colon screening a la fantastic voyage

Check Cap may provide an alternative to conventional colon screening techniques in the near future. An ingestible, disposable capsule that requires no laxative preparation, Check Cap takes low-energy xrays while traveling through the colon and is naturally passed with excreta. The device is currently under development in a joint venture with General Electric.

improving doctor-patient communication

It is of obvious importance for health-care providers to communicate well with patients and their family members. The ONCOTALK faculty at the University of Washington offer a series of teaching modules that are designed to help doctors do just that. Downloadable videos available.

Effectively conveying bad news to patients is particularly important in practicing cancer medicine. In the above video, faculty at the Albert Einstein College of Medicine teach residents how to do this through role playing exercises. The late Robert Buckman, MD, PhD, was instrumental in developing instruction about bad news delivery (see his SPIKE video), as well as about communication sensitivity in general (see a collection of Buckman videos on MD Anderson's Clinical Communication Skills page).

sniffing out cancer

Dogs have long been assumed to be sensitive to some human diseases. And as shown in this video, lung cancer seems particularly amenable to detection through the scent of subjects' breath. A recent article by Ehmann and associates in the European Respiratory Journal reported that family dogs, trained rather easily for such detection, achieved sensitivity and specificity rates in excess of 70 and 90 percent, respectively, in differentiating cancer versus non-cancer breath specimens. While the ability of dogs to do this may be remarkable, researchers stress that the major implication of these findings is that lung cancer patients carry distinctive markers in their breath (also see Gever.)    

what is colonoscopy?

The standard procedure for detecting colon cancer is colonoscopy, but much of the population has little understanding of what one is and what it involves. These questions and many more are effectively addressed through videos provided by numerous treatment centers and support organizations. Those displayed above were prepared by MD Anderson (see YouTube MD Anderson playlist for "colonoscopy" videos).

young adult colon cancer and Lynch Syndrome

 

Although colon cancer is known as a condition affecting post-50 year old people, it does occasionally occur among younger adults. The top video highlights Candace, a 41 year-old mother of five, whose early symptoms were dismissed by practitioners. The bottom news story addresses the primary genetic basis for early adult colon cancer, Lynch syndrome, as it affected one Ohio family. Also hear a recent interview with MD Anderson's Eduardo Vilar-Sanchez, MD, PhD, on the link between genes and colon cancer.

devices for locating online multimedia

In addition to conventional online search techniques, such as googling via key word or tag, there are other alternative strategies which can keep instructors, practitioners, and students abreast of emerging multimedia in an efficient manner. One excellent technique is to create a Google Alert, which e-mails news alerts on the query term(s) to subscribers on a regular basis. The video shown above was recently brought to attention by way of my alert for "colon cancer."

Another productive technique making for almost effortless search is to create an iGoogle page embedded with gadgets such as RSS feeds, which automatically relay the latest items added to the website. The above video was brought to my attention through the NCI Benchmarks feed on my iGoogle page for cancer multimedia. 

awareness events: Super Colon & Undy 5000

Colon cancer awareness events are increasingly commonplace in US cities. The inflatable 20-foot Super Colon, sponsored by the Prevent Cancer Foundation, is one huge vehicle for stimulating interest in matters of that organ. As shown in the top video, which includes interviews with MD Anderson's Roxanne McCormac and Dr. Rene Mueller, Super Colon encourages walking tours through it where polyps, cancerous masses, and other conditions can be inspected up close. Organizations may also now purchase inflatable colons from the Colon Cancer Alliance. The Undy 5000, shown in the bottom clip, is another attention-grabbing event that has been sponsored in many cities over recent years by the Colon Cancer Alliance.

Confronting Colon Cancer documentary

This informative documentary produced by PBS-affiliate WVIZ explores in step-by-step detail causes, symptoms, and surgical treatment of colorectal cancer. Uses case studies of patients to examine colonoscopy preparation and procedure, laparoscopic resection, and pathological findings. Chemotherapy is not addressed. Provides interviews with practitioners, patients, and family members. WVIZ website includes related coverage of colon cancer issues. Highly recommended for beginning students and patient education.

anticolonoscopy pop culture and "science"

The ultimate anticolonoscopy statement is the 2007 feature film, Sublime.  The protagonist's procedure goes awry and leaves him in a prolonged, excruciatingly terror-filled coma mercifully ended by death. 

Advisory: do not recommend to anyone in need of a colonoscopy. Practitioners should view in order to deal with possible patient fears generated by it. 

Although considered the "gold standard" for colon cancer screening, opposition comes in part from pseudoscience elements who claim it not only ineffective, but unsafe. In his Death by Colonoscopy video series, Konstantin Monastyrsky, self-proclaimed expert in the field of "forensic nutrition," selects bits and pieces from various studies and commonly misinterprets findings to support his anticolonoscopy bias (see, e.g, the segment in the bottom video from 1:25 to 2:15). Recommended to use as object of critique for beginning students. 

The New York Times cancer-related multimedia

The New York Times clearly stands out among news media in its multimedia coverage of cancer. In the above video, cancer effects are demonstrated to extend beyond the patient to other family members in many ways. The clip is from the series, Life Interrupted: A Video Portrait of Cancer in Young Adulthood, created by Suleika Jaouad, a 23 year-old writer now chronicling her experiences with leukemia.

Relevant multimedia may be located and accessed through search by media type (see "cancer videos" playlists). Searching by cancer type provides lists of articles, videos, and graphics (click here for colon cancer media).

The online paper allows for 10 free visits per month.

online news video

It is good that instructors and practitioners keep abreast of news stories on cancer-related matters. In this recent ABC report, breaking news is provided about MD Anderson research findings on the therapeutic effects of Metformin (glucophage) in treating various cancers. Such stories can be forwarded to inform relevant target populations of developments. But they are also at times quite incomplete in important details or seriously flawed, and therefore can be used as objects for critique.



One of the best sources of news stories in the sense of giving more than a sound-bite approach is the PBS NewsHour (see playlist search of stories involving cancer). In the above clip, Ray Suarez recently talked to Dr. Andrew Chan about research findings suggesting that a daily dose of aspirin can be an effective prophylactic against various cancers.

Cancer Statistics via the NCI

There is an abundance of online data available for the description and analysis of cancer incidence and mortality in the U.S. The best source appears to be the National Cancer Institute's Cancer Statistics website, where there are a host of relevant resources. For example, instructors, students, and practitioners interested in the epidemiology of cancer should become familiar with State Cancer Profiles from which they can select demographic variables to create cancer incidence tables and interactive maps at national and state levels (see above).  Another useful NCI resource is the Surveillance Epidemiology End Results (SEER) site, which includes various data sets and software for analysis and Fast Stats, an interactive tool allowing for the easy generation of tables and graphs through simplified access. Also available through NCI is Cancer Control P.L.A.N.E.T. which provides statistics and applied resources useful for planning, intervention, and evaluation efforts.

Understanding Cancer series

Understanding Cancer is a set of tutorials provided by The National Cancer Institute on the biology of cancer, and particularly the role of genetics in contributing to cancer. Graphic slides can be easily adopted to presentation software, if not already in PowerPoint formats. The collection is a solid teaching resource for introductory-level students, and for public and patient education.

big decisions re cancer

Cancer is a life-changing, as well as an oft life-ending, condition. Videos can be used effectively from both clinical and popular media angles to enhance the introduction of health-care students with such matters. In the bottom clip, David S. Ettinger, MD addresses the importance of making end-of-life decisions upfront, while in the top clip, Breaking Bad protagonist, methamphetamine manufacturer, and lung-cancer patient, Walter White, seizes the moment to voice his preferences about how he wants to go out (view series creator Vince Gilligan's comments here about the emotions evoked on the set while shooting this scene).     

NCCN.com video collection

National Comprehensive Cancer Network, NCCN, is a significant resource for patients, caregivers, and family. Collections of  cancer-patient education videos, many of which are also highly relevant for practitioners, are available at its video center and YouTube channel. In the above clip, an oncologist draws on his own experience as a cancer patient in stressing the importance of the first interview with a new patient.

Clinical Care Options: Oncology

Clinical Care Options: Oncology provides a massive collection of free workshops and tutorials on screening, testing, and treatment across various cancers (registration required). Includes, as well, a case challenges component which entails interactive instruction about patient management (see sample case study here). Free downloadable PowerPoint slides are available for many topics, including numerous presentations on colorectal cancer. CME credit provided for some modules.  

a critique of cancer and positive thinking

Barbara Ehrenreich does not agree with the conventional wisdom holding that cancer patients must think positively about their condition. For a fuller treatment of her critique, watch this video. Barbara's detailed ideas originally appeared in a 2001 article she wrote for Harper's, Welcome to Cancerland.

cancer donation ads in the UK

Cancer Research UK has created an extensive television advertising campaign to solicit funds from the public to support research (see YouTube playlist here). Describing this effort on its website, "Our new TV ad is part of a wider campaign in which we demonstrate how we use generous donations from the public to fund cutting edge cancer research that benefits thousands of cancer patients each year. Thanks to research into cancer, survival rates have doubled in the last 40 years and we have been at the heart of that progress. However, we have a lot more work to do in order to realise our vision of a world without cancer, and this is the final message of our campaign" (see bottom clip).

what is cancer?

This tutorial, provided through Cancer Research UK, introduces the topic "What is cancer?" in clear, concise terms. It includes various user-driven slideshows and graphics, and serves as a solid introduction for students beginning to study cancer, as well as patients.

cancer can be funny: Dov Siporin

Despite the fact that Dov Siporin has terminal colon cancer, his irrepressible humor has helped him and his loved ones cope with it and all that he has gone through. In the top segment, Dov talks about his attempt to break through the formality of interacting with treatment providers with the assistance of a sausage. In the bottom video, Dov performs a practical joke on the Grim Reaper during IV therapy. See a serial of Dov's amazing clips at YouTube's huntsmancancervideos and at his own collection. Also, hear Dov's discussion about using humor with cancer at this interview conducted by his father via StoryCorps.       

Inside Cancer: Multimedia Guide to Cancer Biology

Inside Cancer, a component of the DNA Learning Center, is an excellent introductory resource on the biology of cancer. Interactive tutorials, comprised of animated graphics with text or voice-over, cover cancer hallmarks, causes and prevention, diagnosis and treatment, and pathways. Some include videos and interactive quizzes, as well. The site also provides a password-protected Teacher Center which provides additional resources and software to build multimedia lessons. 

cancer-center multimedia collections

In addition to MD Anderson, many other research and training hospitals produce cancer-related multimedia for purposes of physician, student, and patient education. In the top video, a Memorial Sloan-Kettering Cancer Center physician addresses the efficacy of  laparoscopic colon resectioning in comparison to traditional surgery (see its cancer playlist here). Also, The Mayo Clinic offers a significant body of cancer-related videos on its YouTube channel. In the lower clip, a Clinic researcher discusses the findings of a large longitudinal study of stage III colon cancer survival among patients being treated with 5-FU-based chemotherapy.

patient voice via vlogging

In my opinion, patient voice is the most significant recent development in cancer multimedia. YouTube and other video-sharing sites allow users to freely upload and distribute personal content to the Web. Video blogs or vlogs have been filmed by thousands of cancer patients, enabling them to communicate on a serial basis about their condition and treatment. As such, these vlogs serve as a rich source of personal insights about coping with cancer for patients, practitioners, and students.

The above video is the first installment of Charlie Awad's vlog on his colon cancer experience and his subsequent challenges as the cancer spread to his lungs. Charlie is dedicated to getting the word out to the public about the critical importance of early detection through screening (for information on Charlie's mission, see his website CancerSucks.TV. 

CDC's Screen For Life campaign

Since 1999, The Centers for Disease Control has waged a nationwide campaign to encourage target populations to undergo colorectal cancer testing. The program also provides guidance and funding to raise screening rates in local settings (see earlier post re Utah PSAs). The latest version of Screen for Life: National Colorectal Cancer Action Campaign employs a series of video, audio, and poster PSAs to get the message out via such celebrities as Morgan Freeman, Diane Keaton, and Jimmy Smits. In my opinion, the Terrence Howard video shown here is one of the more effective as he talks about how the cancer death of his mother could have been easily prevented. Despite such efforts, the CDC indicates that participation is still too low as 1 in 3 Americans between 50-75 years old are not currently screened (see Campaign Overview, 2012).

MD Anderson multimedia collection

MD Anderson provides a significant body of audio podcasts and videos about cancer and cancer-related issues for patients, their family members, and the public in general. A comprehensive collection of resources are available at the MD Anderson Cancer Center YouTube site. Content can be easily found through topical playlists. Users may also search for MD Anderson-related multimedia at the Cancer Newsline indexed site and at Cancer Newsline YouTube.

colorectal surgeon song

Affairs of the colon invite dark humor. In the top video, members of the American Society of Colon and Rectal Surgeons were entertained by Bowser and Blue's song in praise of those who practice the craft. University of British Columbia students also recently sang their rendition at the annual medical school gala (video below).

patient education through MD Anderson

Multimedia provides a great way for health-care practitioners to educate patients about what they can expect to encounter as they go through testing and subsequent treatment, if necessary. For example, MD Anderson has produced materials on what patients can expect with a colonoscopy (top video) and what comes after discovery of a polyp (bottom video).

celebrity colonoscopy

Since Katie Couric underwent her televised colonoscopy in 2000 (see top video), several other celebrities have likewise had theirs performed for the public good, including Charles Barkley, Homer Simpson, and Harry Smith. Smith, a CBS news anchor, occupies a special place as his reportedly was the first-ever celebrity procedure televised live that gave an inside tour of the colon (see bottom video).

"the cancer talk"

Just as your mom or dad likely gave you "the sex talk" when you were a teen, it's time to give the elders you love "the cancer talk," according to Fuck Cancer. Start here for guidance on how to motivate your parents to get themselves examined.

colonoscopy song

CBS Cares has long been promoting heath-care issues, including colon cancer prevention. Peter Yarrow of Peter, Paul, and Mary fame, sings his colonoscopy song in 2010 (see full version here).

colonoscopy sweepstakes

CBS Cares and New York Presbyterian Hospital are working together to promote this year's Colonoscopy Sweepstakes. Sharon Osbourne, who along with husband Ozzy are spokespersons for the campaign this year, shares her experience as a colon cancer patient and the need for testing on The Talk. CBS Cares has now been promoting colonoscopy screening through such efforts for the past several years (e.g., see 2009 promo).

cartoon animations via xtranormal

Animated cartoons can be generated fairly easily through cloud software applications. In the top video, the creator employs xtranormal to discuss the importance of colonoscopy for cancer screening. In the bottom video, I provide an animated version of the dialog I had with my surgeon before my colon cancer resection.  Cartoons can promote cancer education in general, as well as serving to facilitate patient voice.

cancer among the Amish

Amish residents of Holmes County, Ohio, who follow the traditional customs of this subculture, have much lower rates of cancer than does the state population in general, according to an investigation lead by Judith Westman of Ohio State University. Researchers had hypothesized that the Amish would have higher rates largely due to their failure to access mainstream medicine and their limited genetic diversity. However, medical histories, along with examination of local death records, found they had an overall cancer incidence of about 40 percent less than that for the general population. The researchers suggest that their aversion to drinking, smoking, and sexual permissiveness plays a significant role in their comparatively positive health status.

Note: PBS has just released a full-length documentary on this subculture, The Amish, through its American Experience series.

pain management problems around the world

Freedom from Pain, a documentary produced by students and instructors at the University of British Columbia's Graduate School of Journalism, addresses the problem of inadequate pain management for cancer patients.  Although morphine is inexpensive, the War on Drugs has lead to overly restrictive laws in some nations against prescribing narcotics or disincentives for their production and distribution.  The documentary centers on several patients in India and Ukraine who are attempting to cope without sufficient palliative treatment.  Similarly, Fifty Milligrams is Not Enough, further explores the Ukrainian problem through a case study of a cancer patient (see accompanying blog article).  This documentary and other videos relative to medical injustice are available at the Open Society Foundations' Stop Torture in Health Care site.

the "great secret" of cancer research

This comic strip panel by Jorge Cham features a young PhD who gives a speech to MD Anderson faculty, and while there, later meets up with graduate students who clue him in to the way things actually operate in the world of cancer research.

on colon cancer: Sal Khan interviews Andy Connolly

Andy Connolly of Stanford Medical School walks the viewer through the process of colon cancer development with the assistance of Sal Khan, creator of the Khan Academy.  Video 1 overviews normal colon tissue, video 2 relates to dysplasia, video 3 focuses on hyperplasia, and video 4, shown above, addresses cancerous colon tissue.  Along the way, Khan's questions to Connolly serve to clarify terminology and muddy points for students and the lay public.

DNA animations

In this TED Talks segment, Drew Berry shows his fantastic animation of DNA replication (see full clip here). Berry works at Australia's Walter & Ezra Hall Institute, and some of his other animations, including breast cancer origins and colony stimulating factor, can be seen at http://www.wehi.edu.au/education/wehitv. (Also go to Harvard's BioVisions site to view Inner Life of Cell series.)

X-Plain interactive tutorials

The National Library of Medicine has created a large body of interactive tutorials to help educate patients about disease and health issues.  Their inventory includes tutorials on leukemia and colon, brain, breast, liver, ovarian, non-melanoma skin, and prostate cancers.  The tutorials provide clear information about the disease and the course of treatment, allow users to advance at their own pace, and give feedback about information retention through self-tests.

cancer statistics via Gapminder

Hans Rosling looks at colon cancer statistics in this video through his Gapminder data visualization application.  Hans shows that rates increase with growing affluence over historical time, and speculates that the culprit is western-style diets.  Nonetheless, his data also indicate that rich societies are better able to treat the disease once discovered as deaths due to colon cancer are lower there than in less affluent nations.  A free API that can be either used in the cloud or downloaded, Gapminder comes with a number of data sets that permit analyses of many health-related variables, including various cancers.

an effective colon cancer campaign in Utah

Utah Cancer Control has created a series of innovative public service announcements that have played a significant role in improving colon cancer screening rates across the state. Utah residents 50 years and older who reported having had a sigmoidoscopy or colonoscopy increased from 48 percent in 2003 to 67 percent by 2010. As shown in the above example, the brief videos broadcast on Utah television deliver a powerful emotional message that is virtually impossible to ignore. The campaign has also generated national recognition, including that from the National Association of Chronic Disease Directors, which will honor it with the 2012 Program Delivery Award.