Combating colorectal cancer: Massey expands its colorectal cancer team, preventative services and treatment options
“If I had one piece of advice for people, it would be to get screened when you’re supposed to,” says Anita Whitlow, who was diagnosed in late 2013 with stage 4 colorectal cancer that spread to her liver. Today, Whitlow continues to beat expectations thanks to her care team at VCU Massey Cancer Center, her positive attitude and the people who help support her.
In 2015, the American Cancer Society (ACS) designated parts of southeast Virginia as one of three colorectal cancer “hot spots” in the U.S. In these areas, deaths from colorectal cancer have remained stagnant or rose in the face of a steady national decline. Researchers cite a number of factors that contribute to low screening rates, such as poverty, lack of health insurance, poor access to health care and low levels of education and health literacy.
“Screening should begin at age 50, preferably with a colonoscopy, unless there is a medical reason not to do the test. If you have a family history, start screening 10 years earlier than the youngest relative to have colorectal cancer,” says Jaime Bohl, M.D., a colorectal surgeon at Massey. “Most people don’t realize that colonoscopies are more than a screening tool. They can also help in the prevention of colorectal cancer by removing pre-cancerous polyps.”
Bohl is one of several recent additions to Massey’s growing multidisciplinary gastrointestinal (GI) cancer team. She along with another new colorectal surgeon, Emily Rivet, M.D., perform colonoscopies at Massey’s downtown and Stony Point locations. Rivet also happens to be one of very few colorectal surgeons in the country to have completed a fellowship in palliative care, which aims to relieve pain and suffering in patients with chronic illness.
While colonoscopies should be performed every 10 years, a high-sensitivity fecal immunochemical test (FIT), which checks for hidden blood in stool samples, should be done every year. Additionally, a flexible sigmoidoscopy, which uses a flexible, lighted tube to look at the interior walls of the rectum and colon, should be performed every five years. Virtual or CT colonoscopies are another option for screening. They use computed tomography (CT) scanning to create two-and three-dimensional images of the colon to check for polyps. If large polyps are found, a traditional colonoscopy is required for biopsy and removal. Radiologists at VCU Health were among the first to adopt virtual colonoscopies in Virginia.
For those who have been diagnosed with colorectal cancer, most will undergo surgery to remove the tumor and may also receive chemotherapy and/or radiation before and/or after surgery. This was true for Whitlow, who underwent several rounds of chemotherapy in 2014 before having part of her colon removed in 2015. She received additional chemotherapy in 2015 and recently began liver ablation therapy, which uses an image-guided probe to heat and destroy cancer cells with an electrical current.
“It’s been a rough couple of years, but I consider myself blessed,” says Whitlow, despite having lasting treatment side effects like neuropathy pain in her hands and feet. “I wouldn’t go anywhere else. You can tell everyone here, from the receptionists to my nurses and doctors, all really care about me and want to make sure I have the support I need to keep fighting.”
Certain colorectal cancer patients may benefit from a new treatment option at Massey. Leopoldo Fernandez, M.D., is a surgical oncologist and another recent addition to Massey’s GI team. He is one of few physicians in the state, and currently the only one in Richmond, offering HIPEC (heated intraperitoneal chemotherapy) for the treatment of advanced abdominal cancers, including colorectal cancer. HIPEC is a complex procedure in which a surgeon circulates a heated chemotherapy solution throughout the abdominal cavity to kill any remaining cancer cells after surgery.
“There’s evidence showing HIPEC provides a clear advantage for certain patients,” says Fernandez. “Prior to our program, patients had to travel several hours for the procedure. We hope to ease some of the travel and recovery burden for patients in our region who could benefit from HIPEC.”
In addition to providing advanced treatment options like HIPEC, Massey also offers clinical trials, many that are only available at National Cancer Institute-designated cancer centers like Massey that are pioneers in cancer research. Clinical trials are research studies that test promising new therapies, evaluate patient interventions and study genetic, social and environmental factors impacting people’s health. Massey offers a wide range of clinical trials for both newly diagnosed and relapsed patients. These trials provide access to investigational agents and innovative, new therapies that may help increase the chance for successful treatment. In addition, Massey’s Clinical Research Affiliation Network helps increase access to clinical trials throughout the commonwealth through partnerships with community oncology practices and local hospitals.
“While the treatment side is important, we also need to address factors that increase people’s risk for developing colorectal cancer, such as poor diet and lack of exercise,” says Bohl. “In addition to recommending regular exercise, I also urge people to eat a diet high in fiber and vegetables and limit their consumption of meat, especially processed meat. Unfortunately, access to healthy food options are limited for many people.”
Through a partnership with Tricycle Gardens, fresh local produce is available every week during the growing season to patients at Massey’s downtown clinics. Thanks to a grant from the National Cancer Institute, Massey operates the Petersburg Health Living and Learning Center in partnership with the Petersburg Public Library and the Crater Health District. The Center helps connect community members with health care resources and provides accurate and reliable health information. It also hosts free weekly health and wellness workshops. Further south, Massey’s Cancer Research and Resource Centers of Southern Virginia in Danville and Lawrenceville fulfill a similar mission by serving as health care information hubs for the community. In addition to coordinating health-related workshops for community members, they are actively involved in educating the local medical community in an effort to close gaps between local health care needs and resources. They also partner with Massey researchers to study the causes of cancer disparities in the region.
Since her diagnosis, Whitlow has committed herself to a healthier lifestyle. She has given up soda and taken up walking, with a goal of losing 20 pounds through a combination of diet and exercise.
“Nobody ever expects to get colorectal cancer, but you need to get screened if you’re over 50 so you can catch it early,” she says. “And if you think something is wrong, don’t be afraid to get a second opinion. If you do have cancer, be strong, stay positive and fight. Don’t give up, don’t skip appointments and always make sure you ask questions and follow up with your doctor.”
To learn more about colorectal cancer care at Massey or to schedule an appointment with our colorectal cancer team, visit our website or call (804) 828-5116. To schedule a colonoscopy, call (804) 827-0045.