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Subject:	A colleague recommends WH - A Guide to Women's Health: Winter 2008
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This month's feature article highlights one of life's most momentous events—having a baby. Explore our guide to the John Muir Birth Center, located at one of the region's most comprehensive medical centers. The Birth Center features the most advanced technology, state-of-the- art facilities and the expertise of our highly skilled physicians and nurses. Don't miss other updates on John Muir's leading-edge cardiac procedures and spine surgeries. There's also news about John Muir Health's participation in an international lung cancer study. Look, too, for reports on everything from computer-induced eyestrain to health problems caused by wearing high-heeled shoes. It's all timely and useful. To your health!

—J. Kendall Anderson
President and CEO,
John Muir Health

Support for Family Mental Health

The John Muir Behavioral Health Center is offering a series of free classes for families or significant others of persons with mental illness. The goal of this series is to provide important information and support for those who provide treatment and care of a family member or significant other. Seminars are held on Mondays from 7-8:30 p.m. at the Behavioral Health Center, 2740 Grant St., Concord. Topics include an introduction to diagnosis; signs and symptoms of mental illness; treatments offered for various disorders; coping strategies to deal with the stress and behaviors associated with having a family member with mental illness; and resource referrals. For more information, call (925) 674-4100 or (800) 680-6555.

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Good News About Colorectal Cancer

Americans' risk of dying from cancer is declining faster than ever, according to a recent report from the nation's leading cancer organizations, and advances in the fight against colorectal cancer are playing a major role. Although colorectal cancer is still the nation's No. 2 cancer killer, deaths from the disease are dropping faster than any other malignancy—by 4.5 percent among women and almost 5 percent among men, according to "The Annual Report to the Nation on the Status of Cancer," released in September 2007.

These findings underscore the importance of colorectal cancer screening and the efficacy of today's colorectal cancer treatments, says Saeed Zamani, M.D., a gastroenterologist on staff at John Muir Health. "One of the best strategies to reduce the cancer rate is to detect cancer before it develops and in its early stages when it is more treatable."

Cancers of the colon (the large intestine) or the rectum almost always start with a small, abnormal growth called an adenomatous polyp. Fortunately, screening tests can detect colorectal polyps early on, so physicians can remove them and stop colorectal cancer before it starts. Screening also identifies actual cancers earlier. Chances of survival improve dramatically if colorectal cancer is found before symptoms, such as blood in the stool, develop.

People over age 50 and those with a family history of colorectal cancer or polyps are at increased risk for this disease, says Dr. Zamani. Other risk factors include long-standing ulcerative colitis, diets high in fat or red meat, smoking or alcohol consumption, obesity and pelvic irradiation. According to American Cancer Society (ACS) guidelines, people at average risk for colorectal cancer should begin regular screenings at age 50. Those at increased risk should start screening at a younger age and have screenings at more frequent intervals. If you're in this category, talk with your doctor about which screening strategy is appropriate for you.

Among the current screening options, according to Dr. Zamani, are the following:

• Colonoscopy: In this outpatient procedure—regarded as the most accurate—a physician closely examines the entire lining of the colon using a flexible, lighted tube, called a colonoscope.
  
  The instrument is inserted through the rectum and is connected to a display monitor. Detected polyps are usually removed and sent to a lab to determine if they are cancerous or pre-cancerous.
• Flexible sigmoidoscopy: Using a sigmoidoscope, a shorter version of the colonoscope, the physician examines only the lower third of the colon.
• Fecal occult blood test: This take-home stool-testing kit can detect occult (hidden) blood in the feces.
• Double-contrast barium enema: This test involves X-ray imaging of the colon lining.
• CT colonosopy or "virtual colonoscopy": This option is another evolving modality and uses a CT scan to find cancerous polyps of concern.

Advances in treatments—surgery, chemotherapy and radiation therapy—are another vital front in the battle against colorectal cancer. In the late 1980s, introduction of 5-fluorouracil-based chemotherapy reduced mortality by as much as 30 percent, according to ACS estimates. More recently developed chemotherapy drugs and combinations may reduce cancer recurrence rates by up to 50 percent.

Despite such progress, "the best treatment for colorectal cancer is still to prevent it," Dr. Zamani says, emphasizing the importance of screening. "There is real hope in the battle against colorectal cancer, because there is something people can do. In this case, prevention is absolutely doable."

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Copyright © 2008 by John Muir Health. WH is published three times a year by John Muir Health as a community service and is not intended for the purpose of diagnosing or prescribing. WH Editorial Advisory Board: American Heart Association and the Office on Women's Health, U.S. Public Health Service. Produced by DCP.

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