UT MD Anderson Patient: Colorectal Cancer Not Just For Those 50 and Older

When Dessa Ledet repeatedly experienced pain on the right of her body, she never dreamed she would hear the words “you have cancer” when she woke up from a colonoscopy. In fact, she didn’t believe that almost three years after her diagnosis she would run in MD Anderson’s seventh annual Sprint for Colorectal Oncology Prevention and Education (SCOPE) Run on Saturday, March 24.

Her new reality as a cancer survivor has her gearing up for the SCOPE Run - organized by Cathy Eng, M.D., associate professor in MD Anderson’s Department of Gastrointestinal Medical Oncology, and Kimberly Tripp, administrative director of Acute Care Services, to help raise awareness about colorectal cancer.

Colorectal cancer continues to be the second-deadliest cancer worldwide. More than 140,000 people in the United States are expected to be diagnosed with the disease this year alone. However, not all of the cases will be adults 50 and older, which is the general age for this type of cancer.

Although colorectal cancer may result from lifestyle habits and aging, a small percentage is associated with genetic instability. “A screening colonoscopy is effective at decreasing the chance of dying from colorectal cancer,” said Eng. “It is also important to know the risks associated with the disease and recognize symptoms so it can be diagnosed in its earliest stages.” To prevent the disease, people are encouraged to live healthy lifestyles including a well-balanced diet and exercise, and begin screening at age 50.

Ledet shares that her grandmother, a heavy smoker, recently died of lung cancer but there is no other history of cancer in her family. As a non-smoker and exercise enthusiast, Ledet took pride in being physically fit. She exercised three to five times a week, and for the most part, tried to eat healthy, well-balanced meals and limit alcohol consumption.

What is colorectal cancer?
Colorectal cancer develops in the colon or the rectum. The colon and rectum are parts of the digestive system, also called the gastrointestinal, or GI, system. The digestive system processes food for energy and rids the body of solid waste (fecal matter or stool).

After food is chewed and swallowed, it travels through the esophagus to the stomach. There it is partially broken down and sent to the small intestine, where digestion continues and most of the nutrients are absorbed. The word “small” refers to the diameter of the small intestine, which is smaller than that of the large intestine. The small intestine is actually the longest part of the digestive system – about 20 feet in length. Cancer occurs infrequently in the small intestine.

The small intestine joins the large intestine in the lower right abdomen. The small and large intestine are sometimes called the small and large bowel. The first and longest part of the large intestine is the colon, a muscular tube about 5 feet long. Water and mineral nutrients are absorbed from the food matter in the colon. Waste (feces) left from this process passes into the rectum, the final 6 inches of the large intestine, and is then expelled from the anus.

The colon has 4 sections:
• The first section is called the ascending colon. It begins where the small intestine attaches to the colon and extends upward on the right side of a person’s abdomen.
• The second section is called the transverse colon because it crosses the body from the right to the left side.
• The third section, the descending colon, continues downward on the left side.
• The fourth section is known as the sigmoid colon because of its “S” shape. The sigmoid colon joins the rectum, which in turn joins the anus.

Breaking the Age Minimum
Diagnosed at age 35, Ledet’s initial thought was that she was too young and healthy for cancer, especially colorectal cancer. “When the pains first started it was nothing horrible, just annoying,” said Ledet. “Having a colonoscopy screening was not even on my radar.”

The initial diagnosis from her doctor in St. Amant, La. was that the pains were caused by picking up her five-month old child. But when the pain persisted, she insisted on discovering the source of her discomfort. After an ultrasound ruled out a cyst on her ovaries, and the kidney stones and constipation theories didn’t pan out, Ledet took a friend’s advice and saw a gastrointestinal doctor.

What are the symptoms of colorectal cancer?
Early colorectal cancer often has no symptoms, which is why screening is so important. Most colorectal cancers begin as a polyp, a small growth in the wall of the colon. As a polyp grows, it can bleed or obstruct the intestine. See your doctor if you have any of these warning signs:

• Bleeding from the rectum
• Blood in the stool or in the toilet after having a bowel movement
• Dark- or black-colored stools
• A change in the shape of the stool
• Cramping pain in the lower stomach
• A feeling of discomfort or an urge to have a bowel movement when there is no need to have one
• New onset of constipation or diarrhea that lasts for more than a few days
• Unintentional weight los

After six weeks of chemotherapy and radiation, Ledet was told that after surgery there would be a 90 percent chance that she would need to wear a colostomy bag - pouch used to collect waste from the body - for the rest of her life.

It wasn’t until after she received the same diagnosis from a second doctor in her hometown that her husband suggested they come to MD Anderson. “The decision to pack up our bags and head to Houston was the best decision we’ve made since my diagnosis,” said Ledet.

Ledet underwent surgery at MD Anderson and only had to wear a colostomy bag temporarily until function was restored to her intestine and rectum. Beside a few side effects, her treatment and care at MD Anderson has improved her quality of life.

“She’s definitely not the usual colorectal cancer patient we see in the clinic,” said Eng. “In fact, this type of cancer is less common in adolescents and young adults than in older people unless there is a family history of cancer.” In Ledet’s case it was important to persist and not ignore continued pain even if it seemed minor.

“I’m grateful to be alive and excited about participating in the SCOPE Run,” said Ledet. “I walk on a treadmill several times a week to stay active, but I’ve never participated in a run for a wonderful cause like this. I’m so excited to join supporters and survivors of colorectal cancer in the annual run. It’s important to continue educating people and raising awareness about this disease.”

For more information about colonoscopies or to schedule an appointment, please visit the Cancer Prevention Center website.

About MD Anderson
The University of Texas MD Anderson Cancer Center in Houston ranks as one of the world’s most respected centers focused on cancer patient care, research, education and prevention. MD Anderson is one of only 41 comprehensive cancer centers designated by the National Cancer Institute. For eight of the past 10 years, including 2011, MD Anderson has ranked No. 1 in cancer care in the “Best Hospitals” survey published annually in U.S. News & World Report.


Source: University of Texas M. D. Anderson Cancer Center

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