By Michaela Gibson Morris/NEMS Daily Journal
Tupelo gastroenterologist Dr. Sam Pace knows colonoscopies and screening guidelines aren’t just academic.
Pace, who has performed thousands of colonoscopies throughout his career, was diagnosed with colon cancer during a follow-up colonoscopy September 2011.
“The first thing I thought when I woke up after the colonoscopy: ‘This is not supposed to happen to me,’” Pace said.
When his surgeon told him none of his lymph nodes were positive, indicating the cancer remained localized to the part of his colon that had been removed, he had a different thought.
“Thank God I practiced what I preached,” Pace said. “I was very, very fortunate.”
There has been a tremendous decline in the rate of deaths from colorectal cancer over the past two decades – more than 30 percent according to American Cancer Society data. Patients have benefited not only from increased awareness and insurance coverage, but improvement in techniques, scopes and fine-tuned treatment guidelines.
“All of those things collectively just made a huge difference,” Pace said. “Ten years from now, it will be even more impressive.”
Pace’s journey began when he had his routine screening colonoscopy at age 60. Colon cancer is one of the few diseases of which doctors can see the warning signs and treat them before cancer ever forms. During a colonoscopy, gastroenterologists are looking for tiny growths in the wall of the colon called polyps. When they find them, they can use the scope to remove them and study them for any signs of cancer.
Because of the wealth of data that has been collected since colorectal cancer has become common, physicians now can tailor follow-up recommendations based on the kinds of polyps that are found, Pace said.
Polyps come in three general varieties. Hyperplastic polyps have minimal risk of developing cancer. Adenomas are watched more closely. Serrated adenomas, which can be hard to detect because they grow in pancake shapes parallel to the wall of the colon, are the worst.
“They tend to grow and change more quickly,” said Pace, whose screening colonoscopy found serrated adenomas. “It’s the reason I had follow-up sooner rather than later.”
When he went back for follow-up, cancer had developed, but it was still confined to his colon. Pace had no symptoms – no abdominal pain or bleeding.
The surgery took about a fourth of his colon, but because the cancer was in the right colon, he didn’t require a colostomy. He went through an evaluation with his oncologists, but didn’t require chemotherapy or radiation.
Pace was able to return to work part time in about 3 1⁄2 weeks and resume a full load in about seven weeks, although folks who do more physically challenging work would need more time. It took a few months for his colon to adapt to its job – removing water from the body’s solid waste – with less length.
“Everyone’s different,” Pace said.
So far, Pace’s follow-up screenings have shown no sign of cancer. Based on his type and stage of cancer, the five-year survival rate is 89 percent.
“It’s changed my approach to taking care of me,” said Pace, who has picked up more exercise and switched to a low-fat, high-fiber diet.
Occasionally, he’ll share his experience with patients, especially if they’re reluctant about colonoscopies, reminding them he had no symptoms that cancer was growing.
“It really seems to connect,” Pace said. “They realize, ‘If it can happen to him, it can happen to me.’”