IBD and Cancer: Up Close and ... Video Transcript

Participants

, Edward V. Loftus Jr, MD, David Rubin MD, Vikram Tarugu MD

Summary

People who have been living with ulcerative colitis for a long time must be checked regularly for colon cancer. Listen to the story a patient that proves the value of frequent screenings.

Webcast Transcript

ANNOUNCER: Like many people with ulcerative colitis, Tom was diagnosed at a young age.

TOM: I had graduated from high school, and I was expecting a lot of myself, and possibly put a lot of pressure on myself. I wasn't doing very well in college. And consequently I had a flare-up of something that I didn't understand. A significant number of trips to the bathroom, much more frequently, starting to pass blood, severe cramping of the abdomen.

ANNOUNCER: Doctors put Tom on prednisone, and then sulfasalazine for long-term maintenance. But occasionally his colitis might flare.

TOM: And each time, it seems, that I would have a flare-up, it would involve more of the bowel. So it was becoming a progressively more pronounced disease.

ANNOUNCER: From the start, Tom was aware that he would always face a higher-than-average risk of a cancer.

TOM: I was first informed that there is a higher risk of colorectal cancer when you have ulcerative colitis in my early stages, when I was first diagnosed. I did some reading on my own, as well, but my physicians were very up-front that this gives you a higher risk factor for colorectal cancer.

ANNOUNCER: Tom came to believe he might get better treatment at a major medical center, rather than at his community hospital. And he became the patient of David Rubin, at the University of Chicago Hospitals.

DAVID RUBIN, MD: Tom shared with me that his disease had been under fairly good control and relatively stable, but, unfortunately, it still flared once or twice a year. But, over the course of the twenty years or more that he had disease, it had been relatively stable in that regard, so there had been no obvious change in his disease characteristics. But, to be clear, he hadn't really had a good control of his disease, which we would prefer to be no flares every year.

ANNOUNCER: Dr. Rubin tried fine tuning Tom's medications. And he, too, warned of colon cancer. Especially in light of the long duration of the disease.

DAVID T. RUBIN, MD: I remember my first discussion with Tom about the risk of cancer in ulcerative colitis. He had had his entire colon inflamed for more than twenty years and we talked with him about an eight to ten percnt risk that he was going to get cancer. And then we think that that risk may increase by about one half to one percent per year after that.

TOM: Well, every time that I had a colonoscopy, whether it be at the community hospital or at the University of Chicago, the thought of cancer being found is always in my mind, at the back of my mind. And I'm on pins and needles for a while until the doctor gets back to me with the pathology results.

ANNOUNCER: Tom's surveillance colonoscopies were clear for many years. Then his symptoms got worse.

TOM: In 2003 -- I'd say probably summer, spring, summer, fall time frame of 2003 -- my symptoms from ulcerative colitis were beginning to get worse, and they were not flare-ups anymore. They were more or less a constant cramping condition. Some blood being passed in the stool. Urgency and frequency were up. The medications that I was on, the 5-ASA treatments, were not seemingly able to control it and get me into a remission state.

ANNOUNCER: Then came a routine colonoscopy, in December 2003.

TOM: I sensed during the course of that colonoscopy that something unusual had been found. Dr. Rubin was being very, very thorough. He was taking more biopsies than I recall in the previous colonoscopies. He was taking care to specifically mark some locations, tagging them, as he called it.