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No one really expects to go to the doctor for shoulder pain and end up with a cancer diagnosis. Well, maybe those of us who are hypochondriacs would, but my husband certainly didn't. Yet that's exactly what happened to him.
John Anderson, my husband of 15 years, died in September 2012 after a five-month battle with colon cancer. He left behind our two children, now nearly 7 and 11, and my stepdaughter, a 33-year-old from his first marriage.
John was 59, and, no, he didn't have a colonoscopy — until it was too late.
Sometimes it's the first question that people ask when they learn our news: "Did he ever get a colonoscopy?" or, even worse, "Didn't he get a colonoscopy?"
Why, despite knowing the facts about colorectal cancer screening, didn't he? That question will plague me for the rest of my life. And it tortured John from the moment he was diagnosed until the day he died.
Colon cancer is one of the cancer success stories. There are various screening methods that can identify colon or rectal changes that may lead to cancer. Tests such as sigmoidoscopy and colonoscopy can find premalignant polyps. These polyps can be removed during the procedure. These tests can also find cancer in its earliest stage, when it's most treatable.
But unfortunately, our family wasn't part of this success story.
According to experts, those considered at average risk for colorectal cancer should begin regular screening at age 50. When John turned 50, I reminded him to get an annual physical and a colonoscopy. He got his physical but no colonoscopy. We had the same conversation maybe half a dozen times over the years. He had physicals. Each time he'd come home with a fecal occult blood test kit and a colonoscopy prescription. But he never followed through with either.
To encourage him, I would invoke our family ("Do it for the kids; they need you"), my own screening habits ("How would you feel if I didn't get my annual mammogram?"), the data (he was a behavioral scientist, after all), the Katie Couric effect (a celebrity whom he liked and respected) and his risk factors (age, weight, diet). In the end, was my nagging just noise?
One month shy of his 59th birthday, John finally got that colonoscopy. It was after shoulder pain, initially diagnosed as a rotator cuff injury, led to side pain, which led to a sonogram, which revealed tumors on his liver. Apparently his enlarged liver or a liver tumor was pressing on his diaphragm, which was causing referred shoulder pain. Who would have thought?
John's diagnosis: stage 4 colon cancer with inoperable liver tumors. Cancer that had started in his colon and spread to his liver. Unless John's cancer responded to treatment, there wasn't much hope.
At some point during his treatment — when we still had hope that the chemotherapy might work — I asked John: "Why didn't you get a colonoscopy?" This was one of many emotional "what if" conversations that he and I had, typically late at night, when the house was quiet. Sometimes initiated by him, sometimes initiated by me, these topics were raw and gut-wrenching. Scary but difficult to ignore.
And I knew that particular question was like salt in a wound. There would be no answer that would ever heal a thing or make a difference. But still, I had to ask him. "Why didn't you get a colonoscopy?"
He didn't have a definitive answer. None of it really made sense, he admitted. And our hearts broke with the reality that no answer could matter, that there was no excuse. It was too late.
During the painful discussion when John's oncologist had to tell us that nothing more could be done, John calmly said, "I should have gotten that colonoscopy." His oncologist — very compassionately and honestly — said not to go there.
But John and I couldn't help it: We knew the truth. Colorectal cancer screening saves lives. And it might have saved John's.
Menashe is a vice president at Ogilvy Public Relations, where she serves as an on-site contractor at the National Cancer Institute. She lives in the District.