Kentucky has made gains when it comes to detecting and treating various cancers.
There may be an impression that all kinds of cancers are striking Kentuckians at a younger age all the time. That’s not the case according to the Kentucky Cancer Registry, which is the state’s program to track cancer rates. Tom Tucker is the founding director of the registry.
“Yes, it’s going up in younger people. However that gets defined..people under 65..people under 50. But, it’s also going up in people over 50 or over 65. And so the proportion of people who are younger has remained about the same. It hasn’t really changed in the last 20 years dramatically,” said Tucker.
And it’s that data, gathered at the cancer registry for more than three decades, that can help in developing cancer prevention strategies.
“Without that data we would simply be blind. The Kentucky Cancer Registry really is the eyes for cancer prevention and control efforts. And we have been pretty successful at using them to identify where we need to target our limited resources and to measure the impact of our interventions,” said Tucker.
Tucker admits that colorectal cancer is particularly challenging. He says the number of cases found in people under 50 is pretty significant and the question is, why? Tucker said it’s happened since screening in Kentucky improved from 49th nationally to 16th.
Dr. Avinash Bhakta is a colorectal surgeon affiliated with the University of Kentucky Markey Cancer Center. He said epidemiologically many people are being screened at appropriate ages, currently starting at age 45.
“We’re getting the word out that colorectal cancer doesn’t always have symptoms and so we need to adhere to national guidelines. But, even with that adherence, why is it that we’re seeing death in the younger patients and death in older patients too,” said Bhakta.
The “why” still remains a difficult issue. Dr. Bhakta said there can be genetic factors, diabetes, obesity, smoking, and lower socio-economic status can all play a role.. And it’s possible the colorectal cancer screening start date of age 45, down from 50, could still go lower.
“With all of the increase in our early-onset colorectal cancer, we’ve changed that recommendation of 45. We’re going to continue evaluating the statistics and as the statistics show earlier and earlier incidence of colorectal cancer, that likely will change,” said Bhakta.
“Good Morning Erica..how are you doing today? Fine, how are you?..Good..back again..good. I was here yesterday where were you? In the back…Oh were you?..Dodging all the madness out here. I’ve never seen it so crowded,” said Herring.
Alex Herring of Lexington, checking in at Baptist Health for a meeting with his oncologist. He was diagnosed with stage four colon cancer 15 months ago.
“I’m 35 years old and when I was 34 last August, I showed up here at this hospital, essentially dying and was told that I couldn’t leave and I had to check in and that’s when I found out I had cancer,” said Herring.
Herring’s undergone two surgeries, first to remove a grapefruit-sized tumor in his colon and a subsequent surgical procedure to remove more than half of his liver. And there have been months of chemotherapy. Herring says he’s accepted his medical condition.
“I had a cousin when she was six months old she had a brain tumor. She lost her left leg to bone cancer at age four and then passed from leukemia when she was age six. That happened between when I was ten and 16. Somebody’s got it worse. These are the cards I’ve been dealt. I’ll deal with the them. I’m happy to deal with it because somebody out there’s got it worse,” said Herrings.
Herring’s wife, Kelsey Wellman admitted it’s been a roller-coaster, saying her thoughts ebb and flow, adding it’s been hard and life-altering. Wellman spoke about a talk she had with her five year old son and his understanding of Alex’s cancer.
“Alex actually wrote a children’s book about that because he was resting and stuff like that and Aiden I went for a walk and he picked a flower and brought it back to..ooh I might cry…Alex and said it’s his magic flower and was gonna make him feel better,” said Wellman.
Alex said his brother, two years younger, got screened for colon cancer after his diagnosis. Herring says the doctors said if he had waited two years, he’d be in his condition. So, the 35-year-old cancer patient hopes his story will help convince others to get screened.
Herring said he’s just starting to organize a group called “Help Kentucky.” It’s aimed at increasing awareness of colorectal cancer and screenings, particularly in the 30 to 40 age group. The Lexington cancer patient noted he’s approached the campaign using comedy and playing on nostalgia for people in that group. Fund raising will partly go toward investing in new treatments and inspire young people to become scientists and doctors who could work in the cancer-fighting arena.
Linda Clifton of Versailles has experienced the same type of cancer in a different way. It came when her daughter Cindy was diagnosed with stage four colorectal cancer during pregnancy. Clifton said her daughter chose to battle a life-threatening disease and maintain the pregnancy.
“But, there she was 19 and a half weeks pregnant and she had two different doctors ask her about aborting the baby and she said absolutely not. And their goal was to treat her, but she wasn’t willing to give up that pregnancy..so she had that mother’s love…and she sacrificed her life for her baby,” said Clifton.
Clifton said Cindy went through five rounds of chemo while in utero and the baby was born at 32 and a half weeks. Caden was ten months with two nine-year-old twin brothers Brayden and Tyler when Cindy died just over 13 months after diagnosis. Linda Clifton said she and her husband’s faith has been key
“Sometimes I’ve heard of marriages that go the opposite direction and in our case, we held each other. We’ve cried, but being together..having Christ in the middle our relationship..our marriage..so important,” said Clifton.
Clifton noted her church family has been an all-important support group. She added her daughter’s legacy lives on through Caden, who’s now eight and her 16-year-old sons. And there is a yearly remembrance at a favorite eating establishment.
“We will now get together with my son, just my son, and my husband and I will go to Red Lobster, because she loved shrimp like no other. So, we’ll go get Red Lobster and we will eat her favorite because that’s what she liked,” said Clifton.
When it comes to prevention and treatment of colorectal cancer, the research is still ongoing. Dr. Avinash Bhakta said the hot topic now focuses on changes that happen in the gut microbiome. In addition to diet, the research centers on such things as the effects of water, processed foods, and exercise.
“It changes the makeup of what our guts are made of and that does…I wouldn’t necessarily say cause colorectal cancer but it’s definitely playing a bigger role in the development and the risk factors associated with colorectal cancer,” said Bhakta.
Dr. Bhakta said having abnormal rectal bleeding, inflammatory bowel disease, or a family history of cancers or colorectal cancer deserves close attention and quite possibly earlier screening.
Additional interviews
Kentucky Cancer Registry's Tom Tucker:
Markey Cancer Center Colorectal Surgeon Dr. Avinash Bhakta
Colorectal Cancer Patient Alex Herring
Linda Clifton-cancer impacted mother of Cindy
Colorectal cancer through the lens of data, medical treatment, and patient experience
Colorectal cancer through the lens of data, medical treatment, and patient experience
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Kentucky Cancer Registry Founder Tom Tucker
Dr. Avinash Bhakta
Colorectal cancer through the lens of data, medical treatment, and patient experience
Kelsey Wellman-Alex Herring
Colorectal cancer through the lens of data, medical treatment, and patient experience
Linda Clifton
