The race against colorectal cancer

Press, 2 October 1987, Page 18

The race against colorectal cancer

Colorectal cancer — cancer of the large bowel — is the most commonly occuring cancer in New Zealand today. M per cent of those found to have the disease will die within five years of diagnosis. And it’s incidence is increasing. The cancer arises through an adenoma, or polyp, which begins as a harmless wart-like growth on the lining of the boweL

It can, however, become malignant and begin to spread, causing bleeding, ulceration, bowel blockage and a great deal of pain. Unfortunately by the time these symptoms occur it is often too late, and the only option remaining is to surgically remove part or even all of the large Intestine — and to hope that all the cancer has been caught There is no “cure” for colorectal cancer.

But by careful monitoring of high-risk groups it can be prevented.

Using a colonoscope, polyps can be detected and removed with relative ease before the cancer has a chance to develop. A colonoscope allows the doctor to see the lining of his patient’s colon. It is fitted with a wire loop which goes over the polyp and tightens to cut it off — an operation certainly preferable to open surgery. A colonoscope costs about $25,W0. Christchurch Hospital currently has three doctors performing colonoscopies — between them they do about 4M a year. The ; difficulty they face is one of checking up on those patients in later years, when they should still be examined regularly. It can take up to 15 years for the cancer to develop, so although a patient may seem to be ’’cured,’* it is vital for the doctor to keep tabs on them. It is likely that people are genetically predisposed to polyp growth. Research has shown that direct relatives of colorectal cancer sufferers are up to twice as likely to develop the disease themselves. Therefore it’s equally important that they be monitored, too. There are currently 25M case records held in the Gastroenterology department of Christchurch Hospital. Dr Bramwell Cook, one of the surgeons who performs colonoscopies at Christchurch Hospital, believes that these records are of unparalleled value for research into — and the prevention of — colorectal cancer in New Zealand.

They are currently stored in looseleaf folders.

This archaic filing system makes it well nigh impossible for this vital information to be used to its full potential. It could form the database for a full screening programme of high-risk groups. What is needed is a storage system which is easily accessible, both for patient follow-up and trend analysis. A computer may not at first seem to be of great use in the fight against cancer. It doesn’t have the glamour of a life-, support system or a body-scanner, and neither does it show the same immediacy of effect

Indeed, it may be of only negligible use to those already suffering advanced colorectal cancer.

Where its effect will be seen is in the next generation — those immediate relatives of sufferers who run twice the risk of contracting the disease themselves and those who are apparently “cured.’’ It’s use is not as a “cure,” but as a means of systematic prevention. Christchurch Hospital’s aim is to set up a screening programme for groups which they know are at risk, as well as a database for research. By programming patients’ records into a computer complete with the appropriate software, they can establish a virtually fool-proof system of checking on patients and calling them in for the necessary examinations on a regular basis.

This will allow the monitoring of previous patients for signs of recurrence, and of highrisk groups for signs of polyp development

Rather than waiting until the stage where symptoms develop — the stage at which there is only a 40 per cent chance of the patient living out the next five years — they will be able to catch the cancer at it’s earliest stage. For many it may quite literally mean the difference between life and death. The computer will also be Invaluable for analysis.

The records held by the Gastroenterology Department present a comprehensive picture of polyp development In Christchurch. Effectively organised, the records could be used to identify further high-risk groups, analyse trends and look at the dietary factors Involved — another big

step towards the prevention of the cancer.

Any funds left over from Zonta’s Gala Race Day will be put into research. New Zealand has one of the highest rates of colorectal cancer in the world — doctors feel it’s important that we examine our own experience of the disease rather than relying totally en overseas studies.

With no cure in sight for a cancer which threatens the life of 3M people in Canterbury alone every year, a programme of screening and research is the only answer.

In the race ho prevent colorectal cancer, a computer may well let Christchurch Hospital’s doctors come out the