that might have made a differ- ease. I want everyone to understand that People need to know that colon cancer ence in saving Jay's life? women as well as men get colon cancer. can strike the young. My husband was My husband's mom, who is now in her Young people as well as old people get it. barely 42 years old. My executive produc- 60s, has ovarian cancer-it was diagnosed And frankly, very few people take advan- er, Jeff Zucker, got it, and he was only 31. about three years ago. His grandmother tage of the preventive tools that exist. Fortunately, he survived. Last weekend, died of breast cancer. There is a growing Too many Americans don't get tested I ran into a farmer I know out in the coun- body of thought that these glandular can- because they don't want to talk about try. Jay and I always bought produce from cers-breast, ovarian, uterine, prostate, that part of their body. him. When I saw him, he said, "I'm so and colon-may be related, that there is How can we break the stigma of this sorry about Jay. You know I lost my perhaps, a genetic link. If we had known disease? fiancée five years ago to colon cancer." I this, Jay might have been screened for I think we have to use the words, say asked how old she was, and he said, colon cancer. I now certainly believe you them. Colon. Rectum. Bowels. The more "Thirty-eight." I can't tell you how many should think long and hard about an matter of fact you are with the language, people wrote to me whose husbands or early colonoscopy, not only if your aunt or the more it helps. You can't be squeam- wives were taken by this disease at very grandmother or other relative has colon cancer, but also if any of these glandular treatment for colon cancer is a drug that going to get through it and continue to fly never for cancers exist in your family. I firmly was developed in the 1950's. I hope that in the healthiest way possible. Talk to weren't believe you have to be your own best more money-government and private- your child's teachers; talk honestly with I'll never children about the death in an age- What did advocate. We're hearing now that every- can be devoted to cancer research. If we one 50 and up should have a colonoscopy can put Sojourner on Mars, we can come appropriate way. Parents can't just forget Just "Thi regardless of risk factors or symptoms. up with something that keeps cancer about it and hope their kids will be okay. you need But all the doctors I know-and I know a What should you do to keep the loved ing, comfi from destroying so many lives. lot of them-say they had or will get a How do you feel about the body's ability one's memory alive? Tuesdays 8 colonoscopy by their fortieth birthday. to "beat cancer"? Is it possible? People talk You can't schedule a child's grief. You fessor dyii That ought to tell you something. a lot about fighting it psychologically. really have to have a good sense of what's his relatio Problem is, even if you have a family I think you have to have hope and a fight- right for your child; you can't force-feed He talke history of colon cancer, doctors often ing spirit. On the other hand, this idea that your child. I try to talk about Jay in a very dreamlike natural way, because he comes up all the how peop time. Yet I don't try to sit with my child lives, chat "Little things help-like having my in some kind of artificial environment, store, and and have her discuss things with me that is going on husband's money clip in my purse. And maybe she's not ready to talk about. I I think think you have to pick up cues from life has cha being in a room where he spent time.' them. The other day my daughter Carrie it's very rea was on her play telephone telling me, world thrc recommend you be screened by a flexible people who survive cancer are stronger "Mom, it's Daddy calling from heaven." Everything sigmoidoscopy, not a colonoscopy. willed or more motivated or have a greater It was heartbreaking, but I wanted to like B.C. a Flexible sigmoidoscopy is effective for explore it with her, so we started talking. After Cance desire to live is really unfair to people who only the lower third to half of the colon. She's only 2½, but I didn't want to just on comme don't beat it. I think cancer, frankly, comes My feeling is if you really want to be sure, down to biology and luck. The cemeteries ignore her and what she was saying. It's buried in a getting a flex sig is like getting a mam- are full of people who wanted to live more an awful lot for grown-ups to handle terrifying. V mogram on one breast. than anything and couldn't their own pain and loss, but they can't After your husband found out he had It's a very confusing concept-the idea forget about the children. They're going colon cancer, what did you do to fight the that if you fight hard enough you can cure through it too. It's very easy in a situation Th disease? yourself. like this to feel completely and utterly I can share some of my personal experi- I'm thrilled for people who beat it, overwhelmed. But I think parents have a ence, but I want to be careful not to because I know they've been to hell and real responsibility to pull it together for invade my husband's privacy or dignity in back. But to imply that they are mentally their children. any way. Immediately after he received superior to those who don't beat it is just Has your mother been helpful to you dur- his diagnosis, I began to amass a lot of plain wrong. ing this ordeal? information on treatment, clinical trials, The other part of your story is surviving Oh, yes. I'm very close to my parents. I and experimental drugs. I was extremely the grief after losing your husband. Is went through a period when I was just frustrated to discover there's no single there anything that's been especially help- impossible to deal with. Because I was source for learning about the various ful in your life in the past months? just so, so upset and angry and furious experimental treatments for your specific Talking to other women who have been with the world. Talk about unconditional disease. Pharmaceutical and biotech com- through similar circumstances. Nobody love. They've always been there for me. panies are highly competitive and some- else really understands. I didn't before it What about friends? How have they times secretive about the kinds of tests happened to me. As empathetic as responded? they're doing. The technology is chang- friends and family want to be, it's just I think this is really important. A lot of ing at breakneck speed. And it's hard to such a lonely, painful experience. It's people are at a loss when it comes to help- find sources that are in plain English, not very meaningful to have someone who ing friends feel better. A lot of people pull medicalese. It was very troubling to me. can relate to an earth-shattering event in back because they don't want to be inva- Here I was, a reporter. I've spent the last the same way you do. sive or intrusive. 20 years researching and investigating. Do you have any advice to parents with Or say the wrong things. But when it came to tracking down infor- young children who have lost a loved one? Or say the wrong things. It's painful for mation that could potentially save a life, I I'd hate to profess to be an expert. It's lot of people because it reminds them of hit one obstacle after another. I'm heart- definitely baptism by fire when you're in their own mortality. But when someone ened to hear that the National Cancer a situation like this. Every child is differ- you care about is going through something E Institute has just implemented a new ent, every parent is different, every situa- as traumatic as this, you can't stop trying Web site clearinghouse, so some of this tion is different. But I do think you need get in-even if they push you away, initial information is easier to access but I defi- to be very proactive in helping your ly, because they're so knocked off their children through an ordeal like this. And foundation and their world has just fallen nitely think more could be done. Do you find it frustrating that cancer is you need to do everything you can to apart. If they push you away, and you real still the No. 2 killer in this country after keep them healthy and whole. You can't ly care-push back. Keep trying. When heart disease? think that they are just children and they you're going through it, you're scared me Incredibly. It's been more than 25 years won't be affected, or they'll get over it, or the time. I had one friend who wrote since Richard Nixon declared war on can- children are resilient. Some of that is true, card every week and called me every But cer. And while there have been tremen- but I think you have to very consciously week, and I never called her back. ГП dous strides, the first-line chemotherapy take steps to make sure that they're I'm so grateful that she kept trying. 126 never forget that. And the people who bility in your life, these things are not fun- the Civil War, at our house in the country weren't there and didn't keep on trying, ny. Even hearing cartoon characters say, and I go into that room and look at the I'll never forget that either. "Drop dead." I remember looking at a things he loved-which, of course, I didn't What did the cards say? magazine cover on summer pleasures, appreciate as much when he was living. Just "Thinking about you," "I'm here if and thinking, Wow, I wish that's all I cared That's a very special place for me. I find you need me." That was a very reassur- about: what I was going to do this summer, that talking about him to those people ing, comforting thing. I think of the book what movies I was going to see. I think it's who cared about him and miss him is real- Tuesdays with Morrie (about a college pro- important to acknowledge that someone's ly helpful. Sometimes when you lose fessor dying of Lou Gehrig's disease and world has taken a gut-wrenching turn. someone, other people just want it to be his relationship with a former student). Is there any place or item that you shared in the past and not talk about it. I appreci- He talked about how you're in this with Jay that now offers comfort? ate having people say how much they dreamlike state and you can't understand Nothing really comforts me, I'm sorry to cared about him and miss him too. how people are just going on with their report. It's only been months since my Are you still close to his family? lives, chatting and going to the grocery husband died. And, frankly, I still can't Yes. Jay was one of seven children, and I store, and pushing baby strollers. That life believe it. When I think about it, it just often speak to his siblings as well as to his is going on swimmingly for everyone else. permeates every cell in my body. You parents. They're all wonderful. I also like I think when people acknowledge that can forget about it temporarily. But then to talk to other people who knew him life has changed in a horrible way for you, the grief comes like a huge wave and like well and were profoundly affected by it's very reassuring. I used to say I saw the a horrible invasion of your heart and soul. him. Someone sent me a letter telling me world through cancer-colored glasses. Little things help me-like having my about Jay's experience in the Navy. I just Everything just looks very different. It's husband's money clip in my purse. And got his transcripts from college and read his like B.C. and A.C.-Before Cancer and just being in a room where he spent a lot guidance counselor's recommendation and After Cancer. You see references to death of time. But I don't have any sort of ritual his entrance essay. It was very revealing. on commercials; you see a man being or supercomforting place. I'm still looking He wrote things that I didn't know about buried in a car, and it's not a big joke. It's for that. My husband had a collection of him. It's nice to have, but sometimes so terrifying. When death is a distinct possi- historic military pieces, particularly from hard to read. (continued on page 188) The Stories of Three Families Left Behind KATHY HOCHHAUSER "HE NEVER LOST HIS SPIRIT" AND? IER DAUGHTERS, I n 1993, Kathy Hochhauser and her husband, Ken, were feeling Ellen, 18, SEATED, hopeful about their future together. The parents of two daughters- 14. Ellen, 12 at the time, and Gwen, 9-they were strong-willed people whose marriage had been troubled; the couple were in counseling. But now they were trying to put the bad times behind them. Then, one day, Ken, a 45-year-old accountant at a computer company in Framingham, MA, noticed blood in his stool. "I urged him to go to the doctor, but he put it off for a few months," says Kathy, now 50, a public school secretary. When he finally had a colonoscopy, an examination of the colon, the news wasn't good: A tumor was found. Ken had surgery immediately, but the cancer had already spread to his liver. Although he would get chemotherapy and radiation-including an experimental drug- the doctors indicated that he didn't have long to live. "He was a fighter; he was going to prove them wrong," recalls Kathy. And he did. For three years after the surgery, he lived life to the fullest. "He'd be nauseated after a chemotherapy session, but he'd insist on playing basketball," says Kathy. And he rallied enough to attend Gwen's bat mitzvah in November 1996. "He even found the strength to dance with me," says Kathy. She and Ken grew closer than they had ever been. Kathy drove him to and from treatments and nursed him through the long nights. "He never lost his spirit," she reports. "Two weeks before he died, I asked him if there was anything I could get for him, and he grinned and said, 'A pastrami sandwich.' went to the deli right away." On July 3, 1997, Ken, at age 49, lost his battle against colon cancer. Kathy had grieved a lot during the years she cared for Ken, but now she couldn't stop thinking about what could have been done to save her young husband's life. For 25 years, Ken had suffered from chronic bowel problems, and Kathy now says she wishes he'd been screened earlier. "If only one person reads this and goes for a checkup," she says, "none of what we went through will have been in vain." -Sondra Forsyth "SHE WAS A REAL GOOD MoM" CHEI SHERER 7, AND FATHER, TRIPP. C helsie Sherer, a 7-year-old who loves to swim and watch videos, T seems like a typical second grader. But those close to her know she's wrestling with a terrible trauma: the loss of her mother. In 1996, at age 28, Lisa Sherer died of a rare, genetic form of colon cancer, leav- ing behind her only child and her husband, Tripp, a dental technician. Chelsie was not yet 3 when Lisa first got sick in 1993. She passed a lot of blood one day and was rushed to the emergency room. It turned out she had familial polyposis, a condition in which thousands of polyps grow on the colon, and her polyps were malignant. She was given a year and a half to live. The doctors told Tripp that the polyps start out benign but if not removed al- most always become malignant by the time the person is 40. Tripp recalled that Lisa frequently had diarrhea and lacked stamina. When he asked her about it, she told him she had received a diagnosis of a spastic colon when I she was a teenager. No formal testing had been done; if it had, the condition could have been detected sooner. Though Lisa didn't know of any relatives with familial polyposis, Tripp wor- volved: I ried that she might have passed it on to Chelsie, so he arranged to have her made up tested. Sure enough, Chelsie had the condition. "But we caught it early tube that enough: her polyps were still precancerous," says Tripp. However, doctors had food and to remove Chelsie's entire large intestine to protect her from cancer. tum, the Lisa was SO ill that, at first, Tripp didn't tell her that Chelsie had inherited large inte her condition and undergone surgery. But three months before Lisa died, Tripp rity has g decided she should know: "She was extremely upset, but I said the way I saw account 0 it, she gave Chelsie life, and now she was saving Chelsie's life. After that, I as former asked her if she wanted to renew our VOWS. She said yes." The ceremony was breast c performed at Lisa's bedside on May 12, 1996. Two weeks later, she died. Schwarzl Today, Lisa's framed photograph sits on the dresser in the bedroom she Many and Tripp once shared. "Sometimes I go into Daddy's room and look at my strikes m mom's picture," says Chelsie. "She was a real good mom." -S.F. doctors a patients "I WISH I COULD SEE HIM AGAIN" develop CLOCKWISE.FROMY netic pre L ast Christmas, not long after she turned 16, Lynne Patterson's LEFT: LYNNE tually kil father, Michael, gave her a 1989 Volkswagen and two promises. PATTERSON, 16. they dor First, as a mechanic, he'd keep the vehicle in top shape. Second, GEORGIA,HER men. TI he'd help her get her license. But Michael, 50, of Medford, MA, wouldn't live MOTHER;AMY,J5 and 64,6 long enough to celebrate that rite of passage with his oldest daughter. Timothy, 11. cer, and On February 6, he was admitted to the hospital with a fever of 103°F. Jacqueline, 14. will die Tests showed that Michael seemed to be losing blood, so a CT scan was can Can performed. It revealed a mass in his abdomen. Surgery turned up a The malignancy on his colon-as well as 14 other tumors. The prognosis? At screenii most, several months for Michael to spend with his wife, Georgia, and Lynne known and her three siblings: Amy, 15; Jacqueline, 14; and Timothy, 11. be prev "I couldn't believe it," says Lynne. "The doctors said the tumor must have could Sa taken at least five years to get that big, but my dad hadn't seemed sick at year, bu all." Michael did experience some rectal bleeding-the No. 1 sign of colon Bond, 1 cancer. At first it was some slight spotting. Then, by October 1997, the Veterar bleeding had become pronounced, SO Michael went to the doctor. His neapoli physician found a hemorrhoid and suggested that Michael have a colon- 50 and cancer test, which he postponed. Georgia now wishes she and Michael had cancer, paid more attention to those earlier symptoms. womer Despite the grim prognosis, Lynne thought she'd have at least one more colon e summer with her father. "We had always been really close," she says. "Ever cording since I was a little girl, our family had traveled to Maine in July. My dad would trol an wake me up at five in the morning, SO the two of us could walk to the bakery us put to get pastries hot from the oven. I pictured us walking together again." barrass It wasn't to be. By February 14, Michael had developed complications plenty from the surgery, and four days later, he was gone. "It's still hard to accept," tors de says Lynne. "Something in the house will break, and I'll think, Oh, Dad will fix some i that. I wish I could see him again, even just one more time, to tell him I love the be him and to hear him say that he loves me." -S.F. The Diges 128 The Preventable Cancer The right testing for colon cancer can save your life. What every woman needs to know. by Lisa Collier Cool t's the second most deadly adults age 50 and over-the group with Screening Tests," page 190). cancer, killing more people the highest rate of colon tumors-an as- I What makes the screening shortfall each year than breast or tonishing 61 percent of women said so troublesome is that colon cancer prostate cancer. Yet colon their doctors had never advised any kind often produces no symptoms in its early cancer doesn't receive nearly of screening. Many primary-care doctors stages, when it is 90 percent curable. If as much attention. That's aren't educated about the tremendous not detected, it typically goes unnoticed partly because no one likes to benefits of testing, according to Albert until it has spread beyond the in- talk about the body parts in- Palitz, M.D., director of the colorectal testines-at which point the five-year volved: namely, the large intestine, cancer prevention program at Kaiser survival rate is less than 60 percent. made up of the colon, a six-foot-long Permanente, a large California-based tube that removes water from digested health maintenance organization. "Only The Best Protection food and expels solid waste; and the rec- in the last five years have studies pro- Colon-cancer experts agree that the "gold tum, the last six to eight inches of the vided clear evidence that screening can standard" of screening is colonoscopy, a large intestine. What's more, no celeb- prevent death," he notes. However, the 15- to 20-minute test in which the entire rity has gone public with a first-person ACS has supported colon-cancer screen- colon is checked for tumors using a account of the disease to raise awareness, ing for nearly two decades, issuing new lighted flexible tube with a cameralike as former First Lady Betty Ford did for guidelines last year (see "Rating the device at one (continued on page 188) breast cancer and General Norman Schwarzkopf did for prostate cancer. Many women assume colon cancer THE GOLD-STANDARD 20-MINUTE TEST: strikes mostly the elderly-or men. But ONE WOMAN'S STORY doctors are seeing younger and younger patients with the disease, some of whom ot long ago, I saw something would be injected into my intestines SO the doctor develop the illness early because of a ge- N alarming in the toilet. "This isn't would have a good view, and that would produce a netic predisposition. And the cancer ac- good," I said out loud, staring at gassy, uncomfortable feeling. Sedation would be tually kills more women-mainly because the bloody stool I discovered. I'm necessary. I was told that there would be no they don't get screened as frequently as 52, and my mother has a history of colon polyps. discomfort when the probe was slowly retracted, men. This year, about 67,000 women- So I made an appointment with William Coll, M.D., so I asked to be awakened midprocedure. I wanted and 64,600 men-will develop colon can- a local gastroenterologist, who helped me arrive at to see for myself what was going on inside. cer, and 28,600 women and 27,900 men an obvious conclusion: I needed to have my colon Dr. Coll used intravenous Demerol (a sedative will die from it, according to the Ameri- checked for cancer. I was scared, SO I elected, as and painkiller) and Versed (another sedative) to can Cancer Society (ACS). advised by Dr. Coll, to have a colonoscopy, which knock me out during the first part of the The good news: With the right would enable him to inspect my entire colon. procedure. Then, I got a drug that would wake me screening, the disease-technically In the 24 hours before the procedure, I needed up. When I opened my eyes, the scope, now about known as colorectal cancer-can actually to cleanse and flush my colon so that Dr. Coll's four feet up my innards, displayed interior shots of be prevented. "Widespread screening view would be unobstructed. My diet was restricted my colon on a monitor only a few feet away. Inside could save at least thirty-thousand lives a to clear liquids and chilled bouillon. But that this strange labyrinth of pink-gold crinkles and year, but sadly, very few get it," says John wasn't all. I was ordered to take one and a half folds were two tiny polyps, six millimeters in Bond, M.D., chief of gastroenterology at ounces of a fizzy laxative potion mixed with eight diameter, which Dr. Coll removed. Also revealed Veterans Affairs Medical Center in Min- ounces of water, once at 11:00 A.M. and again at were two tiny hemorrhoids that had ruptured and neapolis. More than half of women age 6:00 P.M. Dr. Coll recommended that I stay home were deemed the cause of my dramatic bowel 50 and over are now checked for breast after the first dose (which I did). It made perfect movement. cancer, but only about 24 percent of sense: This nasty-tasting salty, lemony drink gave Afterward, I dozed lightly in the recovery room. I women age 50 and over have had their me cramps and diarrhea almost immediately, and was a little WOOZY, but my stomach felt fine. in fact, colon examined in the past five years, ac- I found myself in the bathroom at 20-minute I was hungry. I fantasized about breaking my fast cording to the Centers for Disease Con- intervals throughout the day. I was not only crampy with barbecued spareribs and garlic mashed trol and Prevention in Atlanta. Many of and crabby but also lightheaded and weak- potatoes, a dream that became a reality that us put off testing, fearing it may be em- probably dehydrated, Dr. Coll said. He also told me evening. I returned to work, spunky as ever, the barrassing or uncomfortable. But there's that all of these reactions were to be expected. next morning. plenty of blame to go around: Some doc- The next morning, at 8:30 A.M., I went to Sharon A few days later, I learned that the polyps were tors don't tell us to get screened-and Hospital in Connecticut. I got undressed, put on a benign. I was glad I'd had the colonoscopy-and some insurance companies won't pay for cotton gown, and was instructed to lie on a relieved when Dr. Coll told me that the type of the best testing. stretcher. A nurse explained that the colonoscope, polyps he'd removed never becomes cancerous. So Three years ago, when the American a thin, lighted probe with a cameralike device at I don't have to have another colonoscopy for seven Digestive Health Foundation polled one end, would be threaded into my colon. Air to ten years. Maxine Paetro KATIE COURIC COLON CANCER cil eraser, and up to seven more years to turn cancerous. (continued from page 127) (continued from page 129) Do you share them with your daughters? end. The device transmits images of the Elizabeth Ely, 55, an interior decora- I'm putting together a book of all the let- colon to a video screen, which the doctor tor in New York City, is grateful that she ters people have written about Jay, so that watches throughout the procedure. Any had a colonoscopy, because it saved her my girls feel like they know a lot about polyps that are discovered can be re- life. Although she didn't have a family their father and what an outstanding per- moved during the test. Colonoscopy history of colon cancer or any symptoms finds 97 percent of colon tumors, and the (in fact, she felt great, she says), her doc- son he was. I'm also writing them a letter ACS now recommends it for everyone age tor encouraged her to get tested because all about our courtship-and how we met and why I fell in love with him. The idea 50 and over. of her age. Last March, a colonoscopy is that when they're older they can read The unique advantage of colonoscopy revealed a malignant rectal tumor. "I about him and appreciate him. I've asked is that it's the only cancer test that can was absolutely shocked," she recalls. "I never believed anything would be people to write to my girls, and I've actually prevent received the most beautiful letters. malignancy. YOUR RISK AND YOUR AGE Do the letters make you feel better, or is it "There's a very all a painful exercise? strong argument Your chance of getting colon cancer increases dramatically as you get It's definitely painful, but part of the that people who older. Check this chart against your age to pinpoint your risk of process. I think it will ultimately help. have this test reg- developing the disease, which strikes at an average age of 66: But for now it reminds me how much I ularly will never, Ages A Woman's Risk A Man's Risk miss him. Some of the letters I just can't ever get colon Birth to 39 1 in 2,000 read. Someday I will. cancer, which 1 in 1,667 40 to 59 1 in 147 1 in 114 When you first went back on the Today means it's much 60 to 79 1 in 31 1 in 24 show following Jay's death, you wore his better for pre- wedding ring around your neck on a venting this dis- Source: American Cancer Society, Cancer Facts & Figures, 1998 chain. Lately, you haven't been wearing it. ease than mammograms are for breast wrong with me. I've always been well." Why did you stop? cancer," says Robert J. Mayer, M.D., di- She had surgery to remove the tumor, The safety chain broke. I didn't stop for rector of the Center for Gastrointestinal and was relieved to learn that it was an any symbolic reason. I just worry that Oncology at the Dana Farber Cancer In- early-stage cancer. She was deemed without the safety clasp, I would lose it. stitute in Boston. That's because virtu- cured after the operation. "I'm very It made me too nervous. And now I'm ally all colon cancers begin as mush- lucky," says Ely. "Now I'm telling my not sure if I'll wear it again. It's a very room-shaped or flat premalignant clients, friends, and relatives to have the outward symbol of one's grief, and I growths called polyps. "About five to test if they're fifty or over." wore it because it made me feel very ten percent may become cancerous, so if Another, more famous survivor: for- close to him, by touching it. It was they're found and removed during mer President Ronald Reagan, who had a hard decision: whether he should colonoscopy, you probably won't get part of his intestines removed in 1985 wear the ring-or I should. I didn't know cancer," explains Jose Guillem, M.D., after doctors discovered a malignant what to do. All of my friends told me it associate attending colorectal surgeon at tumor through colonoscopy. was okay for me to keep it. And I found Memorial Sloan-Kettering Cancer Cen- a lot of solace in it. I don't think he ter in New York City. What's Your Life Worth? would mind. It appears that one colonoscopy is Despite the lifesaving power of Has throwing yourself back into work enough to protect people at average risk colonoscopy, Medicare and a number of helped you cope? for an entire decade, because polyps other health plans won't pay for it. "This You do what you have to do. I have chil- grow very slowly, taking about five to is unjust to the American public," says dren to support. And kids just automati- seven years to become the size of a pen- Michael D. Moseson, M.D., a clinical as- cally make you stronger. Work was a way for me to keep going while Jay was sick. For two hours I could distract YOUR RISK AND YOUR FAMILY HISTORY myself, and I think it serves the same A person who has no cancer in her family has a one in 17 chance of developing colon cancer over a purpose now. lifetime. That risk increases if your relatives have had certain kinds of cancers. If you fall into any of the What is your advice to couples who have categories listed below, you should get a colonoscopy (total exam of the colon) by age 40, or ten years been spared a life-threatening illness? before the youngest age at which a family member received a diagnosis of colon cancer. If there are Cherish each day. Get under the covers several cases of colon cancer in your family, consider getting a genetic test at a major cancer center to with your kids on a Saturday morning. check for an inherited syndrome. Testing, which can cost anywhere from $250 to $2,400, can help And even if your spouse drives you crazy determine the age and frequency at which you need to be screened. sometimes, remember what made you fall in love to begin with. My daughter is 1. You have a distant relative-an uncle, aunt, or grandparent-who has/had colon cancer. Your risk: 1.5 in 17 obsessed with The Wizard of Oz, and there's one thing that Dorothy says 2. You have an immediate family member-a parent, sibling, or child-who has/had colon cancer. Your risk: 2 or 3 in 17 toward the end of the movie that always affects me so much: "IfI ever go looking 3. You have two or more members who have/had colon cancer, or have one relative for my heart's desire again, I won't look who developed the disease before age 50. Your risk: 3 or 4 in 17 any further than my own backyard." 4. You have one or more immediate ordistant relatives who have/had breast, ovarian, uterine, or prostate cancer. Your risk: 1.5 in 17 Our Safti-Gr -LC.C. to your tub. 188 good housekeeping|October 1998 Things To Do "I feel fine." "My schedule is too hectic." 7:00 Tennis Staff Meeting 9:00 Colon Cancer Test "I'm only 50." 11:00 12:30 Dry Cleaning MAKE THE TIME TO GET 1:45 Lunch w/ Rita A TEST THAT COULD SAVE 3:00 Conference Call YOUR LIFE. Colon cancer is the second-leading cancer killer and every- one aged 50 and older is at risk. More than 50,000 Americans will die from colon cancer and 131,600 new cases will be diagnosed this year. Colon cancer is an equal-opportunity disease that affects both women and men. This silent killer frequently begins without symptoms and those with a family history are at even greater risk. THE GOOD NEWS IS: Colon cancer is preventable-even curable when detected early. In fact, if cancer is found early enough, the patient has more than a 90 percent chance of survival. Colon cancer screenings are safe and effective and are now covered by Medicare and an increasing number of other health providers. There's even a test that can be used in the privacy of your own home. Talk to your doctor about getting tested. "You can prevent colon cancer, even beat it." HILLARY RODHAM CLINTON NATIONAL olorectal Cancer ROUNDTABLE SPONSORED BY THE NATIONAL COLORECTAL CANCER ROUNDTABLE FOR MORE INFORMATION, CALL THE AMERICAN CANCER SOCIETY AT 1-800-ACS-2345 The National Colorectal Cancer Roundtable TV PSAs 1599 Clifton Road NE Atlanta, GA 30329-425₹ :60/:30/:15 NATIONAL olorectal "Hillary Rodham Clinton on Colon Cancer" ancer ROUNDTABLE MEMBERS OF THE NATIONAL Public Service Director: COLORECTAL CANCER ROUNDTABLE Dear having a disease that rarely in the produces United symptomsbutts Agency for Healthcare Policy & Research Imagine the most deadly cancer women and men risk. This Alliance of Community Health Plans cancer equal second frequency is a silent and killer everyone that Americans affects over will the age die diagnosed. from of 50 colorectal is at can- American Academy of Family Physicians year, more nearly than 131,600 50,000 new cases will be American Cancer Society American College of Gastroenterology cer and news is that colorectal cancer is preventable, and the dis- There even American College of Physicians American College of Radiology The curable ease good could when reduce detected the about death which rate we by can more make than this 50 percent. claim. col- American Digestive Health Foundation American Gastroenterological Association is First Colorectal orectal no Lady other cancer Hillary disease an urging everyone oublic Clinton has joined the information, deadly the age National about of 50 American Medical Association we to get need American Medical Women's Association American Society for Gastrointestinal Endoscopy screened. your As spreading disease this PSA and do as American Society of Colon and Rectal Surgeons Association of State & Territorial Directors of Health the frequently schedule benefits help in it as when of possible. screening. viewers 1 over THE a 50 are to Promotion & Public Health Education Centers for Disease Control & Prevention Collaborative Group of the Americas on Inherited Colorectal Cancer Sincerely, Digestive Diseases National Coalition Slamu Memorial Sloan-Kettering Cancer Center National Cancer Institute National Caucus & Center on Black Aged, Inc. Bernard Levin, National M.D. Colorectal Prevention Cancer Roundtable STOP Colorectal Cancer Foundation Chairman, President for Cancer Center University of Minnesota Cancer Center Vice M.D. Anderson Cancer University of Texas M.D. Anderson Cancer Center 1ST WOMAN: Okay, who's up for lunch? 2ND WOMAN: Oh yeah. It's just a colon 3RD WOMAN: I'm supposed to get screened 2ND WOMAN: Oh, sorry. I've got to take cancer test. too, but I don't have the time my husband to the doctor. 4TH WOMAN: But he's so young. 3RD WOMAN: Is everything okay? Only fifty-two. MAKE THE TIME TO get A TEST THAT COULD SAVE YOUR LIFE. Call the American Cancer Society 1-800-ACS-2345 ancer Hillary Rodham Clintom BOUNDTABLE HILLARY RODHAM CLINTON: Colon can- But you can beat it if it's detecred early. ANNCR: Call 1-800-ACS-2345. cer kills over 50,000 people a year and So if you're fifty or older please get tested. strikes women nearly as often as men. It can save your life. NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE Colorectal Cancer Public Service Announcements Featuring First Lady Hillary Rodham Clinton Founding Organizations: American Cancer Society WHAT: Television, print, and radio public service announcements (PSAs) Centers for Disease Control and Prevention on the importance of screening to prevent and detect colorectal cancer. Television and radio PSAs are available in :15, :30 and :60 Member Organizations: formats. The print PSA is available in a variety of dimensions. Agency for Healthcare Policy and Research Alliance of Community WHO: The PSAs feature First Lady Hillary Rodham Clinton urging all Health Plans Americans over the age of 50 to see their doctors about getting American Academy of Family Physicians screened for colorectal cancer. The PSAs are sponsored by the American College of National Colorectal Cancer Roundtable, a coalition of medical Gastroenterology professional, consumer advocacy, and voluntary organizations, American College of Physicians committed to raising awareness about the prevention and early American College of Radiology detection of colorectal cancer (see Roundtable fact sheet). American Digestive Health Foundation WHY: 50,000 Americans die every year from colorectal cancer, the American Gastroenterological Association second leading cancer killer, and the disease affects women nearly American Medical Association as often as men. Everyone aged 50 and older is at risk for American Medical developing colorectal cancer, and those with a family history are at Women's Association even greater risk. However, colorectal cancer is preventable, even American Society of Colon and Rectal Surgeons curable, when detected early. In fact, widespread screening for American Society for colorectal cancer could reduce the death rate by over 50 percent. Gastrointestinal Endoscopy There is no other disease about which we can make this claim. Association of State and Territorial Directors of Health Everyone 50 and older should see his or her doctor about getting Promotion and Public Health screened for colorectal cancer. Education Digestive Diseases National Coalition WHERE: The television PSAs will be available via satellite broadcast on the Collaborative Group of the following days: Americas on Inherited Colorectal Cancer Memorial Sloan-Kettering Thursday, September 10th Friday, September 11th Cancer Center 7:30pm to 7:45pm EDT 1:00pm to 1:15pm EDT National Cancer Institute Satellite GE1, Transponder 1 Satellite Telestar 4, Transponder 23 National Caucus and Center on Black Aged, Inc. Downlink 3720 Downlink 4160 STOP Colorectal Cancer Audio on 6.2 and 6.8 Audio on 6.2 and 6.8 Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center The PSAs will be widely distributed to television, radio and print public service directors across the country. A nationally distributed trade publication for television PSA directors will feature Mrs. Clinton's PSAs in the September issue, and the PSAs also will be distributed through the grassroots efforts of the member organizations of the National Colorectal Cancer Roundtable. For copies of the television, radio or print PSAs, contact Bill Goodwill at (703) 426-0881. ### NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE Roundtable Member Organization Launches Chat Room on Colorectal Cancer www.gastro.org/adhf.html Founding Organizations: American Cancer Society Centers for Disease Control and Prevention On September 10th, 1998, the American Digestive Health FoundationSM's (ADHFSM) Digestive Health Initiative (DHI) will debut its Internet chat Member Organizations: room on colorectal cancer. Located at www.gastro.org/adhf.html, this public Agency for Healthcare Policy and Research to public chat room will allow consumers, colorectal cancer patients, family Alliance of Community members, survivors, and people at high risk for developing the disease to Health Plans engage in live, real-time discussions of the many issues related to colorectal American Academy of Family Physicians cancer. At this same electronic location, the DHI also will offer a colorectal American College of cancer message board, on which participants can post questions, answers, Gastroenterology information about resources, and topics for discussion concerning this disease. American College of Physicians American College of Radiology In addition to the address above, the chat room can be accessed through the American Digestive home pages of the three ADHF member societies: Health Foundation American Gastroenterological Association American Gastroenterological Association: www.gastro.org American Medical Association American Society for Gastrointestinal Endoscopy: www.asge.org American Medical Women's Association American Association for the Study of Liver Diseases: American Society of Colon www.hepar-sfgh.ucsf.edu and Rectal Surgeons American Society for "Guest of the Month" Feature Gastrointestinal Endoscopy Each month, the DHI colorectal cancer chat room will feature a guest expert. Association of State and Territorial Directors of Health These guest experts, drawn from the medical, patient support, and cancer Promotion and Public Health Education survivor communities, will be scheduled to appear live in the chat room to Digestive Diseases discuss their personal and professional experiences with colorectal cancer. National Coalition Throughout the month, the guest experts will also respond to questions and Collaborative Group of the Americas on Inherited Colorectal topics of discussion posted on the message board. Cancer Memorial Sloan-Kettering Cancer Center September's live guest will be actress and colorectal cancer survivor Barbara National Cancer Institute Barrie, co-star of the NBC sitcom "Suddenly Susan" and author of the 1997 National Caucus and Center book Second Act: Life After Colostomy and Other Adventures. Ms. Barrie on Black Aged. Inc. will participate live in the chat room on September 11th from 1 p.m. to 2 p.m. STOP Colorectal Cancer EDT to discuss her personal experience and will respond to inquiries on the Foundation University of Minnesota message board during the month of September. Dr. Bernard Levin, vice Cancer Center president for Cancer Prevention at the M.D. Anderson Cancer Center in University of Texas Houston and chair of the National Colorectal Cancer Roundtable, also M.D. Anderson Cancer Center will be available during the last two weeks of September to respond to message board questions and comments. See the opening page of the chat room for information on future guest experts. The American Digestive Health Foundation is a cooperative effort of the American Gastroenterological Association, the American Society for Gastrointestinal Endoscopy, and the American Association for the Study of Liver Diseases. The ADHF promotes digestive health for all Americans by supporting educational initiatives and research into the causes, prevention, diagnosis, treatment and cure of digestive and liver diseases. The ADHF funds basic research, clinical research, and investigations into prevention strategies, and has established four interdependent initiatives to advance its digestive health agenda. ### * National Colorectal Cancer Roundtable member. c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE The National Colorectal Cancer Roundtable Founding Organizations: The National Colorectal Cancer Roundtable is a coalition of medical American Cancer Society professional, consumer advocacy and voluntary organizations, committed to Centers for Disease Control and Prevention raising awareness about the prevention and early detection of colorectal cancer. The Roundtable's ongoing mission is to reduce the incidence of and Member Organizations: mortality from this disease by achieving screening rates for colorectal cancer Agency for Healthcare Policy and Research that are equivalent to screening rates for other cancers (currently four out of Alliance of Community five people Health Plans American Academy of Family Physicians Colorectal cancer is the second leading cancer killer in the US, causing the American College of deaths of more than 50,000 Americans every year. Men and women over the Gastroenterology age of 50, and those with a family history of colorectal cancer, are most at risk American College of Physicians for developing this disease. American College of Radiology American Digestive Health Foundation To advance its major objectives, the Roundtable has set the following goals: American Gastroenterological Association Develop a national strategic plan for the early detection and control of American Medical Association colorectal cancer. American Medical Women's Association Advocate for key policy issues that will help reduce colorectal cancer American Society of Colon rates. and Rectal Surgeons Identify research needs and potential barriers to reducing colorectal cancer American Society for rates, and recommend solutions. Gastrointestinal Endoscopy Association of State and Develop and sustain partnerships to enhance efforts in the prevention and Territorial Directors of Health early detection of colorectal cancer. Promotion and Public Health Education Monitor progress in disease reduction efforts and participation in Digestive Diseases screening. National Coalition Collaborative Group of the Produce periodic reports on the current state of colorectal cancer control, Americas on Inherited Colorectal and progress towards national objectives. Cancer Memorial Sloan-Kettering Cancer Center For more information on the National Colorectal Cancer Roundtable, call Dr. National Cancer Institute Gabriel Feldman at the American Cancer Society, (404) 329-7504. National Caucus and Center on Black Aged, Inc. STOP Colorectal Cancer Foundation ### University of Minnesota Cancer Center * Breast and cervical cancers. University of Texas M.D. Anderson Cancer Center Member Organizations of the National Colorectal Cancer Roundtable Agency for Healthcare Policy and Research Alliance of Community Health Plans American Academy of Family Physicians American Cancer Society American College of Gastroenterology American College of Physicians American College of Radiology American Digestive Health FoundationSM American Gastroenterological Association American Medical Association American Medical Women's Association American Society of Colon and Rectal Surgeons American Society for Gastrointestinal Endoscopy Association of State and Territorial Directors of Health Promotion and Public Health Education Centers for Disease Control and Prevention Collaborative Group of the Americas on Inherited Colorectal Cancer Digestive Diseases National Coalition Memorial Sloan-Kettering Cancer Center National Cancer Institute National Caucus and Center on Black Aged, Inc. STOP Colorectal Cancer Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE National Colorectal Cancer Roundtable Private Industry Partnerships Promoting Awareness of Colorectal Cancer Prevention and Detection Founding Organizations: American Cancer Society The National Colorectal Cancer Roundtable, a coalition of medical Centers for Disease Control and Prevention professional, consumer advocacy and voluntary organizations, has developed partnerships with private industry to raise awareness of the importance of Member Organizations: colorectal cancer prevention and early detection. These national companies, Agency for Healthcare Policy and Research with their powerful reach, have committed to activities that will educate Alliance of Community hundreds of thousands of Americans over the age of 50 about the importance Health Plans of getting screened for colorectal cancer, the nation's second leading cancer American Academy of Family Physicians killer. American College of Gastroenterology American Airlines American College of Physicians American Airlines will publish First Lady Hillary Rodham Clinton's public American College of Radiology service announcement on colon cancer in its in-flight magazine, American American Digestive Health Foundation Way, reaching approximately two million air travelers in the US and around American Gastroenterological the world. In addition, American Airlines' in-house medical staff will provide Association free colorectal cancer screening cards to more than 200,000 American Medical Association employees, spouses and retirees. American Medical Women's Association American Society of Colon American Greetings Corporation / National Association of Chain Drugstores and Rectal Surgeons American Greetings will create a prescription insert reflecting National American Society for Colorectal Cancer Roundtable messages about prevention and early detection. Gastrointestinal Endoscopy The National Association of Chain Drugstores will distribute the insert to its Association of State and Territorial Directors of Health 30,000 chain pharmacies and 90,000 chain pharmacists. Beginning in early Promotion and Public Health Education 1999, individuals having prescriptions filled at participating drugstores and Digestive Diseases pharmacies will receive the insert in their prescription bags. National Coalition Collaborative Group of the Americas on Inherited Colorectal Beckman Coulter, Inc. / SmithKline Diagnostics, Inc. Cancer Beckman Coulter/SKD will publish First Lady Hillary Rodham Clinton's Memorial Sloan-Kettering public service announcement on colorectal cancer through the company Cancer Center intranet and in-house publication, Beckman Coulter Life, reaching more than National Cancer Institute National Caucus and Center 10,000 employees worldwide. SKD-trained representatives and an in-house on Black Aged, Inc. support staff of 50 will promote the message about screening for colorectal STOP Colorectal Cancer cancer by making themselves, and SKD's Basic Training TM Patient Education Foundation Program, available to National Colorectal Cancer Roundtable participants and University of Minnesota Cancer Center partners. University of Texas M.D. Anderson Cancer Center Bristol-Mvers Squibb Oncology / Better Health Foundation Bristol-Myers Squibb Oncology has provided an initial $100,000 grant to the Better Health Foundation to develop a colorectal cancer workplace awareness program that companies nationwide can adopt at no cost. Bristol-Myers Squibb Oncology will initiate the program at all of its work sites. Eli Lilly and Company Eli Lilly will conduct a new employee education campaign to increase awareness about the prevention of colon cancer through regular screenings. The campaign will reach more than 31,000 Lilly employees worldwide and their families using the public service materials developed by the National Colorectal Cancer Roundtable, as well as educational materials created by the company's employee health services department in cooperation with corporate communications. Lilly will inform employees through a number of venues, including publications and its in-house television network. General Motors Corporation General Motors will publish an article on the importance of colorectal cancer prevention and early detection in its newsletter, Feelin' Good, which is distributed to 1.5 million employees, retirees, and families. The article will encourage employees to access the audio-tapes General Motors has in its Audio Health Library on colorectal cancer risk factors, early detection guidelines, signs and symptoms, and treatment, and will encourage enrollees in the corporation's wellness program to discuss any colorectal cancer questions or symptoms with registered nurses available through a toll-free number. The article also will contain information on how readers can access General Motors' web site information on the prevention and early detection of colorectal cancer, and will encourage employees to read the information on the disease contained in their wellness program self-care manuals. Kellogg Company Kellogg will promote colorectal cancer prevention and early detection messages to a variety of audiences, including: consumers via five million packages of Kellogg's All Bran and Bran Buds; 5,000 hospital health care sites; 5,000 health care professionals; 500 retailers; and to its thousands of employees and retirees through its publication, The Kellogg News. In addition, Kellogg Company will provide in-store consumer education messages in 12,000 stores, as well as information on the Internet generating approximately five million "hits" per month. Olympus America Inc. Olympus America will sponsor and videotape a "Colorectal Cancer Education -What Everyone Needs to Know" program which will be open to employees, family members and the general public. Olympus will initiate a direct mailing to the administrators of retirement communities across the country, offering copies of the videotaped program at no cost, and will show the videotaped program at the five Olympus Service Center branches in Atlanta, Cleveland, Chicago, Dallas, and Long Beach. The program will be held at Olympus America headquarters in Melville, NY, or at a local medical university, and will be repeated at Olympus' repair and distribution facility in San Jose, CA. A panel of leading experts will speak about the problem of colorectal cancer, as well as solutions, including preventive measures, nutrition, and screening. The program will be promoted through a direct mail piece and internal Olympus Bulletin. Zeneca Pharmaceuticals Zeneca will offer to all employees over the age of 40 a new educational session on nutrition and its role in colorectal cancer, as well as a new session on the importance of screening women for colorectal cancer. In addition, a new work-site guide for detection/screening for colorectal cancer will be issued for customer use. ### NATIONAL olorectal Cancer ROUNDTABLE White House Event on New Efforts to Promote Colon Cancer Prevention September 10, 1998 PHOTOCOPY PRESERVATION NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE The Facts About Colorectal Cancer What is Colorectal Cancer? Founding Organizations: American Cancer Society Almost all cases of colorectal cancer, also referred to as colon cancer, Centers for Disease Control and Prevention begin with the development of benign colonic polyps. Polyps form when cells lining the colon grow, divide and reproduce in an Member Organizations: unhealthy, disorderly way, producing a growth. Agency for Healthcare Policy and Research These polyps can be cancerous, invading the colon wall and surrounding Alliance of Community blood vessels, and spreading to other parts of the body. Health Plans American Academy of Colorectal cancer frequently begins without symptoms. Family Physicians American College of What Causes Colorectal Cancer? Gastroenterology American College of Physicians The exact causes of colorectal cancer are unknown, but the disease American College of Radiology appears to be caused by both inherited and lifestyle factors. American Digestive Health Foundation Diets high in fat and low in fruits and vegetables - such as those that American Gastroenterological include red meat, fried foods and high-fat dairy products - may increase Association the risk of colorectal cancer. American Medical Association Lifestyle factors -such as cigarette smoking, a sedentary lifestyle, and American Medical Women's Association obesity - also may increase the risk of developing the disease. American Society of Colon Genetic factors may determine a person's susceptibility to the disease, and Rectal Surgeons whereas dietary and other lifestyle factors may determine which at-risk American Society for Gastrointestinal Endoscopy individuals actually go on to develop the disease. Association of State and Territorial Directors of Health How Common is Colorectal Cancer? Promotion and Public Health Education Digestive Diseases National Coalition Colorectal cancer is the second leading cancer killer in the United States, and the third most common cancer overall. Collaborative Group of the Americas on Inherited Colorectal Cancer This year, more than 50,000 Americans will die from colorectal cancer Memorial Sloan-Kettering and approximately 131,600 new cases will be diagnosed. Cancer Center Eighty to 90 million Americans (approximately 25 percent of the US National Cancer Institute population) are considered at risk because of age or other factors. National Caucus and Center on Black Aged. Inc. More women over the age of 75 die from colorectal cancer than from STOP Colorectal Cancer breast cancer. Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center Who Is At Risk? Men and women aged 50 and older are at almost equal risk of developing colorectal cancer. Those who have a personal or family history of colorectal neoplasia (cancer or polyps) are at high risk of developing the disease. Anyone who has a personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn's disease, is also at high risk. Although the incidence of colorectal cancer appears to be the same among all racial groups, survival rates seem to be lower for African-Americans. How Can You Prevent Colorectal Cancer? Know your family history. See your doctor for yearly screenings if you are aged 50 or older. Maintain a diet low in animal fat and high in fruits, vegetables and fiber. Exercise regularly. Prevent obesity. Avoid cigarette smoking. What You Need To Know ... Early detection saves lives - colorectal cancer is preventable, even curable when detected early. If colorectal cancer is found early enough, the patient has more than a 90 percent chance of survival. Colorectal cancer screenings are safe and effective and are now covered by Medicare and an increasing number of other health providers. Several screening methods can be used to detect polyps before they become cancerous, such as fecal occult blood test, colonoscopy, flexible sigmoidoscopy and barium x-ray. These tests also can detect cancer in its early stages. ### NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE FOR IMMEDIATE RELEASE Contact: Carole Anikis (301) 941-2626 Founding Organizations: American Cancer Society HILLARY RODHAM CLINTON HOSTS WHITE HOUSE EVENT TO Centers for Disease Control and Prevention PROMOTE PREVENTION, EARLY DETECTION OF COLORECTAL CANCER Member Organizations: Agency for Healthcare Policy and Research First Lady Joins National Colorectal Cancer Roundtable In Urging Alliance of Community Americans Over 50 to Get Tested Health Plans American Academy of Family Physicians American College of WASHINGTON, DC (September 10, 1998) - Today at the White House, First Gastroenterology Lady Hillary Rodham Clinton announced her support for raising awareness of American College of Physicians colorectal cancer and unveiled new efforts to promote the prevention and American College of Radiology early detection of the disease. Joining Mrs. Clinton at the event were American Digestive Health Foundation Secretary of the Department of Health and Human Services Donna Shalala, American Gastroenterological co-anchor of NBC's "Today" show Katie Couric, National Colorectal Cancer Association Roundtable Chair Bernard Levin, MD, and Good Housekeeping Editor-in- American Medical Association Chief Ellen Levine. More than 50,000 Americans die each year from American Medical Women's Association colorectal cancer, which is preventable and even curable when detected early. American Society of Colon Men and women over the age of 50 are at risk for developing this disease. and Rectal Surgeons American Society for In urging age 50 and older Americans to be screened for colorectal cancer, Gastrointestinal Endoscopy Mrs. Clinton said, "You can prevent colon cancer, even beat it. In fact, if Association of State and Territorial Directors of Health cancer is found early enough, the patient has more than a 90 percent chance of Promotion and Public Health Education survival." Dr. Levin, echoing Mrs. Clinton's comments, said, "widespread Digestive Diseases screening for colorectal cancer could reduce the death rate from this killer by National Coalition over 50 percent. There is no other disease about which we can make this Collaborative Group of the claim." Americas on Inherited Colorectal Cancer Memorial Sloan-Kettering To underscore their efforts, Mrs. Clinton, who at the event was made Cancer Center Honorary Chair of the National Colorectal Cancer Roundtable, unveiled National Cancer Institute National Caucus and Center survey results and several new initiatives to help spread the word about the on Black Aged. Inc. importance of colorectal cancer prevention and early detection. STOP Colorectal Cancer Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center Results of National Survey Results of a national colorectal cancer awareness survey, commissioned by the Roundtable (a coalition of medical professional, consumer advocacy, and voluntary organizations) and conducted by the Gallup Organization, were released at the White House event (see news release on survey results). The survey found that nearly 50 percent of people over age 50 - the age group considered at highest risk for developing colorectal cancer - - have never been screened for the disease. Of those people, most reported that no medical professional had ever recommended a screening test for colorectal cancer. Public Service Announcements Dr. Levin unveiled a new public service announcement (PSA) campaign, sponsored by the Roundtable and featuring the First Lady. In the television, print, and radio PSAs, shown during the event, Mrs. Clinton urges all Americans over the age of 50 to be screened for colorectal cancer, a test that could save their lives. The print PSA will appear in the January issue of Good Housekeeping. The PSAs will be distributed nationally via satellite broadcast and mailings to public service directors across the country. The PSAs also will receive additional distribution and visibility through the grassroots efforts of the National Colorectal Cancer Roundtable members (see Roundtable fact sheet for list of members). Colorectal Cancer Chat Room As a member of the Roundtable, the American Digestive Health FoundationˢM's Digestive Health Initiative debuted its Internet chat room on colorectal cancer located at www.gastro.org/adhf.html. This public to public chat room will allow consumers, colorectal cancer patients, family members, survivors, and people at high risk for the disease to engage in live, real time discussions of the many issues related to colorectal cancer. Each month, the chat room will feature a guest expert, beginning with actress and colorectal cancer survivor Barbara Barrie, co-star of the NBC sitcom "Suddenly Susan" and author of the 1997 book Second Act: Life After Colostomy and Other Adventures. On September 11th, from 1 p.m. - 2 p.m. EDT, Ms. Barrie will appear in the chat room live to discuss her personal experience as a colorectal cancer survivor. In addition, Ms. Barrie will respond to questions posted on the chat room's message board during the month of September. Private Sector Partnerships In its efforts to spread the word about the importance of colorectal cancer prevention and early detection, the Roundtable sought and secured partnerships with members of private industry, which were announced at the White House event. In her remarks, Mrs. Clinton recognized the following companies for the activities they will undertake to raise awareness about the importance of colon cancer prevention and screening among their employees and customers (see Private Sector Partnerships fact sheet for details on individual company activities): American Airlines American Greetings Corporation / National Association of Chain Drugstores Beckman Coulter, Inc. / SmithKline Diagnostics, Inc. Bristol Myers Squibb Oncology / Better Health Foundation Eli Lilly and Company General Motors Corporation Kellogg Company National Association of Chain Drugstores Olympus America Inc. Zeneca Pharmaceuticals ### c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE FOR IMMEDIATE RELEASE Contact: Carole Anikis (301) 941-2626 Founding Organizations: American Cancer Society SURVEY SHOWS NEARLY HALF OF AMERICANS AT RISK FOR Centers for Disease Control and Prevention COLON CANCER ARE NOT BEING SCREENED Member Organizations Large Number Report That Physicians Are Not Recommending Tests Agency for Healthcare Policy and Research Alliance of Community WASHINGTON, DC (September 10, 1998) - Survey results released today at Health Plans a White House event on new efforts to promote colorectal cancer prevention American Academy of Family Physicians reveal that nearly half of all adults aged 50 and older -the age group American College of considered at highest risk for developing colorectal cancer -have not been Gastroenterology screened for the disease. The White House event was hosted by First Lady American College of Physicians Hillary Rodham Clinton, who announced her support for raising awareness of American College of Radiology colorectal cancer and unveiled new efforts to promote the prevention and American Digestive Health Foundation early detection of the disease. Colorectal cancer, also known as colon cancer, American Gastroenterological kills more than 50,000 Americans each year, even though it is preventable and Association curable when detected early. American Medical Association American Medical Women's Association The survey, conducted for the National Colorectal Cancer Roundtable by the American Society of Colon Gallup Organization, underscores the need for new national initiatives and Rectal Surgeons promoting colorectal cancer prevention and early detection. One of the most American Society for alarming findings is that most of the 47 percent of people over 50 not being Gastrointestinal Endoscopy screened for colorectal cancer reported that no medical professional had ever Association of State and Territorial Directors of Health recommended screening. Promotion and Public Health Education Digestive Diseases "Physicians must make testing for colorectal cancer a part of their medical National Coalition practices," said Roundtable Chair Bernard Levin, MD, vice president for Collaborative Group of the Cancer Prevention at the M.D. Anderson Cancer Center in Houston. "I have Americas on Inherited Colorectal Cancer spent too much of my professional career delivering bad news to people Memorial Sloan-Kettering whose lives and health could have been saved if they had been screened for Cancer Center National Cancer Institute this preventable disease." National Caucus and Center on Black Aged, Inc. Although colorectal cancer occurs with almost equal frequency in men and STOP Colorectal Cancer women, the survey found that women aged 50 and older are less likely than Foundation men in this same age group to undergo screening (49 percent of women University of Minnesota Cancer Center reported not having been screened versus 36 percent of men). Dramatic University of Texas differences were also seen between whites and non-whites. Among survey M.D. Anderson Cancer Center respondents, 44 percent of whites reported not having had any of the three tests - fecal occult blood tests, flexible sigmoidoscopy, barium x-ray - compared to 56 percent of non-whites. The majority of adults surveyed seem to believe that early detection can save lives; however, when asked what they could do to help prevent colorectal cancer, fewer than half cited regular screening tests. Even fewer mentioned dietary changes, such as eating a high-fiber diet (21 percent), or general references to diet (20 percent). A sizable minority (22 percent) could not name anything a person might do to help prevent colorectal cancer. Asked to estimate their own chances for developing colorectal cancer, one in five adults (20 percent) believe they are very likely to develop cancer of the colon or rectum. Another 35 percent say it is somewhat likely they will develop the disease. A small proportion - one percent - reported they already have colon or rectal cancer. Sixteen percent could not estimate their chances of getting colorectal cancer. The Gallup Organization conducted telephone interviews from August 11 through August 23, 1998, with a national sample of 1,062 adults aged 50 or older, to examine the knowledge and experience of adults with testing for colorectal cancer. ### The National Colorectal Cancer Roundtable is a coalition of medical professional, consumer advocacy, and voluntary organizations committed to raising awareness about the prevention and early detection of colorectal cancer. BERNARD LEVIN, MD Gastroenterologist Bernard Levin, MD, currently is professor of medicine and vice president for cancer prevention at University of Texas M.D. Anderson Cancer Center in Houston, Texas. Prior to his fourteen years at M.D. Anderson, Dr. Levin was associate professor of medicine and attending physician at University of Chicago Hospital and Clinics. For the American Digestive Health Foundation (ADHFSM), Dr. Levin serves as co-chair of the Digestive Health Initiative Colorectal Cancer Education Campaign. He also is chair of the American Cancer Society's National Advisory Task Force on Colorectal Cancer and recently was appointed as chair of the National Colorectal Cancer Roundtable. Affiliated with a number of professional organizations, Dr. Levin is a member of the American Gastroenterological Association and a fellow of the American College of Physicians. He participates as a consultant to the National Cancer Institute. Dr. Levin has written extensively for distinguished medical publications including Journal of the National Cancer Institute, Gastroenterology, the International Journal of Cancer, Cancer and Science. A graduate of the University of Witwatersrand in Johannesburg, South Africa, Dr. Levin completed fellowships in gastroenterology and biochemistry in pathology at the University of Chicago. Things To Do "I feel fine." "My schedule is too hectic." 7:00 Tennis Staff Meeting 9:00 Colon Cancer Test "I'm only 50." 11:00 12:30 Dry Cleaning Rita MAKE THE TIME TO GET 1:45 Lunch w/ A TEST THAT COULD SAVE 3:00 Conference Call YOUR LIFE. Colon cancer is the second-leading cancer killer and every- one aged 50 and older is at risk. More than 50,000 Americans will die from colon cancer and 131,600 new cases will be diagnosed this year. Colon cancer is an equal-opportunity disease that affects both women and men. This silent killer frequently begins without symptoms and those with a family history are at even greater risk. THE GOOD NEWS IS: Colon cancer is preventable-even curable when detected early. In fact, if cancer is found early enough, the patient has more than a 90 percent chance of survival. Colon cancer screenings are safe and effective and are now covered by Medicare and an increasing number of other health providers. There's even a test that can be used in the privacy of your own home. Talk to your doctor about getting tested. "You can prevent colon cancer, even beat it." HILLARY RODHAM CLINTON NATIONAL olorectal Cancer ROUNDTABLE SPONSORED BY THE NATIONAL COLORECTAL CANCER ROUNDTABLE FOR MORE INFORMATION, CALL THE AMERICAN CANCER Society AT 1-800-ACS-2345 The National Colorectal Cancer Roundtable TV PSAs NATIONAL 1599 Clifton Road NE Atlanta. GA 30329-4251 :60/:30/:15 olorectal "Hillary Rodham Clinton on Colon Cancer" ancer ROUNDTABLE MEMBERS OF THE NATIONAL Public Service Director: COLORECTAL CANCER ROUNDTABLE Dear having a disease that rarely in the produces United symptoms but is symptoms buttal Agency for Healthcare Policy & Research Imagine the cancer equal second frequency is a most silent deadly and killer everyone that cancer Americans affects over women will the age die and diagnosed. from of 50 men colorectal is at risk. This can- Alliance of Community Health Plans American Academy of Family Physicians year, more nearly than 131,600 50,000 new cases will be American Cancer Society American College of Gastroenterology cer and news is that colorectal cancer is preventable, and the dis- There even American College of Physicians The curable ease good could when reduce disease detected the about death which rate we by can more make than this 50 percent. claim. American College of Radiology American Digestive Health Foundation American Gastroenterological Association is First Colorectal orectal screened. no Lady other cancer Hillary As an and urging everyone oublic the Clinton has joined the information, deadly the age National air disease about of this 50 we PSA to col- and get need as American Medical Association American Medical Women's Association American Society for Gastrointestinal Endoscopy American Society of Colon and Rectal Surgeons Association of State & Territorial Directors of Health your the frequently schedule benefits help in it as when of spreading possible. screening. viewers 1 We over 50 are do to Promotion & Public Health Education Centers for Disease Control & Prevention Collaborative Group of the Americas on Inherited Colorectal Cancer Sincerely, Digestive Diseases National Coalition Slamin Memorial Sloan-Kettering Cancer Center National Cancer Institute National Caucus & Center on Black Aged, Inc. Bernard Levin, National M.D. Colorectal Prevention Cancer Roundtable STOP Colorectal Cancer Foundation Chairman, President for Cancer Center University of Minnesota Cancer Center Vice M.D. Anderson Cancer University of Texas M.D. Anderson Cancer Center 1ST WOMAN: Okay, who's up for lunch? 2ND WOMAN: Oh yeah. It's just a colon 3RD WOMAN: I'm supposed to get screened 2ND WOMAN: Oh, sorry. I've got to take cancer test. too, but I don't have the time. my husband to the doctor. 4TH WOMAN: But he's SO young. 3RD WOMAN: Is everything okay? Only fifty-two. MAKE THE TIME TO get A TEST THAT COULD SAVE YOUR LIFE. Call the American Cancer Society 1-800-ACS-2345 ancer Hillary Rodham Clinton SOUNDTABLE HILLARY RODHAM CLINTON: Colon can- But you can beat it if it's detected early. ANNCR: Call 1-800-ACS-2345. cer kills over 50,000 people a year and So if you're fifty or older please get tested. strikes women nearly as often as men. It can save your life. NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE Colorectal Cancer Public Service Announcements Featuring First Lady Hillary Rodham Clinton Founding Organizations: American Cancer Society WHAT: Television, print, and radio public service announcements (PSAs) Centers for Disease Control and Prevention on the importance of screening to prevent and detect colorectal cancer. Television and radio PSAs are available in :15, :30 and :60 Member Organizations: formats. The print PSA is available in a variety of dimensions. Agency for Healthcare Policy and Research Alliance of Community WHO: The PSAs feature First Lady Hillary Rodham Clinton urging all Health Plans Americans over the age of 50 to see their doctors about getting American Academy of Family Physicians screened for colorectal cancer. The PSAs are sponsored by the American College of National Colorectal Cancer Roundtable, a coalition of medical Gastroenterology professional, consumer advocacy, and voluntary organizations, American College of Physicians committed to raising awareness about the prevention and early American College of Radiology detection of colorectal cancer (see Roundtable fact sheet). American Digestive Health Foundation WHY: 50,000 Americans die every year from colorectal cancer, the American Gastroenterological Association second leading cancer killer, and the disease affects women nearly American Medical Association as often as men. Everyone aged 50 and older is at risk for American Medical developing colorectal cancer, and those with a family history are at Women's Association even greater risk. However, colorectal cancer is preventable, even American Society of Colon and Rectal Surgeons curable, when detected early. In fact, widespread screening for American Society for colorectal cancer could reduce the death rate by over 50 percent. Gastrointestinal Endoscopy There is no other disease about which we can make this claim. Association of State and Territorial Directors of Health Everyone 50 and older should see his or her doctor about getting Promotion and Public Health screened for colorectal cancer. Education Digestive Diseases National Coalition WHERE: The television PSAs will be available via satellite broadcast on the Collaborative Group of the following days: Americas on Inherited Colorectal Cancer Memorial Sloan-Kettering Thursday, September 10th Friday, September 11th Cancer Center 7:30pm to 7:45pm EDT 1:00pm to 1:15pm EDT National Cancer Institute Satellite GE1, Transponder 1 Satellite Telestar 4, Transponder 23 National Caucus and Center on Black Aged. Inc. Downlink 3720 Downlink 4160 STOP Colorectal Cancer Audio on 6.2 and 6.8 Audio on 6.2 and 6.8 Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center The PSAs will be widely distributed to television, radio and print public service directors across the country. A nationally distributed trade publication for television PSA directors will feature Mrs. Clinton's PSAs in the September issue, and the PSAs also will be distributed through the grassroots efforts of the member organizations of the National Colorectal Cancer Roundtable. For copies of the television, radio or print PSAs, contact Bill Goodwill at (703) 426-0881. ### NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE Roundtable Member Organization Launches Chat Room on Colorectal Cancer www.gastro.org/adhf.html Founding Organizations: American Cancer Society Centers for Disease Control and Prevention On September 10th, 1998, the American Digestive Health FoundationSM's (ADHFSM) Digestive Health Initiative® (DHI®) will debut its Internet chat Member Organizations: room on colorectal cancer. Located at www.gastro.org/adhf.html, this public Agency for Healthcare Policy and Research to public chat room will allow consumers, colorectal cancer patients, family Alliance of Community members, survivors, and people at high risk for developing the disease to Health Plans engage in live, real-time discussions of the many issues related to colorectal American Academy of Family Physicians cancer. At this same electronic location, the DHI also will offer a colorectal American College of cancer message board, on which participants can post questions, answers, Gastroenterology information about resources, and topics for discussion concerning this disease. American College of Physicians American College of Radiology In addition to the address above, the chat room can be accessed through the American Digestive home pages of the three ADHF member societies: Health Foundation American Gastroenterological Association American Gastroenterological Association: www.gastro.org American Medical Association American Society for Gastrointestinal Endoscopy: www.asge.org American Medical Women's Association American Association for the Study of Liver Diseases: American Society of Colon www.hepar-sfgh.ucsf.edu and Rectal Surgeons American Society for "Guest of the Month" Feature Gastrointestinal Endoscopy Each month, the DHI colorectal cancer chat room will feature a guest expert. Association of State and Territorial Directors of Health These guest experts, drawn from the medical, patient support, and cancer Promotion and Public Health Education survivor communities, will be scheduled to appear live in the chat room to Digestive Diseases discuss their personal and professional experiences with colorectal cancer. National Coalition Throughout the month, the guest experts will also respond to questions and Collaborative Group of the Americas on Inherited Colorectal topics of discussion posted on the message board. Cancer Memorial Sloan-Kettering Cancer Center September's live guest will be actress and colorectal cancer survivor Barbara National Cancer Institute Barrie, co-star of the NBC sitcom "Suddenly Susan" and author of the 1997 National Caucus and Center book Second Act: Life After Colostomy and Other Adventures. Ms. Barrie on Black Aged, Inc. will participate live in the chat room on September 11th from 1 p.m. to 2 p.m. STOP Colorectal Cancer EDT to discuss her personal experience and will respond to inquiries on the Foundation University of Minnesota message board during the month of September. Dr. Bernard Levin, vice Cancer Center president for Cancer Prevention at the M.D. Anderson Cancer Center in University of Texas Houston and chair of the National Colorectal Cancer Roundtable, also M.D. Anderson Cancer Center will be available during the last two weeks of September to respond to message board questions and comments. See the opening page of the chat room for information on future guest experts. The American Digestive Health Foundation is a cooperative effort of the American Gastroenterological Association, the American Society for Gastrointestinal Endoscopy, and the American Association for the Study of Liver Diseases. The ADHF promotes digestive health for all Americans by supporting educational initiatives and research into the causes, prevention, diagnosis, treatment and cure of digestive and liver diseases. The ADHF funds basic research, clinical research, and investigations into prevention strategies, and has established four interdependent initiatives to advance its digestive health agenda. ### * National Colorectal Cancer Roundtable member. NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE The National Colorectal Cancer Roundtable Founding Organizations: The National Colorectal Cancer Roundtable is a coalition of medical American Cancer Society professional, consumer advocacy and voluntary organizations, committed to Centers for Disease Control and Prevention raising awareness about the prevention and early detection of colorectal cancer. The Roundtable's ongoing mission is to reduce the incidence of and Member Organizations mortality from this disease by achieving screening rates for colorectal cancer Agency for Healthcare Policy and Research that are equivalent to screening rates for other cancers (currently four out of Alliance of Community five people* Health Plans American Academy of Family Physicians Colorectal cancer is the second leading cancer killer in the US, causing the American College of deaths of more than 50,000 Americans every year. Men and women over the Gastroenterology age of 50, and those with a family history of colorectal cancer, are most at risk American College of Physicians for developing this disease. American College of Radiology American Digestive Health Foundation To advance its major objectives, the Roundtable has set the following goals: American Gastroenterological Association Develop a national strategic plan for the early detection and control of American Medical Association colorectal cancer. American Medical Women's Association Advocate for key policy issues that will help reduce colorectal cancer American Society of Colon rates. and Rectal Surgeons Identify research needs and potential barriers to reducing colorectal cancer American Society for rates, and recommend solutions. Gastrointestinal Endoscopy Association of State and Develop and sustain partnerships to enhance efforts in the prevention and Territorial Directors of Health early detection of colorectal cancer. Promotion and Public Health Education Monitor progress in disease reduction efforts and participation in Digestive Diseases screening. National Coalition Collaborative Group of the Produce periodic reports on the current state of colorectal cancer control, Americas on Inherited Colorectal and progress towards national objectives. Cancer Memorial Sloan-Kettering Cancer Center For more information on the National Colorectal Cancer Roundtable, call Dr. National Cancer Institute Gabriel Feldman at the American Cancer Society, (404) 329-7504. National Caucus and Center on Black Aged. Inc. STOP Colorectal Cancer Foundation ### University of Minnesota Cancer Center * Breast and cervical cancers. University of Texas M.D. Anderson Cancer Center Member Organizations of the National Colorectal Cancer Roundtable Agency for Healthcare Policy and Research Alliance of Community Health Plans American Academy of Family Physicians American Cancer Society American College of Gastroenterology American College of Physicians American College of Radiology American Digestive Health Foundation SM American Gastroenterological Association American Medical Association American Medical Women's Association American Society of Colon and Rectal Surgeons American Society for Gastrointestinal Endoscopy Association of State and Territorial Directors of Health Promotion and Public Health Education Centers for Disease Control and Prevention Collaborative Group of the Americas on Inherited Colorectal Cancer Digestive Diseases National Coalition Memorial Sloan-Kettering Cancer Center National Cancer Institute National Caucus and Center on Black Aged, Inc. STOP Colorectal Cancer Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE National Colorectal Cancer Roundtable Private Industry Partnerships Promoting Awareness of Colorectal Cancer Prevention and Detection Founding Organizations: American Cancer Society The National Colorectal Cancer Roundtable, a coalition of medical Centers for Disease Control and Prevention professional, consumer advocacy and voluntary organizations, has developed partnerships with private industry to raise awareness of the importance of Member Organizations: colorectal cancer prevention and early detection. These national companies, Agency for Healthcare Policy and Research with their powerful reach, have committed to activities that will educate Alliance of Community hundreds of thousands of Americans over the age of 50 about the importance Health Plans of getting screened for colorectal cancer, the nation's second leading cancer American Academy of Family Physicians killer. American College of Gastroenterology American Airlines American College of Physicians American Airlines will publish First Lady Hillary Rodham Clinton's public American College of Radiology service announcement on colon cancer in its in-flight magazine, American American Digestive Health Foundation Way, reaching approximately two million air travelers in the US and around American Gastroenterological the world. In addition, American Airlines' in-house medical staff will provide Association free colorectal cancer screening cards to more than 200,000 American Medical Association employees, spouses and retirees. American Medical Women's Association American Society of Colon American Greetings Corporation / National Association of Chain Drugstores and Rectal Surgeons American Greetings will create a prescription insert reflecting National American Society for Colorectal Cancer Roundtable messages about prevention and early detection. Gastrointestinal Endoscopy The National Association of Chain Drugstores will distribute the insert to its Association of State and Territorial Directors of Health 30,000 chain pharmacies and 90,000 chain pharmacists. Beginning in early Promotion and Public Health Education 1999, individuals having prescriptions filled at participating drugstores and Digestive Diseases pharmacies will receive the insert in their prescription bags. National Coalition Collaborative Group of the Americas on Inherited Colorectal Beckman Coulter, Inc. / SmithKline Diagnostics. Inc. Cancer Beckman Coulter/SKD will publish First Lady Hillary Rodham Clinton's Memorial Sloan-Kettering public service announcement on colorectal cancer through the company Cancer Center intranet and in-house publication, Beckman Coulter Life, reaching more than National Cancer Institute National Caucus and Center 10,000 employees worldwide. SKD-trained representatives and an in-house on Black Aged. Inc. support staff of 50 will promote the message about screening for colorectal STOP Colorectal Cancer cancer by making themselves, and SKD's Basic Training TM Patient Education Foundation Program, available to National Colorectal Cancer Roundtable participants and University of Minnesota Cancer Center partners. University of Texas M.D. Anderson Cancer Center Bristol-Myers Squibb Oncology / Better Health Foundation Bristol-Myers Squibb Oncology has provided an initial $100,000 grant to the Better Health Foundation to develop a colorectal cancer workplace awareness program that companies nationwide can adopt at no cost. Bristol-Myers Squibb Oncology will initiate the program at all of its work sites. Eli Lilly and Company Eli Lilly will conduct a new employee education campaign to increase awareness about the prevention of colon cancer through regular screenings. The campaign will reach more than 31,000 Lilly employees worldwide and their families using the public service materials developed by the National Colorectal Cancer Roundtable, as well as educational materials created by the company's employee health services department in cooperation with corporate communications. Lilly will inform employees through a number of venues, including publications and its in-house television network. General Motors Corporation General Motors will publish an article on the importance of colorectal cancer prevention and early detection in its newsletter, Feelin' Good, which is distributed to 1.5 million employees, retirees, and families. The article will encourage employees to access the audio-tapes General Motors has in its Audio Health Library on colorectal cancer risk factors, early detection guidelines, signs and symptoms, and treatment, and will encourage enrollees in the corporation's wellness program to discuss any colorectal cancer questions or symptoms with registered nurses available through a toll-free number. The article also will contain information on how readers can access General Motors' web site information on the prevention and early detection of colorectal cancer, and will encourage employees to read the information on the disease contained in their wellness program self-care manuals. Kellogg Company Kellogg will promote colorectal cancer prevention and early detection messages to a variety of audiences, including: consumers via five million packages of Kellogg's All Bran and Bran Buds; 5,000 hospital health care sites; 5,000 health care professionals; 500 retailers; and to its thousands of employees and retirees through its publication, The Kellogg News. In addition, Kellogg Company will provide in-store consumer education messages in 12,000 stores, as well as information on the Internet generating approximately five million "hits" per month. Olympus America Inc. Olympus America will sponsor and videotape a "Colorectal Cancer Education -What Everyone Needs to Know" program which will be open to employees, family members and the general public. Olympus will initiate a direct mailing to the administrators of retirement communities across the country, offering copies of the videotaped program at no cost, and will show the videotaped program at the five Olympus Service Center branches in Atlanta, Cleveland, Chicago, Dallas, and Long Beach. The program will be held at Olympus America headquarters in Melville, NY, or at a local medical university, and will be repeated at Olympus' repair and distribution facility in San Jose, CA. A panel of leading experts will speak about the problem of colorectal cancer, as well as solutions, including preventive measures, nutrition, and screening. The program will be promoted through a direct mail piece and internal Olympus Bulletin. Zeneca Pharmaceuticals Zeneca will offer to all employees over the age of 40 a new educational session on nutrition and its role in colorectal cancer, as well as a new session on the importance of screening women for colorectal cancer. In addition, a new work-site guide for detection/screening for colorectal cancer will be issued for customer use. ### NATIONAL olorectal Cancer ROUNDTABLE White House Event on New Efforts to Promote Colon Cancer Prevention September 10, 1998 PHOTOCOPY PRESERVATION NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE FOR IMMEDIATE RELEASE Contact: Carole Anikis (301) 941-2626 Founding Organizations: American Cancer Society HILLARY RODHAM CLINTON HOSTS WHITE HOUSE EVENT TO Centers for Disease Control and Prevention PROMOTE PREVENTION, EARLY DETECTION OF COLORECTAL CANCER Member Organizations: Agency for Healthcare Policy and Research First Lady Joins National Colorectal Cancer Roundtable In Urging Alliance of Community Americans Over 50 to Get Tested Health Plans American Academy of Family Physicians American College of WASHINGTON, DC (September 10, 1998) - Today at the White House, First Gastroenterology Lady Hillary Rodham Clinton announced her support for raising awareness of American College of Physicians colorectal cancer and unveiled new efforts to promote the prevention and American College of Radiology early detection of the disease. Joining Mrs. Clinton at the event were American Digestive Health Foundation Secretary of the Department of Health and Human Services Donna Shalala, American Gastroenterological co-anchor of NBC's "Today" show Katie Couric, National Colorectal Cancer Association Roundtable Chair Bernard Levin, MD, and Good Housekeeping Editor-in- American Medical Association Chief Ellen Levine. More than 50,000 Americans die each year from American Medical Women's Association colorectal cancer, which is preventable and even curable when detected early. American Society of Colon Men and women over the age of 50 are at risk for developing this disease. and Rectal Surgeons American Society for In urging age 50 and older Americans to be screened for colorectal cancer, Gastrointestinal Endoscopy Mrs. Clinton said, "You can prevent colon cancer, even beat it. In fact, if Association of State and Territorial Directors of Health cancer is found early enough, the patient has more than a 90 percent chance of Promotion and Public Health Education survival." Dr. Levin, echoing Mrs. Clinton's comments, said, "widespread Digestive Diseases screening for colorectal cancer could reduce the death rate from this killer by National Coalition over 50 percent. There is no other disease about which we can make this Collaborative Group of the claim." Americas on Inherited Colorectal Cancer Memorial Sloan-Kettering To underscore their efforts, Mrs. Clinton, who at the event was made Cancer Center Honorary Chair of the National Colorectal Cancer Roundtable, unveiled National Cancer Institute National Caucus and Center survey results and several new initiatives to help spread the word about the on Black Aged. Inc. importance of colorectal cancer prevention and early detection. STOP Colorectal Cancer Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center Results of National Survey Results of a national colorectal cancer awareness survey, commissioned by the Roundtable (a coalition of medical professional, consumer advocacy, and voluntary organizations) and conducted by the Gallup Organization, were released at the White House event (see news release on survey results). The survey found that nearly 50 percent of people over age 50 - the age group considered at highest risk for developing colorectal cancer - have never been screened for the disease. Of those people, most reported that no medical professional had ever recommended a screening test for colorectal cancer. Public Service Announcements Dr. Levin unveiled a new public service announcement (PSA) campaign, sponsored by the Roundtable and featuring the First Lady. In the television, print, and radio PSAs, shown during the event, Mrs. Clinton urges all Americans over the age of 50 to be screened for colorectal cancer, a test that could save their lives. The print PSA will appear in the January issue of Good Housekeeping. The PSAs will be distributed nationally via satellite broadcast and mailings to public service directors across the country. The PSAs also will receive additional distribution and visibility through the grassroots efforts of the National Colorectal Cancer Roundtable members (see Roundtable fact sheet for list of members). Colorectal Cancer Chat Room As a member of the Roundtable, the American Digestive Health FoundationSM, Digestive Health Initiative debuted its Internet chat room on colorectal cancer located at www.gastro.org/adhf.html. This public to public chat room will allow consumers, colorectal cancer patients, family members, survivors, and people at high risk for the disease to engage in live, real time discussions of the many issues related to colorectal cancer. Each month, the chat room will feature a guest expert, beginning with actress and colorectal cancer survivor Barbara Barrie, co-star of the NBC sitcom "Suddenly Susan" and author of the 1997 book Second Act: Life After Colostomy and Other Adventures. On September 11th, from 1 p.m. - 2 p.m. EDT, Ms. Barrie will appear in the chat room live to discuss her personal experience as a colorectal cancer survivor. In addition, Ms. Barrie will respond to questions posted on the chat room's message board during the month of September. Private Sector Partnerships In its efforts to spread the word about the importance of colorectal cancer prevention and early detection, the Roundtable sought and secured partnerships with members of private industry, which were announced at the White House event. In her remarks, Mrs. Clinton recognized the following companies for the activities they will undertake to raise awareness about the importance of colon cancer prevention and screening among their employees and customers (see Private Sector Partnerships fact sheet for details on individual company activities): American Airlines American Greetings Corporation / National Association of Chain Drugstores Beckman Coulter, Inc. / SmithKline Diagnostics, Inc. Bristol Myers Squibb Oncology / Better Health Foundation Eli Lilly and Company General Motors Corporation Kellogg Company National Association of Chain Drugstores Olympus America Inc. Zeneca Pharmaceuticals ### c/o American Cancer Society NATIONAL 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE FOR IMMEDIATE RELEASE Contact: Carole Anikis (301) 941-2626 Founding Organizations: American Cancer Society SURVEY SHOWS NEARLY HALF OF AMERICANS AT RISK FOR Centers for Disease Control and Prevention COLON CANCER ARE NOT BEING SCREENED Member Organizations: Large Number Report That Physicians Are Not Recommending Tests Agency for Healthcare Policy and Research Alliance of Community WASHINGTON, DC (September 10, 1998) - Survey results released today at Health Plans a White House event on new efforts to promote colorectal cancer prevention American Academy of Family Physicians reveal that nearly half of all adults aged 50 and older -the age group American College of considered at highest risk for developing colorectal cancer -have not been Gastroenterology screened for the disease. The White House event was hosted by First Lady American College of Physicians Hillary Rodham Clinton, who announced her support for raising awareness of American College of Radiology colorectal cancer and unveiled new efforts to promote the prevention and American Digestive Health Foundation early detection of the disease. Colorectal cancer, also known as colon cancer, American Gastroenterological kills more than 50,000 Americans each year, even though it is preventable and Association curable when detected early. American Medical Association American Medical Women's Association The survey, conducted for the National Colorectal Cancer Roundtable by the American Society of Colon Gallup Organization, underscores the need for new national initiatives and Rectal Surgeons promoting colorectal cancer prevention and early detection. One of the most American Society for alarming findings is that most of the 47 percent of people over 50 not being Gastrointestinal Endoscopy screened for colorectal cancer reported that no medical professional had ever Association of State and Territorial Directors of Health recommended screening. Promotion and Public Health Education Digestive Diseases "Physicians must make testing for colorectal cancer a part of their medical National Coalition practices," said Roundtable Chair Bernard Levin, MD, vice president for Collaborative Group of the Cancer Prevention at the M.D. Anderson Cancer Center in Houston. "I have Americas on Inherited Colorectal Cancer spent too much of my professional career delivering bad news to people Memorial Sloan-Kettering whose lives and health could have been saved if they had been screened for Cancer Center National Cancer Institute this preventable disease." National Caucus and Center on Black Aged, Inc. Although colorectal cancer occurs with almost equal frequency in men and STOP Colorectal Cancer women, the survey found that women aged 50 and older are less likely than Foundation University of Minnesota men in this same age group to undergo screening (49 percent of women Cancer Center reported not having been screened versus 36 percent of men). Dramatic University of Texas differences were also seen between whites and non-whites. Among survey M.D. Anderson Cancer Center respondents, 44 percent of whites reported not having had any of the three tests - fecal occult blood tests, flexible sigmoidoscopy, barium x-ray - compared to 56 percent of non-whites. The majority of adults surveyed seem to believe that early detection can save lives; however, when asked what they could do to help prevent colorectal cancer, fewer than half cited regular screening tests. Even fewer mentioned dietary changes, such as eating a high-fiber diet (21 percent), or general references to diet (20 percent). A sizable minority (22 percent) could not name anything a person might do to help prevent colorectal cancer. Asked to estimate their own chances for developing colorectal cancer, one in five adults (20 percent) believe they are very likely to develop cancer of the colon or rectum. Another 35 percent say it is somewhat likely they will develop the disease. A small proportion - one percent - reported they already have colon or rectal cancer. Sixteen percent could not estimate their chances of getting colorectal cancer. The Gallup Organization conducted telephone interviews from August 11 through August 23, 1998, with a national sample of 1,062 adults aged 50 or older, to examine the knowledge and experience of adults with testing for colorectal cancer. ### The National Colorectal Cancer Roundtable is a coalition of medical professional, consumer advocacy, and voluntary organizations committed to raising awareness about the prevention and early detection of colorectal cancer. NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE The Facts About Colorectal Cancer What is Colorectal Cancer? Founding Organizations: American Cancer Society Almost all cases of colorectal cancer, also referred to as colon cancer, Centers for Disease Control and Prevention begin with the development of benign colonic polyps. Polyps form when cells lining the colon grow, divide and reproduce in an Member Organizations: unhealthy, disorderly way, producing a growth. Agency for Healthcare Policy and Research These polyps can be cancerous, invading the colon wall and surrounding Alliance of Community blood vessels, and spreading to other parts of the body. Health Plans American Academy of Colorectal cancer frequently begins without symptoms. Family Physicians American College of What Causes Colorectal Cancer? Gastroenterology American College of Physicians The exact causes of colorectal cancer are unknown, but the disease American College of Radiology appears to be caused by both inherited and lifestyle factors. American Digestive Health Foundation Diets high in fat and low in fruits and vegetables - such as those that American Gastroenterological include red meat, fried foods and high-fat dairy products - may increase Association the risk of colorectal cancer. American Medical Association American Medical Lifestyle factors -such as cigarette smoking, a sedentary lifestyle, and Women's Association obesity - also may increase the risk of developing the disease. American Society of Colon Genetic factors may determine a person's susceptibility to the disease, and Rectal Surgeons whereas dietary and other lifestyle factors may determine which at-risk American Society for Gastrointestinal Endoscopy individuals actually go on to develop the disease. Association of State and Territorial Directors of Health How Common is Colorectal Cancer? Promotion and Public Health Education Digestive Diseases National Coalition Colorectal cancer is the second leading cancer killer in the United States, Collaborative Group of the and the third most common cancer overall. Americas on Inherited Colorectal Cancer This year, more than 50,000 Americans will die from colorectal cancer Memorial Sloan-Kettering and approximately 131,600 new cases will be diagnosed. Cancer Center Eighty to 90 million Americans (approximately 25 percent of the US National Cancer Institute population) are considered at risk because of age or other factors. National Caucus and Center on Black Aged. Inc. More women over the age of 75 die from colorectal cancer than from STOP Colorectal Cancer breast cancer. Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center Who Is At Risk? Men and women aged 50 and older are at almost equal risk of developing colorectal cancer. Those who have a personal or family history of colorectal neoplasia (cancer or polyps) are at high risk of developing the disease. Anyone who has a personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn's disease, is also at high risk. Although the incidence of colorectal cancer appears to be the same among all racial groups, survival rates seem to be lower for African-Americans. How Can You Prevent Colorectal Cancer? Know your family history. See your doctor for yearly screenings if you are aged 50 or older. Maintain a diet low in animal fat and high in fruits, vegetables and fiber. Exercise regularly. Prevent obesity. Avoid cigarette smoking. What You Need To Know ... Early detection saves lives - colorectal cancer is preventable, even curable when detected early. If colorectal cancer is found early enough, the patient has more than a 90 percent chance of survival. Colorectal cancer screenings are safe and effective and are now covered by Medicare and an increasing number of other health providers. Several screening methods can be used to detect polyps before they become cancerous, such as fecal occult blood test, colonoscopy, flexible sigmoidoscopy and barium x-ray. These tests also can detect cancer in its early stages. ### BERNARD LEVIN, MD Gastroenterologist Bernard Levin, MD, currently is professor of medicine and vice president for cancer prevention at University of Texas M.D. Anderson Cancer Center in Houston, Texas. Prior to his fourteen years at M.D. Anderson, Dr. Levin was associate professor of medicine and attending physician at University of Chicago Hospital and Clinics. For the American Digestive Health Foundation (ADHFSM), Dr. Levin serves as co-chair of the Digestive Health Initiative Colorectal Cancer Education Campaign. He also is chair of the American Cancer Society's National Advisory Task Force on Colorectal Cancer and recently was appointed as chair of the National Colorectal Cancer Roundtable. Affiliated with a number of professional organizations, Dr. Levin is a member of the American Gastroenterological Association and a fellow of the American College of Physicians. He participates as a consultant to the National Cancer Institute. Dr. Levin has written extensively for distinguished medical publications including Journal of the National Cancer Institute, Gastroenterology, the International Journal of Cancer, Cancer and Science. A graduate of the University of Witwatersrand in Johannesburg, South Africa, Dr. Levin completed fellowships in gastroenterology and biochemistry in pathology at the University of Chicago. OCTOBER 1998 $1.95 Good Wina New CONTEST: Gained Back KITCHEN Those Pounds? MAKEOVERS Lose Them For Good Great Looks You Can AIR BAG DANGERS Afford How To Keep Your Family Saf Do You Talk To Yourself? When It Helps INTERVIEW BEST EVER Katie's Wish PASTA RECIPES Speaking out in her husband's memory...what she KIDS' HEALTH desperately wants you to know Update on Unsafe Medicines, New Vaccines, and More http://goodhousekeping.co 10 PLUS: Other stories of courage. 08345 And real hope in the 0 754714"o $1.95 battle to beat colon cancer. GOOD HOUSEKEEPING october Katie's Crusade Still coming to terms with her husband's death from colon cancer, the Today show's Katie Couric is speaking out in his memory. What she wants you to know could save your life. BY JOANNA POWELL 124 In her handsome corner office at New York City's Rockefeller young ages. At least 13,000 new cases Center, Katie Couric is trying to get on with her life. Dressed each year involve people under 50. Does having lost a loved one to cancer in a baby-blue tailored suit and heavy makeup from her make you terrified of developing the morning duties as cohost of NBC's Today show, she's both disease yourself? poised and funny as she gives a rare interview. First, she Terrified is probably too strong a word. But it certainly makes me feel vulnera- takes time for a bit of girl talk about shoes. Then she turns ble. My husband was trim, healthy, had serious as the subject moves to her recent loss. never smoked a cigarette. It makes me feel vulnerable for everyone, not just for Despite her courageous front, Katie's myself. It's very frightening. voice cracks often during our conversa- How did you keep going after Jay's death? tion, and her eyes well up with tears. It As hard as it is for everybody who faces a has been just a few months since the tragedy in their lives, you really don't death of her husband, TV legal analyst have much of a choice. You can stay in Jay Monahan, who at 42, lost a swift, bed every day, or for weeks or months at a brutal fight with colon cancer. As a new- time, or you can just keep going. Children ly single mother with two small children force you to keep going. You don't have (Ellie, 7, and Carrie, 2½), Katie is still the luxury of putting your head in the reeling from the shock. sand. My children are a tremendous But in her search for solace, she has source of comfort, tremendously motivat- found some touchstones. In one corner ing for me. Because I have responsibili- of her office there is a small antique ties. It's not just financial. It's being there chest of drawers that was a birthday gift for them because they are children. from her husband the year before he How was Jay's cancer discovered? died. Once a scientist's display cabinet, He was already very sick when doctors it is filled with delicate eggs of various diagnosed it in April 1997. He had no wild birds. Even though some of the symptoms. Jay was tired, but we thought eggs have already broken, Katie has it was because he was flying back and protectively made a handwritten sign forth to California for his job [as a TV that reads FRAGILE and taped it to the Katie with husband Jay in 1995. legal analyst]. And we had two small chil- top of the chest. "I'm just so afraid it "We had no idea dren bringing every bug in America into might get damaged," she says. "It the house. We had no idea what was means so much to me." what was going on in going on in his body. This cancer is so What also means a lot to Katie is her decision to turn her grief into action-by his body. This cancer insidious. What are the lessons to be learned? launching a fight to raise awareness is so insidious." For one, that there are often very few about colon cancer. It is to that end that symptoms until it's too late. I'm not say- she is anchoring a five-part series about ish about it. It might cost you your life. ing everyone in America is walking the disease on the Today show from For the Today show's series on colon can- around with colon cancer, but everyone September 14 to 18. And it is why, for cer, we interviewed a Yale-educated doc- needs to know that it is a possibility. And this interview, she agreed to talk inti- tor who was going to give a talk on colon they need to rule it out. The only way to mately about her loss-and her ongoing cancer at the Yale Club in New York be really safe is to be tested. I'd like for effort to understand it. City. He was asked to change the subject people to become more aware of Joanna Powell: You've been very private of his talk to make it more palatable. Peo- colonoscopy, an exam that allows a doctor since your husband died. Why are you ple educated at a university like Yale can- to check the colon for abnormalities, and speaking out now? not deal with colon cancer? I just couldn't to decide with their doctors whether one Katie Couric: Colon cancer has taken a believe it. is warranted. huge personal toll on my life. Now I'd What do you want people to be especially Do you think there's anything doctors like to help educate others about this dis- aware of. know now that might have made a differ- ease. I want everyone to understand that People need to know that colon cancer ence in saving Jay's life? women as well as men get colon cancer. can strike the young. My husband was My husband's mom, who is now in her Young people as well as old people get it. barely 42 years old. My executive produc- 60s, has ovarian cancer-it was diagnosed And frankly, very few people take advan- er, Jeff Zucker, got it, and he was only 31. about three years ago. His grandmother tage of the preventive tools that exist. Fortunately, he survived. Last weekend, died of breast cancer. There is a growing Too many Americans don't get tested I ran into a farmer I know out in the coun- body of thought that these glandular can- because they don't want to talk about try. Jay and I always bought produce from cers-breast, ovarian, uterine, prostate, that part of their body. him. When I saw him, he said, "I'm so and colon-may be related, that there is How can we break the stigma of this sorry about Jay. You know I lost my perhaps, a genetic link. If we had known disease? fiancée five years ago to colon cancer." I this, Jay might have been screened for I think we have to use the words, say asked how old she was, and he said, colon cancer. I now certainly believe you them. Colon. Rectum. Bowels. The more "Thirty-eight." I can't tell you how many should think long and hard about an matter of fact you are with the language, people wrote to me whose husbands or early colonoscopy, not only if your aunt or the more it helps. You can't be squeam- wives were taken by this disease at very grandmother or other relative has colon cancer, but also if any of these glandular treatment for colon cancer is a drug that going to get through it and continue to fly never fo: cancers exist in your family. I firmly was developed in the 1950's. I hope that in the healthiest way possible. Talk to weren't t believe you have to be your own best more money-government and private- your child's teachers; talk honestly with I'll never advocate. We're hearing now that every- can be devoted to cancer research. If we children about the death in an age- What did one 50 and up should have a colonoscopy can put Sojourner on Mars, we can come appropriate way. Parents can't just forget Just "Thi regardless of risk factors or symptoms. up with something that keeps cancer about it and hope their kids will be okay. you need But all the doctors I know-and I know a from destroying so many lives. What should you do to keep the loved ing, comfi lot of them-say they had or will get a How do you feel about the body's ability one's memory alive? Tuesdays & colonoscopy by their fortieth birthday. to "beat cancer"? Is it possible? People talk You can't schedule a child's grief. You fessor dyii That ought to tell you something. a lot about fighting it psychologically. really have to have a good sense of what's his relatic Problem is, even if you have a family I think you have to have hope and a fight- right for your child; you can't force-feed He talke history of colon cancer, doctors often ing spirit. On the other hand, this idea that your child. I try to talk about Jay in a very dreamlike natural way, because he comes up all the how peop time. Yet I don't try to sit with my child lives, chat "Little things help-like having my in some kind of artificial environment, store, and and have her discuss things with me that is going on husband's money clip in my purse. And maybe she's not ready to talk about. I I think being in a room where he spent time." think you have to pick up cues from life has cha them. The other day my daughter Carrie it's very rea was on her play telephone telling me, world thrc recommend you be screened by a flexible people who survive cancer are stronger "Mom, it's Daddy calling from heaven." Everything sigmoidoscopy, not a colonoscopy. willed or more motivated or have a greater It was heartbreaking, but I wanted to like B.C. a Flexible sigmoidoscopy is effective for explore it with her, so we started talking. After Cance desire to live is really unfair to people who only the lower third to half of the colon. don't beat it. I think cancer, frankly, comes She's only 2½, but I didn't want to just on comme My feeling is if you really want to be sure, down to biology and luck. The cemeteries ignore her and what she was saying. It's buried in a getting a flex sig is like getting a mam- are full of people who wanted to live more an awful lot for grown-ups to handle terrifying. V mogram on one breast. than anything and couldn't their own pain and loss, but they can't After your husband found out he had It's a very confusing concept-the idea forget about the children. They're going colon cancer, what did you do to fight the that if you fight hard enough you can cure through it too. It's very easy in a situation Th disease? yourself. like this to feel completely and utterly I can share some of my personal experi- I'm thrilled for people who beat it, overwhelmed. But I think parents have a ence, but I want to be careful not to because I know they've been to hell and real responsibility to pull it together for invade my husband's privacy or dignity in back. But to imply that they are mentally their children. any way. Immediately after he received superior to those who don't beat it is just Has your mother been helpful to you dur- his diagnosis, I began to amass a lot of plain wrong. ing this ordeal? information on treatment, clinical trials, The other part of your story is surviving Oh, yes. I'm very close to my parents. I and experimental drugs. I was extremely the grief after losing your husband. Is went through a period when I was just frustrated to discover there's no single there anything that's been especially help- impossible to deal with. Because I was source for learning about the various ful in your life in the past months? just so, so upset and angry and furious experimental treatments for your specific Talking to other women who have been with the world. Talk about unconditional disease. Pharmaceutical and biotech com- through similar circumstances. Nobody love. They've always been there for me. panies are highly competitive and some- else really understands. I didn't before it What about friends? How have they times secretive about the kinds of tests happened to me. As empathetic as responded? they're doing. The technology is chang- friends and family want to be, it's just I think this is really important. A lot of ing at breakneck speed. And it's hard to such a lonely, painful experience. It's people are at a loss when it comes to help- find sources that are in plain English, not very meaningful to have someone who ing friends feel better. A lot of people pull medicalese. It was very troubling to me. can relate to an earth-shattering event in back because they don't want to be inva- Here I was, a reporter. I've spent the last the same way you do. sive or intrusive. 20 years researching and investigating. Do you have any advice to parents with Or say the wrong things. But when it came to tracking down infor- young children who have lost a loved one? Or say the wrong things. It's painful for mation that could potentially save a life, I I'd hate to profess to be an expert. It's lot of people because it reminds them of hit one obstacle after another. I'm heart- definitely baptism by fire when you're in their own mortality. But when someone ened to hear that the National Cancer a situation like this. Every child is differ- you care about is going through something Institute has just implemented a new ent, every parent is different, every situa- as traumatic as this, you can't stop trying to Web site clearinghouse, so some of this tion is different. But I do think you need get in-even if they push you away, initial- information is easier to access but I defi- to be very proactive in helping your ly, because they're so knocked off their nitely think more could be done. children through an ordeal like this. And foundation and their world has just fallen Do you find it frustrating that cancer is you need to do everything you can to apart. If they push you away, and you real- still the No. 2 killer in this country after keep them healthy and whole. You can't ly care-push back. Keep trying. When all heart disease? think that they are just children and they you're going through it, you're scared Incredibly. It's been more than 25 years won't be affected, or they'll get over it, or the time. I had one friend who wrote me since Richard Nixon declared war on can- children are resilient. Some of that is true, card every week and called me every But cer. And while there have been tremen- but I think you have to very consciously week, and I never called her back: ['ll dous strides, the first-line chemotherapy take steps to make sure that they're I'm so grateful that she kept trying. 126 never forget that. And the people who bility in your life, these things are not fun- the Civil War, at our house in the country weren't there and didn't keep on trying, ny. Even hearing cartoon characters say, and I go into that room and look at the I'll never forget that either. "Drop dead." I remember looking at a things he loved-which, of course, I didn't What did the cards say? magazine cover on summer pleasures, appreciate as much when he was living. Just "Thinking about you," "I'm here if and thinking, Wore, I wish that's all I cared That's a very special place for me. I find you need me." That was a very reassur- about: what I was going to do this summer, that talking about him to those people ing, comforting thing. I think of the book what movies I was going to see. I think it's who cared about him and miss him is real- Tuesdays with Morrie (about a college pro- important to acknowledge that someone's ly helpful. Sometimes when you lose fessor dying of Lou Gehrig's disease and world has taken a gut-wrenching turn. someone, other people just want it to be his relationship with a former student). Is there any place or item that you shared in the past and not talk about it. I appreci- He talked about how you're in this with Jay that now offers comfort? ate having people say how much they dreamlike state and you can't understand Nothing really comforts me, I'm sorry to cared about him and miss him too. how people are just going on with their report. It's only been months since my Are you still close to his family? lives, chatting and going to the grocery husband died. And, frankly, I still can't Yes. Jay was one of seven children, and I store, and pushing baby strollers. That life believe it. When I think about it, it just often speak to his siblings as well as to his is going on swimmingly for everyone else. permeates every cell in my body. You parents. They're all wonderful. I also like I think when people acknowledge that can forget about it temporarily. But then to talk to other people who knew him life has changed in a horrible way for you, the grief comes like a huge wave and like well and were profoundly affected by it's very reassuring. I used to say I saw the a horrible invasion of your heart and soul. him. Someone sent me a letter telling me world through cancer-colored glasses. Little things help me-like having my about Jay's experience in the Navy. I just Everything just looks very different. It's husband's money clip in my purse. And got his transcripts from college and read his like B.C. and A.C.-Before Cancer and just being in a room where he spent a lot guidance counselor's recommendation and After Cancer. You see references to death of time. But I don't have any sort of ritual his entrance essay. It was very revealing. on commercials; you see a man being or supercomforting place. I'm still looking He wrote things that I didn't know about buried in a car, and it's not a big joke. It's for that. My husband had a collection of him. It's nice to have, but sometimes so terrifying. When death is a distinct possi- historic military pieces, particularly from hard to read. (continued on page 188) The Stories of Three Families Left Behind KATHY HOCHHAUSER "HE NEVER LOST HIS SPIRIT" NDHER DAUGHTERS," I n 1993, Kathy Hochhauser and her husband, Ken, were feeling Ellen, 18, SEATED, hopeful about their future together. The parents of two daughters- GWEN, 14. Ellen, 12 at the time, and Gwen, 9-they were strong-willed people whose marriage had been troubled; the couple were in counseling. But now they were trying to put the bad times behind them. Then, one day, Ken, a 45-year-old accountant at a computer company in Framingham, MA, noticed blood in his stool. "I urged him to go to the doctor, but he put it off for a few months," says Kathy, now 50, a public school secretary. When he finally had a colonoscopy, an examination of the colon, the news wasn't good: A tumor was found. Ken had surgery immediately, but the cancer had already spread to his liver. Although he would get chemotherapy and radiation-including an experimental drug- the doctors indicated that he didn't have long to live. "He was a fighter; he was going to prove them wrong," recalls Kathy. And he did. For three years after the surgery, he lived life to the fullest. "He'd be nauseated after a chemotherapy session, but he'd insist on playing basketball," says Kathy. And he rallied enough to attend Gwen's bat mitzvah in November 1996. "He even found the strength to dance with me," says Kathy. She and Ken grew closer than they had ever been. Kathy drove him to and from treatments and nursed him through the long nights. "He never lost his spirit," she reports. "Two weeks before he died, I asked him if there was anything I could get for him, and he grinned and said, 'A pastrami sandwich.' went to the deli right away." On July 3, 1997, Ken, at age 49, lost his battle against colon cancer. Kathy had grieved a lot during the years she cared for Ken, but now she couldn't stop thinking about what could have been done to save her young husband's life. For 25 years, Ken had suffered from chronic bowel problems, and Kathy now says she wishes he'd been screened earlier. "If only one person reads this and goes for a checkup," she says, "none of what we went through will have been in vain." -Sondra Forsyth CHELSIE SHERER! "SHE WAS A REAL GOOD MoM" 7, AND HER FATHER, TRIPP. C helsie Sherer, a 7-year-old who loves to swim and watch videos, T seems like a typical second grader. But those close to her know she's wrestling with a terrible trauma: the loss of her mother. In 1996, at age 28, Lisa Sherer died of a rare, genetic form of colon cancer, leav- ing behind her only child and her husband, Tripp, a dental technician. Chelsie was not yet 3 when Lisa first got sick in 1993. She passed a lbt of blood one day and was rushed to the emergency room. It turned out she had familial polyposis, a condition in which thousands of polyps grow on the colon, and her polyps were malignant. She was given a year and a half to live. The doctors told Tripp that the polyps start out benign but if not removed al- most always become malignant by the time the person is 40. Tripp recalled that Lisa frequently had diarrhea and lacked stamina. When he asked her about it, she told him she hac received a diagnosis of a spastic colon when I she was a teenager. No formal testing had been done; if it had, the condition could have been detected sooner. Though Lisa didn't know of any relatives with familial polyposis, Tripp wor- volved: I ried that she might have passed it on to Chelsie, SO he arranged to have her made up tested. Sure enough, Chelsie had the condition. "But we caught it early tube that enough; her polyps were still precancerous," says Tripp. However, doctors had food and to remove Chelsie's entire large intestine to protect her from cancer. tum, the Lisa was SO ill that, at first, Tripp didn't tell her that Chelsie had inherited large inte her condition and undergone surgery. But three months before Lisa died, Tripp rity has g decided she should know: "She was extremely upset, but I said the way I saw account 0 it, she gave Chelsie life, and now she was saving Chelsie's life. After that, 1 as former asked her if she wanted to renew our VOWS. She said yes." The ceremony was breast c performed at Lisa's bedside on May 12, 1996. Two weeks later, she died. Schwarzl Today, Lisa's framed photograph sits on the dresser in the bedroom she Many and Tripp once shared. "Sometimes I go into Daddy's room and look at my strikes IT mom's picture," says Chelsie. "She was a real good mom." -S.F. doctors a patients "I WISH I COULD SEE HIM AGAIN" develop CLOCKWISETROMY netic pre L ast Christmas, not long after she turned 16, Lynne Patterson's LEFT: LYNNI father, Michael, gave her a 1989 Volkswagen and two promises. tually kil PATTERSON, 16; First, as a mechanic, he'd keep the vehicle in top shape. Second, they dor GEORGIA /HER men. TI he'd help her get her license. But Michael, 50, of Medford, MA, wouldn't live MOTHER; AMY,15 and 64,6 long enough to celebrate that rite of passage with his oldest daughter. TIMOTHY, 11; (ND cer, and On February 6, he was admitted to the hospital with a fever of 103°F. JACQUELINE.44 will die Tests showed that Michael seemed to be losing blood, SO a CT scan was can Can performed. It revealed a mass in his abdomen. Surgery turned up a The malignancy on his colon-as well as 14 other tumors. The prognosis? At screeni most, several months for Michael to spend with his wife, Georgia, and Lynne known and her three siblings: Amy, 15; Jacqueline, 14; and Timothy, 11. be prev "I couldn't believe it," says Lynne. "The doctors said the tumor must have could sa taken at least five years to get that big, but my dad hadn't seemed sick at year, bu all." Michael did experience some rectal bleeding-the No. 1 sign of colon Bond, M cancer. At first it was some slight spotting. Then, by October 1997, the Veterar bleeding had become pronounced, SO Michael went to the doctor. His neapoli physician found a hemorrhoid and suggested that Michael have a colon- 50 and cancer test, which he postponed. Georgia now wishes she and Michael had cancer, paid more attention to those earlier symptoms. women Despite the grim prognosis, Lynne thought she'd have at least one more colon e summer with her father. "We had always been really close," she says. "Ever cording since I was a little girl, our family had traveled to Maine in July. My dad would trol an wake me up at five in the morning, SO the two of us could walk to the bakery us put to get pastries hot from the oven. I pictured us walking together again." barrass It wasn't to be. By February 14, Michael had developed complications plenty from the surgery, and four days later, he was gone. "It's still hard to accept," tors do says Lynne. "Something in the house will break, and I'll think, Oh, Dad will fix some i that. I wish I could see him again, even just one more time, to tell him I love the be him and to hear him say that he loves me." -S.F. The Diges 128 The Preventable Cancer The right testing for colon cancer can save your life. What every woman needs to know. by Lisa Collier Cool t's the second most deadly adults age 50 and over-the group with Screening Tests," page 190). cancer, killing more people the highest rate of colon tumors-an as- I What makes the screening shortfall each year than breast or tonishing 61 percent of women said so troublesome is that colon cancer prostate cancer. Yet colon their doctors had never advised any kind often produces no symptoms in its early cancer doesn't receive nearly of screening. Many primary-care doctors stages, when it is 90 percent curable. If as much attention. That's aren't educated about the tremendous not detected, it typically goes unnoticed partly because no one likes to benefits of testing, according to Albert until it has spread beyond the in- talk about the body parts in- Palitz, M.D., director of the colorectal testines-at which point the five-year volved: namely, the large intestine, cancer prevention program at Kaiser survival rate is less than 60 percent. made up of the colon, a six-foot-long Permanente, a large California-based tube that removes water from digested health maintenance organization. "Only The Best Protection food and expels solid waste; and the rec- in the last five years have studies pro- Colon-cancer experts agree that the "gold tum, the last six to eight inches of the vided clear evidence that screening can standard" of screening is colonoscopy, a large intestine. What's more, no celeb- prevent death," he notes. However, the 15- to 20-minute test in which the entire rity has gone public with a first-person ACS has supported colon-cancer screen- colon is checked for tumors using a account of the disease to raise awareness, ing for nearly two decades, issuing new lighted flexible tube with a cameralike as former First Lady Betty Ford did for guidelines last year (see "Rating the device at one (continued on page 188) breast cancer and General Norman Schwarzkopf did for prostate cancer. Many women assume colon cancer THE GOLD-STANDARD 20-MINUTE TEST: strikes mostly the elderly-or men. But ONE WOMAN'S STORY doctors are seeing younger and younger patients with the disease, some of whom ot long ago, I saw something would be injected into my intestines SO the doctor develop the illness early because of a ge- netic predisposition. And the cancer ac- N alarming in the toilet. "This isn't would have a good view, and that would produce a good," I said out loud, staring at gassy, uncomfortable feeling. Sedation would be tually kills more women-mainly because the bloody stool I discovered. I'm necessary. I was told that there would be no they don't get screened as frequently as 52, and my mother has a history of colon polyps. discomfort when the probe was slowly retracted, men. This year, about 67,000 women- So I made an appointment with William Coll, M.D., SO I asked to be awakened midprocedure. I wanted and 64,600 men-will develop colon can- a local gastroenterologist, who helped me arrive at to see for myself what was going on inside. cer, and 28,600 women and 27,900 men an obvious conclusion: I needed to have my colon Dr. Coll used intravenous Demerol (a sedative will die from it, according to the Ameri- checked for cancer. I was scared, SO I elected, as and painkiller) and Versed (another sedative) to can Cancer Society (ACS). advised by Dr. Coll, to have a colonoscopy, which knock me out during the first part of the The good news: With the right would enable him to inspect my entire colon. procedure. Then, I got a drug that would wake me screening, the disease-technically In the 24 hours before the procedure, I needed up. When I opened my eyes, the scope, now about known as colorectal cancer-can actually to cleanse and flush my colon SO that Dr. Coll's four feet up my innards, displayed interior shots of be prevented. "Widespread screening view would be unobstructed. My diet was restricted my colon on a monitor only a few feet away. Inside could save at least thirty-thousand lives a to clear liquids and chilled bouillon. But that this strange labyrinth of pink-gold crinkles and year, but sadly, very few get says John wasn't all. I was ordered to take one and a half folds were two tiny polyps, six millimeters in Bond, M.D., chief of gastroenterology at ounces of a fizzy laxative potion mixed with eight diameter, which Dr. Coll removed. Also revealed Veterans Affairs Medical Center in Min- ounces of water, once at 11:00 A.M. and again at were two tiny hemorrhoids that had ruptured and neapolis. More than half of women age 6:00 P.M. Dr. Coll recommended that I stay home were deemed the cause of my dramatic bowel 50 and over are now checked for breast after the first dose (which I did). It made perfect movement. cancer, but only about 24 percent of sense: This nasty-tasting salty, lemony drink gave Afterward, I dozed lightly in the recovery room. I women age 50 and over have had their me cramps and diarrhea almost immediately, and was a little WOOZY, but my stomach felt fine. In fact, colon examined in the past five years, ac- I found myself in the bathroom at 20-minute I was hungry. I fantasized about breaking my fast cording to the Centers for Disease Con- intervals throughout the day. I was not only crampy with barbecued spareribs and garlic mashed trol and Prevention in Atlanta. Many of and crabby but also lightheaded and weak- potatoes, a dream that became a reality that us put off testing, fearing it may be em- probably dehydrated, Dr. Coll said. He also told me evening. I returned to work, spunky as ever, the barrassing or uncomfortable. But there's that all of these reactions were to be expected. next morning. plenty of blame to go around: Some doc- The next morning, at 8:30 A.M., I went to Sharon A few days later, I learned that the polyps were tors don't tell us to get screened-and Hospital in Connecticut. I got undressed, put on a benign. I was glad I'd had the colonoscopy-and some insurance companies won't pay for cotton gown, and was instructed to lie on a relieved when Dr. Coll told me that the type of the best testing. stretcher. A nurse explained that the colonoscope, polyps he'd removed never becomes cancerous. So Three years ago, when the American a thin, lighted probe with a cameralike device at I don't have to have another colonoscopy for seven Digestive Health Foundation polled one end, would be threaded into my colon. Air to ten years. -Maxine Paetro KATIE COURIC COLON CANCER cil eraser, and up to seven more years to turn cancerous. (continued from page 127) (continued from page 129) Elizabeth Ely, 55, an interior decora- Do you share them with your daughters? end. The device transmits images of the tor in New York City, is grateful that she I'm putting together a book of all the let- colon to a video screen, which the doctor had a colonoscopy, because it saved her ters people have written about Jay, so that watches throughout the procedure. Any life. Although she didn't have a family my girls feel like they know a lot about polyps that are discovered can be re- history of colon cancer or any symptoms their father and what an outstanding per- moved during the test. Colonoscopy (in fact, she felt great, she says), her doc. son he was. I'm also writing them a letter finds 97 percent of colon tumors, and the tor encouraged her to get tested because all about our courtship-and how we met ACS now recommends it for everyone age of her age. Last March, a colonoscopy and why I fell in love with him. The idea 50 and over. revealed a malignant rectal tumor. "I is that when they're older they can read The unique advantage of colonoscopy was absolutely shocked," she recalls. "I about him and appreciate him. I've asked is that it's the only cancer test that can never believed anything would be people to write to my girls, and I've actually prevent received the most beautiful letters. malignancy. YOUR RISK AND YOUR AGE Do the letters make you feel better, or is it "There's a very all a painful exercise? strong argument Your chance of getting colon cancer increases dramatically as you get that people who older. Check this chart against your age to pinpoint your risk of It's definitely painful, but part of the process. I think it will ultimately help. have this test reg- developing the disease, which strikes at an average age of 66: But for now it reminds me how much I ularly will never, Ages A Woman's Risk A Man's Risk miss him. Some of the letters I just can't ever get colon Birth to 39 1 in 2,000 1 in 1,667 read. Someday I will. cancer, which 40 to 59 1 in 147 1 in 114 When you first went back on the Today means it's much 60 to 79 1 in 31 1 in 24 show following Jay's death, you wore his better for pre- Source: American Cancer Society, Cancer Facts & Figures, 1998 wedding ring around your neck on a venting this dis- chain. Lately, you haven't been wearing it. ease than mammograms are for breast wrong with me. I've always been well." Why did you stop? cancer," says Robert J. Mayer, M.D., di- She had surgery to remove the tumor, The safety chain broke. I didn't stop for rector of the Center for Gastrointestinal and was relieved to learn that it was an any symbolic reason. I just worry that Oncology at the Dana Farber Cancer In- early-stage cancer. She was deemed without the safety clasp, I would lose it. stitute in Boston. That's because virtu- cured after the operation. "I'm very It made me too nervous. And now I'm ally all colon cancers begin as mush- lucky," says Ely. "Now I'm telling my not sure if I'll wear it again. It's a very room-shaped or flat premalignant clients, friends, and relatives to have the outward symbol of one's grief, and I growths called polyps. "About five to test if they're fifty or over." wore it because it made me feel very ten percent may become cancerous, so if Another, more famous survivor: for- close to him, by touching it. It was they're found and removed during mer President Ronald Reagan, who had a hard decision: whether he should colonoscopy, you probably won't get part of his intestines removed in 1985 wear the ring-or I should. I didn't know cancer," explains Jose Guillem, M.D., after doctors discovered a malignant what to do. All of my friends told me it associate attending colorectal surgeon at tumor through colonoscopy. was okay for me to keep it. And I found Memorial Sloan-Kettering Cancer Cen- a lot of solace in it. I don't think he ter in New York City. What's Your Life Worth? would mind. It appears that one colonoscopy is Despite the lifesaving power of Has throwing yourself back into work enough to protect people at average risk colonoscopy, Medicare and a number of helped you cope? for an entire decade, because polyps other health plans won't pay for it. "This You do what you have to do. I have chil- grow very slowly, taking about five to is unjust to the American public," says dren to support. And kids just automati- seven years to become the size of a pen- Michael D. Moseson, M.D., a clinical as- cally make you stronger. Work was a way for me to keep going while Jay was sick. For two hours I could distract YOUR RISK AND YOUR FAMILY HISTORY myself, and I think it serves the same A person who has no cancer in her family has a one in 17 chance of developing colon cancer over a purpose now. lifetime. That risk increases if your relatives have had certain kinds of cancers. If you fall into any of the What is your advice to couples who have categories listed below, you should get a colonoscopy (total exam of the colon) by age 40, or ten years been spared a life-threatening illness? before the youngest age at which a family member received a diagnosis of colon cancer. If there are Cherish each day. Get under the covers several cases of colon cancer in your family, consider getting a genetic test at a major cancer center to with your kids on a Saturday morning. check for an inherited syndrome. Testing, which can cost anywhere from $250 to $2,400, can help And even if your spouse drives you crazy determine the age and frequency at which you need to be screened. sometimes, remember what made you 1. You have a distant relative-an uncle, aunt, or grandparent-who has/had colon cancer. fall in love to begin with. My daughter is Your risk: 1.5 in 17 obsessed with The Wizard of Oz, and 2. You have an immediate family member-a parent, sibling, or child-who has/had colon cancer. there's one thing that Dorothy says Your risk: 2 or 3 in 17 toward the end of the movie that always 3. You have two or more members who have/had colon cancer, or have one relative affects me so much: "If ever go looking who developed the disease before age 50. Your risk: 3 or 4 in 17 for my heart's desire again, I won't look 4. You have one or more immediate ordistant relatives who have/had breast, ovarian, uterine, or prostate Our Safti-Gr any further than my own backyard." cancer. Your risk: 1.5 in 17 -L.C.C. to your tub. 188 good housekreping|October 1998 1998 $1.95 Good House New Wina CONTEST Gained Back KITCHEN Those Pounds? MAKEOVERS Lose Them For Good Great Looks You Can AIR BAG DANGERS Afford How To Keep Your Family Saf Do You Talk To Yourself? When It Helps INTERVIEW BEST EVER Katie's Wish PASTA RECIPES Speaking out in her husband's memory...what she KIDS' HEALTH desperately wants you to know Update on Unsafe Medicines, New Vaccines, and More http://goodhousekeeping.com 10 PLUS: Other stories of courage. 08345 And real hope in the 0 754714 0 $1.95 battle to beat colon cancer. GOOD HOUSEKEEPING october Katie's Crusade Still coming to terms with her husband's death from colon cancer, the Today show's Katie Couric is speaking out in his memory. What she wants you to know could save your life. BY JOANNA POWELL 124 In her handsome corner office at New York City's Rockefeller young ages. At least 13,000 new cases Center, Katie Couric is trying to get on with her life. Dressed each year involve people under 50. Does having lost a loved one to cancer in a baby-blue tailored suit and heavy makeup from her make you terrified of developing the morning duties as cohost of NBC's Today show, she's both disease yourself? poised and funny as she gives a rare interview. First, she Terrified is probably too strong a word. But it certainly makes me feel vulnera- takes time for a bit of girl talk about shoes. Then she turns ble. My husband was trim, healthy, had serious as the subject moves to her recent loss. never smoked a cigarette. It makes me feel vulnerable for everyone, not just for Despite her courageous front, Katie's myself. It's very frightening. voice cracks often during our conversa- How did you keep going after Jay's death? tion, and her eyes well up with tears. It As hard as it is for everybody who faces a has been just a few months since the tragedy in their lives, you really don't death of her husband, TV legal analyst have much of a choice. You can stay in Jay Monahan, who at 42, lost a swift, bed every day, or for weeks or months at a brutal fight with colon cancer. As a new- time, or you can just keep going. Children ly. single mother with two small children force you to keep going. You don't have (Ellie, 7, and Carrie, 2½), Katie is still the luxury of putting your head in the reeling from the shock. sand. My children are a tremendous But in her search for solace, she has source of comfort, tremendously motivat- found some touchstones. In one corner ing for me. Because I have responsibili- of her office there is a small antique ties. It's not just financial. It's being there chest of drawers that was a birthday gift for them because they are children. from her husband the year before he How was Jay's cancer discovered? died. Once a scientist's display cabinet, He was already very sick when doctors it is filled with delicate eggs of various diagnosed it in April 1997. He had no wild birds. Even though some of the symptoms. Jay was tired, but we thought eggs have already broken, Katie has it was because he was flying back and protectively made a handwritten sign that reads FRAGILE and taped it to the Katie with husband Jay in 1995. forth to California for his job [as a TV legal analyst]. And we had two small chil- top of the chest. "I'm just so afraid it "We had no idea dren bringing every bug in America into might get damaged," she says. "It the house. We had no idea what was means so much to me." what was going on in going on in his body. This cancer is so What also means a lot to Katie is her decision to turn her grief into action-by his body. This cancer insidious. What are the lessons to be learned? launching a fight to raise awareness is so insidious." For one, that there are often very few about colon cancer. It is to that end that symptoms until it's too late. I'm not say- she is anchoring a five-part series about ish about it. It might cost you your life. ing everyone in America is walking the disease on the Today show from For the Today show's series on colon can- around with colon cancer, but everyone September 14 to 18. And it is why, for cer, we interviewed a Yale-educated doc- needs to know that it is a possibility. And this interview, she agreed to talk inti- tor who was going to give a talk on colon they need to rule it out. The only way to mately about her loss-and her ongoing cancer at the Yale Club in New York be really safe is to be tested. I'd like for effort to understand it. City. He was asked to change the subject people to become more aware of Joanna Powell: You've been very private of his talk to make it more palatable. Peo- colonoscopy, an exam that allows a doctor since your husband died. Why are you ple educated at a university like Yale can- to check the colon for abnormalities, and speaking out now? not deal with colon cancer? I just couldn't to decide with their doctors whether one Katie Couric: Colon cancer has taken a believe it. is warranted. huge personal toll on my life. Now I'd What do you want people to be especially Do you think there's anything doctors like to help educate others about this dis- aware of. know now that might have made a differ- ease. I want everyone to understand that People need to know that colon cancer ence in saving Jay's life? women as well as men get colon cancer. can strike the young. My husband was My husband's mom, who is now in her Young people as well as old people get it. barely 42 years old. My executive produc- 60s, has ovarian cancer-it was diagnosed And frankly, very few people take advan- er, Jeff Zucker, got it, and he was only 31. about three years ago. His grandmother tage of the preventive tools that exist. Fortunately, he survived. Last weekend, died of breast cancer. There is a growing Too many Americans don't get tested I ran into a farmer I know out in the coun- body of thought that these glandular can- because they don't want to talk about try. Jay and I always bought produce from cers-breast, ovarian, uterine, prostate, that part of their body. him. When I saw him, he said, "I'm so and colon-may be related, that there is How can we break the stigma of this sorry about Jay. You know I lost my perhaps, a genetic link. If we had known disease? fiancée five years ago to colon cancer." I this, Jay might have been screened for I think we have to use the words, say asked how old she was, and he said, colon cancer. I now certainly believe you them. Colon. Rectum. Bowels. The more "Thirty-eight." I can't tell you how many should think long and hard about an matter of fact you are with the language, people wrote to me whose husbands or early colonoscopy, not only if your aunt or the more it helps. You can't be squeam- wives were taken by this disease at very grandmother or other relative has colon cancer, but also if any of these glandular treatment for colon cancer is a drug that going to get through it and continue to fly never for cancers exist in your family. I firmly was developed in the 1950's. I hope that in the healthiest way possible. Talk to weren't believe you have to be your own best more money-govemment and private- your child's teachers; talk honestly with I'll never advocate. We're hearing now that every- can be devoted to cancer research. If we children about the death in an age- What did one 50 and up should have a colonoscopy can put Sojourner on Mars, we can come appropriate way. Parents can't just forget Just "Thi regardless of risk factors or symptoms. up with something that keeps cancer about it and hope their kids will be okay. you need But all the doctors I know-and I know a from destroying so many lives. What should you do to keep the loved ing, comfi lot of them-say they had or will get a How do you feel about the body's ability one's memory alive? Tuesdays a colonoscopy by their fortieth birthday. to "beat cancer"? Is it possible? People talk You can't schedule a child's grief. You fessor dyii That ought to tell you something. a lot about fighting it psychologically. really have to have a good sense of what's his relatic Problem is, even if you have a family I think you have to have hope and a fight- right for your child; you can't force-feed He talke history of colon cancer, doctors often ing spirit. On the other hand, this idea that your child. I try to talk about Jay in a very dreamlike natural way, because he comes up all the how peop time. Yet I don't try to sit with my child lives, chat "Little things help-like having my in some kind of artificial environment, store, and and have her discuss things with me that is going on husband's money clip in my purse. And maybe she's not ready to talk about. I I think being in a room where he spent time." think you have to pick up cues from life has cha them. The other day my daughter Carrie it's very rea was on her play telephone telling me, world thrc recommend you be screened by a flexible people who survive cancer are stronger "Mom, it's Daddy calling from heaven." Everything sigmoidoscopy, not a colonoscopy. willed or more motivated or have a greater It was heartbreaking, but I wanted to like B.C. a Flexible sigmoidoscopy is effective for explore it with her, so we started talking. After Cance desire to live is really unfair to people who only the lower third to half of the colon. don't beat it. I think cancer, frankly, comes She's only 2½, but I didn't want to just on comme My feeling is if you really want to be sure, down to biology and luck. The cemeteries ignore her and what she was saying. It's buried in a getting a flex sig is like getting a mam- are full of people who wanted to live more an awful lot for grown-ups to handle terrifying. V mogram on one breast. than anything and couldn't. their own pain and loss, but they can't After your husband found out he had It's a very confusing concept-the idea forget about the children. They're going colon cancer, what did you do to fight the that if you fight hard enough you can cure through it too. It's very easy in a situation Th disease? yourself. like this to feel completely and utterly I can share some of my personal experi- I'm thrilled for people who beat it, overwhelmed. But I think parents have ence, but I want to be careful not to because I know they've been to hell and real responsibility to pull it together for invade my husband's privacy or dignity in back. But to imply that they are mentally their children. any way. Immediately after he received superior to those who don't beat it is just Has your mother been helpful to you dur- his diagnosis, I began to amass a lot of plain wrong. ing this ordeal? information on treatment, clinical trials, The other part of your story is surviving Oh, yes. I'm very close to my parents. 1 and experimental drugs. I was extremely the grief after losing your husband. Is went through a period when I was just frustrated to discover there's no single there anything that's been especially help- impossible to deal with. Because I was source for learning about the various ful in your life in the past months? just so, so upset and angry and furious experimental treatments for your specific Talking to other women who have been with the world. Talk about unconditional disease. Pharmaceutical and biotech com- through similar circumstances. Nobody love. They've always been there for me. panies are highly competitive and some- else really understands. I didn't before it What about friends? How have they times secretive about the kinds of tests happened to me. As empathetic as responded? they're doing. The technology is chang- friends and family want to be, it's just I think this is really important. A lot of ing at breakneck speed. And it's hard to such a lonely, painful experience. It's people are at a loss when it comes to help- find sources that are in plain English, not very meaningful to have someone who ing friends feel better. A lot of people pull medicalese. It was very troubling to me. can relate to an earth-shattering event in back because they don't want to be inva- Here I was, a reporter. I've spent the last the same way you do. sive or intrusive. 20 years researching and investigating. Do you have any advice to parents with Or say the wrong things. But when it came to tracking down infor- young children who have lost a loved one? Or say the wrong things. It's painful for mation that could potentially save a life, I I'd hate to profess to be an expert. It's lot of people because it reminds them of hit one obstacle after another. I'm heart- definitely baptism by fire when you're in their own mortality. But when someone ened to hear that the National Cancer a situation like this. Every child is differ- you care about is going through something Institute has just implemented a new ent, every parent is different, every situa- as traumatic as this, you can't stop trying to Web site clearinghouse, so some of this tion is different. But I do think you need get in-even if they push you away, initial information is easier to access. but I defi- to be very proactive in helping your ly, because they're so knocked off their nitely think more could be done. children through an ordeal like this. And foundation and their world has just fallen Do you find it frustrating that cancer is you need to do everything you can to apart. If they push you away, and you still the No. 2 killer in this country after keep them healthy and whole. You can't ly care-push back. Keep trying. When all heart disease? think that they are just children and they you're going through it, you're scared me Incredibly. It's been more than 25 years won't be affected, or they'll get over it, or the time. I had one friend who wrote since Richard Nixon declared war on can- children are resilient. Some of that is true, card every week and called me every But cer. And while there have been tremen- but I think you have to very consciously week, and I never called her back. ΓO dous strides, the first-line chemotherapy take steps to make sure that they're I'm so grateful that she kept trying. 126 never forget that. And the people who bility in your life, these things are not fun- the Civil War, at our house in the country weren't there and didn't keep on trying, ny. Even hearing cartoon characters say, and I go into that room and look at the I'll never forget that either. "Drop dead." I remember looking at a things he loved-which, of course, I didn't What did the cards say? magazine cover on summer pleasures, appreciate as much when he was living. Just "Thinking about you," "I'm here if and thinking, Wow, I wish that's all I cared That's a very special place for me. I find you need me." That was a very reassur- about: what I was going to do this summer, that talking about him to those people ing, comforting thing. I think of the book what movies I was going to see. I think it's who cared about him and miss him is real- Tuesdays with Morrie (about a college pro- important to acknowledge that someone's ly helpful. Sometimes when you lose fessor dying of Lou Gehrig's disease and world has taken a gut-wrenching turn. someone, other people just want it to be his relationship with a former student). Is there any place or item that you shared in the past and not talk about it. I appreci- He talked about how you're in this with Jay that now offers comfort? ate having people say how much they dreamlike state and you can't understand Nothing really comforts me, I'm sorry to cared about him and miss him too. how people are just going on with their report. It's only been months since my Are you still close to his family? lives, chatting and going to the grocery husband died. And, frankly, I still can't Yes. Jay was one of seven children, and I store, and pushing baby strollers. That life believe it. When I think about it, it just often speak to his siblings as well as to his is going on swimmingly for everyone else. permeates every cell in my body. You parents. They're all wonderful. I also like I think when people acknowledge that can forget about it temporarily. But then to talk to other people who knew him life has changed in a horrible way for you, the grief comes like a huge wave and like well and were profoundly affected by it's very reassuring. I used to say I saw the a horrible invasion of your heart and soul. him. Someone sent me a letter telling me world through cancer-colored glasses. Little things help me-like having my about Jay's experience in the Navy. I just Everything just looks very different. It's husband's money clip in my purse. And got his transcripts from college and read his like B.C. and A.C.-Before Cancer and just being in a room where he spent a lot guidance counselor's recommendation and After Cancer. You see references to death of time. But I don't have any sort of ritual his entrance essay. It was very revealing. on commercials; you see a man being or supercomforting place. I'm still looking He wrote things that I didn't know about buried in a car, and it's not a big joke. It's for that. My husband had a collection of him. It's nice to have, but sometimes so terrifying. When death is a distinct possi- historic military pieces, particularly from hard to read. (continued on page 188) The Stories of Three Families Left Behind KATHY HOCHHAUSER "HE NEVER LOST HIS SPIRIT" AND HER DAUGHTERS, I n 1993, Kathy Hochhauser and her husband, Ken, were feeling ELLEN, 18, SEATED, hopeful about their future together. The parents of two daughters- AND GWEN, 14. Ellen, 12 at the time, and Gwen, 9-they were strong-willed people whose marriage had been troubled; the couple were in counseling. But now they were trying to put the bad times behind them. Then, one day, Ken, a 45-year-old accountant at a computer company in Framingham, MA, noticed blood in his stool. "I urged him to go to the doctor, but he put it off for a few months," says Kathy, now 50, a public school secretary. When he finally had a colonoscopy, an examination of the colon, the news wasn't good: A tumor was found. Ken had surgery immediately, but the cancer had already spread to his liver. Although he would get chemotherapy and radiation-including an experimental drug- the doctors indicated that he didn't have long to live. "He was a fighter; he was going to prove them wrong," recalls Kathy. And he did. For three years after the surgery, he lived life to the fullest. "He'd be nauseated after a chemotherapy session, but he'd insist on playing basketball," says Kathy. And he rallied enough to attend Gwen's bat mitzvah in November 1996. "He even found the strength to dance with me," says Kathy. She and Ken grew closer than they had ever been. Kathy drove him to and from treatments and nursed him through the long nights. "He never lost his spirit," she reports. "Two weeks before he died, I asked him if there was anything I could get for him, and he grinned and said, 'A pastrami sandwich.' went to the deli right away." On July 3, 1997, Ken, at age 49, lost his battle against colon cancer. Kathy had grieved a lot during the years she cared for Ken, but now she couldn't stop thinking about what could have been done to save her young husband's life. For 25 years, Ken had suffered from chronic bowel problems, and Kathy now says she wishes he'd been screened earlier. "If only one person reads this and goes for a checkup," she says, "none of what we went through will have been in vain." -Sondra Forsyth CHELSIE SHERER, "SHE WAS A REAL GOOD MoM" 7, AND her FATHER, TRIPP. C helsie Sherer, a 7-year-old who loves to swim and watch videos, T seems like a typical second grader. But those close to her know she's wrestling with a terrible trauma: the loss of her mother. In 1996, at age 28, Lisa Sherer died of a rare, genetic form of colon cancer, leav- ing behind her only child and her husband, Tripp, a dental technician. Chelsie was not yet 3 when Lisa first got sick in 1993. She passed a lot of blood one day and WES ushed to the emergency room. It turned out she had familial polyposis, a condition in which thousands of polyps grow on the colon, and her polyps were malignant. She was given a year and a half to live. The doctors told Tripp that the polyps start out benign but if not removed al- most always become malignant by the time the person is 40. Tripp recalled that Lisa frequently had diarrhea and lacked stamina. When he asked her about it, she told him she had received a diagnosis of a spastic colon when I she was a teenager. No formal testing had been done; if it had, the condition could have been detected sooner. Though Lisa didn't know of any relatives with familial polyposis, Tripp wor- volved: I ried that she might have passed it on to Chelsie, so he arranged to have her made up tested. Sure enough, Cheisie had the condition. "But we caught it early tube that enough; her polyps were still precancerous," says Tripp. However, doctors had food and to remove Chelsie's entire large intestine to protect her from cancer. tum, the Lisa was SO ill that, at first, Tripp didn't tell her that Chelsie had inherited large inte her condition and undergone surgery. But three months before Lisa died, Tripp rity has g decided she should know: "She was extremely upset, but I said the way I saw account 0 it, she gave Chelsie life, and now she was saving Chelsie's life. After that, I as former asked her if she wanted to renew our VOWS. She said yes." The ceremony was breast c performed at Lisa's bedside on May 12, 1996. Two weeks later, she died. Schwarzl Today, Lisa's framed photograph sits on the dresser in the bedroom she Many and Tripp once shared. "Sometimes I go into Daddy's room and look at my strikes IT mom's picture," says Chelsie. "She was a real good mom." -S.F. doctors a patients "I WISH I COULD SEE HIM AGAIN" develop CLOCKWISE.FROMY netic pre L ast Christmas, not long after she turned 16, Lynne Patterson's father, Michael, gave her a 1989 Volkswagen and two promises. ,LEFT:LYNNI tually kil First, as a mechanic, he'd keep the vehicle in top shape. Second, Patterson, 16: they dor he'd help her get her license. But Michael, 50, of Medford, MA, wouldn't live GEORGIA,HER men. TI and 64,6 long enough to celebrate that rite of passage with his oldest daughter. ΓiMoTHy, 11,5 cer, and On February 6, he was admitted to the hospital with a fever of 103°F. Jacqueljine,14. will die Tests showed that Michael seemed to be losing blood, so a CT scan was can Can performed. It revealed a mass in his abdomen. Surgery turned up a The malignancy on his colon-as well as 14 other tumors. The prognosis? At screeni most, several months for Michael to spend with his wife, Georgia, and Lynne known and her three siblings: Amy, 15; Jacqueline, 14; and Timothy, 11. be prev "I couldn't believe it," says Lynne. "The doctors said the tumor must have could Sa taken at least five years to get that big, but my dad hadn't seemed sick at year, bu all." Michael did experience some rectal bleeding-the No. 1 sign of colon Bond, I cancer. At first it was some slight spotting. Then, by October 1997, the Veterar bleeding had become pronounced, SO Michael went to the doctor. His neapoli physician found a hemorrhoid and suggested that Michael have a colon- 50 and cancer test, which he postponed. Georgia now wishes she and Michael had cancer, paid more attention to those earlier symptoms. womer Despite the grim prognosis, Lynne thought she'd have at least one more colon e summer with her father. "We had always been really close," she says. "Ever cording since I was a little girl, our family had traveled to Maine in July. My dad would trol an wake me up at five in the morning, SO the two of us could walk to the bakery us put to get pastries hot from the oven. I pictured us walking together again." barrass It wasn't to be. By February 14, Michael had developed complications plenty from the surgery, and four days later, he was gone. "It's still hard to accept," tors do says Lynne. "Something in the house will break, and I'll think, Oh, Dad will fix some i that. I wish I could see him again, even just one more time, to tell him I love the be him and to hear him say that he loves me." -S.F. The Diges 128 The Preventable Cancer The right testing for colon cancer can save your life. What every woman needs to know. by Lisa Collier Cool t's the second most deadly adults age 50 and over-the group with Screening Tests," page 190). cancer, killing more people the highest rate of colon tumors-an as- I What makes the screening shortfall each year than breast or tonishing 61 percent of women said so troublesome is that colon cancer prostate cancer. Yet colon their doctors had never advised any kind often produces no symptoms in its early cancer doesn't receive nearly of screening. Many primary-care doctors stages, when it is 90 percent curable. If as much attention. That's aren't educated about the tremendous not detected, it typically goes unnoticed partly because no one likes to benefits of testing, according to Albert until it has spread beyond the in- talk about the body parts in- Palitz, M.D., director of the colorectal testines-at which point the five-year volved: namely, the large intestine, cancer prevention program at Kaiser survival rate is less than 60 percent. made up of the colon, a six-foot-long Permanente, a large California-based tube that removes water from digested health maintenance organization. "Only The Best Protection food and expels solid waste; and the rec- in the last five years have studies pro- Colon-cancer experts agree that the "gold tum, the last six to eight inches of the vided clear evidence that screening can standard" of screening is colonoscopy, a large intestine. What's more, no celeb- prevent death," he notes. However, the 15- to 20-minute test in which the entire rity has gone public with a first-person ACS has supported colon-cancer screen- colon is checked for tumors using a account of the disease to raise awareness, ing for nearly two decades, issuing new lighted flexible tube with a cameralike as former First Lady Betty Ford did for guidelines last year (see "Rating the device at one (continued on page 188) breast cancer and General Norman Schwarzkopf did for prostate cancer. Many women assume colon cancer THE GOLD-STANDARD 20-MINUTE TEST: strikes mostly the elderly-or men. But ONE Woman's STORY doctors are seeing younger and younger patients with the disease, some of whom ot long ago, I saw something would be injected into my intestines SO the doctor develop the illness early because of a ge- netic predisposition. And the cancer ac- N alarming in the toilet. "This isn't would have a good view, and that would produce a good," I said out loud, staring at gassy, uncomfortable feeling. Sedation would be tually kills more women-mainly because the bloody stool I discovered. I'm necessary. I was told that there would be no they don't get screened as frequently as 52, and my mother has a history of colon polyps. discomfort when the probe was slowly retracted, men. This year, about 67,000 women- So I made an appointment with William Coll, M.D., SO I asked to be awakened midprocedure. I wanted and 64,600 men-will develop colon can- a local gastroenterologist, who helped me arrive at to see for myself what was going on inside. cer, and 28,600 women and 27,900 men an obvious conclusion: I needed to have my colon Dr. Coll used intravenous Demerol (a sedative will die from it, according to the Ameri- checked for cancer. I was scared, SO I elected, as and painkiller) and Versed (another sedative) to can Cancer Society (ACS). advised by Dr. Coll, to have a colonoscopy, which knock me out during the first part of the The good news: With the right would enable him to inspect my entire colon. procedure. Then, I got a drug that would wake me screening, the disease-technically In the 24 hours before the procedure, I needed up. When I opened my eyes, the scope, now about known as colorectal cancer-can actually to cleanse and flush my colon SO that Dr. Coll's four feet up my innards, displayed interior shots of be prevented. "Widespread screening view would be unobstructed. My diet was restricted my colon on a monitor only a few feet away. Inside could save at least thirty-thousand lives a to clear liquids and chilled bouillon. But that this strange labyrinth of pink-gold crinkles and year, but sadly, very few get says John wasn't all. I was ordered to take one and a half folds were two tiny polyps, six millimeters in Bond, M.D., chief of gastroenterology at ounces of a fizzy laxative potion mixed with eight diameter, which Dr. Coll removed. Also revealed Veterans Affairs Medical Center in Min- ounces of water, once at 11:00 A.M. and again at were two tiny hemorrhoids that had ruptured and neapolis. More than half of women age 6:00 P.M. Dr. Coll recommended that I stay home were deemed the cause of my dramatic bowel 50 and over are now checked for breast after the first dose (which I did). It made perfect movement. cancer, but only about 24 percent of sense: This nasty-tasting salty, lemony drink gave Afterward, I dozed lightly in the recovery room. I women age 50 and over have had their me cramps and diarrhea almost immediately, and was a little WOOZY, but my stomach felt fine. In fact, colon examined in the past five years, ac- I found myself in the bathroom at 20-minute I was hungry. I fantasized about breaking my fast cording to the Centers for Disease Con- intervals throughout the day. I was not only crampy with barbecued spareribs and garlic mashed trol and Prevention in Atlanta. Many of and crabby but also lightheaded and weak- potatoes, a dream that became a reality that us put off testing, fearing it may be em- probably dehydrated, Dr. Coll said. He also told me evening. I returned to work, spunky as ever, the barrassing or uncomfortable. But there's that all of these reactions were to be expected. next morning. plenty of blame to go around: Some doc- The next morning, at 8:30 A.M., I went to Sharon A few days later, I learned that the polyps were tors don't tell us to get screened-and Hospital in Connecticut. I got undressed, put on a benign. I was glad I'd had the colonoscopy-and some insurance companies won't pay for cotton gown, and was instructed to lie on a relieved when Dr. Coll told me that the type of the best testing. stretcher. A nurse explained that the colonoscope, polyps he'd removed never becomes cancerous. So Three years ago, when the American a thin, lighted probe with a cameralike device at I don't have to have another colonoscopy for seven Digestive Health Foundation polled one end, would be threaded into my colon. Air to ten years. -Maxine Paetro KATIE COURIC COLON CANCER cil eraser, and up to seven more years to turn cancerous. (continued from page 127) (continued from page 129) Elizabeth Ely, 55, an interior decora- Do you share them with your daughters? end. The device transmits images of the tor in New York City, is grateful that she I'm putting together a book of all the let- colon to a video screen, which the doctor had a colonoscopy, because it saved her ters people have written about Jay, so that watches throughout the procedure. Any life. Although she didn't have a family my girls feel like they know a lot about polyps that are discovered can be re- history of colon cancer or any symptoms their father and what an outstanding per- moved during the test. Colonoscopy (in fact, she felt great, she says), her doc- son he was. I'm also writing them a letter finds 97 percent of colon tumors, and the tor encouraged her to get tested because all about our courtship-and how we met ACS now recommends it for everyone age of her age. Last March, a colonoscopy and why I fell in love with him. The idea 50 and over. revealed a malignant rectal tumor. "I is that when they're older they can read The unique advantage of colonoscopy was absolutely shocked," she recalls. "I about him and appreciate him. I've asked is that it's the only cancer test that can never believed anything would be people to write to my girls, and I've actually prevent received the most beautiful letters. malignancy. YOUR RISK AND YOUR AGE Do the letters make you feel better, or is it "There's a very all a painful exercise? strong argument Your chance of getting colon cancer increases dramatically as you get that people who older. Check this chart against your age to pinpoint your risk of It's definitely painful, but part of the process. I think it will ultimately help. have this test reg- developing the disease, which strikes at an average age of 66: But for now it reminds me how much I ularly will never, Ages A Woman's Risk A Man's Risk miss him. Some of the letters I just can't ever get colon Birth to 39 1 in 2,000 1 in 1,667 read. Someday I will. cancer, which 40 to 59 1 in 147 1 in 114 When you first went back on the Today means it's much 60 to 79 1 in 31 1 in 24 show following death, you wore his better for pre- wedding ring around your neck on a venting this dis- Source: American Cancer Society, Cancer Facts & Figures, 1998 chain. Lately, you haven't been wearing it. ease than mammograms are for breast wrong with me. I've always been well." Why did you stop? cancer," says Robert J. Mayer, M.D., di- She had surgery to remove the tumor, The safety chain broke. I didn't stop for rector of the Center for Gastrointestinal and was relieved to learn that it was an any symbolic reason. I just worry that Oncology at the Dana Farber Cancer In- early-stage cancer. She was deemed without the safety clasp, I would lose it. stitute in Boston. That's because virtu- cured after the operation. "I'm very It made me too nervous. And now I'm ally all colon cancers begin as mush- lucky," says Ely. "Now I'm telling my not sure if I'll wear it again. It's a very room-shaped or flat premalignant clients, friends, and relatives to have the outward symbol of one's grief, and I growths called polyps. "About five to test if they're fifty or over." wore it because it made me feel very ten percent may become cancerous, so if Another, more famous survivor: for- close to him, by touching it. It was they're found and removed during mer President Ronald Reagan, who had a hard decision: whether he should colonoscopy, you probably won't get part of his intestines removed in 1985 wear the ring-or I should. I didn't know cancer," explains Jose Guillem, M.D., after doctors discovered a malignant what to do. All of my friends told me it associate attending colorectal surgeon at tumor through colonoscopy. was okay for me to keep it. And I found Memorial Sloan-Kettering Cancer Cen- a lot of solace in it. I don't think he ter in New York City. What's Your Life Worth? would mind. It appears that one colonoscopy is Despite the lifesaving power of Has throwing yourself back into work enough to protect people at average risk colonoscopy, Medicare and a number of helped you cope? for an entire decade, because polyps other health plans won't pay for it. "This You do what you have to do. I have chil- grow very slowly, taking about five to is unjust to the American public," says dren to support. And kids just automati- seven years to become the size of a pen- Michael D. Moseson, M.D., a clinical as- cally make you stronger. Work was a way for me to keep going while Jay was sick. For two hours I could distract YOUR RISK AND YOUR FAMILY HISTORY myself, and I think it serves the same A person who has no cancer in her family has a one in 17 chance of developing colon cancer over a purpose now. lifetime. That risk increases if your relatives have had certain kinds of cancers. If you fall into any of the What is your advice to couples who have categories listed below, you should get a colonoscopy (total exam of the colon) by age 40, or ten years been spared a life-threatening illness? before the youngest age at which a family member received a diagnosis of colon cancer. If there are Cherish each day. Get under the covers several cases of colon cancer in your family, consider getting a genetic test at a major cancer center to with your kids on a Saturday morning. check for an inherited syndrome. Testing, which can cost anywhere from $250 to $2,400, can help And even if your spouse drives you crazy determine the age and frequency at which you need to be screened. sometimes, remember what made you 1. You have a distant relative-an uncle, aunt, or grandparent-who has/had colon cancer. fall in love to begin with. My daughter is Your risk 1.5 in 17 obsessed with The Wizard of Oz, and 2. You have an immediate family member-a parent, sibling, or child-who has/had colon cancer. there's one thing that Dorothy says Your risk: 2 or 3 in 17 toward the end of the movie that always 3. You have two or more immediate family members who have/had colon cancer, or have one relative affects me so much: "If I ever go looking who developed the disease before age 50. Your risk: 3 or 4 in 17 for my heart's desire again, I won't look 4. You have one or more immediate rdistant relatives who have/had breast, ovarian, uterine, or prostate Our Safti-Gr any further than my own backyard." cancer. Your risk: 1.5 in 17 -LC.C. to your tub. 188 good housekeeping|October 1998 OCTOBER 1998 $1.95 Good Win a CONTEST Gained Back KITCHEN Those Pounds? MAKEOVERS Lose Them For Good Great Looks You Can AIR BAG DANGERS Afford How To Keep Your Family Safe Do You Talk To Yourself? When It Helps INTERVIEW BEST EVER Katie's Wish PASTA RECIPES Speaking out in her husband's memory...what she KIDS' HEALTH desperately wants you to know Update on Unsafe Medicines, New Vaccines, and More http://goodhousekeeping.com 10 PLUS: Other stories of courage. 08345 And real hope in the 0754714 $1.95 battle to beat colon cancer. GOOD HOUSEKEEPING october Katie's Crusade Still coming to terms with her husband's death from colon cancer, the Today show's Katie Couric is speaking out in his memory. What she wants you to know could save your life. BY JOANNA POWELL 124 In her handsome corner office at New York City's Rockefeller young ages. At least 13,000 new cases Center, Katie Couric is trying to get on with her life. Dressed each year involve people under 50. le Does having lost a loved one to cancer in a baby-blue tailored suit and heavy makeup from her make you terrified of developing the morning duties as cohost of NBC's Today show, she's both disease yourself? poised and funny as she gives a rare interview. First, she Terrified is probably too strong a word. But it certainly makes me feel vulnera- takes time for a bit of girl talk about shoes. Then she turns ble. My husband was trim, healthy, had serious as the subject moves to her recent loss. never smoked a cigarette. It makes me feel vulnerable for everyone, not just for Despite her courageous front, Katie's myself. It's very frightening. voice cracks often during our conversa- How did you keep going after Jay's death? tion, and her eyes well up with tears. It As hard as it is for everybody who faces a has been just a few months since the tragedy in their lives, you really don't death of her husband, TV legal analyst have much of a choice. You can stay in Jay Monahan, who at 42, lost a swift, bed every day, or for weeks or months at a brutal fight with colon cancer. As a new- time, or you can just keep going. Children ly single mother with two small children force you to keep going. You don't have (Ellie, 7, and Carrie, 2½), Katie is still the luxury of putting your head in the reeling from the shock. sand. My children are a tremendous But in her search for solace, she has source of comfort, tremendously motivat- found some touchstones. In one corner ing for me. Because I have responsibili- of her office there is a small antique ties. It's not just financial. It's being there chest of drawers that was a birthday gift for them because they are children. from her husband the year before he How was Jay's cancer discovered? died. Once a scientist's display cabinet, He was already very sick when doctors it is filled with delicate eggs of various diagnosed it in April 1997. He had no wild birds. Even though some of the symptoms. Jay was tired, but we thought eggs have already broken, Katie has it was because he was flying back and protectively made a handwritten sign forth to California for his job [as a TV that reads FRAGILE and taped it to the Katie with husband Jay in 1995. legal analyst]. And we had two small chil- top of the chest. "I'm just so afraid it "We had no idea dren bringing every bug in America into might get damaged," she says. "It the house. We had no idea what was means so much to me." what was going on in going on in his body. This cancer is so What also means a lot to Katie is her decision to turn her grief into action-by his body. This cancer insidious. What are the lessons to be learned? launching a fight to raise awareness is so insidious.' For one, that there are often very few about colon cancer. It is to that end that symptoms until it's too late. I'm not say- she is anchoring a five-part series about ish about it. It might cost you your life. ing everyone in America is walking the disease on the Today show from For the Today show's series on colon can- around with colon cancer, but everyone September 14 to 18. And it is why, for cer, we interviewed a Yale-educated doc- needs to know that it is a possibility. And this interview, she agreed to talk inti- tor who was going to give a talk on colon they need to rule it out. The only way to mately about her loss-and her ongoing cancer at the Yale Club in New York be really safe is to be tested. I'd like for effort to understand it. City. He was asked to change the subject people to become more aware of Joanna Powell: You've been very private of his talk to make it more palatable. Peo- colonoscopy, an exam that allows a doctor since your husband died. Why are you ple educated at a university like Yale can- to check the colon for abnormalities, and speaking out now? not deal with colon cancer? I just couldn't to decide with their doctors whether one Katie Couric: Colon cancer has taken a believe it. is warranted. huge personal toll on my life. Now I'd What do you want people to be especially Do you think there's anything doctors like to help educate others about this dis- aware of? know now that might have made a differ- ease. I want everyone to understand that People need to know that colon cancer ence in saving Jay's life? women as well as men get colon cancer. can strike the young. My husband was My husband's mom, who is now in her Young people as well as old people get it. barely 42 years old. My executive produc- 60s, has ovarian cancer-it was diagnosed And frankly, very few people take advan- er, Jeff Zucker, got it, and he was only 31. about three years ago. His grandmother tage of the preventive tools that exist. Fortunately, he survived. Last weekend, died of breast cancer. There is a growing Too many Americans don't get tested I ran into a farmer I know out in the coun- body of thought that these glandular can- because they don't want to talk about try. Jay and I always bought produce from cers-breast, ovarian, uterine, prostate, that part of their body. him. When I saw him, he said, "I'm SO and colon-may be related, that there is How can we break the stigma of this sorry about Jay. You know I lost my perhaps, a genetic link. If we had known disease? fiancée five years ago to colon cancer." I this, Jay might have been screened for I think we have to use the words, say asked how old she was, and he said, colon cancer. I now certainly believe you them. Colon. Rectum. Bowels. The more "Thirty-eight." I can't tell you how many should think long and hard about an matter of fact you are with the language, people wrote to me whose husbands or early colonoscopy, not only if your aunt or the more it helps. You can't be squeam- wives were taken by this disease at very grandmother or other relative has colon cancer, but also if any of these glandular treatment for colon cancer is a drug that going to get through it and continue to fly never forg in the healthiest way possible. Talk to weren't th cancers exist in your family. I firmly was developed in the 1950's. I hope that believe you have to be your own best more money-government and private- your child's teachers; talk honestly with I'll never fc children about the death in an age- What did 1 advocate. We're hearing now that every- can be devoted to cancer research. If we one 50 and up should have a colonoscopy can put Sojourner on Mars, we can come appropriate way. Parents can't just forget Just "Thin regardless of risk factors or symptoms. up with something that keeps cancer about it and hope their kids will be okay. you need I But all the doctors I know-and I know a What should you do to keep the loved ing, comfor from destroying so many lives. lot of them-say they had or will get a How do you feel about the body's ability one's memory alive? Tuesdays wr colonoscopy by their fortieth birthday. to "beat cancer"? Is it possible? People talk You can't schedule a child's grief. You fessor dying That ought to tell you something. a lot about fighting it psychologically. really have to have a good sense of what's his relation Problem is, even if you have a family I think you have to have hope and a fight- right for your child; you can't force-feed He talked history of colon cancer, doctors often ing spirit. On the other hand, this idea that your child. I try to talk about Jay in a very dreamlike si natural way, because he comes up all the how people time. Yet I don't try to sit with my child lives, chatti "Little things help-like having my in some kind of artificial environment, store, and pu and have her discuss things with me that is going on S' husband's money clip in my purse. And maybe she's not ready to talk about. I I think wl being in a room where he spent time." think you have to pick up cues from life has chan them. The other day my daughter Carrie it's very reas: was on her play telephone telling me, world throu recommend you be screened by a flexible people who survive cancer are stronger "Mom, it's Daddy calling from heaven." Everything sigmoidoscopy, not a colonoscopy. willed or more motivated or have a greater It was heartbreaking, but I wanted to like B.C. an Flexible sigmoidoscopy is effective for explore it with her, so we started talking. After Cancer desire to live is really unfair to people who only the lower third to half of the colon. don't beat it. I think cancer, frankly, comes She's only 2½, but I didn't want to just on commerce My feeling is if you really want to be sure, down to biology and luck. The cemeteries ignore her and what she was saying. It's buried in a ca getting a flex sig is like getting a mam- are full of people who wanted to live more an awful lot for grown-ups to handle terrifying. WI mogram on one breast. than anything and couldn't. their own pain and loss, but they can't After your husband found out he had It's a very confusing concept-the idea forget about the children. They're going colon cancer, what did you do to fight the that if you fight hard enough you can cure through it too. It's very easy in a situation Th disease? yourself. like this to feel completely and utterly I can share some of my personal experi- I'm thrilled for people who beat it, overwhelmed. But I think parents have a ence, but I want to be careful not to because I know they've been to hell and real responsibility to pull it together for invade my husband's privacy or dignity in back. But to imply that they are mentally their children. any way. Immediately after he received superior to those who don't beat it is just Has your mother been helpful to you dur- his diagnosis, I began to amass a lot of plain wrong. ing this ordeal? information on treatment, clinical trials, The other part of your story is surviving Oh, yes. I'm very close to my parents. I and experimental drugs. I was extremely the grief after losing your husband. Is went through a period when I was just frustrated to discover there's no single there anything that's been especially help- impossible to deal with. Because I was source for learning about the various ful in your life in the past months? just so, so upset and angry and furious experimental treatments for your specific Talking to other women who have been with the world. Talk about unconditional disease. Pharmaceutical and biotech com- through similar circumstances. Nobody love. They've always been there for me. panies are highly competitive and some- else really understands. I didn't before it What about friends? How have they times secretive about the kinds of tests happened to me. As empathetic as responded? they're doing. The technology is chang- friends and family want to be, it's just I think this is really important. A lot of ing at breakneck speed. And it's hard to such a lonely, painful experience. It's people are at a loss when it comes to help- find sources that are in plain English, not very meaningful to have someone who ing friends feel better. A lot of people pull medicalese. It was very troubling to me. can relate to an earth-shattering event in back because they don't want to be inva- Here I was, a reporter. I've spent the last the same way you do. sive or intrusive. 20 years researching and investigating. Do you have any advice to parents with Or say the wrong things. But when it came to tracking down infor- young children who have lost a loved one? Or say the wrong things. It's painful for a mation that could potentially save a life, I I'd hate to profess to be an expert. It's lot of people because it reminds them of hit one obstacle after another. I'm heart- definitely baptism by fire when you're in their own mortality. But when someone ened to hear that the National Cancer a situation like this. Every child is differ- you care about is going through something Institute has just implemented a new ent, every parent is different, every situa- as traumatic as this, you can't stop trying to Web site clearinghouse, so some of this tion is different. But I do think you need get in-even if they push you away, initial- information is easier to access but I defi- to be very proactive in helping your ly, because they're so knocked off their children through an ordeal like this. And foundation and their world has just fallen nitely think more could be done. Do you find it frustrating that cancer is you need to do everything you can to apart. If they push you away, and you real- still the No. 2 killer in this country after keep them healthy and whole. You can't ly care-push back. Keep trying. When all heart disease? think that they are just children and they you're going through it, you're scared Incredibly. It's been more than 25 years won't be affected, or they'll get over it, or the time. I had one friend who wrote mea since Richard Nixon declared war on can- children are resilient. Some of that is true, card every week and called me every cer. And while there have been tremen- but I think you have to very consciously week, and I never called her back. But I'll dous strides, the first-line chemotherapy take steps to make sure that they're I'm so grateful that she kept trying. 126 never forget that. And the people who bility in your life, these things are not fun- the Civil War, at our house in the country weren't there and didn't keep or trying, ny. Even hearing cartoon characters say, and I go into that room and look at the I'll never forget that either. "Drop dead." I remember looking at a things he loved-which, of course, I didn't What did the cards say? magazine cover on summer pleasures, appreciate as much when he was living. Just "Thinking about you," "I'm here if and thinking, Wow, I wish that's all I cared That's a very special place for me. I find you need me." That was a very reassur- about: what I was going to do this summer, that talking about him to those people ing, comforting thing. I think of the book what movies I was going to see. I think it's who cared about him and miss him is real- Tuesdays with Morrie (about a college pro- important to acknowledge that someone's ly helpful. Sometimes when you lose fessor dying of Lou Gehrig's disease and world has taken a gut-wrenching tum. someone, other people just want it to be his relationship with a former student). Is there any place or item that you shared in the past and not talk about it. I appreci- He talked about how you're in this with Jay that now offers comfort? ate having people say how much they dreamlike state and you can't understand Nothing really comforts me, I'm sorry to cared about him and miss him too. how people are just going on with their report. It's only been months since my Are you still close to his family? lives, chatting and going to the grocery husband died. And, frankly, I still can't Yes. Jay was one of seven children, and I store, and pushing baby strollers. That life believe it. When I think about it, it just often speak to his siblings as well as to his is going on swimmingly for everyone else. permeates every cell in my body. You parents. They're all wonderful. I also like I think when people acknowledge that can forget about it temporarily. But then to talk to other people who knew him life has changed in a horrible way for you, the grief comes like a huge wave and like well and were profoundly affected by it's very reassuring. I used to say I saw the a horrible invasion of your heart and soul. him. Someone sent me a letter telling me world through cancer-colored glasses. Little things help me-like having my about Jay's experience in the Navy. I just Everything just looks very different. It's husband's money clip in my purse. And got his transcripts from college and read his like B.C. and A.C.-Before Cancer and just being in a room where he spent a lot guidance counselor's recommendation and After Cancer. You see references to death of time. But I don't have any sort of ritual his entrance essay. It was very revealing. on commercials; you see a man being or supercomforting place. I'm still looking He wrote things that I didn't know about buried in a car, and it's not a big joke. It's for that. My husband had a collection of him. It's nice to have, but sometimes so terrifying. When death is a distinct possi- historic military pieces, particularly from hard to read. (continued on page 188) The Stories of Three Families Left Behind KATHY JOCHHAUSER "HE NEVER LOST HIS SPIRIT" DAUGHTERS I n 1993, Kathy Hochhauser and her husband, Ken, were feeling Ellen, 18, SEATED, hopeful about their future together. The parents of two daughters- 14. Ellen, 12 at the time, and Gwen, 9-they were strong-willed people whose marriage had been troubled: the couple were in counseling. But now they were trying to put the bad times behind them. Then, one day, Ken, a 45-year-old accountant at a computer company in Framingham, MA, noticed blood in his stool. "I urged him to go to the doctor, but he put it off for a few months," says Kathy, now 50, a public school secretary. When he finally had a colonoscopy, an examination of the colon, the news wasn't good: A tumor was found. Ken had surgery immediately, but the cancer had already spread to his liver. Although he would get chemotherapy and radiation-including an experimental drug- the doctors indicated that he didn't have long to live. "He was a fighter; he was going to prove them wrong," recalls Kathy. And he did. For three years after the surgery, he lived life to the fullest. "He'd be nauseated after a chemotherapy session, but he'd insist on playing basketball," says Kathy. And he rallied enough to attend Gwen's bat mitzvah in November 1996. "He even found the strength to dance with me," says Kathy. She and Ken grew closer than they had ever been. Kathy drove him to and from treatments and nursed him through the long nights. "He never lost his spirit," she reports. "Two weeks before he died, I asked him if there was anything I could get for him, and he grinned and said, 'A pastrami sandwich.' I went to the deli right away." On July 3. 1997, Ken, at age 49, lost his battle against colon cancer. Kathy had grieved a lot during the years she cared for Ken, but now she couldn't stop thinking about what could have been done to save her young husband's life. For 25 years, Ken had suffered from chronic bowel problems, and Kathy now says she wishes he'd been screened earlier. "If only one person reads this and goes for a checkup," she says, "none of what we went through will have been in vain." -Sondra Forsyth Chelsie SHERER "SHE WAS A REAL GOOD MoM" 7, ANDHER father, Tripp. C helsie Sherer, a 7-year-old who loves to swim and watch videos, T seems like 8 typical second grader. But those close to her know she's wrestling with a terrible trauma: the loss of her mother. In 1996, at age 28, Lisa Sherer died of a rare, genetic form of colon cancer, leav- ing behind her only child and ner husband, Tripp, a dental technician. Chelsie was not yet 3 when Lisa first got sick in 1993. She passed a lot of blood one day and was rushed to the emergency room. It turned out she had familial polyposis, a condition in which thousands of polyps grow or the - colon, and her polyps were malignant. She was given a year and a half to live. ( The doctors told Tripp that the polyps start out benign but if not removed al- most always become malignant by the time the person is 40. Tripp recalled II ( I that Lisa frequently had diarrhea and lacked stamina. When he asked her ( about it, she told him she had received a diagnosis of a spastic colon when : she was a teenager. No formai testing had been done. if it had, the condition 1 could have been detected sooner. Though Lisa didn't know of any relatives with familial polypos:s, Tripp wor- volved: n: ried that she might have passed it on to Chelsie, so he arranged to have her made up . tested. Sure enough, Chelsie had the condition. "But we caught it early tube that I enough; her polyps were still precancerous," says Tripp. However, doctors had food and e: to remove Chelsie's eatire large intestine to protect her from cancer. tum, the I: Lisa was SO ill that, at first, Tripp didn't tell her that Chelsie had inherited large intes her condition and undergone surgery. But three months before Lisa died, Tripp rity has go decided she should know: "She was extremely upset, but I said the way I saw account of it, she gave Chelsie life, and now she was saving Chelsie's life. After that, I as former asked her if she wanted to renew our VOWS. She said yes." The ceremonywas breast ca: performed at Lisa's bedside on May 12, 1996. Two weeks later, she died. Schwarzk Today, Lisa's framed photograph sits on the dresser in the bedroom she Many . and Tripp once shared. "Sometimes I go into Daddy's room and look at my strikes m mom's picture," says Chelsie. "She was a real good mom." -S.F. doctors an patients w "I WISH I COULD SEE HIM AGAIN" develop tl CLOCKWISETROM ast Christmas, not long after she turned 16, Lynne Patterson's netic prec L LEFT: Lynni father, Michael, gave her a 1989 Volkswagen and two promises. tually kills Patterson, 16. First, as a mechanic, he'd keep the vehicle in top shape. Second, they don' GEORGIA her men. Thi he'd help her get her license. But Michael, 50, of Medford, MA, wouldn't live MOTHER; Amy, 15 and 64,60 long enough to celebrate that rite of passage with his oldest daughter. TIMOTHY, 11, (ND cer, and 2 On February 6, he was admitted to the hospital with a fever of 103°F. JACQUELINE, 14. will die fi Tests showed that Michael seemed to be losing blood, SO a CT scan was can Canc performed. It revealed a mass in his abdomen. Surgery turned up a The : malignancy on his colon-as well as 14 other tumors. The prognosis? At screening most, several months for Michael to spend with his wife, Georgia, and Lynne known ai and her three siblings: Amy, 15; Jacqueline, 14; and Timothy, 11. be preve "I couldn't believe it," says Lynne. "The doctors said the tumor must have could sav taken at least five years to get that big, but my dad hadn't seemed sick at year, but all." Michael did experience some rectal bleeding-the No. 1 sign of colon Bond, M cancer. At first it was some slight spotting. Then, by October 1997, the Veterans bleeding had become pronounced, SO Michael went to the doctor. His neapolis physician found a hemorrhoid and suggested that Michael have a colon- 50 and o cancer test, which he postponed. Georgia now wishes she and Michael had cancer, paid more attention to those earlier symptoms. women Despite the grim prognosis, Lynne thought she'd have at least one more colon ex summer with her father. "We had always been really close," she says. "Ever cording since I was a little girl, our family had traveled to Maine in July. My dad would trol and wake me up at five in the morning, SO the two of us could walk to the bakery us put o to get pastries hot from the oven. I pictured us walking together again." barrassi It wasn't to be. By February 14, Michael had developed complications plenty of from the surgery, and four days later. he was gone. "It's still hard to accept," tors do says Lynne. "Something in the house will break, and I'll think, Oh, Dad will fix some in that. I wish I could see him again, even just one more time, to tell him I love the best him and to hear him say that he loves me." -S.F. Thre Digest 128 The Preventable Cancer The right testing for colon cancer can save your life. What every woman needs to know. by Lisa Collier Cool t's the second most deadly adults age 50 and over-the group with Screening Tests," page 190). cancer, killing more people the highest rate of colon tumors-an as- What makes the screening shortfall I each year than breast or tonishing 61 percent of women said so troublesome is that colon cancer prostate cancer. Yet colon their doctors had never advised any kind often produces no symptoms in its early cancer doesn't receive nearly of screening. Many primary-care doctors stages, when it is 90 percent curable. If as much attention. That's aren't educated about the tremendous not detected, it typically goes unnoticed partly because no one likes to benefits of testing, according to Albert until it has spread beyond the in- talk about the body parts in- Palitz, M.D., director of the colorectal testines-at which point the five-year volved: namely, the large intestine, cancer prevention program at Kaiser survival rate is less than 60 percent. made up of the colon, a six-foot-long Permanente, a large California-based tube that removes water from digested health maintenance organization. "Only The Best Protection food and expels solid waste; and the rec- in the last five years have studies pro- Colon-cancer experts agree that the "gold tum, the last six to eight inches of the vided clear evidence that screening can standard" of screening is colonoscopy, a large intestine. What's more, no celeb- prevent death," he notes. However, the 15- to 20-minute test in which the entire rity has gone public with a first-person ACS has supported colon-cancer screen- colon is checked for tumors using a account of the disease to raise awareness, ing for nearly two decades, issuing new lighted flexible tube with a cameralike as former First Lady Betty Ford did for guidelines last year (see "Rating the device at one (continued on page 188) breast cancer and General Norman Schwarzkopf did for prostate cancer. Many women assume colon cancer THE GOLD-STANDARD 20-MINUTE TEST: strikes mostly the elderly-or men. But ONE Woman's STORY doctors are seeing younger and younger patients with the disease, some of whom ot long ago, I saw something would be injected into my intestines so the doctor develop the illness early because of a ge- netic predisposition. And the cancer ac- N alarming in the toilet. "This isn't would have a good view, and that would produce a good," I said out loud, staring at gassy, uncomfortable feeling. Sedation would be tually kills more women-mainly because the bloody stool I discovered. I'm necessary. I was told that there would be no they don't get screened as frequently as 52, and my mother has a history of colon polyps. discomfort when the probe was slowly retracted, men. This year, about 67,000 women- So I made an appointment with William Coll, M.D., so I asked to be awakened midprocedure. I wanted and 64,600 men-will develop colon can- a local gastroenterologist, who helped me arrive at to see for myself what was going on inside. cer, and 28,600 women and 27,900 men an obvious conclusion: I needed to have my colon Dr. Coll used intravenous Demerol (a sedative will die from it, according to the Ameri- checked for cancer. I was scared, so I elected, as and painkiller) and Versed (another sedative) to can Cancer Society (ACS). advised by Dr. Coll, to have a colonoscopy, which knock me out during the first part of the The good news: With the right would enable him to inspect my entire colon. procedure. Then, I got a drug that would wake me screening, the disease-technically In the 24 hours before the procedure, I needed up. When I opened my eyes, the scope, now about known as colorectal cancer-can actually to cleanse and flush my colon SO that Dr. Coll's four feet up my innards, displayed interior shots of be prevented. "Widespread screening view would be unobstructed. My diet was restricted my colon on a monitor only a few feet away. Inside could save at least thirty-thousand lives a to clear liquids and chilled bouillon. But that this strange labyrinth of pink-gold crinkles and year, but sadly, very few get it," says John wasn't all. I was ordered to take one and a half folds were two tiny polyps, six millimeters in Bond, M.D., chief of gastroenterology at ounces of a fizzy laxative potion mixed with eight diameter, which Dr. Coll removed. Also revealed Veterans Affairs Medical Center in Min- ounces of water, once at 11:00 A.M. and again at were two tiny hemorrhoids that had ruptured and neapolis. More than half of women age 6:00 P.M. Dr. Coll recommended that I stay home were deemed the cause of my dramatic bowel 50 and over are now checked for breast after the first dose (which I did). It made perfect movement. cancer, but only about 24 percent of sense: This nasty-tasting salty, lemony drink gave Afterward, I dozed lightly in the recovery room. I women age 50 and over have had their me cramps and diarrhea almost immediately, and was a little WOOZY, but my stomach felt fine. In fact, colon examined in the past five years, ac- I found myself in the bathroom at 20-minute I was hungry. I fantasized about breaking my fast cording to the Centers for Disease Con- intervals throughout the day. I was not only crampy with barbecued spareribs and garlic mashed trol and Prevention in Atlanta. Many of and crabby but also lightheaded and weak- potatoes, a dream that became a reality that us put off testing, fearing it may be em- probably dehydrated, Dr. Coll said. He also told me evening. I returned to work, spunky as ever, the barrassing or uncomfortable. But there's that all of these reactions were to be expected. next morning. plenty of blame to go around: Some doc- The next morning, at 8:30 A.M., I went to Sharon A few days later, I learned that the polyps were tors don't tell us to get screened-and Hospital in Connecticut. I got undressed, put on a benign. I was glad I'd had the colonoscopy-and some insurance companies won't pay for cotton gown, and was instructed to lie on a relieved when Dr. Coll told me that the type of the best testing. stretcher. A nurse explained that the colonoscope, polyps he'd removed never becomes cancerous. So Three years ago, when the American a thin, lighted probe with a cameralike device at I don't have to have another colonoscopy for seven Digestive Health Foundation polled one end, would be threaded into my colon. Air to ten years. Maxine Paetro KATIE COURIC COLON CANCER cil eraser, and up to seven more years to turn cancerous. (continued from page 127) (continued from page 129) Elizabeth Ely, 55, an interior decora- Do you share them with your daughters? end. The device transmits images of the tor in New York City, is grateful that she I'm putting together a book of all the let- colon to a video screen, which the doctor had a colonoscopy, because it saved her ters people have written about Jay, so that watches throughout the procedure. Any my girls feel like they know a lot about polyps that are discovered can be re- life. Although she didn't have a family history of colon cancer or any symptoms their father and what an outstanding per- moved during the test. Colonoscopy (in fact, she felt great, she says), her doc- son he was. I'm also writing them a letter finds 97 percent of colon tumors, and the tor encouraged her to get tested because all about our courtship-and how we met ACS now recommends it for everyone age of her age. Last March, a colonoscopy and why I fell in love with him. The idea 50 and over. revealed a malignant rectal tumor. "I is that when they're older they can read The unique advantage of colonoscopy was absolutely shocked," she recalls. "I about him and appreciate him. I've asked is that it's the only cancer test that can never believed anything would be people to write to my girls, and I've actually prevent received the most beautiful letters. malignancy. YOUR RISK AND YOUR AGE Do the letters make you feel better, or is it "There's a very all a painful exercise? strong argument Your chance of getting colon cancer increases dramatically as you get It's definitely painful, but part of the that people who older. Check this chart against your age to pinpoint your risk of process. I think it will ultimately help. have this test reg- developing the disease, which strikes at an average age of 66: But for now it reminds me how much I ularly will never, Ages A Woman's Risk A Man's Risk miss him. Some of the letters I just can't ever get colon Birth to 39 1 in 2,000 1 in 1,667 read. Someday I will. cancer, which 40 to 59 1 in 147 1 in 114 When you first went back on the Today means it's much 60 to 79 1 in 31 1 in 24 show following Jay's death, you wore his better for pre- wedding ring around your neck on a venting this dis- Source: American Cancer Society, Cancer Facts & Figures, 1998 chain. Lately, you haven't been wearing it. ease than mammograms are for breast wrong with me. I've always been well." Why did you stop? cancer," says Robert J. Mayer, M.D., di- She had surgery to remove the tumor, The safety chain broke. I didn't stop for rector of the Center for Gastrointestinal and was relieved to learn that it was an any symbolic reason. I just worry that Oncology at the Dana Farber Cancer In- early-stage cancer. She was deemed without the safety clasp, I would lose it. stitute in Boston. That's because virtu- cured after the operation. "I'm very It made me too nervous. And now I'm ally all colon cancers begin as mush- lucky," says Ely. "Now I'm telling my not sure if I'll wear it again. It's a very room-shaped or flat premalignant clients, friends, and relatives to have the outward symbol of one's grief, and I growths called polyps. "About five to test if they're fifty or over." wore it because it made me feel very ten percent may become cancerous, so if Another, more famous survivor: for- close to him, by touching it. It was they're found and removed during mer President Ronald Reagan, who had a hard decision: whether he should colonoscopy, you probably won't get part of his intestines removed in 1985 wear the ring-or I should. I didn't know cancer," explains Jose Guillem, M.D., after doctors discovered a malignant what to do. All of my friends told me it associate attending colorectal surgeon at tumor through colonoscopy. was okay for me to keep it. And I found Memorial Sloan-Kettering Cancer Cen- a lot of solace in it. I don't think he ter in New York City. What's Your Life Worth? would mind. It appears that one colonoscopy is Despite the lifesaving power of Has throwing yourself back into work enough to protect people at average risk colonoscopy, Medicare and a number of helped you cope? for an entire decade, because polyps other health plans won't pay for it. "This You do what you have to do. I have chil- grow very slowly, taking about five to is unjust to the American public," says dren to support. And kids just automati- seven years to become the size of a pen- Michael D. Moseson, M.D., a clinical as- cally make you stronger. Work was a way for me to keep going while Jay was sick. For two hours I could distract YOUR RISK AND YOUR FAMILY HISTORY myself, and I think it serves the same A person who has no cancer in her family has a one in 17 chance of developing colon cancer over a purpose now. lifetime. That risk increases if your relatives have had certain kinds of cancers. If you fall into any of the What is your advice to couples who have categories listed below, you should get a colonoscopy (total exam of the colon) by age 40, or ten years been spared a life-threatening illness? before the youngest age at which a family member received a diagnosis of colon cancer. If there are Cherish each day. Get under the covers several cases of colon cancer in your family, consider getting a genetic test at a major cancer center to with your kids on a Saturday morning. check for an inherited syndrome. Testing, which can cost anywhere from $250 to $2,400, can help And even if your spouse drives you crazy determine the age and frequency at which you need to be screened. sometimes, remember what made you 1. You have a distant relative-an uncle, aunt, or grandparent-who has/had colon cancer. fall in love to begin with. My daughter is Your risk: 1.5 in 17 obsessed with The Wizard of Oz, and 2. You have an immediate family member-a parent, sibling, or child-who has/had colon cancer. there's one thing that Dorothy says Your risk: 2 or 3 in 17 toward the end of the movie that always 3. You have two or more immediate family members who have/had colon cancer, or have one relative affects me so much: "IfI ever go looking who developed the disease before age 50. Your risk: 3 or 4 in 17 for my heart's desire again, I won't look 4. You have one or more immediate or distant relatives who have/had breast, ovarian, uterine, or prostate Our Safti-Gri any further than my own backyard." cancer. Your risk: 1.5 in 17 -LC.C. to your tub. \ 188 good housekeeping|October 1998 FIRST LADY HILLARY RODHAM CLINTON PROMOTES COLON CANCER AWARENESS AND PREVENTION September 10, 1998 Today, at the White House, the First Lady will announce a series of initiatives to raise awareness about colon cancer. She will announce a new research grant to fight colon cancer, release a survey reporting that many Americans do not receive appropriate screening for this disease, unveil a new public service announcement to promote prevention, and announce new public and private sector partnerships to raise awareness. The First Lady will be joined by Katie Couric, NBC "Today Show" Anchor; Ellen Levine, Editor-in-Chief of "Good Housekeeping" Magazine; Dr. Bernard Levin, a colon cancer specialist and chair of the National Colorectal Cancer Roundtable; and Secretary Shalala. Colon Cancer - A Preventable Killer. Colon cancer is the number one non-tobacco-related cancer killer, with more than 50,000 Americans dying each year from the disease. For both men and women, it is the third most common cancer, and 130,000 Americans contract the disease each year. Men and women over the age of 50 have the greatest risk of developing colorectal cancer. However, it is preventable and curable when detected early; in fact, a patient whose cancer is detected early has more than a 90 percent chance of survival. Raising awareness about colon cancer and the importance of screening can save lives. New Grant to Fund Colon Cancer Research. The First Lady will announce a new $8 million grant by the National Institutes of Health to the Seattle Gastrointestinal Program Project for research aimed at preventing, diagnosing and treating colon cancer. The grant will help scientists better determine who is at risk for colon cancer and will test new strategies to reduce their cancer risk. The grant will also be used to develop more sensitive and precise ways of screening colon cancer than those available today. New Survey Demonstrates Need for Greater Need for Colon Cancer Awareness. The First Lady will release a survey finding that nearly 50 percent of men and women over the age of 50 of those at highest risk for colon cancer have never been screened. Forty-seven percent of those not tested reported that no medical professional had ever recommended that they be screened for colon cancer. Although colon cancer occurs with almost equal frequency in men and women over the age of 50, 49 percent of women reported not having been screened compared to 36 percent of men. Dramatic differences were also present between whites and non- whites. Forty-four percent of whites reported not having taken any of the three tests used for screening, as opposed to 56 percent of non-whites. While most of the adults surveyed believed that early detection could save lives, few were aware that screening and dietary changes could help prevent the onset of colorectal cancer. This national survey was conducted by the Gallup Organization. A New Media Campaign: With its October issue, "Good Housekeeping" Magazine is initiating a year-long colon cancer awareness campaign. The October issue will contain a major medical report on what women can do to protect themselves from colon cancer. In addition, NBC's "Today Show" will present a week-long in-depth series, "Confronting Colon Cancer," that will offer a comprehensive look at this preventable disease. New Partnership Between Public and Private Sector. The First Lady will also announce the creation of the National Colorectal Cancer Roundtable unprecedented private and public sector partnership to promote greater awareness of colon cancer. Group members include the Centers for Disease Control, the American Cancer Society, the American Digestive Health Foundation. Raising Awareness through a New Public Service Announcement. A new public service announcement featuring the First Lady will be unveiled urging all Americans over the age of 50 to be screened for colorectal cancer. NBC will air the PSA, and the print version will appear in the January issue of Good Housekeeping. The PSA will also be distributed nationally. New Internet Site to Answer Questions on Colon Cancer. The First Lady will also announce a new Internet chatroom that will allow consumers, patients, family members, survivors, and people at high risk for the disease to engage in live discussions of issues relating to colorectal cancer. Doctors and other experts will be available on line to answer questions about this disease. The website address is www.gastro.org/adhf.html, and it will be sponsored by the American Digestive Health Foundation, a member of the Colorectal Cancer Roundtable. New Private Sector Commitments to Raise Awareness: The First Lady will also announce new private sector commitments to promote colon cancer awareness, by bringing attention to the importance of prevention and early detection. Commitments include: American Airlines will publish the public service announcement on colon cancer in its in- flight magazine, where it may reach approximately two million travelers in the U.S. and abroad. The Kellogg Company USA will promote colorectal cancer prevention and early detection by printing public service messages on five million packages of All Bran and Bran Buds cereal boxes. American Greetings will create an insert for prescriptions that promotes prevention and early detection of colorectal cancer. The National Association of Chain Drug Stores will distribute the insert to all of its pharmacies and pharmacists. Bristol-Meyers Squibb Oncology has provided a $100,000 grant to the Better Health Foundation to develop a colorectal cancer workplace awareness program that it will initiate at all of its work sites, and send to companies all around the country. Olympus America, Inc., will sponsor an education program on colon cancer that will be sent to the administrators of retirement communities all across the country. General Motors will publish an article in its newsletter to encourage its two million employees to research information relating to preventing, detecting and understanding colorectal cancer. Other private industries included in the partnership are Smith Kline Diagnostics, Eli Lilly and Company, and Zeneca Pharmaceuticals, all of whom have committed to raise awareness among their thousands of employees about colon cancer. Things To Do "I feel fine." "My schedule is too hectic." 7:00 9:00 Tennis Staff Meeting Colon Cancer Test "I'm only 50." 11:00 12:30 Dry Cleaning Rita MAKE THE TIME TO GET 1:45 Lunch w/ A TEST THAT COULD SAVE 3:00 Conference Call YOUR LIFE. Colon cancer is the second-leading cancer killer and every- one aged 50 and older is at risk. More than 50,000 Americans will die from colon cancer and 131,600 new cases will be diagnosed this year. Colon cancer is an equal-opportunity disease that affects both women and men. This silent killer frequently begins without symptoms and those with a family history are at even greater risk. THE GOOD NEWS IS: Colon cancer is preventable-even curable when detected early. In fact, if cancer is found early enough, the patient has more than a 90 percent chance of survival. Colon cancer screenings are safe and effective and are now covered by Medicare and an increasing number of other health providers. There's even a test that can be used in the privacy of your own home. Talk to your doctor about getting tested. "You can prevent colon cancer, even beat it." HILLARY RODHAM CLINTON NATIONAL olorectal Cancer ROUNDTABLE SPONSORED BY THE NATIONAL COLORECTAL CANCER ROUNDTABLE FOR MORE INFORMATION, CALL THE AMERICAN CANCER SOCIETY AT 1-800-ACS-2345 The National Colorectal Cancer Roundtable TV PSAs NATIONAL 1599 Clifton Road NE Atlanta, GA 30329-4251 :60/:30/:15 olorectal "Hillary Rodham Clinton on Colon Cancer" ancer ROUNDTABLE MEMBERS OF THE NATIONAL Public Service Director: COLORECTAL CANCER ROUNDTABLE Dear having a disease that rarely in the produces United symploms but is Agency for Healthcare Policy & Research Imagine the second a most silent deadly killer that cancer affects over women the age and of 50 men is at risk. This Alliance of Community Health Plans cancer frequency is and everyone Americans will die from colorectal can- American Academy of Family Physicians equal year, more nearly than 131,600 50,000 new cases will be diagnosed. American Cancer Society American College of Gastroenterology cer and news is that colorectal cancer is preventable, and the dis- There even American College of Physicians American College of Radiology The curable ease is First Colorectal no good could other Lady when reduce disease detected the about death which rate we by has can more over make awareness than the information, the this 50 age National percent. claim. about of 50 we to col- and get need American Digestive Health Foundation American Gastroenterological Association American Medical Association American Medical Women's Association American Society for Gastrointestinal Endoscopy orectal screened. your the benefits help cancer As in of spreading an and screening. important the We source word a about this deadly air disease this PSA do as to American Society of Colon and Rectal Surgeons Association of State & Territorial Directors of Health Promotion & Public Health Education frequently schedule it as when possible. viewers I over Centers for Disease Control & Prevention Collaborative Group of the Americas on Inherited Colorectal Cancer Sincerely, Digestive Diseases National Coalition Slamin Memorial Sloan-Kettering Cancer Center National Cancer Institute National Caucus & Center on Black Aged, Inc. Bernard Levin, National M.D. Colorectal Prevention Cancer Roundtable STOP Colorectal Cancer Foundation Chairman, President for Cancer Center University of Minnesota Cancer Center Vice M.D. Anderson Cancer University of Texas M.D. Anderson Cancer Center 1ST WOMAN: Okay, who's up for lunch? 2ND WOMAN: Oh yeah. It's just a colon 3RD WOMAN: I'm supposed to get screened 2ND WOMAN: Oh, sorry. I've got to take cancer test. too, but I don't have the time my husband to the doctor. 4TH WOMAN: But he's so young. 3RD WOMAN: Is everything okay? Only fifty-two. MAKE THE TIME TO GET A TEST THAT COULD SAVE YOUR LIFE. Call the American Cancer Society 1-800-ACS-2345 ancer Hillary Rodham Clintom HILLARY RODHAM CLINTON: Colon can- But you can beat it if it's detected early. ANNCR: Call 1-800-ACS-2345. cer kills over 50,000 people a year and So if you're fifty or older please get tested. strikes women nearly as often as men. It can save your life. NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE Colorectal Cancer Public Service Announcements Featuring First Lady Hillary Rodham Clinton Founding Organizations: American Cancer Society WHAT: Television, print, and radio public service announcements (PSAs) Centers for Disease Control on the importance of screening to prevent and detect colorectal and Prevention cancer. Television and radio PSAs are available in :15, :30 and :60 Member Organizations formats. The print PSA is available in a variety of dimensions. Agency for Healthcare Policy and Research Alliance of Community WHO: The PSAs feature First Lady Hillary Rodham Clinton urging all Health Plans Americans over the age of 50 to see their doctors about getting American Academy of screened for colorectal cancer. The PSAs are sponsored by the Family Physicians American College of National Colorectal Cancer Roundtable, a coalition of medical Gastroenterology professional, consumer advocacy, and voluntary organizations, American College of Physicians committed to raising awareness about the prevention and early American College of Radiology detection of colorectal cancer (see Roundtable fact sheet). American Digestive Health Foundation WHY: 50,000 Americans die every year from colorectal cancer, the American Gastroenterological Association second leading cancer killer, and the disease affects women nearly American Medical Association as often as men. Everyone aged 50 and older is at risk for American Medical developing colorectal cancer, and those with a family history are at Women's Association even greater risk. However, colorectal cancer is preventable, even American Society of Colon and Rectal Surgeons curable, when detected early. In fact, widespread screening for American Society for colorectal cancer could reduce the death rate by over 50 percent. Gastrointestinal Endoscopy There is no other disease about which we can make this claim. Association of State and Territorial Directors of Health Everyone 50 and older should see his or her doctor about getting Promotion and Public Health screened for colorectal cancer. Education Digestive Diseases National Coalition WHERE: The television PSAs will be available via satellite broadcast on the Collaborative Group of the following days: Americas on Inherited Colorectal Cancer Memorial Sloan-Kettering Thursday, September 10th Friday, September 11th Cancer Center 7:30pm to 7:45pm EDT 1:00pm to 1:15pm EDT National Cancer Institute Satellite GE1, Transponder 1 Satellite Telestar 4, Transponder 23 National Caucus and Center on Black Aged, Inc. Downlink 3720 Downlink 4160 STOP Colorectal Cancer Audio on 6.2 and 6.8 Audio on 6.2 and 6.8 Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center The PSAs will be widely distributed to television, radio and print public service directors across the country. A nationally distributed trade publication for television PSA directors will feature Mrs. Clinton's PSAs in the September issue, and the PSAs also will be distributed through the grassroots efforts of the member organizations of the National Colorectal Cancer Roundtable. For copies of the television, radio or print PSAs, contact Bill Goodwill at (703) 426-0881. ### NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 Folorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE Roundtable Member Organization Launches Chat Room on Colorectal Cancer www.gastro.org/adhf.html Founding Organizations: American Cancer Society Centers for Disease Control and Prevention On September 10th, 1998, the American Digestive Health FoundationSM's (ADHFSM) Digestive Health Initiative® (DHI®) will debut its Internet chat Member Organizations: room on colorectal cancer. Located at www.gastro.org/adhf.html, this public Agency for Healthcare Policy and Research to public chat room will allow consumers, colorectal cancer patients, family Alliance of Community members, survivors, and people at high risk for developing the disease to Health Plans engage in live, real-time discussions of the many issues related to colorectal American Academy of Family Physicians cancer. At this same electronic location, the DHI also will offer a colorectal American College of cancer message board, on which participants can post questions, answers, Gastroenterology information about resources, and topics for discussion concerning this disease. American College of Physicians American College of Radiology In addition to the address above, the chat room can be accessed through the American Digestive home pages of the three ADHF member societies: Health Foundation American Gastroenterological Association American Gastroenterological Association: www.gastro.org American Medical Association American Society for Gastrointestinal Endoscopy: www.asge.org American Medical Women's Association American Association for the Study of Liver Diseases: American Society of Colon www.hepar-sfgh.ucsf.edu and Rectal Surgeons American Society for "Guest of the Month" Feature Gastrointestinal Endoscopy Each month, the DHI colorectal cancer chat room will feature a guest expert. Association of State and Territorial Directors of Health These guest experts, drawn from the medical, patient support, and cancer Promotion and Public Health Education survivor communities, will be scheduled to appear live in the chat room to Digestive Diseases discuss their personal and professional experiences with colorectal cancer. National Coalition Throughout the month, the guest experts will also respond to questions and Collaborative Group of the Americas on Inherited Colorectal topics of discussion posted on the message board. Cancer Memorial Sloan-Kettering Cancer Center September's live guest will be actress and colorectal cancer survivor Barbara National Cancer Institute Barrie, co-star of the NBC sitcom "Suddenly Susan" and author of the 1997 National Caucus and Center book Second Act: Life After Colostomy and Other Adventures. Ms. Barrie on Black Aged, Inc. will participate live in the chat room on September 11th from 1 p.m. to 2 p.m. STOP Colorectal Cancer EDT to discuss her personal experience and will respond to inquiries on the Foundation University of Minnesota message board during the month of September. Dr. Bernard Levin, vice Cancer Center president for Cancer Prevention at the M.D. Anderson Cancer Center in University of Texas Houston and chair of the National Colorectal Cancer Roundtable, also M.D. Anderson Cancer Center will be available during the last two weeks of September to respond to message board questions and comments. See the opening page of the chat room for information on future guest experts. The American Digestive Health Foundation is a cooperative effort of the American Gastroenterological Association, the American Society for Gastrointestinal Endoscopy, and the American Association for the Study of Liver Diseases. The ADHF promotes digestive health for all Americans by supporting educational initiatives and research into the causes, prevention, diagnosis, treatment and cure of digestive and liver diseases. The ADHF funds basic research, clinical research, and investigations into prevention strategies, and has established four interdependent initiatives to advance its digestive health agenda. ### * National Colorectal Cancer Roundtable member. NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 olorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE The National Colorectal Cancer Roundtable Founding Organizations: The National Colorectal Cancer Roundtable is a coalition of medical American Cancer Society professional, consumer advocacy and voluntary organizations, committed to Centers for Disease Control and Prevention raising awareness about the prevention and early detection of colorectal cancer. The Roundtable's ongoing mission is to reduce the incidence of and Member Organizations: mortality from this disease by achieving screening rates for colorectal cancer Agency for Healthcare Policy and Research that are equivalent to screening rates for other cancers (currently four out of Alliance of Community five people*). Health Plans American Academy of Family Physicians Colorectal cancer is the second leading cancer killer in the US, causing the American College of deaths of more than 50,000 Americans every year. Men and women over the Gastroenterology age of 50, and those with a family history of colorectal cancer, are most at risk American College of Physicians for developing this disease. American College of Radiology American Digestive Health Foundation To advance its major objectives, the Roundtable has set the following goals: American Gastroenterological Association Develop a national strategic plan for the early detection and control of American Medical Association colorectal cancer. American Medical Women's Association Advocate for key policy issues that will help reduce colorectal cancer American Society of Colon rates. and Rectal Surgeons Identify research needs and potential barriers to reducing colorectal cancer American Society for rates, and recommend solutions. Gastrointestinal Endoscopy Association of State and Develop and sustain partnerships to enhance efforts in the prevention and Territorial Directors of Health early detection of colorectal cancer. Promotion and Public Health Education Monitor progress in disease reduction efforts and participation in Digestive Diseases screening. National Coalition Collaborative Group of the Produce periodic reports on the current state of colorectal cancer control, Americas on Inherited Colorectal and progress towards national objectives. Cancer Memorial Sloan-Kettering Cancer Center For more information on the National Colorectal Cancer Roundtable, call Dr. National Cancer Institute Gabriel Feldman at the American Cancer Society, (404) 329-7504. National Caucus and Center on Black Aged, Inc. STOP Colorectal Cancer Foundation ### University of Minnesota Cancer Center * Breast and cervical cancers. University of Texas M.D. Anderson Cancer Center Member Organizations of the National Colorectal Cancer Roundtable Agency for Healthcare Policy and Research Alliance of Community Health Plans American Academy of Family Physicians American Cancer Society American College of Gastroenterology American College of Physicians American College of Radiology American Digestive Health FoundationSM American Gastroenterological Association American Medical Association American Medical Women's Association American Society of Colon and Rectal Surgeons American Society for Gastrointestinal Endoscopy Association of State and Territorial Directors of Health Promotion and Public Health Education Centers for Disease Control and Prevention Collaborative Group of the Americas on Inherited Colorectal Cancer Digestive Diseases National Coalition Memorial Sloan-Kettering Cancer Center National Cancer Institute National Caucus and Center on Black Aged, Inc. STOP Colorectal Cancer Foundation University of Minnesota Cancer Center University of Texas M.D. Anderson Cancer Center NATIONAL c/o American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329-4251 Folorectal Phone: 404-329-7631 Fax: 404-248-1780 Cancer Email: [email protected] ROUNDTABLE National Colorectal Cancer Roundtable Private Industry Partnerships Promoting Awareness of Colorectal Cancer Prevention and Detection Founding Organizations: American Cancer Society The National Colorectal Cancer Roundtable, a coalition of medical Centers for Disease Control and Prevention professional, consumer advocacy and voluntary organizations, has developed partnerships with private industry to raise awareness of the importance of Member Organizations: colorectal cancer prevention and early detection. These national companies, Agency for Healthcare Policy and Research with their powerful reach, have committed to activities that will educate Alliance of Community hundreds of thousands of Americans over the age of 50 about the importance Health Plans of getting screened for colorectal cancer, the nation's second leading cancer American Academy of Family Physicians killer. American College of Gastroenterology American Airlines American College of Physicians American Airlines will publish First Lady Hillary Rodham Clinton's public American College of Radiology service announcement on colon cancer in its in-flight magazine, American American Digestive Health Foundation Way, reaching approximately two million air travelers in the US and around American Gastroenterological the world. In addition, American Airlines' in-house medical staff will provide Association free colorectal cancer screening cards to more than 200,000 American Medical Association employees, spouses and retirees. American Medical Women's Association American Society of Colon American Greetings Corporation / National Association of Chain Drugstores and Rectal Surgeons American Greetings will create a prescription insert reflecting National American Society for Colorectal Cancer Roundtable messages about prevention and early detection. Gastrointestinal Endoscopy The National Association of Chain Drugstores will distribute the insert to its Association of State and Territorial Directors of Health 30,000 chain pharmacies and 90,000 chain pharmacists. Beginning in early Promotion and Public Health Education 1999, individuals having prescriptions filled at participating drugstores and Digestive Diseases pharmacies will receive the insert in their prescription bags. National Coalition Collaborative Group of the Americas on Inherited Colorectal Beckman Coulter, Inc. / SmithKline Diagnostics, Inc. Cancer Beckman Coulter/SKD will publish First Lady Hillary Rodham Clinton's Memorial Sloan-Kettering public service announcement on colorectal cancer through the company Cancer Center intranet and in-house publication, Beckman Coulter Life, reaching more than National Cancer Institute National Caucus and Center 10,000 employees worldwide. SKD-trained representatives and an in-house on Black Aged, Inc. support staff of 50 will promote the message about screening for colorectal STOP Colorectal Cancer cancer by making themselves, and SKD's Basic Training TM Patient Education Foundation Program, available to National Colorectal Cancer Roundtable participants and University of Minnesota Cancer Center partners. University of Texas M.D. Anderson Cancer Center Bristol-Myers Squibb Oncology / Better Health Foundation Bristol-Myers Squibb Oncology has provided an initial $100,000 grant to the Better Health Foundation to develop a colorectal cancer workplace awareness program that companies nationwide can adopt at no cost. Bristol-Myers Squibb Oncology will initiate the program at all of its work sites. Eli Lilly and Company Eli Lilly will conduct a new employee education campaign to increase awareness about the prevention of colon cancer through regular screenings. The campaign will reach more than 31,000 Lilly employees worldwide and their families using the public service materials developed by the National Colorectal Cancer Roundtable, as well as educational materials created by the company's employee health services department in cooperation with corporate communications. Lilly will inform employees through a number of venues, including publications and its in-house television network. General Motors Corporation General Motors will publish an article on the importance of colorectal cancer prevention and early detection in its newsletter, Feelin' Good, which is distributed to 1.5 million employees, retirees, and families. The article will encourage employees to access the audio-tapes General Motors has in its Audio Health Library on colorectal cancer risk factors, early detection guidelines, signs and symptoms, and treatment, and will encourage enrollees in the corporation's wellness program to discuss any colorectal cancer questions or symptoms with registered nurses available through a toll-free number. The article also will contain information on how readers can access General Motors' web site information on the prevention and early detection of colorectal cancer, and will encourage employees to read the information on the disease contained in their wellness program self-care manuals. Kellogg Company Kellogg will promote colorectal cancer prevention and early detection messages to a variety of audiences, including: consumers via five million packages of Kellogg's All Bran and Bran Buds; 5,000 hospital health care sites; 5,000 health care professionals; 500 retailers; and to its thousands of employees and retirees through its publication, The Kellogg News. In addition, Kellogg Company will provide in-store consumer education messages in 12,000 stores, as well as information on the Internet generating approximately five million "hits" per month. Olympus America Inc. Olympus America will sponsor and videotape a "Colorectal Cancer Education -What Everyone Needs to Know" program which will be open to employees, family members and the general public. Olympus will initiate a direct mailing to the administrators of retirement communities across the country, offering copies of the videotaped program at no cost, and will show the videotaped program at the five Olympus Service Center branches in Atlanta, Cleveland, Chicago, Dallas, and Long Beach. The program will be held at Olympus America headquarters in Melville, NY, or at a local medical university, and will be repeated at Olympus' repair and distribution facility in San Jose, CA. A panel of leading experts will speak about the problem of colorectal cancer, as well as solutions, including preventive measures, nutrition, and screening. The program will be promoted through a direct mail piece and internal Olympus Bulletin. Zeneca Pharmaceuticals Zeneca will offer to all employees over the age of 40 a new educational session on nutrition and its role in colorectal cancer, as well as a new session on the importance of screening women for colorectal cancer. In addition, a new work-site guide for detection/screening for colorectal cancer will be issued for customer use. ###