Not Knowing Can Hurt You
● By Robert Frey
April Is Cancer Control MonthBy Patrice Doucet
Kim Bourgeois often wonders what would have happened to her by now if she hadn’t been diagnosed with breast cancer in 2017. She believes that blessings sometimes come in disguises. After all, she has no history of breast cancer in her family, so there was no reason to suspect that her mammogram would find anything. But what she did have was dense breast tissue which made self-exams challenging and was another important reason she was diligent about getting an annual mammogram. Looking back, she says it was a “slow motion whirlwind” of getting the news of Stage 1 breast cancer, having to choose an oncologist and tell her family - all within a few days. But, 16 rounds of chemo, a lumpectomy, and 33 treatments of radiation later, she is well and happy - and, most importantly, she is with her family.
During April, Cancer Control Month, we are reminded of the importance of early detection and the role we play in getting the recommended annual screenings. With more than 100 types of cancer, we focus here on the impact of screening for the three most prevalent disease types in Acadiana: Breast, colorectal and lung.
BreastIn 2017, Kim was one of the approximate 122,000 cases of breast cancer diagnosed in Louisiana, estimated by the Centers for Disease Control and Prevention.
It is a surprise to many women who are diagnosed that a family history (mother or sister with the disease) is not a primary cause, even though, according to the American Cancer Institute, it doubles the risk.
Other Risk Factors• Obesity- particularly after menopause
• Not having children- or getting pregnant later in life (over age 35) Breastfeeding may help to
lower your breast cancer risks.
• High breast density- women with less fatty tissue and more glandular and fibrous tissue
• Certain breast changes- some benign (noncancerous) breast conditions may increase risk.
• Menstrual history- Women who start menstruation at an early age (before age 12) and/or
menopause at an older age (after age 55) have a slightly higher risk
When To Get A Mammogram• Women at no significant risk for breast cancer should begin getting an annual mammogram
at age 40.
• Women at higher or very high risk, because of family history or dense breasts, should get an
annual mammogram and an MRI starting at age 30.
Dr. Kurt O’Brien, General Surgeon at The Surgery Center in New Iberia, says if breast cancer is diagnosed in Stage 1 or 2, there is an 80% chance of survival - unlike lung cancer that he often sees having spread by the time it is diagnosed.
ColorectalLouisiana has the third highest incidence of colorectal cancer and the fourth highest death rate of the disease in the U.S. A study of colorectal cancer in Louisiana’s Acadian region showed that in the nine-parish region, with the most French speakers, including Vermilion parish, colorectal cancer rates in white males were 19% higher than the entire state and 37% higher than U.S. rates.
Dr. Jonathan Thompson, Radiation Oncologist at OncoLogics in New Iberia, concurs saying he still treats a lot of preventable cancers, like colon and, in the past year, rectal cancer.
But this doesn’t have to be the case. Dr. Son V. Nguyen, gastroenterologist at Iberia Gastroenterology Associates in New Iberia, says, “A colon screening is unique in that it can prevent cancer from developing. With a colonoscopy, you can identify and remove precancerous polyps safely before they develop into cancer.”
Screening RecommendationsPatients should get an annual colonoscopy beginning at age 50 - sooner if they have a family history of the disease or have been diagnosed with Inflammatory Bowel Disease, which is a risk factor.
Additionally, Dr. Thompson advises men who receive radiation therapy for prostate cancer that they may have a higher risk of bladder and colorectal cancers and may require more intensive screening for those diseases.
Repeat colonoscopies depend on what is found during the procedure and the patient’s risk factors. If no polyps are found and there is no family history, then colonoscopies are recommended every 10 years.
LungTobacco users (of cigarettes, cigars- and even smokeless tobacco products) and those breathing secondhand smoke from a nearby smoker are a group who should take screenings very seriously. Louisiana has one of the highest occurrences of lung cancer diagnosis in the country, according to the American Cancer Society. This is the deadliest of the cancers in Louisiana, as reported by the Louisiana Cancer Prevention and Control Program.
To battle this statistic, Lafayette General Medical Center has recently opened a Lung Cancer Screening Program. The program offers low-dose CT scans to patients at high risk for lung cancer, and who meet certain criteria, to detect the disease as early as possible. Patients must have a referral from a physician for a screening.
“This program is important to screen patients at high risk, primarily due to smoking with the goal of identifying lunch cancer at an earlier stage with a higher chance of successful and potentially curative treatment,” says Dr. Michael Cain, Medical Director of Cancer Center of Acadiana at Lafayette General.
Dr. Paulette Blanchette, Board Certified Medical Oncologist with Cancer Center of Acadiana at Iberia Medical Center, says lung cancer has been difficult to detect in earlier stages before now, in part, because of the organ’s structure. “The lung is quite large and occupies about half of the torso. If the cancer is not near another structure such as the bronchial tree or blood vessels, the tumor can grow quite large before it causes symptoms. This screening can find tumors at a much smaller size and earlier stage,” she explains.
Criteria For Lung Cancer Screening-Patients 55 to 75 years who have a history of heavy smoking and are current smokers or quit within the past 15 years. Heavy smoking means the individual has a history of 30 pack-years or more. (A pack-year is smoking an average of one pack of cigarettes per day for one year.)
Dr. Blanchette says it is common for her to see patients who have waited too long before going to a doctor to evaluate a suspicious lump or symptom. “When I ask them why they waited, some say they thought it would go way,” she says. “But, delaying evaluation gives a cancer more time to spread and grow and be at a higher stage with a lower cure rate.”
Kim Bourgeois reminds her friends and others of annual screenings, sharing her story now and again as a testament to how a cancer screening can turn into a life challenge, but also a life-saving experience.