Colon and Rectal Cancer Awareness
Don't let patients die of embarrassment

As a veteran of the Vietnam War, I am well aware that Vietnam vets were not welcomed as heroes when they came home from the war. In fact, they were “welcomed” home only by their families. Our national schizophrenia over the war led many Americans to identify those who served in the war with their dislike of the war itself. It didn’t make much difference for me as a physician returning home and pursuing further residency training. However, it made an enormous difference to those who were wounded in the war and came home without a leg, for instance, only to be spurned, rather than thanked. It also made a difference to those who missed several years of school because of their military service, only to discover that after coming back and completing school, they were considered “too old” by prospective employers when compared to their classmates who had been lucky enough to avoid the draft.

Therefore, it was with great relief and pride that I learned years later that a Vietnam Veterans’ Memorial was to be built in Washington, DC. When I learned that the design was a ground-level wall with the names of those killed in the war on it, rather than a monument rising to the sky, I thought the Vietnam vets again were being slighted by their country. When I saw the wall for myself, I expected to be disappointed and angry. Instead, I was overwhelmed at its effectiveness. A walkway gradually descends along the wall until the top of the wall is well over your head in its midpoint, then gradually ascends to the other end as you walk past the end of the wall at your feet. As I started down the walkway, the wall gradually rose above me. At the beginning of the wall, I noticed columns of names starting to appear. In the first column was a single name—the first American soldier to lose his life in the war. The names continued in order of date of death, each column progressively longer as the wall grew upward as I continued my descent. By the time I reached the bottom of the walkway in the middle of the wall, the number of names in the columns that rose over my head was overwhelming. I knew that some names on that wall were of men to whom I had tried to render aid. Toward the end of the war, there were fewer casualties, so as I continued up the walkway, the number of names in the columns decreased as the height of the wall decreased in front of me. The columns gradually shrank to one final name—the last soldier to lose his life in the war. There were 58,196 names on that wall—a staggering number.

The American Cancer Society predicts that 56,600 Americans will die of colorectal cancer in 2002—almost as many Americans as died in the entire Vietnam War! More Americans will die of colorectal cancer than breast cancer or prostate cancer. Only lung cancer kills more of us. The good news is that colorectal cancer essentially is a preventable disease. Because colorectal cancers begin as a colon polyp, removing polyps before they turn into cancer prevents the disease. We do a great job of curing colorectal cancer when we find it early (90 percent cure rate). Therefore, screening and early detection can save the vast majority of these people. The bad news is that we are losing so many people from a preventable disease!

Over the last 10 to 20 years, the death rate from colorectal cancer per 100,000 population has started to decline, ever so slowly. So, in the war on colorectal cancer, we have just started up the ascending walkway of the colorectal cancer victims memorial wall. With diligent screening, the number of names in the yearly columns of colorectal cancer deaths should steadily decline. If we treat colorectal cancer prevention as a war, then we have the potential for a great victory. Are some of your patients going to appear in those columns of colorectal cancer deaths? Are you recommending colorectal cancer screening appropriately to your patients? If the very idea of colorectal cancer screening is repugnant to some of them, please remind them that this is one disease from which you really can die of embarrassment!

Copyright 1997-2002, Dallas County Medical Society.
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