Grand Forks man advocates for colorectal cancer screening
GRAND FORKS, N.D. -- Terry Harmon took some good-natured ribbing when he turned 50 in January 2013.
“Now that you’re in this ‘50s club’ you know what you’ve gotta do,” his older brother Tom told him, Harmon said.
But Harmon was feeling “strong and healthy,” and not inclined to heed Tom’s advice to get screened for colorectal cancer.
“I had no loss of weight, I had a good appetite,” said Harmon, who lives in Grand Forks. “I was sleeping well.”
He didn’t relish the idea of a colonoscopy, but “something said I should do it.”
Maybe it was the picture of a good friend he keeps on his bedroom dresser, he said. A few years ago, at age 39, this friend lost his life to cancer by ignoring symptoms and neglecting to get medical care that might have made a difference.
Harmon had a colonoscopy in late March.
During the procedure, Dr. Robin Hape, a general surgeon at Altru Health System, found and removed seven polyps, small growths on the wall of the colon, or large intestine, that can develop into cancer.
He also noticed an abnormal area from which he took a sample, or biopsy, for closer analysis.
The polyps turned out to be noncancerous, but the biopsy, Harmon learned later, revealed cancer that had invaded three of the colon’s four layers.
“I just started shaking,” he said, when Hape gave him the news. He peppered the doctor with questions: “What do I need to do? How do we handle this?”
Hape quickly set up several appointments for Harmon to undergo further medical tests. The same day that he received the news, Harmon was on his way to Altru for a blood draw. He was “frazzled” during the procedure but didn’t let on to anyone how he felt.
The diagnosis hit him when he returned to his pickup, he said. “I broke down.”
Delay or deny
Like many men, Harmon hadn’t paid close attention to his health and didn’t follow an especially healthy diet and lifestyle, he said.
“I think men are less aware of the fact that something could be wrong,” he said. “They don’t want to know that something is wrong. Or they feel it’s not necessary to go in” for screening.
The expense may be a deterrent for some, he said.
“The biggest thing is, if you have good insurance, and (reasonable) copay, it will save you (money) in the long run.”
Most people are fearful of colonoscopy, Hape said. “But after they have it done, they find it’s not so bad.”
Improvements in the initial step of the procedure — emptying the bowel of its contents — have made colonoscopy a little easier on patients, he said.
Some people “just gamble,” Hape said. “They say, ‘It (cancer) can’t happen to me.’
“I think everyone with cancer has probably said that at some time in their lives.”
Avoid cancer completely
Colorectal cancer differs from other types of cancer in one important aspect, Hape said. “With other cancers, the best you can do is find it early,” but the cancer is already present.
Colonoscopy allows doctors to locate and remove polyps before they become cancerous, he said. “With colorectal cancer, you can prevent cancer from happening at all — that’s the greatest thing.”
It takes up to five years for these tiny polyps to grow and turn into cancer, he said.
Of the 70 or so colorectal cancer cases Altru physicians identify each year, “I’d estimate that 60 of those would be completely preventable if they had gotten scoped early,” Hape said.
Dr. Anthony Chu, gastroenterologist at Altru, said, “With colonoscopy, we’re not really checking for cancer but really catching the precursor to cancer — looking for the polyp which occurs before that.”
People are getting cancer at younger ages, Chu said, but those 50 and older are at the highest risk for colorectal cancer. Early detection is critical for this age group because 25 percent of men and 15 percent of women will have a polyp.
Cancer that has spread, or metastasized, to other organs is categorized as stage 4, he said. At this stage, the five-year survival rate is 5 percent.
When cancer is detected at earlier stages, 2 or 3 — when other organs are not affected — the survival rate jumps to 70 percent. At stage 1, it’s more than 90 percent, he said.
“Our best screening tool is the colonoscopy,” Chu said.
He’s concerned that, of the North Dakotans eligible for colon cancer screening -- those 50 and older with no family history -- half are not getting screened, said Chu, who added that Altru has committed to cutting its rate of late-stage colon cancers by half in the next five years.
After recovering from five weeks of chemotherapy and radiation treatment, Harmon underwent surgery in June to remove the cancer.
Treatment had reduced the tumor from about 4 inches in length to much smaller than the size of a nickel, Hape said.
Eight inches of colon was removed to ensure “a margin” around the tumor and increase the likelihood that all cancer cells are taken, Hape said. The cancer had not spread to other parts of the body.
In the operation, surgeons rerouted Harmon’s intestine and created an ileostomy, an opening constructed by bringing part of the small intestine to the skin surface to permit waste elimination into an external bag attached to the front of the body — a temporary measure that allows the colon time to rest and heal, Hape said.
Harmon’s youth and general health worked in his favor, Hape said.
“Terry is young and otherwise so healthy. He’s tolerated chemo and radiation well, and bounced back from surgery.”
Some complications, including a blood infection, have slowed his progress toward full recovery, Harmon said, but he’s anxious to return to his job, when approved by his doctor, and ride his scooter this summer.
Encouraging the reluctant
Harmon said some of his friends have had colorectal screening because of what he has gone through. But he knows others who are reluctant could also benefit.
The number of people diagnosed with colorectal cancer could be less if it’s caught sooner, he said.
Harmon’s mother, Marie Harmon of East Grand Forks, Minn., has become “a sounding board for me,” he said. “She’s a positive thinker.”
She’s also “a spiritual woman who believes everything happens for a reason,” he said. “She said it was by ‘divine intervention’ that I went in for the colonoscopy when I did.
“She said, ‘What if you had been too proud’ to have it done?”
If Harmon had delayed the colonoscopy six to 12 months or put it off altogether, a permanent colostomy, rerouting of the colon to eliminate waste through an external bag, would have been necessary, Hape said.
‘Made me stronger’
The experience with cancer has “made me stronger,” Harmon said. “I am more adamant about taking care of myself.”
He recommends colorectal screening to others, and tells his story to those who ask him.
He has become “not a crusader but an informant — somebody who’d like to spread the word,” he said. “It would only do good.”
The battle with cancer raised his concern for others in his life.
“The friends I have, what if they have something in them? I care enough to force the issue … I wouldn’t want anyone else to go through what I have.”
Taking time to get screened “is not that big of a deal,” he said.
“One day of your life could save your life.”
Colorectal cancer: Signs and symptoms
Colorectal cancer usually doesn’t cause any symptoms in its early stages. Symptoms occur later, when the cancer may be more difficult to treat.
The most common symptoms include:
- Pain in the belly, such as cramping.
- Rectal bleeding, blood in your stool or very dark stools.
- A change in your bowel habits — such as more frequent stools, diarrhea, constipation, a feeling that your bowels are not emptying completely, or narrowing of the stool that lasts for more than a few days.
- Constant tiredness (fatigue).
- In rare cases, unexplained weight loss.
Having these symptoms does not mean you have cancer. A number of other medical problems could cause similar symptoms. It’s important to see you doctor, so the cause can be found and treated, if needed.
Sources: American Cancer Society and WebMD.com.