Colonoscopy screenings: sooner is better

By Jack Kintner

Terry Pickering went to her physician, Dr. Marta Kazymyra, for a routine visit last April 30 and two days later found herself at St. Joseph Hospital in Bellingham recuperating from cancer surgery. Doctors removed a section of her large intestine that contained a dense, hard tumor the size of a grapefruit, big enough for Kazymyra to feel and to order Pickering down to Bellingham immediately for further tests.
“Her surgery was scheduled for two hours, but it took us seven,” Kazymyra said.

Pickering, who has never smoked and drinks very occasionally, developed cancer of the colon, after lung cancer the second leading cause of cancer death.

But despite the scary interruption to her life, she remains positive. “It’s not a death sentence,” said Pickering, an active and still enthusiastic 54-year-old mother of two, “and I’ve never had a thought of ‘why me?’ because it doesn’t matter.”

While she credits her deep Christian faith with providing a context for her to face the disease, she agreed to share her story specifically to get people to realize the value of early screening with a colonoscopy procedure, by consensus the best screening test currently available for early detection of what can easily become an undetected killer, usually in people over 50.

Since the test involves running a TV camera into the large intestine through the rectum, many are understandably reluctant to do it despite the sometimes life-saving information that results.

But even though scheduling a day off for the test may be inconvenient, so is the disease: two days after the surgery Pickering’s older son graduated from Washington State University with her still in the hospital. “Like so many, I procrastinated,” Pickering admitted, “but there’s a silver lining, because my kids now know to begin having the exam at age 35.”

Doctors now recommend a colonoscopy every three to 10 years depending on other risk factors, previous results and an annual fecal occult blood test (FOBT), which can detect minute traces of blood in the stool.

To Kazymyra and her staff, the discovery was a wake-up call. “We’re like everyone else, not able to find the time, either, making all kinds of excuses” she said, “so this became a chance for us to set a good example to look after ourselves as well as out patients.”

At 8:30 a.m. on July 23 Kazymyra, along with four other staff members of the Blaine medical practice she shares with her husband Dave Allan, left for the Northwest Endoscopy center next to St. Joseph Hospital. By noon they were done and back in Blaine, a bit dizzy from the “conscious anesthesia” but none the worse for wear. “All five of us expected to be totally clear and not to have to return for 10 years,” said Kazymyra, “but lo and behold all of us had polyps. And we’re all healthy people, from 51 to 59-years-old.”

Once her gastorenterologist removed the polyps and the pathology report came back then the five were told the results and asked to return for another procedure in three, five or 10 years depending upon the size, number and kind of polyps found.

Colorectal cancer develops in the cells in the surface lining of the large intestine. Mutations in specific deoxyribonucleic acid (DNA) sequences lead to unrestricted cell division, or cancer. These mutations can be caused by such factors as smoking, drinking, obesity, a diet too rich in animal fats and deficient in fiber, a lack of exercise and inborn genetic variations – also known as a family tendency.

“Family history is a really big consideration,” Kazymyra said, “and means getting tested earlier even though 93 percent of all cases occur in people over 50. It’s the second leading cause of cancer deaths behind lung cancer,” she said, “but is also an almost totally preventable disease.”

The colonoscopy screening “was a piece of cake,” Kazymyra said, although both she and office staff Chris Dodd said that the after effects of the anesthesia made them feel dizzy and disoriented afterward. “There’s no way I could have driven or gone back to work,” she said.
She tried, in fact, to rent a limousine for her staff but found none available. She accepted a ride for all five in the Stafholt Good Samaritan van graciously offered for the occasion at the last minute by director Wayne Weinschenk.

“In my case,” said Pickering, “it’s spread locally, so they’re giving me 12 chemotherapy treatments and then at six months we’ll re-assess. Further treatment may involve radiation or some kind of follow-up, but it’s not taking over my life. I’m still me. This is an illness, it isn’t the worst thing in the world. Hopefully my experience will help others decide to get a colonoscopy, the sooner the better.”