This is Colon Cancer

Mar 11

March is National Colorectal Cancer Awareness Month. I write this in honor of my husband, John, whom I miss intensely every day. Hopefully our story can help someone else.

John and the kids in West Virginia during happy times

John Anderson, my husband of fifteen years, died in September after a fierce five month battle with colon cancer. He leaves behind our two children ages five and nine, and a 32-year old daughter from his first marriage. John was 59, and no, he never had a colonoscopy.

Why, despite knowing the facts about colorectal cancer screening didn’t he? That question will plague me for the rest of my life. And it tortured John from the moment he was diagnosed until the day he died.

The good news: colorectal cancer screening rates have increased since 2002, perhaps due in large part to significant resources the federal government and others have put into effective awareness campaigns. Yet despite this, and a documented increase in knowledge about colorectal cancer, approximately one-third of people age 50 or older have not been screened.

The disconnect between knowledge and certain behaviors is one that challenges social marketers every day. And while we’ve made tremendous strides in creating evidence-based programs that yield positive results, there are still (and will always be?) people whom we can’t reach. John was one of them.

Behaviors can be so illogical and complex, and John, a PhD level behavioral scientist, is the perfect example of how that plays out in real life.

When John turned 50 I reminded him to get a physical and colonoscopy. He got his physical but no colonoscopy. We had the same conversation half a dozen times over the years. He had physicals. Each time he came home with a fecal occult blood test kit and colonoscopy prescription. But he never followed through with either.

To encourage him, I would invoke our family (“Do it for the kids…they need you.”), my own screening habits (“How would you feel if I didn’t get my annual mammogram?”), the data (he was a scientist after all), the Katie Couric effect (a celebrity whom he liked and respected), and his risk factors (age, weight, diet). In the end was my nagging just noise?

Typical screening barriers (not knowing risk, no physician reminder, no health insurance, or fear of the test) didn’t really apply to John. So what was his barrier(s), and could addressing it have made a difference?

One month shy of his 59th birthday, John finally got that colonoscopy. It was after side pain led to a sonogram, which revealed tumors on his liver. His diagnosis: stage 4 colon cancer with inoperable liver tumors. Unless he responded to treatment, there wasn’t much hope. He didn’t respond, and died five months to the day that he began chemotherapy.

I knew it was like salt in a wound. And I knew there would be no answer that would ever heal a thing or make a difference. But still, I had to ask.

“Why didn’t you get a colonoscopy?”

I desperately wanted an answer that would make sense of this awful truth that in many ways would define the rest of our lives.

He didn’t have a definitive answer. And said that he didn’t think it was that complicated. Said he felt invincible, didn’t have the time, didn’t have cancer in his family…

None of it really made sense, he admitted. And our hearts broke with the reality that there really was no answer that mattered because, in the end, there was no excuse.

His oncologist kindly waived it away and said not to go there. We’d never know. John’s cancer was very aggressive. It’s possible that a colonoscopy or other test wouldn’t have made a difference.

But we knew the truth. Colorectal cancer screening saves lives. And it might have saved John’s.

I also asked John if I could have done anything that might have made a difference. After a pause, he half-jokingly said “well, maybe if you withheld sex”. As quickly as we laughed it off, it occurred to me that maybe he really was on to something. But what, I’m not quite sure.

Withholding sex is not the answer, but maybe it begs a bigger question…what are we competing against with people who, despite having the knowledge, still don’t get screened? What’s so important that if they were confronted with it, they might change their behavior? If we figured that out, could we use it successfully to reach them?

So I’ll leave you with this…in the end, for John, it was all about his family. That’s what devastated him the most. Not being there for or with us. Not watching his children grow. That’s what mattered.

So what do you suggest I do with that?

This entry was posted on Monday, March 11th, 2013 at 4:38 pm and is filed under Behavior Change, Public Health, Social Marketing. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

13 Responses to “This is Colon Cancer”

  1. Carrie Dooher says:

    This is an important reminder about the people we love and the importance of finding the right reason, whatever and whomever that is – different for every person. Thank you for this powerful and honest post.

  2. Claudia Menashe says:

    Thanks for your thoughtful comment, Carrie. And you’re so right — often what might be compelling for one person might not be for the other, and it’s always important to consider and respect individual differences and motivations.

  3. Kathy ashby says:

    So very sorry that the story you tell ended with loss..i lost a dear friend to colon cancer.he had other health issues that were always causing his physicians to treat ailments and by the time the colon cancer was found it was too make a great spokesperson for the voice of colon cancer..i think so many times families are missed.thank you for bringing this tough issue into a view from a different perspective..

  4. I am 57 years old and have not had a colonoscopy yet. I write about health for a living. The biggest barrier for me is that I am tired of paying medical bills. As a freelance journalist I would rather ( call me crazy ) buy a pair of $300 shoes than pay $300 to a doctor. I gave a friend a ride to his colonoscopy and the doctor asked me if I’d had one yet. I said NO and he asked Why and I told him it was too expensive. He said he’d barter the cost of the procedure if I wrote about the importance of screening. Now I’ve got a solution! Thanks for encouraging me to call for an appointment.

  5. Andrea Solarz says:

    Believe it or not, I was talking with a friend earlier today about John’s story (certainly not the first time I’ve told someone about him). So, with or without your brave and compelling column, John is still “helping” to get the word out about the importance of getting screened.

    It’s so difficult to be in the position where you so desperately wish that you could step back in time and make just that one decision differently (we’re in a similar position with my Mom, who has a different form of cancer that would have been detected much earlier by a colonoscopy).

    As important as so many things were to John, there is nothing that was more important to him than you and his children. But, maybe that joie de vivre of his also made it impossible for him to conceive of anything happening to him that would take him away from you. Or, maybe going forward with a colonscopy was so difficult because, in a way, it was like admitting that something COULD take him away…and that was just too painful to confront…

    So, what can you do? I think you are already doing it. Telling John’s (and your) story. Reaching out. Urging others to make that appointment they’ve been putting off. And, motivating people to take the steps they need to in order to get their “John” (or, Jane) screened.

    (Of course you know he would be very proud of you for writing this…)

  6. Juliette says:

    I’m so proud of you Claudia for writing this powerful statement and for all you do. Even at a time when it would be easy to turn inward, you are reaching out to help others. Love

  7. Jennifer Dawson says:

    Claudia, I am sharing your story with my company. Thank you for sharing your experience, and what you have learned. Think of you every day. ox

  8. Cody Morrissey says:

    Dear Claudia, a truly inspiring and heartfelt article and I am so sorry for your loss. I too was stubborn and reluctant to get a colonoscopy until my wife basically dragged me there. Unfortunately I think men have an issue both with asking for help and that particular procedure, but I think your situation and response to your loss is truly inspiring and admirable! I know it’s been forever since we have been in touch but not surprising that you are able to be so strong and are thinking of others after you loss. I hope you are able inspire more men to get checked with this article as you have done for me. Thinking of you, Cody

  9. Allis says:

    Claudia-Thank you for writing this. Ron and I have been putting it off, but will rethink it after your convincing piece. One big reason I think is that it’s unpleasant and time consuming-but as you demonstrate the consequenses for not doing it are far worse.

  10. Diane says:

    So powerful in its honesty. I have posted it on my Facebook page and am hoping it goes ‘viral’ at least among my friends. You certainly will have made a difference in at least one person’s life with this piece. Thank you.

  11. Anna Zawislanski says:

    Thank you for sharing this honest, powerful story. I will make my husband read it… I may have to withhold sex to do so, but I’m willing to make that sacrifice.

  12. Claudia Menashe says:

    Carolyn, it’s good to hear that this physician checked in with you about getting a colonoscopy. All too often physicians don’t. I do hope you write about the importance of screening. Happy to contribute to your story, if helpful. Thank you for reading my blog.

  13. Claudia Menashe says:

    Thank you all for reading this blog, and for all the thoughtful, and thought provoking comments. I also so appreciate you sharing my blog post with others…as I said in the post, I do hope our story helps someone else.