The American Cancer Society (ACS) released its annual cancer statistics last week, reporting that the risk of dying from cancer in the U.S. has fallen 32% over the past 28 years. Cancer deaths in the U.S. reached their peak in 1991, with 215 out of every 100,000 people dying from cancer, and have been falling ever since, largely due to a decline in the amount of people who smoke.
Evan Conant was one of the lucky ones. His stage I colon cancer was caught early, during a routine colonoscopy, and doctors at the University of Colorado Cancer Center were able to perform a surgery to remove the tumors entirely.
The recent decrease in the age recommendation for colorectal cancer screening came as no surprise to Chris Lieu, MD, associate director of clinical research at the CU Cancer Center. Like many cancer doctors around the country, Lieu has seen an alarming increase in recent years of cases of colorectal cancer in patients younger than 50.
The U.S. Preventive Services Task Force recently lowered its recommended age to begin screening for colon cancer from 50 to 45. It’s the third most common cancer in America, and in Colorado, there are an estimated 2,100 new cases each year.
Dr. Chris Lieu, the Associate Director of Clinical Research at the CU Cancer Center, explained the change stems from an increase in the number of colorectal cancer cases among younger people.
In a move that has the potential to save thousands of lives, the U.S. Preventive Services Task Force (USPSTF) this week lowered the recommended screening age for colorectal cancer from 50 to 45 for asymptomatic patients with no family history of colorectal cancer. Considered the leading source of medical guidance in the U.S., the USPSTF is an independent, volunteer organization made up of national experts in internal medicine, family medicine, pediatrics, OB/GYN, nursing, behavioral health, and more.
Pablo Garcia started to worry when he began experiencing unusual stomach symptoms. He worried even more when his doctor at the Salud Family Health Center in Longmont, Colorado, ordered a colonoscopy to check for signs of colon cancer. Pablo was unfamiliar with the procedure, the preparation, and the hospital where the test was to take place.
There’s never a good time for a cancer diagnosis, but it’s especially difficult in the middle of a pandemic, when concerns about safety compound the worry and anxiety that come along with hearing, “you have cancer.”
Chemotherapy used to shrink a tumor before surgery, called neoadjuvant chemotherapy, is becoming more common in many cancers, including stage II and III rectal cancer. However, the chemotherapy regimens FOLFOX and CapeOx used in this setting come with significant side effects, to the degree that many patients are unable to complete the recommended schedule. Now a University of Colorado Cancer Center study presented at the 2020 Gastrointestinal Cancers Symposium shows they may not have to: A small study of 48 patients with locally advanced rectal cancer receiving neoadjuvant chemotherapy, found that patients receiving lower-than-recommended doses in fact saw their tumors shrink more than patients receiving the full dose.
Heather and Lauren Squire credits the University of Colorado Cancer Center for giving them a couple more years with their beloved father and husband.
“My husband was a beast,” explains Heather Squire. “Up until the very end, he was an absolute beast.”
“Beast” may be the perfect way to describe someone who would run three to four miles right after a chemo infusion. “Beast” may also be the perfect way to describe a dedicated doctor who saw his last patient exactly two months before his passing. But for Heather Squire and their daughter Lauren, the “beast” Doug Squire, was a loving and compassionate husband and father who made the most of each and every day.
It Can Happen to Anyone
After nearly 18 months of stomach issues that doctors were unable to explain, Doug Squire, MD, oral and maxillofacial surgeon, from Longmont, CO, found himself in a waiting room with his wife, Heather, to undergo a colonoscopy procedure.
“I remember what I was wearing that day,” says Heather. “The whole day is so clear in my head. It was absolutely traumatic. After just about ten minutes into the procedure the doctor came out and said, ‘we need to talk’.”
Doug was diagnosed with stage 4 colon cancer that had metastasized to his liver. The prognosis was bleak: 2 to 3 years, “if he was lucky”.
“I did not accept that. I physically and mentally could not accept that,” says Heather. “I was 39, we had a 10-year-old daughter and we had our whole life together waiting for us. I remember saying to the doctor ‘that’s not going to work for us’”.
A cancer diagnosis never crossed the Squire’s mind. Doug was only 41, extremely fit, ate well, and took care of his health. You could say he was the opposite of someone you would imagine being diagnosed with cancer and especially colon cancer.
“People think that colon cancer is just an ‘old person disease’. That is not the case. If the most freaking fit human can get it, anyone can!” says Heather.
A Long(er) Road
At the time he was diagnosed Doug was given just 2 to 3 years to live. The Squires’ were determined to beat those odds.
“We ended up going to another cancer center before we were officially connected with Dr. Messersmith,” explains Heather. “Doug said many, many times throughout his treatment that he completely trusted Dr. Messersmith and felt comfortable with him, which was the most important thing for us.”
Doug’s care team stretched state lines. His oncologist at the University of Colorado Cancer Center and his surgeon at another cancer center in Texas.
“The collaboration worked out wonderfully because Dr. Messersmith and the surgeon actually knew each other and were able to go back and forth with different ideas throughout the treatment process,” says Heather.
His treatment included surgery to slowly kill off parts of his liver. In addition, Doug went through countless rounds of radiation and chemotherapy.
“He never complained. Not even once,” says Heather. “He would actually go for runs, pump in hand, during his infusions. No one could believe he had stage 4 cancer and that’s exactly how he wanted it”
A long road (luckily) became a little bit longer when Doug hit the three-year mark after diagnosis. He even ran a half marathon in New Orleans on the 3 year anniversary of diagnosis to prove his point. However, in year four, his chemo treatments stopped working. Messersmith brought up the idea of starting immunotherapy as a last resort but, devastatingly, Doug did not qualify for the trial. Doug passed away on August 3rd, 2017 at his home surrounded by his family. He was just 46.
“Dr. Messersmith and Doug’s entire care team gave us the gift of more time with our husband, father, and friend,” says Heather. “We got an additional two and a half years to make memories and be together thanks to the care we received. Before Doug passed, we knew that we wanted to do something to give back.”
Before Doug passed, he gave Heather the instructions to sell his BMW and give 100% of the profits to Dr. Messersmith. This started a domino effect in the Squire family.
“Doug was always a very humble man. He did not want me to have a funeral. Instead, we had ‘Dougtoberfest’, a chance for friends to gather and an opportunity to raise awareness and money for colorectal cancer research,” explains Heather. “At the event, we were humbled and honored to have hundreds of people attend and we were able to create the Doug Squire Honorary Fund.”
The Doug Squire Honorary Fund supports many aspects of colorectal cancer research, including the training of future oncologists in the CU Cancer Center’s Summer Research Fellowship Program.
“This year we were able to sponsor Hannah (Frederick),” says Heather. “She is amazing! We were lucky enough to have a private lunch with her after the program was completed and really get to know her and her hopes for the future. It means the world that we were able to support her in her colon cancer research endeavors.”
“Hannah Frederick is a junior at the University of Maryland,” says Jill Penafiel, Education Manager at the CU Cancer Center. “She’s a stellar student who has a passion for research. She really enjoyed presenting her research results to Heather and Lauren Squire and Dr. Messersmith and was so appreciative of the sponsorship and connection to a colon cancer patient.”
Cartwheeling for Colon Cancer
In addition to support research, Heather has made it her life’s mission to raise awareness about colon cancer in young people.
“When Doug was going through treatment, being healthy and active remained important in our lives” she says. “I traveled frequently for work and in an effort to stay active on the road and let him know I was thinking of him, I did a cartwheel at the end of each run and sent him a photo. Now, it has grown to be an awareness effort and a unique way to get people’s attention on the topic of colon cancer.”
The instagram account Cartwheels4ColonCancer has hundreds of followers. Heather, who manages the account, has met many of the followers, heard their stories and knows first-hand her awareness passion is helping save lives.
“I have people come up and tell me ‘thank you’ for not only raising awareness of colon cancer in young people but also encouraging people to be proactive about their health,” says Heather. “If something feels off in your body, don’t dismiss it!”
It has been just over two years since Doug’s passing. Since then, Heather and Lauren have dedicated their lives to awareness and funding life-saving cancer research. They have no plans to stop in the future.
“We move forward, but we don’t move on,” says Heather. “We never expected to lose Doug as early as we did. I can only hope that our efforts are making him proud and saving lives in the process.”
Fight Colorectal Cancer (Fight CRC) is excited to announce that the manuscript titled “A summary of the Fight Colorectal Cancer working meeting: exploring risk factors and etiology of sporadic early-age onset colorectal cancer” has been published in the August edition of Gastroenterology. Over 45 experts studying colon and rectal (colorectal) cancer in young adults participated in this effort.
The incidence of early onset colorectal cancer has increased nearly 50 percent in the last 30 years. A University of Colorado Cancer Center study presented at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago aimed to identify factors that may aid in earlier diagnosis and treatment of the disease.
More and more young people are being diagnosed with colorectal cancer. The increase is not small—the number of cases is up approximately 40 percent in the last 25 years. This is a stark contrast to the decrease of 40 percent in populations typically affected by the disease. Researchers at the University of Colorado Cancer Center want to know why more young people are being diagnosed and what can be done to reduce the burden in this population.
Colorectal cancer is unique in that, unlike many other cancers, we know how it progresses from healthy to cancerous. We also know how to prevent it and catch it in its early stages, making it one of the only truly preventable cancers. Unfortunately, even with this knowledge, about 140,000 people are diagnosed with colorectal cancer in the United States every year. Even worse, colorectal cancer is the second leading cause of cancer-related death in the United States behind lung cancer.
While the overall incidence of colorectal cancer has fallen about 2 percent annually over the previous two decades, the incidence of early-onset colorectal cancer has risen. In adults ages 20-49, the incidence of colorectal cancer rose 1.5 percent annually over this period. For the youngest end of this age range, those aged 20-29, the annual percentage increase in colorectal cancer incidence was 5.2 percent in men and 5.6 percent in women.
Nearly a decade ago, a lightbulb went on in Christopher Lieu’s head. At the time, Dr. Lieu was in the beginning of his fellowship and the lightbulb was his recognition of a disturbing trend: More and more young people were being diagnosed with colon cancer.
A trip to Jamaica means white sandy beaches, warm waters, and a perfect get away for most people. But for Stephen Estrada, a colon cancer patient at the University of Colorado Cancer Center, his trip to the island turned into a nightmare.
With long blonde hair, a fit physique, and an overwhelmingly positive attitude, Katy Davenport hardly looks like someone who is enduring cancer. Yet at 34 years old Katy went in for a precautionary colonoscopy after noticing some blood in her stool. Her doctor was shocked to discover a tumor.
When the going gets tough, grape seed extract gets going: A University of Colorado Cancer Center study recently published in the journal Cancer Letters shows that the more advanced are colorectal cancer cells, the more GSE inhibits their growth and survival. On the other end of the disease spectrum, GSE leaves healthy cells alone entirely.