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Idaho Enterprise

March is Colorectal Cancer Awareness Month

John Williams receiving chemotherapy in the chemo room at Nell J Redfield from Chemo certified nurse Brenda Barney.

Recent studies have found that colon cancer rates are on the rise among younger cohorts, causing various organizations to revise their suggestions about cancer screenings downward.  In fact, one of the new public service awareness campaigns is using the phrase “45 is the new 50” to encourage people to schedule a screening earlier than they had in the past.  Nell J. Redfield has both the capacity to screen and detect the development of cancer in its early forms, and it also has the trained staff and facilities to administer chemotherapy treatments for many types of cancers right in the hospital itself, which many people may not be aware of.  “A lot of people don’t know that they can get a lot of the treatments they need right here,” Kathy Hubbard says.

One person who is a perfect illustration of the wisdom of the change in age guidelines is the CEO of Nell J. Redfield Memorial Hospital, John Williams.  Williams took over in the position in 2013, and not long after became a patient.  Not only is Williams committed to promoting the services offered by the hospital and clinic, but he is also a recipient of those services himself, and in fact credits the persistence of his doctors and the in-house chemotherapy treatments with saving his life.

A little over ten years ago, Williams underwent a procedure, which indicated a small anomaly.  Dr. Clark felt that he wanted to further test the results, which ultimately uncovered a malignant tumor.

Williams, in discussion with his doctors from Utah, decided that there was no reason he couldn’t arrange to have his chemo done in Malad.  There are a number of chemo certified nurses at the hospital, including Nancy Asay, Brenda Barney, and Vicky Kent, and there is a chemo room which can be used by patients during treatment.

The procedure for chemotherapy depends on the specifics of the cancer type, location, and concentration in the body.  For Williams, the treatment involved a ball pump, which releases a controlled amount of the chemical solution into the body at a defined rate of speed.  The process generally takes an hour or two for completion, and often results in the patient experiencing weakness and fatigue, as well as nausea and other potential effects afterward. 

Williams acknowledges that it may seem odd, but he relates how he has some wonderful memories of receiving chemo with his mother at NJRMH.  “It’s an unusual thing, but those really are some great memories of getting our treatments together here, which I’m so glad we were able to do.”

Although any cancer diagnosis can be terrifying, the relatively good news is that colon cancer has a very good prognosis if caught during an early stage of progress.  Dr. Murphy does screenings for the hospital, and is on site every Thursday.  Dr. Anderson is the hospital's contracted oncologist, who visits in person once a month, and is available for telehealth outside
of that.

Bo Clark was the doctor at the time of Williams’ diagnosis.  “I started to show symptoms of cancer in my early 40s.  Because of my age, everyone assumed it was most likely due to ulcers.  So we did an EDG.  They go down using a scope and look at your stomach and esophagus.  They saw some stuff that concerned them and put me on some medication.  It didn’t get better with the medication. I came here and saw Bo Clark.  He told me ‘I’m not comfortable with it.  I think if we’re doing the EDG we might as well do the colonoscopy as well."   

Williams agreed to move forward with the more rigorous testing.  “We did the Colonoscopy, which showed a mass.  The CT was pretty conclusive—it showed that I had a very large tumor that had fortunately attached funny.  The attachment site was quite small.  Even though the tumor itself was the size of a grapefruit, the place where it attached to the intestine was only about the size of a fifty cent piece.”  

Williams proceeded with surgery on the mass.  “A doctor named Finlayson did the surgery on me.  I went to him on a Wednesday, and I told them ‘I want the guy who does six of these by breakfast.’  That turned out to be Findlayson down in Utah.  He said we can either do it Friday, or we can wait three weeks.  I decided I’d just as rather get it done. I got out of the surgery room at about 10 p.m. and asked if the doctor would be around.  They told me he had gone on vacation—he had just worked me in right before he left.  The degree of professionalism and great care we get in this region is great.”

Williams is clear that he is grateful to doctor Bo Clark, who found the mass after a couple of other doctors had missed it, primarily due to Williams’ age at the time.

“I had the first chemo done at Portneuf, because they wanted to see if I could handle it.  And then after that, we are very lucky that we are one of the few hospitals around that has chemo certified nurses.  Vicky Kent, Nancy Asay, and Brenda Barney are all chemo certified, so we were able to do all of my treatments here.  That was in 2015.” 

Williams and Hubbard stress that colon cancer is usually not a fast moving cancer.  If they catch it in the screening, the outcomes are very good.  

“For me, it had progressed to stage three by the time they caught it, so I did need chemo.  But even then, things had come a long way in terms of care.  In fact, the docs told me not to read things about it on the internet, because by the time I saw them they were out of date because things were changing so dramatically.  And of course, it’s changed even more dramatically since then.”

The key for colon cancer is early detection.  “They used to recommend it at 50, but now its 45.  If you have it, it’s really worth it to have everyone in your family, and even your extended family, checked for it.  For me, an aunt, my brother, and my mom all ended up having it.  First degree relatives (parents, siblings, or offspring) have 2 to 4 times the risk of developing colon cancer,” Williams says.

“One of the things that was so great for me was that because I could do it here. I just needed to make sure I had someone here who could give me a ride.  It’s one of the things that was so great for my treatment process was that I was able to keep the same routine.  Your attitude toward the treatment is a major factor in the recovery.  If I had been sitting in the waiting rooms at the University of Utah in the cancer institute after driving for two hours and so on, I wouldn’t have had the same positive attitude about things, I
don’t think.”

“It’s one of the reasons we try to make sure everyone has the opportunity to get services here.  And this happened way before me, Mr. Winger and Nancy Asay, they’re the ones that got that program up and running here, and it benefitted me absolutely.  By and large it was just business as usual,” Williams says.

“I always get choked up, but I’m so grateful for Bo, for being the guy who said ‘I don’t know, let’s keep looking at what’s going on.’  And having nurses that were as professional and caring through the process as Nancy and Vicky and Brenda were was lucky.”

“We are lucky in this community to have people willing to learn the skillsets they have.  At the time I had it done, there were bigger hospitals around us that didn’t have anyone who had passed the test, and we had Nancy, Vicky and Brenda, which was amazing.  The trio of nurses hold a Chemotherapy Immunotherapy Certificate from the Oncology nursing Society, which is renewed every two years.   

Nell J. Redfield has an agreement with Portneuf for oncology services, and an agreement with Dr. Murphy through IHC in Tremonton.  When the procedures are done in Malad, the revenue stays in the county.  

“One other thing I’d say is that cancer screening is scary.  Being told that you have cancer is very scary.  But that’s one of the things about colon cancer—if you catch it early, the prognosis is really, really good.”  Williams relates that his mother was resistant to having the colonoscopy done out of a “sense of propriety.”  He has seen that be the case for other, especially older individuals as well, and he suggests that it’s just something that people need to be encouraged to get over.  “Catching it early through screening and exam is critical to good recovery outcomes, so I strongly encourage everyone to have an exam done at 45.”

“Fortunately,” Williams says, “I caught it early being as young as I was.  And I’m just so thankful for Bo.  If I had waited much longer it probably would have metastasized and I wouldn’t be here to talk about it today. “

“What surprises me so much in the community is when I tell people I am a cancer survivor and got my treatments here, so many of them say they didn’t know they could do it here.  Some meds we can’t do here [as they require specialized chemical venting hoods and other equipment], but for the most part it’s the exact same thing you’d get done elsewhere, but you can stay in town.”

Williams and Hubbard encourage everyone 45 years and older to make sure to schedule routine colon cancer screenings to try to catch anything as early as possible.  If caught early enough, as they stress, the procedures for chemo can be handled here in town.

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