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Colonoscopies Save Lives

March 19th, 2020


Colorectal cancer, or cancer located in the colon or rectum, is the second leading cause of cancer death in the United States. The American Cancer Society estimates there will be more than 104,000 new cases of colon cancer and more than 43,000 new cases of rectal cancer in 2020. We know that 90 percent of new cases occur in people over the age of 50, but new research suggests an uptick in incidence of this condition in younger people and for those who are not considered high risk for the disease.  

“When it comes to colon cancer, you can prevent this terrible disease with one simple test – a colonoscopy. Colon cancer is very easily detected and very successfully treated if caught early,” says Shauna Lorenzo-Rivero, MD, colorectal surgeon with University Surgical Associates (USA). “But the fact is in Tennessee and in Chattanooga specifically, the rate for colon cancer is higher than the national average particularly in the black community. Among African American men, the risk of developing colorectal cancer is four times higher than what it is for a white male. You have to do the test to catch the cancer.”  

Ten years ago, Dr. Lorenzo started thinking seriously about the lack of colorectal cancer awareness after looking specifically at the statistics of colon cancer in Chattanooga and the surrounding areas. There were awareness events for breast cancer and other health conditions, but there was an obvious opportunity to reach out and spread the word about how effective colonoscopies are in detecting, and effectively treating, colorectal cancer. Her mission was clear. 

“I started the Greater Chattanooga Colon Cancer Foundation and the Rump Run because I wanted to have more of these open conversations, raise awareness about the disease, and dispel the myths that often circulate about colonoscopies. Not only that, I wanted the money that we raised from our events to stay in Chattanooga and help people right here in our community,” says Dr. Lorenzo.  



Why does screening matter? 
Colon cancer has been called a silent disease because symptoms aren’t typically present until the disease is more advanced. That’s why the American Society of Colon and Rectal Surgeons (ASCRS) recommends coloscopy screening beginning at age 45 for those without other risk factors. If your first-degree relative (parent, sibling or child) has been diagnosed with colorectal cancer or adenomas before age 60, the recommend screening is a colonoscopy every five years, beginning at age 40 or 10 years before the age of the youngest affected relative (whichever is first). 

Dr. Lorenzo concedes that most people dread the thought of having a colonoscopy and will avoid it even when it’s something their primary care physician recommends. Many people don’t even consider it unless they’ve known someone who’s been diagnosed with colorectal cancer or have been told that the test itself isn’t so bad. The good news is that improvements have been made in the taste and quantity of liquids individuals must drink to prepare for the procedure – making it much easier than before. 

“Some people try to avoid colonoscopy because they are fearful of the procedure being uncomfortable, painful or risky. Because most colon cancers start as non-cancerous growths called polyps that can be removed during the procedure, cancer can be prevented, and major surgery can usually be avoided as well,” says Dr. Lorenzo. “The purpose of screening is to catch the cancer before it’s too late. One day of inconvenience can truly save your life.” 

Expertise You Can Trust 

We understand that the thought of colon cancer can be scary. USA colorectal surgeons are experts in the surgical and nonsurgical treatment of colon and rectal problems and play an instrumental role in the effective screening, prevention and treatment of colorectal cancer. Studies have shown that patients treated by colorectal surgeons are more likely to survive colorectal cancer because of their advanced training and the large number of colon and rectal disease surgeries they perform. 

To schedule a colonoscopy or appointment, call USA at (423) 267-0466. 

Symptoms You Should Never Ignore 

Colorectal cancers can present in many different ways. Part of why screening colonoscopies are so important is that many times people have no symptoms at all. Even if you don’t have a family history and aren’t yet 45 but are experiencing symptoms, talk to your doctor right away. These warning signs are a reason to see your doctor: 

  • Blood in your stool
  • Bowel never empties completely
  • Constipation, diarrhea or narrower stools than usual
  • Nausea or vomiting
  • Persistent gas, pain, cramps or feeling bloated
  • Rectal bleeding
  • Unexplained weight loss 
  • Weakness or fatigue

It’s Our 10 Year Rump-a-versary! 

The Greater Chattanooga Colon Cancer Foundation (GCCCF) is celebrating 10 years of raising colon cancer awareness at this year’s Rump Run. Typically held in March at Enterprise South Nature Park, the Rump Run will take place on October 3 due to COVID-19 concerns and recent park closures. For more information visit rumprun.com. 

As a dentist with a busy practice and a husband and father of three, Chad Owens never imagined that he could be affected by cancer. In December 2013, he came down with a stomach virus and was having lots of uncomfortable issues that just wouldn’t go away. He kept chalking it up to this lingering virus, but things weren’t improving. He was dealing with urinary and bowel issues including constipation, and he finally scheduled an appointment with a gastroenterologist to get checked out in late February 2014. 

“When I think about it, there was bright red blood in my stool for a couple of years before any of these other issues began. I honestly didn’t think much about it,” remembers Chad. “I worked out, I ran a lot and thought I was taking decent care of my body, so I basically ignored the early symptoms. I didn’t even have a family practice physician at that time, so when I got sick I’d just go to the quick care for help.”  

Because of his age and severity of symptoms, Chad’s gastroenterologist, Dr. Rob Yates, recommended that he have a colonoscopy. The test revealed that he had colorectal cancer, which was a complete shock to Chad and his family. He was immediately referred to a medical and surgical oncologist, and then had a follow up colonoscopy the next week where they staged the cancer at 3c because of the lymph nodes that were also involved. 

“I really couldn’t believe that this could happen to someone who was just 36 years old. It seemed completely impossible. But I was so thankful to finally know what was going on, even though I recognized that this would be a fight,” says Chad. 


Intensive Treatment 
For phase 1 of his treatment, Chad received radiation and oral chemotherapy for five weeks. After that, he began feeling a little better and less constipated. He continued to work at his dentist office for three days week until the surgical phase of his treatment began in late September. During that time, many of his colleagues stepped in to provide care for his patients until he was able to sell his practice. 

“Dr. Charles Portera was my surgeon, and I’m so thankful to him for how he cared for me. I was in the hospital for 10 days after my surgery – it was very extensive – and I developed radiation necrosis, which is a side effect of my phase 1 treatment. When they sent me home, I was extremely weak from all my body had been though, and I ended up in the hospital again for five more days,” says Chad. “Recovering from surgery was really rough, and I also had to have a permanent colostomy, which is a completely separate challenge to manage.” 

Unfortunately, the pathology report from Chad’s surgery revealed that there were still active cancer cells, and he would need nine more days of radiation followed by more chemotherapy.  The emotional impact of that news hit Chad and family very hard, and he recognized that he was fighting both a physical and spiritual battle. As his body struggled to fight the cancer and deal with the effects of the treatment itself, Chad never gave up. All in all, he continued with these extensive treatments that lasted nearly a full year. 


Looking to the Future
Today, Chad has a completely different career working at Brainerd Baptist School, where he’s able to spend more time with his kids. He follows up with his physician and has CT scans every six months along with routine colonoscopies. Doctors discovered that he has Lynch Syndrome, which predisposed him for developing colon cancer. Knowing this information means his children will be screened for colorectal cancer at a much earlier age.

“At my age and in my condition, cancer was not in my mindset. I was doing my dream job, had three wonderful kids, but my world came crashing down in that moment. My kids were so young at the time, and they really didn’t understand all that was happening. But they were such a great motivation for me to see their smiles every day. I had to keep going,” says Chad. 

At five years out from his cancer, Chad believes now is the time for him to raise awareness about colorectal cancer and to share his story with others, encouraging them to pay attention to your body. “You know when things are not normal, but you can’t let embarrassment get in the way of talking with your doctor,” says Chad. “Many of my friends had their colonoscopies after they saw what I went through. A colonoscopy is not that bad, and I’d much rather go through that than a cancer diagnosis.”  


Support from Every Side 
Through it all, Chad’s wife, Kelli, was his constant companion who never left his side. Together they experienced God’s grace that helped through every day and the peace and comfort that comes from being fully supported by family and friends.

“I don’t know what I would have done without Kelli’s help and strength. She is a pharmacist by profession but was forced to become my personal nurse in September 2014.  I don’t think she realized what she was signing up for with me,” laughs Chad. “We couldn’t have made it through without all the prayers and the support of our faith family. It seemed there was always someone there to help – through a call or text, or a meal, or cutting our grass – it really blew us away. I think the goodness of people comes out in times of tragedy, and it’s so important to take time to be part of someone’s life when they’re struggling. Being a part of that kind of community really made an impact in our lives.” 

University Surgical Associates’ Dr. Daniel Fisher was recognized at the Erlanger Health System Foundation’s Dinner of Distinction 2020 held in January. Dr. Fisher, who specializes in vascular and transplant surgery, was honored because of his commitment to improving the health of citizens in our region by contributing a lifetime of medical benefits to the community. Distinguished Physician honorees are selected by previous physician award winners, who are recognized for fostering quality medical services within the community and for demonstrating the highest character and compassion. 

Looking back on his 30-year career at USA, Dr. Fisher shared insights into what led him into medicine, the challenging and rewarding aspects of his chosen profession, and the ways his colleagues have contributed to his success. 

Q: What drew you to medicine and to ultimately choose surgery as your specialty? 

A: “My father was an eye doctor, and on my father’s side of the family there were doctors throughout. Medicine was a very natural fit for me. From five years old, I would go to the hospital and make rounds with my father on Sundays. It was fun to go to the hospital and see patients, and medicine was something I always wanted to do. 

I never cared for ophthalmology as a specialty and felt like surgery would be a better fit for me. I think many people who choose surgery have visions of working on the heart. Just as I was going into medicine, heart surgery was beginning to explode with better training and results. For a while I was pursuing heart surgery but realized that I wanted a greater variety that I felt vascular surgery could provide. I liked that I could continue to also do general surgery, but over time, I further specialized in vascular.” 

Q: What has changed in vascular surgery over the course of your career? 

A: “No doubt there have been major changes in vascular surgery, particularly in the last 15 years. When I trained in 1982, vascular surgery was considered an open specialty – meaning I took a knife and made an incision to perform any surgery. Everything started to change in 2003 to 2005, with vascular surgery adapting radiologic approaches to what we do. The years following resulted in many minimally invasive approaches that once required an open procedure. Now much of my work is done with wires and balloons and stents, which is great for our patients. It’s been really interesting to stay up with what’s happened in the field, and I enjoy the process of always learning new technologies and techniques.” 

Q: What is the most rewarding aspect of your career? 

A: “I’ve always enjoyed being in a place where I can take care of my patients’ needs. Looking back on 30 years in Chattanooga, the successes have been many. It’s always rewarding to find a problem and have the tools and expertise to fix it. Although I also perform procedures at other hospitals, Erlanger has been my home base hospital. Working alongside other surgeons, some like Dr. Burns, who have been doing this even longer than I have, has benefited us, but also the organization itself. It was an honor to be recognized for doing the work I love.” 

Q: How has working with colleagues at USA contributed to your success? 

A: “It’s been a real benefit to me to work with the great group of surgeons at USA. I really enjoy being around and operating side by side with comrades. We’re all there for an essential purpose. We enjoy taking care of people – and enjoy teaching. Some of us do it a little differently, and it’s valuable to have a second or third opinion or to bounce an idea off of someone you trust. My colleagues offer sound advice, and I’ve found them to be incredibly supportive and good people to work with.”  

Dr. Fisher earned his medical degree from the University of Tennessee College of Medicine in Memphis, Tennessee. He completed an internship and general surgery residency from the University of Texas – Southwestern Medical Center in Dallas, Texas. He then completed three separate fellowships – in vascular surgery from Baylor College of Medicine in Houston; transplant surgery from the University of Cambridge Clinical School in Cambridge, England, and a second transplant surgery fellowship from University of Texas – SW Medical Center and Parkland Memorial Hospital in Dallas. 

Dr. Fisher is an associate professor of surgery, Department of Surgery, for the University of Tennessee College of Medicine, Chattanooga, the Medical Director of Tennessee Donor Services in Chattanooga and Surgical Director of Erlanger’s Regional Kidney Transplant Program. He is board certified through the American Board of Surgery and a Fellow of the American College of Surgeons (FACS). Dr. Fisher specializes in vascular and transplant surgery.  

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