By BERNIE BELLAN This paper has been writing about the importance of being screened for colorectal cancer for years, focusing on what has now become an annual event: The Kick Butt Run for Colorectal Cancer.
But, as much as we’ve focused on the less serious side of this event, we’ve been remiss in not writing more about colorectal cancer itself. That changed this past week when I had a call from our sales rep, Robbie Mazo, who asked me whether I’d be interested in speaking with someone who was recently diagnosed with both colorectal and liver cancer, and who was willing to talk about his condition.
The person about whom Robbie was speaking was David Novikoff, whose name I recognized from annual ads for the Ashkeanzie Synagogue around this time of year, where Novikoff serves as cantor during the high holydays.
I contacted Novikoff and asked him to tell me his story. I wasn’t quite sure what point we might be making by talking about one specific person’s experience with cancer, but after speaking with Novikoff, then consulting with the president of the Colorectal Cancer Association of Canada, Barry Stein, who lives in Montreal, I realized the benefit that talking about this disease might serve to our readers.
According to David Novikoff, who is now 73, he “had never been admitted to a hospital in his life.” Unfortunately, however, he was all too familiar with cancer, as his wife, Sandra, has had both breast and colon cancer and, most recently, was diagnosed with a sarcoma (a malignant tumor in connective tissue). Sandra was given a clean bill of health after her last surgery. As well, both Sandra’s mother and father died of cancer.
For David Novikoff, however, it was only this past March that he realized something was seriously wrong with him. “I was shivering and coughing; my ribs hurt from all the coughing,” he says. “I hit a wall”, he adds and Sandra rushed him to his doctor, Grant Goldberg.
After a series of tests showed that Novikoff’s red blood cell count was quite low, he had a colonoscopy performed on May 31. The colonoscopy showed the presence of cancer in his rectum. I asked Novikoff whether he had ever done what is considered the first line of screening for colorectal cancer, the Fetal Occult Blood Test, or FOBT for short.
He said that he hadn’t – for the same reason that so many individuals shy away from taking that test: it involves taking samples of your own feces. “I used to be given the tests and throw them away,” he admits. That was a mistake, he now acknowledges. However, he did do the FOBT this time and it came back positive, which led him to having a colonoscopy performed.
When Novikoff consulted with well-known gastroenterologist Dr. Allan Micflikier he was told that he likely had had cancer for about a year. Dr. Micflikier had a biopsy performed; the biopsy confirmed the cancer diagnosis. After having a CT scan and an MRI done that bleak diagnosis was confirmed. After meeting with two liver specialists, it was confirmed that surgery was not an option. The news, moreover, was even worse. The cancer had metastasized to his liver. At that point Novikoff became a patient of CancerCare Manitoba. He began a course of chemotherapy, which is administered every two weeks – six sessions altogether, and which is ongoing as of the time of writing.
Still, despite the bad news he was given not that long ago, Novikoff insists that he will maintain a positive attitude. He says he’s determined to participate in the Kick Butt Run for Cancer September 10, even if it’s only for part of the run. He adds that he’s scheduled to receive his fifth chemotherapy treatment two days later.
When asked what the hardest part of coping with cancer has been, Novikoff says: “The shock of being told is the hardest part; the second hardest thing was telling my wife.”
Still, he says, “I won’t let anyone feel sorry for me…They tell you all the side effects you’re likely to experience from chemotherapy (such as nausea and fatigue), but so far, aside from being a little tired and losing some of my hair, it hasn’t been that rough.”
Novikoff says that he “will never accept negativity from anyone,” including other cancer patients. Maintaining a positive attitude is something he’s carried throughout his life, he adds. That’s not going to change now.
After speaking with Novikoff, however, I wasn’t quite sure what lessons I wanted readers to draw from this article. What I haven’t mentioned thus far is that Novikoff had suggested to me that all adults over the age of 50 have a colonoscopy every five years. I had never heard that kind of advice offered previously, so I decided to investigate further to see what others more expert in the field might have to say. Novikoff now does suggest doing the FOBT test as a first line of defense at least once every two years.
I ended up chatting with Barry Stein, himself a cancer survivor, also the founder and president of the Colorectal Cancer Association of Canada (CCAC). Stein was first diagnosed with stage 4 colorectal cancer in 1995. Subsequently, it metastasized into his lung. After going through a harrowing series of treatments in New York, all of which he was forced to pay for himself (and which later became the basis for a landmark lawsuit against the Province of Quebec), Stein, who had been a successful lawyer, changed his life’s focus to raising awareness of colorectal cancer.
I specifically asked Stein about David Novikoff’s suggestion that everyone over the age of 50 have a colonoscopy every five years. Stein said that he understood where Novikoff was coming from, but that the first line of screening for colon cancer is generally taking the FOBT. He noted that a colonoscopy is recommended either when there’s a family history of colorectal cancer or a genetic predisposition toward colorectal cancer. As well, “women who have a history of ovarian, uterine, endometrial or breast cancer have a somewhat increased risk of developing colorectal cancer” according to the CCAC website, http://www.colorectal-cancer.ca.
In that regard, Stein pointed out that Jews of Ashkenazi descent have one of the highest rates of colorectal cancer in the world. I’ve deliberately avoided giving a series of statistics about cancer rates in this article to this point because I had wanted to tell David Novikoff’s story first, but in light of the fact that Ashkenazi Jews have a much higher predisposition to colorectal cancer, I thought it important to cite some of the more pertinent statistics at this point.
According to the Canadian Cancer Society’s website, an estimated “196,900 new cases of cancer and 78,000 deaths from cancer” were forecast to occur in 2015. “Lung, breast, colorectal and prostate cancer are the most common types of cancer in Canada (excluding non-melanoma skin cancer).”
According to the CCAC website, in 2015, “1 in 14 men and 1 in 16 women” were expected to be diagnosed with colorectal cancer. “This amounts to approximately 25,100 (about 14,000 (56%) men and 11,100 (44%) women) Canadian new cases of colorectal cancer.” Of the total number of individuals who were expected to be diagnosed with colorectal cancer in 2015 it was expected that “approximately 9,300 Canadians would die from the disease (about 5,100 (55%) men and 4,200 (45%) women).”
However, according to Barry Stein, proper screening, i.e. either through the FOBT or colonoscopy – depending upon one’s history, would reduce the number of deaths from colon cancer by 15%. Looking at figures from Manitoba, Stein said that would mean 340 fewer deaths in this province alone.
So, while David Novikoff is basing his advice for everyone over the age 50 to have a colonoscopy every five years upon his own experience, the fact is that not only is having what is, in truth, quite a painful test, he does agree that the FOBT should be the first line of defence.
What lessons, therefore, can we draw from Novikoff’s story? Proper screening, through the simple to take FOBT, every two years, is the first line of prevention. At the same time, Barry Stein’s own remarkable story of survival (now some 21 years after he was first diagnosed with what seemed a certain death sentence) should give hope to any cancer patient. David – take heart.
Certainly your positive attitude is of great importance in your outcome. By coming forward with your own story let’s hope that anyone reading this will take note of the importance of proper screening for colorectal cancer – and the courage that you are showing in not letting your diagnosis dampen your spirit. B’hatslachah, my friend.