Colorectal Cancer Awareness

Colorectal Cancer: The Cancer No One Wanted to Talk About

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Retired local physician Dr. Jack Hardy remembers what happened a few years ago when the Commonwealth Cancer Association (CCA) launched a project to develop an educational DVD about colorectal cancer in the CNMI: the project failed.   

“We identified several survivors of colorectal cancer who were well-known, respected members of the community and asked them to participate in the project.  We felt that personal stories would be a particularly powerful way to get the message out about this very common, vey preventable, form of cancer,” Dr. Hardy recalls.  “But no one wanted to talk about it.” 

The social and emotional stigmas associated with cancers of the colon and rectum proved too great.  The CCA suspended the project.   

Dr. Hardy serves as senior advisor to the Commonwealth Cancer Association, the local cancer support organization for the CNMI.  Like many other public health officials, he believes that the need to break through the sensitivity and silence surrounding colorectal cancer has never been more urgent.  “There is a high incidence rate here in the CNMI,” Dr. Hardy says.  “We absolutely need to talk about colorectal cancer.  We need to talk about it openly, and we need to talk about it now.” 



By U.S. mainland standards, Veni Folta is not the typical colorectal cancer survivor.  In the United States, 90% of all colorectal cancer cases are diagnosed in people over the age of 50.  Folta, on the other hand, is considerably younger than that – still in her early 40s, and the mother of two young children, with no known family history of the disease. 

By CNMI standards, Folta also does not fit the mold.  Typically, and unfortunately, colorectal cancer in the CNMI is found in late stages, when the chances of successful treatment are smallest.  In Folta’s case, her colorectal cancer was detected and treated early, and she lives an active and healthy life today.   

By any standard, Folta is remarkable because she is willing to talk openly about her experiences in coping with -- and ultimately beating – colorectal cancer.  “If my success story of early detection and treatment can help just one person, then it will be all worth it,” she says, in explaining why she finds it important to share her story with others.  She adds that it is important that people “listen to their bodies and trust their intuition” because people who are mindful of their bodies will know if something is wrong. “I listened to my body, and took time from my very busy schedule to seek medical attention,” she says.  Folta eventually went through surgery, and technically, was cancer-free before she found out she had cancer: the biopsy came back after the cancer had already been removed and tested. 


Cancer is a difficult subject for many people to discuss, and colorectal cancer in particular.  But efforts to reduce the incidence and number of deaths caused by colorectal cancer in the community demand breaking the silence surrounding the disease and raising awareness about the importance of early screening and a healthy lifestyle in prevention.  For Folta, talking openly about colorectal cancer prevention is like paying it forward.  After seeing her example, several of her friends have gotten screened, and Folta says she is committed to making sure her children understand the importance of getting screened 10 years younger than the age she had been when she was diagnosed with colorectal cancer, as recommended by her surgeon. Early screening saved her life, she says, and she wants the community to know that early screening can save many other lives, too.    


In addition to early screening, research shows that a healthy lifestyle can significantly the reduce risk of developing colorectal cancer.  According to the American Cancer Society, several lifestyle-related factors have been linked to colorectal cancer, including diet, weight, exercise, alcohol consumption and tobacco use.  “We know that diets that are heavy on meat products and less on vegetables create an increased independent risk for colorectal cancer.  We also know that tobacco use is strongly associated with colorectal cancer.  This message has to get out to the public,” emphasizes Dr. Divya Sharma, a physician who served for several years as the Medical Director for the Commonwealth Health Center.   During her recent tenure in the CNMI, Dr. Sharma had been troubled by how many young people were being diagnosed with metastatic (late-stage) colorectal cancer – individuals with no known family history of the disease.  “[But] without a formal public health study and without a registry, it is really hard to start looking into this,” she notes.


Dr. Sharma’s comments highlight a pressing and long-standing concern for many public health officials in the CNMI: the lack of a cancer registry.  The CNMI is one of the last jurisdictions in the United States that has yet to develop a standardized, population-based cancer registry program. Current local data on all forms of cancer, including colorectal cancer, are limited and not readily available.  A functioning cancer registry would provide invaluable data for public health officials, providing better documentation regarding cancer demographics in the CNMI, and helping to determine, among other things, whether U.S. cancer prevention and screening guidelines (based on U.S. mainland population data) apply here.        

Senator Ralph Torres has recently introduced Senate Bill 17-10, SS1, to authorize the creation of a population-based cancer registry program for the CNMI.  If enacted, this legislation will give the Department of Public Health (DPH) the mandate it needs to develop and maintain a standardized registry to record and track data that are essential for identifying and monitoring cancer trends and delivering timely, appropriate, and coordinated healthcare services.  Private healthcare providers will also be required to submit data for the registry.  The Department of Public Health has already secured federal funding and established a cooperative agreement with the University of Hawaii that will be instrumental in developing and operating this cancer registry.  The passage of enabling legislation is now required in order for DPH to move forward with implementation.


Living with colorectal cancer can be challenging, and circumstances are unique for each individual.  Learning as much as you can after diagnosis is for many people one of the most important first steps in fighting the disease.  Talk to doctors, other health providers and educators, social workers, counselors, and others going through similar experiences.  Learn how the disease progresses, the level of care that will be needed, the types of treatment options, the expected benefits and side effects of each option, how to manage potential side effects, and what resources are available to help.  Read books and brochures, do research online, and become familiar with the pertinent medical, legal, and financial documents you will need to develop a care plan.  Knowledge is empowering, and the more you know about colorectal cancer, the better equipped you and your loved ones will be to navigate the path ahead.         

Consider also joining a support group.  Support groups provide a safe and confidential place to share ideas and experiences, learn practical strategies for dealing with cancer, and receive as well as give social and emotional support.  Here on Saipan, cancer survivor support groups are held on a monthly basis, usually at the Hyatt’s Chamolinian Room. In addition, online support groups are available through numerous organizations such as the American Cancer Society’s Cancer Survivors Network at http://csn.cancer.org


For more information about colorectal cancer, visit the National Institute for Cancer at
www.cancer.gov/cancertopics/types/colon-and-rectal , or the Centers for Disease Control and Prevention at http://www.cdc.gov/features/colorectal .  For information about the Department of Public Health’s Comprehensive Cancer Control Program, contact Joanne Ogo, CCCP Coordinator, at 236-8728 or This email address is being protected from spambots. You need JavaScript enabled to view it. .  For information about cancer support programs in the CNMI, contact the Commonwealth Cancer Association (CCA) at 682-0050 or This email address is being protected from spambots. You need JavaScript enabled to view it.. The CCA is a community-based nonprofit organization that provides information, financial assistance for certain consumable items, equipment on loan, and other support services for cancer survivors and their families.