Walter Hughes was feeling fine when he went out fishing in January 2016. So the 65-year-old Atlantic Highlands man, who had been healthy all his life, brushed off the stomach pains he felt in February as work-related stress.
But the colonoscopy he got in March – his first ever – revealed bad news: cancer had invaded his colon and parts of his bladder wall and small intestine and it was already in an advanced stage.
Hughes may owe his life to the minimally invasive, yet multi-hour surgery that he underwent in May, and the long months of chemotherapy he’s endured ever since last summer. He is grateful to his family, who prodded him to see a doctor and helped keep his business going while he recovered, and full of praise for his treatment team at Monmouth Medical Center, a leading provider of this type of treatment.
But he also knows the ordeal could have been far less onerous – and possibly avoided entirely — if he had been screened for colon cancer earlier. (Doctors recommend men and women get tested after age 50, or sooner if they have a family history of the disease. Smoking, obesity, lack of exercise, and conditions like Crohn’s disease also increase colon cancer risk.)
“Colonoscopies are not something that is supper-table conversation,” Hughes, a longtime fisherman who now runs a clam-processing plant, recalled this week. “It’s an uncomfortable part of the body to talk about,” he added, “but the other side of not addressing this is so much worse. The takeaway is don’t put off getting the test.”
Colon cancer is the third most common type of cancer and, while mortality rates have declined in recent years, it remains a leading cause of death among both men and women — resulting in the loss of nearly 800 lives a year in New Jersey, according to state officials, a rate that has traditionally been higher than the national average. But it is also curable and preventable; when diagnosed early, the five-year survival rate is nearly 90 percent, they said.
Many people have no symptoms
Despite the prevalence, many people will have no, or only minor, symptoms, experts note. Some develop polyps — a small growth in their colon or rectum, which may or may not be cancerous — and never know it. Others notice bloody stool, unexplained weight loss, or stomach cramps or pains, as Hughes did.
Former President Bill Clinton designated March as National Colorectal Cancer Awareness Month in 2000, in an effort to raise awareness and increase screening rates. But even today, one in three Americans over age 50 — the age group at greatest risk for developing colon cancer — has yet to be screened, according to the federal Centers for Disease Control and Prevention. A study by a team at Memorial Sloan Kettering, released several years ago, found that early screenings can cut the death rate in half.
“At any sign of symptoms it is important to consult your doctor; the sooner it is caught the likelier the chance for recovery. When caught early enough, colorectal cancer is a completely curable disease,” said Dr. Michael Arvanitis, the chief of colon and rectal surgery at Monmouth Medical. “Regular screenings can be the difference between finding a cure to lead a healthy life and becoming a statistic.”
Hospitals like Monmouth Medical, now a part of the RWJ Barnabas network, are part of the national “80% by 2018” campaign designed to boost screening rates to eight in 10 adults by next year. The state Department of Health’s Cancer Education and Early Detection program also maintains a list of nearly two-dozen sites that offer free or low-cost screenings for those who earn up to 250 percent of the federal poverty level (about $48,800 for a family of three, or $4,000 a month) and has connected nearly 60,000 people with screenings since 2002, the majority of them women.
Officials at Monmouth Medical said they introduced the “laparoscopic colectomy” in 2002 and have treated more than 1,000 patients since, making them one of the leading providers in the Northeast. The procedure involves powerful microscopes, videocameras, and tools inserted through several quarter-inch incisions, instead of a larger opening. This results in less pain, shorter hospital stays, and easier recoveries.
Determined to think positively
Arvanitis said Hughes’ case was “very advanced” and required “aggressive” treatment, but — since many patients don’t have noticeable symptoms — it is not uncommon to encounter patients at this stage of the disease. “When colon cancer is in such an advanced stage such as Walt’s was, the chances of recovery are significantly reduced which is why so many doctors advocate for regular screenings,” Arvanitis said.
Hughes also knew his diagnosis was serious. Getting the colonoscopy results, “that was pretty devastating,” he recalled. “It doesn’t have real good numbers.”
But the fisherman was determined to think positively and he worked hard to beat the odds; he credits the care he got at Monmouth Medical for making it possible. The surgery involved multiple physicians, including Dr. Ira Keselman, a urology surgeon Arvanitis added in case the procedure involved work on the bladder, which it did.
“I can’t point to one thing [at Monmouth Medical] that wasn’t done to the tenth degree,” Hughes said. He went home within a week and began chemotherapy a month later with Dr. David Sharon, who heads the hospital’s hematology and oncology section, a process he has repeated every two weeks since then.
Because he opted for a laparoscopic procedure, Arvanitis said Hughes was able to proceed through different phases of treatment more quickly than if he had traditional surgery. Starting chemotherapy within four weeks is an “incredibly fast turnaround,” he said.
The chemotherapy has not been easy, Hughes concedes, but the latest scans show progress: his remaining cancer has decreased by nearly 60 percent. That said, he does not look forward to treatment weeks: a full day at an outpatient center in Long Branch followed by two more days at home with a portable chemo pump.
“The first few days [after that] are tough. I’m pretty well shot as far as trying to do anything productive,” he said, explaining how he had to “step away” from his business for several months, during which his family pitched in to keep things going.
“I’m lucky not to have too many side effects, but it kind of dominates your life,” Hughes added. But he knows the alternative — not getting treatment —could have been far, far worse. “You have to take the battle to heart. You can’t let the numbers scare you.”