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Get Your Rear in Gear

It's Colorectal Cancer Awareness Month.

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March is Colorectal Cancer Awareness month, so OutSmart decided to help spread the word. We searched Houston’s LGBTQ community to find people with insightful or uplifting stories regarding their journey with the disease, and we didn’t have to look far. Thousands are in treatment for, or survivors of, this common—and curable—cancer. Here are just a few.

VICTORIOUS: Early detection is the key to surviving CRC.

In 2014, Paula Chambers and her partner of three decades traveled to New York City, where they exchanged legal marriage vows.

During the ceremony, Chambers expressed and heard two beautiful (and formerly forbidden) words that she never thought she would hear: “I do.”

The couple’s honeymoon did not last long. Only one day after the wedding, Chambers fell ill. Three months later, she laid in a hospital bed in Houston while her now-wife, Lara Chambers, held her hand. The newlyweds were waiting for the diagnosing physician.

Then Paula Chambers heard three more words that she never dreamed she would hear: “You have cancer,” the doctor stated, his eyes lowered to the ground.

“I heard the word ‘cancer,’ and that’s the last thing I remember,” Chambers explained. “I was looking at the faces in the room and their mouths were moving, but I went deaf. I looked over at Lara and she looked like she was melting. I am so grateful she was there to hear the rest, because I sure wasn’t,” Chambers stated, laughing at her own reaction.

Chambers’ diagnosis is one that plays itself out daily in hospital rooms all over America. Colorectal cancer, or CRC, is the third most common cancer identified in both men and women. It is the second most fatal cancer diagnosis, exceeded only by lung cancer.

Just how common is it? In 2019, the American Cancer Society predicts that the U.S. will see 101,420 new colon-cancer cases and 44,180 new rectal-cancer cases, for a total of 145,600 under the colorectal umbrella. That’s about 400 new cases every day.

Paula and Laura Chambers.

The term “colorectal” refers to two types of cancer, determined by where the cancerous tissue first appears. The colon (also known as the large intestine) is about five to six feet long and ends with the anus. The last five to ten inches of the colon are called the rectum.

Cancer located in the rectum is called rectal cancer, and cancer located in the rest of the colon is colon cancer. About 72 percent of new CRCs appear in the colon, and the remaining 28 percent appear in the rectum. While they are similar, treatment often varies between the two.

Statistics regarding CRCs vary by sex and ethnicity. Diagnoses are about 35 percent higher in men than in women, and 15 percent higher in African-Americans than in whites. Alarmingly, the mortality rate for African-Americans is 40 percent higher, due to a multitude of reasons including cancers being discovered at a more advanced stage.

Is there any good news regarding this common killer? There is! About 60 percent of CRCs can be treated and even cured if they are caught early enough. Timely detection is absolutely the best defense.

Dalton DeHart

“In 1998, I went to my doctor for a routine visit,” said Dalton DeHart, a professional photographer who is known throughout Houston’s LGBTQ community. “My doctor did a cursory examination and discovered a few polyps in my colon, so he suggested I have a colonoscopy and get the polyps treated.”

A week later, DeHart had his first colonoscopy exam. He was woozy from the medications, but conscious for the procedure. As the exam progressed, he remembers the doctor expressing concern. The physician found some troubling tissue, gathered a sample, and sent it to a lab for a biopsy.

“The following Monday, the doctor, who is also a dear friend of mine, called,” DeHart remembers. “My friend said, ‘This is the most difficult phone call of my life.’” 

Typical of DeHart, his first reaction was to spare his friend from having to say anything. The photographer was prepared for the results. While he had absolutely no cancer symptoms and was not in the high-risk age range, there is an extensive history of cancers in the DeHart family.

“You don’t have to tell me; I know already,” DeHart told his doctor friend. “I have colon cancer.”

That was more than 20 years ago, back when medical practitioners were suggesting Americans have a colonoscopy every five years starting at age 60. Today, professionals recommend exams starting at age 50 because CRC is appearing in younger and younger populations. As rectal cancer in younger patients continue to rise, several cancer societies now recommend having the first colonoscopy by the age of 45.  

These guidelines are great for average-risk patients, but there is an exception to the rule. The American Cancer Society strongly encourages people with a first-degree relative (mom, dad, sister, or brother) who had colon cancer to start exams at age 40, or 10 years before the age of the family member who was diagnosed.

Paula Chambers has no cancer in her family, but had been suffering with all the classic systems of CRC at the time of her diagnosis. For about two years prior, she had visited a parade of general practitioners regarding her recurring digestive issues—diarrhea, constipation, pain in her abdomen, anemia, weight loss and, significantly, blood in her stool. But the vital, energetic Chambers was in her early 40s at the time, and the typical GP’s diagnosis was “bad food,” or a “stomach flu.”

“I was prescribed a truckload of antibiotics,” she recalls, laughing. “They just were not considering colorectal cancer due to my young age.”

On the day of Chambers’ diagnosis, doctors identified a baseball-sized tumor in the 44-year-old’s colon. “Today, I tell everyone who is under 50 and looking for answers to keep pushing. Find a doctor who is willing to look beyond common disorders. Get checked out! Medical professionals just won’t think of colorectal cancer for people who are young, but younger people are getting it too. I have a friend who is 28 with colorectal cancer!” Chambers exclaimed.

Ted Voloyiannis, MD –Texas Oncology

Is there anything we can do to prevent this? The answer is yes, says Dr. Ted Voloyiannis. This fine doctor is one of Houston’s leading board-certified colon and rectal surgeons, and practices with Texas Oncology Surgical Specialists. Dr. Voloyiannis operates clinics in both the Texas Medical Center and Clear Lake-Webster due to the demand for his skills. According to this expert, there are common-sense steps we can take to protect ourselves.

“Making smart lifestyle choices is a good place to start,” Dr. Voloyiannis said. “Choose a healthy diet, low in fat and processed foods. Avoid a sedentary life by staying active, maintain a healthy body weight, minimize alcohol consumption, and don’t smoke. Still, the best prevention of CRC and anal-canal cancer is early detection with a colonoscopy. We recommend one every five years for average-risk patients. It is the single most effective way to fight this very, very curable disease,” Dr. Voloyiannis stated firmly.

So are the risks any higher for the LGBTQ community? We asked Dr. Voloyiannis (who is also a member of the community), fully expecting the answer to be no. We were wrong.

“There are a higher number of anal-canal cancers identified in gay and bisexual men, due to the transmission of the Human Papilloma Virus (HPV) during sexual activity,” the doctor explained. “HPV is a virus that has many types, and while some are harmless, several develop as genital-anal warts that often stay unnoticed for years, but eventually become cancerous,” the doctor continued.

“The HPV can be found at high rates in HIV-negative patients (about 50 percent), and in about 90 percent of HIV-positive patients. We recommend an anal-canal exam every two years to detect HPV for the high-risk, sexually active LGBTQ population. Now there’s a vaccine offered for the most aggressive HPVs for those individuals who have not yet been exposed to the virus. Almost all the CRCs are very treatable, but they must be caught early. As we say, catch it before it catches you,” Dr. Voloyiannis concluded.

How did the cancer treatments go for Dalton DeHart and Paula Chambers? Back in the late 1990s, DeHart’s doctor chose six months of chemotherapy, and the first few weeks of chemo went well for him. But then he slowly started losing weight. Normally a very energetic man, DeHart eventually found it hard to get out of bed. The chemo was killing his cancer, but it was taking him with it.

“My doctor decided to terminate the chemo at three months,” Dehart remembers. “The second three months are preventative, and my doctor determined the cancer was gone. He decided the toll chemo was taking on me was too great. About five percent of patients can’t tolerate chemotherapy, and I guess I was one of them,” DeHart concluded.

That was more than 20 years ago. Today, DeHart can be found photographing events of all kinds, as his many LGBTQ friends know. Not only is he still with us, he’s back to being everywhere with his camera. Dehart’s early detection saved his life.

While Paula Chambers is also doing very well, she is only in her fourth year post-diagnosis, and her recovery was a long slog. First, doctors surgically removed the tumor in her colon (as well as 36 lymph nodes) to see if the cancer had metastasized. Remarkably, her tumor was fully contained, and her lymph nodes were clear. Then the courageous women entered a series of radiation treatments.

Chambers views her journey as the gift of life, and her gratitude is limitless. She has become an official ambassador for Fight CRC, the country’s leading nonprofit advocacy organization focused on colorectal cancer policy and research. 

Throughout March, Chambers will be one of 29 people featured in a public-service announcement video shown in New York’s Times Square for CRC Awareness Month.

“Today, I am happy—even thriving—but I could not have done it alone. I was grateful to find mentors and support from Fight CRC.  My Fight CRC family has helped me move forward and guide me through this. Now I feel compelled to help others to thrive. But it all starts with ‘getting your rear in gear.’ Get checked out!” Chambers concluded with a smile.

To learn more about colorectal cancer, its prevention, and much more, go to www.FightCRC.org.

This article appears in the March 2019 edition of OutSmart magazine.

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Kim Hogstrom

Kim Hogstrom is a regular contributor to OutSmart Magazine.

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