Medicine: Family History

A 61-year-old retired nurse came to see me in my office. She had an ascending colon cancer, and I scheduled her for a right hemicolectomy. The frightening thing was the circuitous route that she took to end up in my care. The only thing that had ever really bothered her was her knees. She retired several years ago to care for her husband, who died just last year from complications of diabetes. These last three years, spent mostly at her ailing husband’s bedside, she gained a tremendous amount of weight, and the arthritis in her knees grew worse and worse. Now, as a widow, trying hard to move on with her life, she was finding it difficult to get around at all. Her average 5 foot, 6 inch frame was no match for her 278 pound body. She consulted an orthopedic surgeon who recommended both knees be replaced.

In preparation for her knee operation, she was found to be anemic (low red blood cell count). The orthopedic surgeon started her on Procrit, a medicine to help boost her body’s ability to make fresh blood. Her internal medicine doctor insisted she have a workup to rule out any source of gastrointestinal blood loss, and sent her to a gastroenterologist. The gastroenterologist did an upper endoscopy and found some minor gastritis (stomach inflammation). The same day he did a colonoscopy and found her cancer. The gastroenterologist sent her to me.

I spoke with my patient’s family after her operation yesterday. I met her two sons, her daughter and son-in law. I explained how her size had made the operation more difficult, and how important it would be to have her up and out of bed as soon as possible. They thanked me for all the hard work, and for taking care of their mom, and explained that it was truly her knees that saved her. In the past ten years, her youngest son had had some benign polyps removed at colonoscopy, her daughter had polyps of a premalignant nature removed, and her older son had actually had a cancerous polyp removed endoscopically. Their mother, so busy caring for their father, had not gone for a colonoscopy in fifteen years, and never, never would have gone for one again if it had not been for her aching knees.

A family history of colorectal cancer is a serious risk factor for colorectal cancer. Your risk is higher when cancer occurs in primary relatives, which include your parents, your brothers and sisters, AND your children. For more information about colonoscopies, colon cancer screening, and what you can do to decrease your own risks of colorectal cancer, visit the ASCRS website.