Till death do us dine?
Doctors: Valley residents' habits augment cancer risk
Melissa McEver Valley Freedom Newspapers March 21, 2009
Rafael Ramirez didn't go to the doctor when he started feeling weak and had trouble breathing. Instead, he drank medicinal tea, as family and friends suggested.
He got worse.
Finally, in April 2004, Ramirez went to a doctor for a routine checkup. The doctor referred Ramirez, a 70-year-old Brownsville resident, to a gastroenterologist, who eventually diagnosed him with colon cancer.
"I didn't know anything about it," Ramirez said of the disease. "I just felt like I was getting the flu."
Ramirez underwent surgery the following month and is now cancer-free. But many other Rio Grande Valley residents remain unaware of the symptoms of colorectal cancer or the need to be screened regularly, and that lack of knowledge can be dangerous, local doctors said.
Too many residents skip routine colonoscopies, which could catch colon cancer at an early stage and save lives, said Dr. Carlos Ponce, a Brownsville gastroenterologist.
"A lot of people don't know they need a screening colonoscopy," Ponce said. "They think they only need one if they have symptoms."
The problem is that by the time symptoms appear, the cancer often has progressed, diminishing the chances for survival, Ponce said.
March is National Colorectal Cancer Awareness Month, and local doctors want patients to know that cancer screenings are important, they said.
"This is a kind of cancer that can be totally cured if caught early," said Dr. Nurul Wahid, an oncologist at Texas Oncology in McAllen. "But in the Hispanic community, people often don't go for regular medical checkups and delay going to the doctor."
DELAYING SCREENINGS
Studies have indicated Hispanics seek preventive care, like cancer screenings, less often than non-Hispanic whites. A 2007 study by the national Centers for Disease Control and Prevention concluded that Hispanics are less likely than whites to be screened for colorectal, breast or cervical cancer.
About 28 percent of Hispanics ages 50 and older had undergone colonoscopies within the past five years as of 2005, according to CDC statistics. About 46 percent of non-Hispanic whites had undergone the screening.
Meanwhile, colorectal cancer is the third most commonly diagnosed cancer among Hispanic Americans, according to the Prevent Cancer Foundation. Hispanics are also more likely than non-Hispanic whites to be diagnosed at a later stage.
The American Cancer Society recommends that people older than 50 undergo a test called a flexible sigmoidoscopy, in which the doctor uses a lighted tube to examine part of the colon, every five years, and a colonoscopy, in which a tube is used to examine the entire colon, every 10 years. Experts also suggest annual tests to check for blood in the stool.
Many patients seem to be nervous about these tests, but they are generally simple and painless, Ponce said.
Typically, the night before a colonoscopy, patients have to drink about 12 ounces of a chemical and consume only soft foods and liquids. The procedure itself takes about 10 minutes, and the patient is lightly sedated, he said.
Medicare, Medicaid and insurance plans often cover 100 percent of the screening, Ponce said. At his clinic in Brownsville, patients also have the option of paying for the procedure in installments.
HIGHER RISK?
Residents on the U.S.-Mexico border should be checked for colon cancer because they generally could face a greater risk of the disease than the broader population, doctors said. That is because diabetes and obesity - conditions prevalent in the Rio Grande Valley - can increase a person's risk of developing colon cancer.
Also, diets that are high in red and processed meats can increase a person's risk, the American Cancer Society says.
Red meat is a staple of the Valley diet, doctors said. But eating fruits and vegetables decreases the risk of colon cancer.
Lack of exercise, smoking and alcohol use also have been linked to colon cancer.
Statistics seem to suggest, however, that the incidence of the disease in this region actually is slightly lower than in the rest of the state. In Cameron County, for example, the incidence was about 53 per 100,000 men and about 30 per 100,000 women in 2008, compared to 59 per 100,000 men and 40 per 100,000 women in Texas that year.
Researchers have said they're not sure why cancer rates here are lower than in the rest of the state.
Still, because many residents put off cancer screening, the cases diagnosed here are more likely to be advanced, doctors said. And poor lifestyle choices don't help.
Making healthier choices, and getting regular screenings, can save many lives, Ponce said.
"If colon cancer is caught early, there's an 80 to 90 percent survival rate," he said.
Melissa McEver covers health and environment issues for Valley Freedom Newspapers. She is based in Harlingen and you can reach her at (956) 430-6252.
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