
- With Mayo Clinic nurse educator
Sheryl M. Ness, R.N.
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Sheryl M. Ness, R.N.
Sheryl M. Ness
Sheryl Ness, R.N., O.C.N., is a nurse educator for the Cancer Education Program at Mayo Clinic in Rochester, Minn. She helps inform patients, families and caregivers about services and resources to help them through the cancer journey.
She has a master's degree in nursing from Augsburg College. In addition, she is an assistant professor of oncology at the College of Medicine, Mayo Clinic, and is certified as a specialist in oncology nursing. Sheryl has worked for more than 20 years at Mayo Clinic as an educator. She has a keen interest in the importance of the quality of life and concerns of people living with cancer.
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Living with cancer blog
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March 20, 2012
Colon cancer prevention — Screening is vital
By Sheryl M. Ness, R.N.
This week I would like to talk about colon cancer. As a survivor, paying attention to regular cancer screening is very important. Remember that developing a second cancer is possible. People at higher risk for developing colon cancer may have a history of inflammatory bowel disease, including ulcerative colitis and Crohn's disease.
The two most common inherited syndromes linked with colorectal cancers are familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome. FAP is caused by changes (mutations) in the APC gene that you inherit from your parents.
Women with HNPCC have a very high risk of developing cancer of the lining of the uterus (endometrium). Other cancers linked with HNPCC include cancer of the ovary, stomach, small bowel, pancreas, kidney, brain, ureters (tubes that carry urine from the kidneys to the bladder) and bile duct.
It's important to know that colon cancer can be prevented with screening and removal of any growths (or polyps) before they develop into cancer. Normally, screening should start at age 50. However, if you have a higher risk or a family history, you may need to be screened at a younger age.
Some of the ways that you can be screened for colon cancer include stool tests to check for blood (fecal occult blood test), sigmoidoscopy, colonoscopy, double-contrast barium enema and virtual colonoscopy (CT colonography).
Recently new methods of screening, including stool DNA (sDNA) testing, have been discussed in the news. The sDNA test identifies abnormal changes (markers) in the cells that are shed from the lining of the colon and can lead to early detection of polyps and colon cancer. This noninvasive test is still pending approval by the Food and Drug Administration. However, research shows that the test accurately detects colon cancer at early stages and precancerous polyps. Look for updates on the new sDNA test on MayoClinic.com.
Work with your health care provider to find out what your personal risk is and how often you should be screened. What has been your experience?
Follow me on Twitter @SherylNess1. Join the discussion at #livingwithcancer.
11 comments posted
July 11, 2012 11:11 a.m.
I had a colon resection for a precancerous polyp 5 months ago. My Dr. wants to do a follow up colonoscopy next month although I am not having any problems or symptoms. I am 66 years old, on Medicare. They paid for the original colonoscopy, biopsy and surgery. My questions are: do I need another colonoscopy so soon and will Medicare pay for it? They say they only cover one every 24 months.
- Rika
May 2, 2012 12:47 p.m.
I am a 39 yr old female who has been experiencing pain in my rectal area for going on four years now. I have always had irregular bowel movemnts and had trouble with constipation. I was told early on to take stool softeners regularly, eat lots of fiber, exercise, and drink plenty of H20. Having done these things, my condition has worsened. At 35, I began having severe pain in rectal and lower abdominal area that would become excruciating during my period. I would have even greater pain as I passed gas or during a BM. I could not stand, walk, or find a comfortable angle at which to tilt my upper body when I would sit so lying down was best position. 2008, I had colonoscopy and laparoscopy and only revealed internal hemorrhoids and minimal endometriosis. GI doc diagn. me with IBS & prescribed Amitiza with daily doses of Milk of Mag, Raisin Bran cereal, high fiber diet with 1 year follow-up. At that point, I could not pinpoint the area of the pain. Since then, the pain has a specific region, in my rectum! My bowels have changed shapes over the years, and I have shared this with local drs here. It flattened, almost ribbon-shaped. I experience pain now all month long with the worst level still during menstruation. During BMs, I have pains "shoot" up the left side of my back and down my left leg. I am so frustrated with my treatment, or lack of. My paternal grndmother passed from colon cancer and parents are concerned. GI doc says no more colonoscopy til 50, so w
- Fina
April 15, 2012 9:21 a.m.
Lyn - Get a colonoscopy! I do not trust CT scan results after my 33 yr old daughter's experience last year. She had two CT scans, and along with her symptoms (nausea, vomiting, elevated WBC, pain on the left side), the diagnosis was probable ulcerative colitis with current infection in the colon. A month later a colonoscopy was done to confirm the diagnosis. What she had was Stage III-C colon cancer. Can I say this any more strongly: GET A COLONOSCOPY!
- Judy
March 23, 2012 1:29 p.m.
Lyn, screening for colon cancer may be recommended sooner - depending on your age and other related family history. For example, if you have other family members who had colon cancer at a young age. A special kind of CT scan (CT- colonography) can be used to look at the colon. Talk with your oncologist about your screening plan. You may need to have special considerations made -because of your history of surgery and radiation.
- Sheryl
March 23, 2012 1:22 p.m.
This post is for Kyle and others who may be interested in genetic counseling. It is great to hear that you are connected with a physician who recommended yearly screening because of your high risk associated with Lynch Syndrome. Genetic counseling will help you deal with any other questions you have related to your risks. For those who may be looking for resources, check out the National Society of Genetic Counselors (www.nsgc.org) for testing and counseling in your local area.
- Sheryl
March 23, 2012 11:45 a.m.
Please get a colonoscopy before age 50 if you have family history of colon cancer. I had one at age 35 because my dad was diagnosed with colon cancer that year. I had a pre- cancerous polyp removed then. I continued to have the test every 3 three years with no polyps found.N Then I got lax on getting them. I went 7 years before having another test. My family doctor sent me to have the test because I was anemic. I ended up having a colon resection with two pre- cancerous polyps and a cancerous polyp removed. Be Pro- active about your health. The test is not bad!
- Kathy
March 22, 2012 2:40 p.m.
My brother who is 29 recently had a tumor and half of his colon removed. He was tested for lynch syndrome and it came back positive. I am 31 and also was tested for lynch syndrome recently and the test also came back positive. I recently had a colonoscopy and all was clear. They recommended my brother and I to have yearly colonoscopy's so that is what we will do. I am thinking about meeting with a geneticist in the near future. Do you think this will be beneficial? FYI- Our father passed away from brain cancer (glioblastoma) at age 47.
- Kyle
March 22, 2012 2:30 p.m.
Sheryl, had surgery for endometrial CA last year along with brachytherapy and chemo. Have need going back for every 3 month visits where a CT scan is performed. Haven't had colonoscopy..just wondering if these CT scans would find any other abdominal CA? My Dad was diagnosed with colo-rectal CA @ age 83 so oncologists say the Lynch syndrome would not be something that I would need to be tested for. Advice re: colonoscopy for me would be appreciated. thanks so much
- Lyn
March 22, 2012 12:09 p.m.
I was screened by colonoscopy at age 52. Two or three polyps were found and removed. Two were found to be atypical. I had several other tests at the same time and was diagnosed with IBS and lactose intolerance. Had fecal occult tests yearly with negative results (no blood in stool) until age 58.Then had another colonoscopy. A malignant tumor was found and further tests revealed metastic disease in my liver. It was determined to be nonoperable and I recieved 10 rounds of chemo. After 8 rounds I had NED. Now at 61 I'm on Avastin maintenance and still NED. The new testing method sounds promising! Perhaps it will prevent stories like mine. My biggest mistake was waiting 6 years to be rescreened.It was a matter of dreading the procedure even though I had experienced it before. The clean out the day before was my bane, not the actual colonoscopy procedure. Nothing is gained by hind sight, but perhaps my story will inspire others to get those screenings. There are a lot worse things. And, by the way, I had no real symptoms that couldn't be explained away as normal occasional bowel problems,IBS or lactose sensitivity.
- Debby
March 22, 2012 11:47 a.m.
Wendy - I belong to a forum for colon cancer patients and caregivers and I think there's someone active there with this situation. You could post a question out there and see if anyone responds. Just google the colon club or go to http://coloncancersupport.colonclub.com/viewf
orum.php?f=1. Good luck, I hope you find the answers you're looking for. - Julia
March 22, 2012 11:16 a.m.
I was wondering if anyone out there who is positve for the Lynch (HNPCC)gene has had a total cholectomy and a gastric bypass procedure? I would like to discuss how they are feeling and if they have notice any physical changes. I have not been sucessful at this point of finding someone who has had both of these procedures done. The gastric bypass surgery was actually done before realizing the risk it would have with the Lynch syndrome. Also who would have thought 5yrs after the surgery you would have colon cancer and end up with your entire large colon removed. I'd love to hear from you if you would like to share. Without very agressive cancer screening and colonoscopies I may very well not be here today. NIH had recommended that I have colon screenings every 2yrs although, I had pushed my MD to re-scope me at 1yr which thank God I did. I was positive for colon cancer. Luckly I caught it very early. Screening and DNA testing has made a huge difference in my life and it has been a gift to my family as well. Let's put a stop to this horrific disease and pre-screen.
- Wendy
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11 comments posted