September 29, 2011

VICC seeks to halt colorectal cancer’s impact on family

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Robert Gordon and his mother, Patricia, at a follow-up appointment for Robert, who was diagnosed with rectal cancer. (Photo by Steve Green)

VICC seeks to halt colorectal cancer’s impact on family

As program coordinator for the Vanderbilt Hereditary Colorectal Cancer Registry, Duveen Sturgeon, R.N., regularly meets with patients and their families in the hospital to discuss the importance of being tested for the disease, which can be carried genetically to other family members.

But not everyone in the family is always available, particularly those who live outside of the Vanderbilt area. And not everyone is comfortable talking about colorectal cancer or genetic testing.
So, in August Sturgeon decided to take one conversation to a place of comfort, familiarity and convenience – to the patient’s home in Paris, Tenn.

Robert Gordon III, was 28 years old when he was diagnosed with stage III rectal cancer. As part of his care he was assessed by Sturgeon for a hereditary cause of his early onset cancer. Genetic testing was done and revealed that he had Lynch Syndrome, also known as hereditary nonpolyposis colorectal (HNPCC) syndrome, an inherited condition that increases the risk of colon and other cancers.

But he was lucky. He was diagnosed early, started chemoradiation therapy for rectal cancer, and in July had surgery at Vanderbilt to remove any remaining tumor masses.

Gordon is doing well, but Sturgeon knows the story doesn’t end there. Like many in Tennessee, he is blessed with a large family, some of whom might carry the gene for Lynch Syndrome.

To break the cycle, Sturgeon met with Gordon and 10 of his family members to talk in the comfort of their living room about how some colorectal cancers are spread genetically, and how a simple blood test or oral swab can determine who in the family carries the gene for the disease.

“The hardest part is starting the conversation,” said Sturgeon. “No one wants to think they carry in them a risk that can be passed on to loved ones. But if we can identify who is carrying the gene then we can institute screening and surveillance that may prevent cancer from occurring,” she said.

By starting regular colorectal screenings, polyps can be removed before they turn into cancer, or if detected early, some cancers are still curable with treatment.

“I like to tell families that through this genetic testing, not only do we know what street the cancer gene lives on, we can find the house number,” Sturgeon said.

For the Gordon family, the conversation made an impact. Five family members decided to be tested.

“Dealing with colorectal cancer is certainly a life-changing experience. But family support, prayers and this new genetic testing are helping me defeat cancer and potentially save the lives of my loved ones,” said Gordon. “I encourage everyone to consider this kind of testing to stop cancer from being passed on from generation to generation,” he said.

Sturgeon, who joined the staff of Colorectal Surgery five years ago, hopes that such house calls will become a standard practice in raising awareness on the importance of genetic testing and early colorectal cancer screening, not only for the patient, but for the entire family.

The Vanderbilt Hereditary Colorectal Cancer Registry was launched in 2006 under the direction of Paul Wise, M.D. One of 20 such programs in the nation, the Vanderbilt registry includes more than 500 patients, of which more than 200 have already participated in genetic testing.

By gathering information on patients and their family members who have either had colorectal cancer, have a family history or are at high risk of developing the disease, Vanderbilt hopes to gain a better understanding of hereditary colorectal cancers.

The registry also serves as a resource for patients and family members, offering cancer screening and surveillance recommendations for high-risk individuals.

“Duveen’s enthusiasm and willingness to serve and educate cancer patients and their families has been the engine that has powered the success of the Vanderbilt Hereditary Colorectal Cancer Registry,” said Wise, assistant professor of Surgery. “I honestly believe that her selflessness has saved many lives,” he said.