Dr. Jon Horine, MD

by Laura Mack | Reprinted courtesy of SimplyKC Magazine

In 2000, President Clinton officially dedicated March as National Colorectal Cancer Awareness Month. Since then, thousands of patients, survivors, caregivers, and advocates have been wearing blue, emphasizing screening, and uniting to promote awareness about colon cancer. According to the Center for Disease Control, “among cancers that affect both men and women, colorectal cancer (cancer of the colon or rectum) is the second leading cause of cancer deaths in the United States.”

On average, the lifetime risk of developing colon cancer is about one in 20 with about 72 percent of cases arising in the colon and approximately 28 percent in the rectum. Every year, about 140,000 Americans are diagnosed with colorectal cancer, and more than 50,000 people die from it. The American Cancer Society (ACS) states that there are currently more than 1 million colon cancer survivors in the U.S. 

Symptoms and Screening

Dr. Jon Horine, MD, of the Medical Group of Kansas City says there are no symptoms. That is because precancerous polyps and colorectal cancer don’t always cause symptoms, especially in the beginning. You could have polyps or colorectal cancer and never even know it. That is why having a screening test is so important. “We try to find things long before you can tell something is wrong,” he says. “If you feel normal at age 50, get checked. It may save your life. If you see blood, have a change in bowel habits, become anemic, have abdominal pain, something just doesn’t seem right, yes — we need to talk. Don’t ignore changes or abnormal things. Act and check with your doctor. Err on the safe side.” 

Dr. Horine also recommends that as a general rule, men and women should go in for their first colonoscopy around 50 years old. However, if you have a family history of colon cancer (especially in a first-degree relative such as your mom, dad, brother or sister), you would check a minimum of 10 years younger or age 50. For example, “If they had cancer at 54, you would check everyone else at age 44,” he explains. Dr. Horine stresses not to wait. Colorectal cancer screening tests can find precancerous polyps so they can be removed before they turn into cancer. Screening tests also can find colorectal cancer early, when treatment often leads to a cure. This is why screening is so crucial.

For an average person with no signs, no family history, and with a normal blood test, Dr. Horine advises to get a colonoscopy every 10 years after the first one. However, if you do have a family history of colon cancer or colon polyps (also called adenomas) and everything else is normal, he urges getting checked every five years. If you have had a typical adenoma removed from your colon, then every three years is recommended. Some of the population considered to be at a higher risk for developing colorectal cancer in addition to family history include those who have inflammatory bowel disease, genetic syndromes such as familial adenomatous polyposis (an inherited condition in which numerous adenomatous polyps form mainly in the epithelium of the large intestine), or hereditary nonpolyposis colorectal cancer (also known as Lynch syndrome) that is a type of inherited cancer of the digestive tract.  

In addition to a colonoscopy, the U.S. Preventive Services Task Force recommends these tests to screen for colorectal cancer as well: a high-sensitivity fecal occult blood test (FOBT), fecal immunochemical test (FIT) every year, and a sigmoidoscopy every five years. The sigmoidoscopy is a routine outpatient procedure in which just the inner lining of the lower large intestine is examined.

Education Is Key

With regular screening, colon cancer can be found early and in many cases is treatable. According to the ACS, more than 90 percent of those diagnosed when cancer is found at the local stage (confined to colon or rectum) survive more than five years. Colon health is so important to check because colon polyps are very common. Dr. Horine says more than half the people he checks each day have polyps he must remove. He explains that some colon cancer is cancer from the start. “We need to find those long before you have symptoms or can tell that anything is wrong,” he explains. “That gives you a better chance of survival.”

Dr. Horine’s passion for awareness is also deeply personal. “My mom had a polyp missed and one and a half years later had a metastatic colon cancer,” he shares. “This is a big problem and people need to know what to expect, what to look for, and what should be discussed, explained, and deserved” with and from their doctor. Simply, awareness and early detection saves lives.

National Dress in Blue Day
March 7 / dressinblueday.org

tags: cancer care