By Susan J. White

With no family history of colon cancer and no health problems of her own, Esther Fisz, 47, expected her first colonoscopy last year to be uneventful. The prep was no fun and while she was a bit nervous about the procedure, she was really just looking forward to going out to eat with a friend when it was over.

Instead, she woke to the news from NorthShore Gastroenterologist Laura K. Bianchi, MD, that they found a large polyp and, given its size and location, were not able to remove it. In other words, Fisz needed surgery to remove the polyp and rule out cancer.

“Everything happened really quickly and it was surreal. I was shocked to say the least, and felt very rattled,” said Fisz, who was immediately referred to NorthShore colorectal surgeon Monika Krezalek, MD.

“Dr. Krezalek was a saint. I wanted the surgery scheduled as quickly as possible and she and her team made that happen,” said Fisz. “Every person in her office was wonderful. I was very afraid, and Dr. Krezalek was so empathetic and so skilled.”

Fortunately Fisz woke to good news this time.  Dr. Krezalek suspected the polyp was precancerous and a few days later the pathology results allowed her to deliver the good news with certainty. “Dr. Krezalek looked me in the eye and confirmed that it was pre-cancerous, but if it hadn’t been removed it could have been far scarier—it could have become cancer,” said Fisz.

March is Colorectal Cancer Awareness month and understandably, Fisz is sharing her story as a self-proclaimed evangelist, encouraging everyone she knows to get screened.

Polyps in the colon are quite common, and the chances of having them increase with age. It’s estimated that 30 to 50% of adults age 45 and over have colon polyps. While advanced polyps like the one Fisz had removed are less common, the incidence of colorectal cancer is rising among young adults, 25 to 49 years old, explained Dr. Bianchi. This is part of the reason the recommended age to begin screening for those without family history changed from age 50 to 45.

“It’s so important to begin screening at 45, or sooner if you have a strong family history,” said Dr. Krezalek. “Surgically removing these large rectal lesions is important. We can remove the full lesion before it may harbor cancer and we can get good margins to ensure proper staging and treatment recommendations when they are cancerous.”

“I feel very fortunate with how this turned out and I feel very confident about the care I’m receiving from the team at NorthShore,” said Fisz, who will now undergo more frequent colonoscopy screenings as recommended by Dr. Bianchi.

There are many non-modifiable risk factors for colorectal cancer including age and family history, but there are modifiable risk factors including tobacco use, alcohol consumption, physical inactivity, obesity and diet, said Dr. Bianchi. Patients who have had polyps are also advised to tell their siblings and adult children that they will need earlier colonoscopy screenings, added Dr. Bianchi.

“I encourage patients to continue to lead an active lifestyle, maintain a healthy weight and consume a diet high in fruits, vegetables and whole grains and low in processed meats and red meats. The Mediterranean diet is my recommendation for a healthy diet that call also meet the goals of a cancer prevention diet,” said Dr. Bianchi. “The rise in colorectal cancer in young adults is concerning.  We need to increase awareness of the new screening age of 45. I recommend patients discuss their family history of colon polyps or colon cancer, as well as other cancers, with their doctor as even earlier screening age may be recommended.  And finally, see your doctor if you have new symptoms as they can guide you to further evaluation if needed.”