What My Dad Didn’t Know
My paternal grandfather – my father’s father – was diagnosed with colon cancer in his late sixties. It was caught early and I was just a child of eight or nine at the time, so it barely registered as a blip to me. He had an operation, did some chemo I didn’t even witness (I grew up in the suburbs of Chicago while he lived in central Indiana) and then he was all better. I don’t think my parents even told me that he HAD cancer until after he was cured, because I don’t remember ever being scared for him, and my friend AJ’s mother had died of ovarian cancer two years earlier, so knowing that my grandfather had cancer would have definitely kept me up nights. (I was an excitable child.)
So when my father was diagnosed with stage-three colon cancer at the age of fifty-nine, I was not overly worried. It was serious, for sure, and he had a tough road ahead of him, but my grandfather had beat this thing, was well into his eighties and still alive, kicking and eating lime Jell-O at the Hoosier version of Shady Acres. Plus, my dad had taken it seriously: Right at 50, he’d started getting his colonoscopy screenings, just like the doctor ordered. In my mind, he’d have surgery, go through a few rounds of chemo, lose his hair and be good as new.
Only it didn’t quite turn out that way. My father’s colon cancer didn’t respond to his pre-surgery chemotherapy as vigorously as everyone had hoped, so we began to learn a whole new vocabulary. Words like transection. Anastomosis. Ileostomy. (Don’t Google that last one if you’re about to eat lunch.) The words meant that my father had a whole huge chunk of is insides cut out, with what remained sewn together, left to heal, before being blasted by more chemotherapy, to make sure that they’d gotten all the bad stuff.
It turned out they hadn’t gotten all the bad stuff. Only this time the bad stuff had moved into worse places. The second time around the words were more like inoperable. Palliative. Hospice. I went with my mother and father to Rochester, Minnesota for a second opinion, but even at the Mayo Clinic the news was no better. The specialist we saw there said he could operate, but the chances were just as good that my father would die on the operating table as that he would survive the surgery. And there was no guarantee that the tumors on the PET scan were all of them. So he went home to spend his last months with his family. On January 31, 2009, with all of us there, he died at home, the cancer that started in his colon having metastasized to his liver and brain. He was sixty-two and I was thirty years younger.
That April, at my yearly physical, I brought up my father’s death and the topic of colon cancer with my physician. My father had done what he was supposed to, I told him, but he’d died anyway, and I wanted to know if there was anything more I could be doing to protect my health. I soon found out that while my father had been doing what he’d been told to do, what he knew to do, that given his family history, there was more he probably should have been doing, and if he’d had that knowledge and followed it, it may have saved his life.
The first thing he needed to know is that the guidelines for colon cancer screening are for the general public who do not have an increased risk of getting the disease. The second thing he needed to know is that having a relative, or multiple relatives, who have had colon cancer increases your risk of developing it. Heredity is even more of a risk factor among first-degree relatives (parent, sibling, child). The third thing he needed to know is that when you are at increased risk, you need to increase your screening.
In April 2009, at the ripe old age of 32, I had my first colonoscopy. I will have one every five years from here on out. I know… not eating for a whole day, only to top it off with a Gatorade-laxative cocktail, just so that you can wake up the next morning for a date with your doctor and a camera that’s going where the sun don’t shine isn’t exactly a day at the beach. But honestly, once the drugs kick in, I’ve never remembered a thing. I swear. And when you compare it to the alternative? (That alternative being having your guts torn out, enduring months of nausea/fatigue-inducing chemo and perhaps even an early, painful, agonizing death. Natch.)
Starting at age fifty, in between colonoscopies, I will also have a fecal occult blood test as part of my yearly physical every year, to test for cancer that might be forming while still in the earliest stages. Yes, this test is not pretty (it requires home poop collection). But I will do this because my father had colon cancer, his father had colon cancer, and my mother has had colon polyps, growth which may be related to cancer. Which means I am more likely to get it. And the faster you catch it, the more treatable it is.
As newer, more accurate tests develop, I’ll make sure I include them in my screening regimen too.
Look, I know that colorectal cancer is not the most comfortable topic to talk about. I myself am guilty of calling it “the butt cancer” at least once while my dad was going through chemo. (Okay! Many, many times.) But the point is this: No one ever told my dad that he was at high risk and needed to be screened a lot more often than your average Joe. If someone had, he’d probably be here right now. And I’d really, really love for him to be here right now. And whether you’re someone’s dad, or sister, or aunt or neighbor or friend, I know that there are a lot of someone’s who want you to be around for a very, very, VERY long time.
If colorectal cancer runs in your family, get screened. Find out about the increased screening guidelines, and follow them. The people in your life will be glad you did.