Healthy Living
Learn and Live
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When it come to colon cancer, knowledge is power
by Jamie Lober
It’s a part of the body we tend not to think about, but knowing something about the colon could save your life.
Located in the abdomen, the colon “connects your small bowel to your anus and rectum, which allows you to empty stool,” says Dr. David Beck, chairman of colon and rectal surgery at Ochsner Clinic. You may be surprised to learn that the colon is five to seven feet long, and though it is important to have, it is not a vital organ. “You can live a normal life without your colon, but if you take out your colon and leave your rectum, you have more bowel movements,” informs Beck. Those without a colon need to use a colostomy bag to collect stool.
Like any aspect of your health, your colon should be monitored for early detection of disease. A colonoscopy, the gold standard in screening, is recommended for those 50 years old, and every 10 years thereafter. During a colonoscopy, “we place a lighted flexible tube in the colon to look at the lining. All cancers in the colon start in the lining, so we look for abnormalities,” says Beck. The procedure is not more than 20 minutes long, and the hardest part is the preparation. The patient’s intestines need to be clean, “which means drinking solutions or taking medicines that help evacuate the stool,” explains Beck.
The colonoscopy has been around since the seventies, and it is the best defense against colon cancer. “Colon cancer is the third most common cancer, and it is the second most common cancer that causes death,” says Beck. There are three warning signs. “We worry about rectal bleeding, a change in bowel habits or abdominal pain,” says Beck. Other red flags include persistent constipation, diarrhea and unexplained fatigue. Sometimes, however, colon cancer can be asymptomatic.
In the best-case scenario, colon cancer is caught before it starts to cause symptoms. “Colon cancer is unique in that we can identify a lesion, like a polyp, that occurs before the cancer develops. If you take out the polyps, you will never get cancer,” says Beck. If your colorectal surgeon or gastroenterologist finds a polyp, it is advised to schedule a colonoscopy in three years.
There are several other screening methods. “We can check for blood in the stool, but eating red meat can make the test positive sometimes, so it is less efficient than the colonoscopy,” says Beck. In a fecal occult blood test, blood in the stool does not always indicate colon cancer. It can show hemorrhoids, ulcerative colitis, diverticular disease or intestinal infections that cause inflammation. X-rays are sometimes used as well. Colon cancer presents in four stages. “Stage one is better, while stage four is worse. It involves how big the tumor is and whether it has spread to other areas,” explains Beck. Early detection is the key.
As with any condition, healthy lifestyle choices, such as good nutrition, are said to have a positive impact on colon health. “There is evidence that if you eat a diet high in fiber and lower in red meat and animal fat that your colon will be healthier,” says Beck. Probiotics, or healthy bacteria, is still being researched, but it may also be linked to good colon health.
Still, other factors, over which you have little control, can come into play. “If a family member had colon cancer or if you have had cancer or polyps before, you are at higher risk,” says Beck. Other contributing factors may include being a male or female over age 50, having a sedentary lifestyle or a personal or family history of irritable bowel syndrome.
Treatment usually involves removing the tumor with surgery, and sometimes chemotherapy. “If we catch it early, the operation takes an hour or two. You are in the hospital for a week or so, and then you are all done with it,” says Beck. It can be helpful to join a support group as you go through the experience, so you won’t feel alone.
Take advantage of the fact that March is National Colorectal Cancer Awareness Month. Take the time to talk to a friend or loved one about the importance of making healthy lifestyle choices and knowing the signs of colon cancer. “If you have those symptoms, you need to talk to your physician to make sure it is something minor and not something serious,” reinforces Beck. Don’t be afraid to begin the conversation today.
Silent Killer
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Heart Disease Takes More Lives Than the Flu, but the Good News
is that You can Prevent It
by Henry Alpert
Dr. Richard Milani
The year 1918 was a bad one in American history. It was the year of a horrific influenza pandemic that killed millions, which made 1918 also notable in that it is the only year in more than a century in which heart disease was not the number one cause of death in the United States. So while a recent strain of influenza, the H1N1 virus (also known as the swine flu), remains a cause for concern, the attention it has received seems outsized in proportion to the consistent, much more pervasive public health problem of heart disease.
“When most people talk about heart disease, they’re thinking of atherosclerosis. That’s the buildup of fats in the arteries called plaque. It’s what leads to heart attacks and often to strokes,” says Dr. Richard Milani, the vice chairman of the Department of Cardiology at Ochsner Health System. “There are other types of heart disease, but that’s the most common. It’s what’s killing the most people.”
For a refresher on biology, the heart’s sole function is to pump blood around the body. If the heart’s the pump, then the arteries are the tubes. When plaque accumulates in the insides of the arteries, the passages become narrower. Heart attacks occur when a passage supplying blood to the heart muscle itself becomes blocked, and a stroke occurs when plaque clogs up the passageways providing blood to areas of the brain.
According to Dr. Milani, key warning signs can let you know that a heart attack may be imminent. “An unexplained shortness of breath is an important warning sign,” he says. “You might also experience discomfort or pain in the chest or upper belly. These symptoms typically come with exertion and are relieved with rest. If someone is experiencing these pains and they’re ongoing, it’s not indigestion. Pay attention to it, and get it checked out quickly.”
Certain risk factors increase an individual’s likelihood of heart disease, including diabetes, smoking, high blood pressure and a history of heart disease in the family. A patient’s cholesterol profile is an important factor, too. A risky cholesterol profile means that a person has too much bad cholesterol and not enough good cholesterol. The bad cholesterol results from a diet high in saturated fats and trans fats. Meanwhile, the good cholesterol, called HDL, isn’t strongly linked to diet but instead to exercise and weight. Exercise and a weight-loss program will raise HDL levels, while smoking will lower them.
“We recommend the consumption of good fats, found in fish and seafoods and the use of olive and canola oils in cooking,” says Dr. Milani. “A heart-healthy diet doesn’t mean eliminating meat altogether, but it should include fruits or vegetables with every meal.”
While New Orleans is not known for its healthy lifestyle, Dr. Milani swears our famous cuisine lends itself to a healthy diet if you want it to.
“There’s a million good things to eat in New Orleans. We have so many fresh, local foods. You don’t have to eat the bad things,” he says. “When I go to a restaurant, I usually get the fish of day, and tons of good vegetables come with it. I don’t go away unhappy, I’ll tell you that.”
Indeed, Dr. Milani practices what he preaches. “Everyone wants to eat at our house, even all my kids’ friends. And if my kids are at someone’s house where something unhealthy is being served, they’ll wait until they come home to eat.” He adds, “Eating healthy is only hard if it doesn’t taste good. But everything we recommend tastes good.”
America’s problem with obesity hasn’t gone away, and obesity is a risk factor in heart disease, but Dr. Milani sees some encouraging trends nationwide. Many Americans are paying more attention to their diet than they used to, while at the same time people are smoking less. On the flip side, the baby boomer generation is aging, which portends an increase in heart disease.
“You don’t have to die of a heart attack. It’s not a natural process of aging,” Dr. Milani says. “The issue is that when people have more years for plaque to build up in their arteries, it starts to catch up with them when they’re older. But you can be 90 years old with clean arteries.”
The crux of the matter is that, as deadly as it is, heart disease is preventable. February is American Heart Month, as designated by a congressional code since 1963, and a number of public activities are happening in the New Orleans area to raise awareness about heart disease and to help nip it in the bud.
Rouses has teamed up with Ochsner Health System and will be providing screenings for total cholesterol, HDL (good cholesterol) and glucose. Results are available in minutes and registered nurses will be on hand to discuss and explain your results. Screenings will be open to the public and conducted at various locations (see below) from 10 a.m. to 1 p.m.
Rouses and Ochsner welcome you to attend and “know your numbers.”
Screenings will be held at these Rouses locations:
Friday, February 19 (10 a.m.–1 p.m.)
- Tchoupitoulas #26
- Gretna #38
- Mandeville #21
- N. Carrollton #29
- Thibodaux #17
- Slidell #22
- Power Blvd. #33
- Thibodaux #16
- Slidell #37
- Veterans #25
- Gretna # 36
- Covington #20
Targeting Cervical Cancer - Regular Pap Tests and HPV Vaccines Help Combat This Sometimes Deadly Disease
by Henry Alpert
While scientists still do not know exactly which factors make cancer afflict some people and not others, cervical cancer provides a rare exception. It is linked just about 100 percent of the time to a virus known as the human papillomavirus, or HPV. In a way, this is good news. By knowing that HPV is a precondition for cervical cancer, doctors are offered a clear target for detection and prevention.
February is Cervical Cancer Awareness Month. In order to assist in the cause of raising awareness, New Orleans Living magazine spoke with Dr. Lisa Bazzett of Ochsner Health System to learn some basic facts about cervical cancer. As a gynecological oncologist, Dr. Bazzett’s professional expertise is in the treatment of women with malignancies of the female reproductive organs, including cancers of the ovary, uterus, cervix, vagina and vulva.
What causes cervical cancer?
We know it is necessary for HPV to be present in the body for cervical cancer to occur. But not everyone who gets HPV will develop the disease. In fact, for the majority of people who get HPV, their immune system fights it, and it goes away on its own. Additional factors make HPV more likely to persist or progress into cervical cancer.
For example, smoking encourages the virus to progress. Also, if you’re very young when you first start to have intercourse, that increases your risk. So do multiple sexual partners, because you’re more apt to be exposed to HPV. But even a single sexual encounter can put you at risk for an HPV infection and cervical cancer.
What are common symptoms of cervical cancer?
When cervical cancer becomes advanced, women can experience irregular vaginal bleeding or bleeding after intercourse and pelvic pain. Eventually, the cancer can spread and be fatal. But if you detect the cancer early, there are no symptoms at all. That’s why we in the medical profession urge women to come in for their regular Pap smears, so we can catch potential problems in their early stages.
How common is this cancer?
There are about 11,000 new cervical cancers each year in the United States. Half a million cases a year appear worldwide. It’s a huge problem in developing countries, where they don’t have access to screening tests. Worldwide, cervical cancer is the second most common cause of cancer death in women.
Can condoms prevent the spread of HPV?
They help, but they’re not 100 percent effective. It’s more like 75 percent. The problem is that the virus is not transmitted in bodily fluids. It spreads through surface-to-surface contact of genital areas.
Is there an HPV vaccine?
One has been available since 2006 and another came out in 2009. It’s really remarkable. Knowing that this cancer is caused by a virus, there’s a way to prevent cancer that we’ve never seen before. The vaccines build up your immune response so when and if you’re exposed to HPV, your body can attack it. It’s best to get vaccinated before sexual activity if possible, but [the vaccines] are recommended for anyone age 9 to 26. They’re available in Louisiana for free up to age 18.
How do you screen for cervical cancer?
The Pap smear. The main point of a Pap smear is to test for abnormal, precancerous cells (severe dysplasia) caused by the HPV. If any are found, we can do a minor procedure to cut them out of the cervix. However, this is not a treatment for the HPV itself. Currently, we have no treatment for the virus and have to rely on a person’s own immune system to clear it, which it usually does over time.
Where did the name “Pap smear” come from anyway?
It’s named after a Greek doctor named Papanicolaou. He’s famous in Greece, and his image is on one of the bills of their currency. The “smear” is because the sample is smeared on a slide for viewing through a microscope.
What are the treatment options for women with cervical cancer?
It depends on when it’s detected. We can do minor procedures if we find it early and save the cervix and uterus. Again, that’s why Pap smears are so important. Advanced treatments use radiation and chemotherapy, and in many cases, a hysterectomy is necessary. Even if a woman wants to have children, there’s often no way around that if we want to save her life.
In cases where a doctor presents more than one treatment option, how does a woman decide what to do?
Surgery is typically a better option for younger patients. It allows them to keep more of their sexual function over the long term. Chemo-radiation is reserved for more advanced cancers or for older patients who may not tolerate surgery well.
Why do some women not get regular Pap smears?
We wish we knew the answer to that one. A lot of people think they don’t need one after a certain age or after they’ve finished having children. Sometimes, it’s complacency. Cost or insurance shouldn’t be a factor. In Louisiana, you can find many options for free Pap smears. You just have to seek it out.
Do you think rates of cervical cancer will go down now that there’s an HPV vaccine?
Yes, but I think it’s going to take a while. The number of candidates for the vaccine is much larger than the women actually getting it. We have to do more education and public outreach.
Dr. Lisa Bazzett can be reached at (504) 842-4165.
