March 6, 2000 (Washington) -- Shirley Heiligman, a 72-year-old grandmother and volunteer advocate for foster children, was diagnosed with colon cancer in 1998. By the time she was diagnosed, the cancer had spread. But according to statistics, Heiligman is lucky. The cancer had been diagnosed early enough for her to begin treatment.
Jay Monahan was not as fortunate. The husband of NBC's Today show host Katie Couric, and a father of two, died in 1997 just nine months after being diagnosed and two weeks after his 42nd birthday. There were no distinguishable symptoms or warning signs such as a family history.
But Monahan and Heiligman do have something in common. On Monday, their distinct experiences served to demonstrate at a Senate hearing the importance of having a colorectal exam at least once every five years after the age of 50, when people enter the high-risk group.
The hearing was held to explore how Medicare can get this message across to its beneficiaries. According to a General Accounting Report released at the hearing, a mere 14% of Medicare beneficiaries had any sort of colorectal cancer screening in 1999 although the federal health insurance program began covering these exams in January 1998.
The benefits seem self-evident. It is estimated that about 56,000 Americans will die from colorectal cancer this year, of which approximately 28,000 could have been prevented through early detection, testified Bernard Levin, MD, vice president of the M.D. Anderson Cancer Center at the University of Texas.
The tests are not 100% effective or 100% safe, Levin tells WebMD. But a colonoscopy, which examines the entire colon, for example, can detect at least 95% of the small lumps that may signal a problem and almost 100% of those patients with cancer, he says.
The problem is getting that message across to Medicare beneficiaries, especially since the colon and rectum represent a taboo subject for many older Americans, said Michael McMullan, a deputy director of the Health Care Financing Administration (HCFA). "It takes a long time to change the behavior of people," she told the Senate panel.
On the plus side, HCFA is getting some unexpected private sector assistance. Couric, along with Lilly Tartikoff, the wife of former NBC president Brandon Tartikoff, and the Entertainment Industry Foundation launched last week the National Colorectal Cancer Research Alliance. The group has since placed five million educational brochures in more than 25,000 drugstores, and will soon air public service announcements during shows such as NYPD Blue and Judge Judy.
That may help make all the difference, even for people like Shirley Heiligman. In 1993, Heiligman had a sigmoidoscopy, a standard colorectal screening procedure in which a slender tube was used to inspect just the lower third of her colon. That test detected no signs of cancer.
It was, though, a special Monday for Heiligman. On Mondays, she usually goes in to the hospital for her chemotherapy.