I’m not going to lie, this is my favorite Q&A session, because it’s with Dr. Derek Helton, the infamous “Dr. H” from my books and in my cancer fighting life :-). This is the Oncologist who treated me from day one and has been doing a damn fine job of it if you ask me.
He works out of the UCSD cancer centers (formerly San Diego cancer centers) in Encinitas and Vista, California. He may come off a bit dry on text with all his “doctor speak”, but look at that sweet face. His soft spoken heart is in it fo shizzle.
So, who better to interview to get an Oncologist’s point of view on colorectal cancer?
Me: With regards to Colorectal Cancer, what’s your experience/specialty?
Dr. H: Mine is gastro intestinal malignancies and general oncology.
Me: gastro whut?
Dr. H: You know that cancerous tumor you had in your colon? That’s what I specialize in.
Me: Ah, right. So, of all the fields in medicine, why did you pick your specialty?
Dr. D: Because of the special relationships that occur with patients and their families. It makes the work I do more meaningful.
Me: There is a family history of cancer, but none for colon cancer, so why would/did I get it?
Dr. H: Most often cancer is due to acquired DNA abnormalities over life. It can happen to anyone.
Me: Why should anyone with no history of colon cancer bother getting screened for it?
Dr. H: Because screening can detect the disease early and there’s no doubt that it saves lives.
Me: How often do you come across a case where someone with no family history of it, gets colon cancer?
Dr. H: Quite frequently.
Me: How many different types of colorectal cancers are there?
Dr. H: There is really just one main type, and it’s called Adenocarcinoma.
Me: Why did they decide that 50 is the age to start getting colonoscopies?
Dr. H: Honestly, because incidences increase with age, so there’s a balance there of cost and effectiveness at screening. A very high percentage of colorectal cancer patients are over the age of 50.
Me: How many cases do you know of where someone under 50 gets colorectal cancer?
Dr. H: I’d say about 10% of my cases.
Me: Does smoking cause colorectal cancer?
Dr. H: It is a known risk factor.
Me: Does smoking cause cancer cells to grow faster or interfere with the progress of cancer treatment?
Dr. H: I can’t say that it does, but it certainly doesn’t help your treatment and can cause a variety of complications.
Me: Does consuming sugar cause colorectal cancer?
Dr. H: It’s not so simple as that. The cause/effect aren’t clear enough to say.
Me: Does consuming sugar cause cancer cells to grow faster?
Dr. H: Less simple sugar is thought to be better, but there’s no certainty of a direct cause/effect.
Me: How fast or slow does colorectal cancer grow compared to other cancers?
Dr. H: I’d consider it “in the middle” compared to others.
Me: Why would a woman get colorectal cancer, isn’t it a man’s cancer? Does it mean she has too much testosterone and not enough estrogen in her body?
Dr. H: Not sure where that one came from, but colorectal cancer is unrelated to sex or hormones.
Me: How could someone like me have prevented getting colon cancer?
Dr. H: You might not have been able to completely prevent the disease, but regular exercise, a diet focused more on proteins, anti-oxidants and less on carbs would your best bet.
Me: What treatment options are there for colorectal cancer?
Dr. H: General surgery, chemotherapy plus radiation techniques like cyber knife.
Me: What do you think is the most effective/least invasive treatment for colorectal cancer?
Dr. H: If we can catch it in it’s earliest stages that would mean fewer therapies would be needed.
Me: Why don’t colorectal cancer patients go bald?
Dr. H: Only certain chemo therapies cause alopecia (baldness). Chemo for colon cancer has other side effects, like sensitivity to sunlight and cold.
These are the latest statistics that are posted in current articles on the subject. According to the National Cancer Institute (NCI), based on a sampling of 120,000 people diagnosed with colon cancer between 1991 and 2000, the five-year survival rates based on the stage of the disease are below.
Stage I Survival Rates – 93%.
Stage II Survival Rates – 72-85%
Stage III Survival Rates – 44-83%
Stage IV Survival Rates – 8%.
Me: Do you believe the odds of surviving colorectal cancer have improved since then? If so, why?
Dr. H: Definitely for stages III and IV, yes. Newer therapies lengthen life for these patients. Stages I and II are hard to improve upon.
Me: At what point is a patient considered “In Remission”?
Dr. H: From the first normal imaging, labs and exams.
Me: How often and for how many years should a patient be screened after being considered “In remission” and what kind of screening?
Dr. H: Every few months for up to five years after the first normal results, but colonoscopies are needed indefinitely.
Me: MRI or Pet Scan, which is more effective in screening for colon cancer and why would you use one or the other?
Dr. H: Neither are used for screening. Both may be used though, for specific cases of surveillance or suspected recurrence.
Me: What are the odds of cancer returning once a patient is in remission?
Dr. H: That’s really hard to say. Unique cases have differing odds by stage and chosen treatments. That’s why it’s important to keep on top of the follow up labs and scans.
Me: Do those odds increase with the level of stage of cancer the patient has by the time it’s diagnosed and treated?
Dr. H: It may be, yes. Earlier detection is absolutely the best.
Me: The term “cured” is not widely recognized in the world of cancer, but some say that once a patient has been in remission for over five years, they can considered themselves “cured”. What’s your take on that?
Dr. H: The definition is arbitrary. The word isn’t used out of fear of being wrong. it imples we know it is never coming back when we can’t be that certain.
Me: If there is just one point that will sink in when someone reads this, what do you hope it will be?
Dr. H: To update your family history with your primary care physician and get your routine health maintenance screening.
Me: Who is your favorite patient ever?
Dr. H: Ali Gilmore, obviously!
Me: Thank you for being an oncologist and saving my life Dr. H.
Dr. H: :-).
– Dr. Helton graduated Alpha Omega Alpha from Loma Linda University School of Medicine, did his fellowship and Cedar Sinai and is board certified in Internal Medicine as well as Medical Oncology. Dr. Helton’s clinical practice encompasses a broad variety of solid tumor malignancies, benign and malignant blood disorders. His solid tumor focus is Gastrointestinal Malignancies. He directs this program for North County UC San Diego Cancer Center.