House Calls

WIN 2019

House Calls Magazine is a quarterly publication that focuses on health and wellness. It includes a wide assortment of articles with topics on the latest health and wellness information, nutrition, safety, lifestyles, and more.

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"I told him, 'Maybe I'm crazy, but something feels off,'" she says. Even so, when her doctor referred her to a gastroenterologist, she was skeptical. "I felt like I was too young to be getting a colonoscopy." But in this case—and in the case of many others nationwide—her age didn't protect her. When she awoke from the colonoscopy the doctor gave her the news: They had found a mass in her colon that they'd sent off to a pathologist. Within minutes, she had a CT scan scheduled for that Friday, and was being referred to a colorectal surgeon and oncologist. "Are you telling me I have cancer?" McLeod remembers asking, stunned. The pathology report confirmed that she did—colorectal cancer to be exact. McLeod's story is less unusual than you may think. While overall rates of colon and rectal cancer have gone down in the U.S. since the mid 1980s (thanks in large part to improved and increased screening among older adults), incidence rates among young and middle-aged adults have risen. A 2018 study by the American Cancer Society (ACS) found that men born in 1990 have double the risk of colon cancer and quadruple the risk of rectal cancer than people born around 1950. The same study found that rates of colon cancer have risen roughly one to two percent annually from 1974 to 2013 among those aged 20 to 39, and that, among the same age group, rectal cancer rates have increased roughly three percent per year between 1980 and 2013. But Roper St. Francis Healthcare affiliated colorectal surgeon Dr. Jorge Lagares-Garcia says that even with the distressing statistics, there's reason to be encouraged. "With early detection, M ount Pleasant resident Marielle McLeod had just turned 36 when she had a gut feeling that something was wrong. "I noticed that I was struggling to use the bathroom," she recalls. Having recently lost 30 pounds, the former college athlete and mom of four figured it was a side effect of her new diet. But when the problems persisted, she checked in with her general practitioner. P H O T O G R A P H ( D R . L A G A R E S ) B Y L I L I A M O N T E R O 38 { winter 2019 } h o u s e c a l l s colorectal cancers can be treated and patients can be cured," he says. And McLeod is a living example. Colorectal cancer begins with a polyp, or a small clump of cells that form on the lining of the colon or rectum (together, these are known as the large intestine and make up the end of the gastrointestinal, or GI, system). Most often, polyps are benign; in some cases, however, they can become cancerous. From there, cancer can move into the wall of the colon or rectum and eventually spread into the lymph nodes, organs, tissues, and beyond—a process called metastasis. Dr. Lagares says that colorectal cancer is especially dangerous because it can be silent, or asymptomatic, for years. And when symptoms do surface, they are often overlooked. "Some patients experience minor bleeding and don't even think about it. Others have cramping, changes in bowel movements, or unexplained constipation or weight loss. All of those are red flags," he says. "If you have any rectal bleeding or a substantial change in the nature of your bowel movements, go have it checked." Diagnosing colorectal cancer begins with a colonoscopy screening (see page 39 for details). If a polyp found during the colonoscopy contains cancer cells, a treatment plan will be determined based on the stage of the disease—or how far it has spread throughout the body—among other factors, like the patient's health. Unless indicated by advanced staging in rectal cancer, typically the first step of treatment is robotic assisted or laparoscopic (minimally invasive) surgery to remove any polyps not extracted during the colonoscopy. The surgery may require a colostomy, or bowel diversion therapy: an operation that either temporarily or permanently diverts stool away from the bowels in order to treat the colon or rectum (a stoma is created to allow waste to exit the body via colostomy bag). Other methods for treating metastatic disease include radiofrequency ablation, which uses heat to treat tumors, and cryoablation, a means of freezing tumors. For large polyps in the rectum, there is also the option of Transanal Endoscopic MicroSurgery (TEMS), which, by performing surgery through the anus, avoids the need for an incision. A 2016 study published in the World Journal of Gastrointestinal Oncology predicts an increase in colon cancer by 90 percent among adults aged 20 to 34, and 27 percent among those aged 35 to 49 by 2030. MEET THE DISEASE TREAT THE DISEASE In November, Marielle got a tattoo to honor her journey. The stars surrounding the ribbon represent her husband and four kids. "They are what I fought so hard for. Not only to survive, but to be a sign of strength for my children," she says.

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