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Posts Tagged ‘identification’

For today’s consideration I offer up some statistics and information about two cancers common in both men and women, bladder and colorectal, along with some pointers about risk and detection.

For starters, how about a little definition of what exactly we’re talking about. First, the bladder. If you remember anything of biology or health and fitness classes, you might recall that the bladder stores urine until certain signals tell you it’s “full,” and then it contracts to help push the urine down the urethra and out of the body. Secondly, the colorectal area. Since they are connected physically and work in tandem as part of the digestive system, the colon and rectum are often grouped under the collective “colorectal” description. Essentially, the colon is the large intestine, and the rectum is the last six inches or so before the anus.

Okay, with the anatomy lesson over, lets get to the bits that actually matter. Bladder cancer is one of the more common cancers found in men and women but is rarely publicized. According to the American Cancer Society (ACS), in 2009 some 52,810 new cases of bladder cancer were expected in men. Using Census Bureau population estimates, that means any given man had a 0.00035% chance of being diagnosed with a new bladder cancer. Those are whopping odds, I know; and, ladies, you’re numbers are even lower. For 2009, any given woman had a roughly 0.00012% chance of being diagnosed with a new bladder cancer. The 18,170 estimated new cases of bladder cancer in women in 2009 means that men are several times more likely to develop bladder cancer than women are. In fact, the ACS reports that “bladder cancer incidence is nearly four times higher in men than in women and more than two times higher in white men than in African American men.” Sorry Team Blue.

But don’t let the numbers get you down. For men, the cumulative chances of developing bladder cancer remain less than 1% until age 70 and beyond. Lifetime odds are less than 4%. And the odds of dying from it? One-fifth the chance of developing it. Women, as the earlier numbers indicated, have even less to worry about: bladder cancer odds never breach 1% by age group and is only 1.2% over the course of a lifetime. So not exactly a raging pandemic by any means. Which is especially good because bladder cancer has no good method of early detection. The most effective assessment of bladder cancer involves running an endoscope up the urethra and taking a look around. For obvious reasons, this is a procedure to be avoided unless you happen to fall among a high-risk group and or show troubling signs (especially painful urination or bloody urine). For the vast majority of us, this will never be a problem, so don’t concern yourself over it too much.

Colorectal numbers are higher. The ACS expected 75,590 new cases in men and 71,380 new cases in women in 2009, making it “the third most common cancer in both men and women.” Those numbers are also fairly even between the sexes, unlike bladder cancer. However, like bladder cancer and prostate cancer and breast cancer and most other cancers as well, the highest odds come later in life. “91% of [colorectal cancer] cases are diagnosed in individuals aged 50 and older,” reads the ACS statistics release. But it also related that in both men and women, the odds of developing colorectal cancer are less than 1% until age 60. Again, little reason to worry.

But if the 5 – 5.5% chance of developing colorectal cancer over your lifetime have you on edge, there are several methods of early detection. Most of us are familiar with the colonoscopy procedures as described (and sometimes filmed) on TV, where an endoscope is run through the large intestine in search of suspicious lesions or polyps. But if that’s too invasive for your tastes, you might consider a sigmoidoscopy, where physicians examine the rectum and lower third of the colon for abnormalities through a thin device called a flexible sigmoidoscope. It takes about 15 minutes, is less invasive, and can still take biopsies of anything suspicious. It’s recommended every five years and, like conventional colonoscopy, can occasionally (but not commonly) cause bleeding or tears in the intestinal walls, both requiring surgery to repair.

If those don’t fit your fancy, perhaps a double-contrast barium enema (DCBE) would do the trick. Recommended every five to 10 years, it involves a very thorough barium sulfate enema that physicians use to examine the lower digestive tract via x-ray. It exposes the patient to less radiation than a typical CT scan (also called CAT scan) and is somewhat less invasive than colonoscopies or sigmoidoscopies. However, if you don’t mind an enema or the slightly higher radiation of CT or MRI scans, you might opt for the virtual colonoscopy. After an enema, a small tube pumps air into colon (for better differentiation) while CT or MRI scans provide images of the intestinal tract. It’s still less invasive than traditional colonoscopies but does not allow for biopsies or as thorough an internal view. However, it does allow for imaging of surrounding tissues and produces more accurate images than DCBEs.

But if you’re not fond of any foreign materials up the backside, you might just opt for the simplicity and complete non-invasiveness of fecal blood tests. There are two types but both are quite accurate and inexpensive. One type, called FOBT (fecal occult blood test), tests feces for the heme blood component (“heme” as in hemoglobin, part of our red blood cells). The other, called FIT (fecal immunochemical test), is more sensitive and tests for the globin blood component. Pre-cancerous polyps in the colon or rectum often bleed into the fecal matter passing through the digestive tract, which can be detected by these tests. They are simple enough to do at home and are sometimes handed out free of charge at proctology centers, clinics, and other medical service providers. Doctors recommend triple-testing to reduce false positives as the body expels small amounts of blood in feces under normal circumstances. But the tests return positive results for bleeding anywhere between the mouth and anus, so don’t automatically assume colorectal cancer even if there is blood. These fecal blood tests are considered a line of primary identification, as are the similar fecal DNA tests, but for conclusive diagnoses you’re still expected to see a doctor and perhaps choose a colorectal treatment of a more invasive kind.

I think the most important thing to remember is how unlikely these cancers are. And being diagnosed with cancer is a long way from dying of it. So keep an eye on yourself, and get your regular medical check-ups if you like, but don’t waste time and energy worrying about something so unlikely. No matter what you hear on the news.

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Crackers Beware

Terrorist profiling isn’t just for Middle Easterners anymore.

A young whitebread American professional was recently held by TSA agents in the St. Louis airport. Did he mistakenly leave a screwdrivier in his carry-on? A pocketknife in his suit pants? He did verbally threaten someone or carry prohibited substances? No. Nothing of the sort. He was detained, his possessions searched, and threatened with arrest because he had roughly $4700. In cash.

Maybe you’ve already heard about this. But probably not. The news broke at least four days ago but I didn’t catch a whiff of it until today. There was no mention of it on Good Morning America, our local news broadcast, or even my Rueters and AP news feeds. And you may be asking yourself why you should care in the first place; what’s the big deal? My reasons for mentioning it here are two-fold.

First: I don’t find $4700 to be an exorbitant sum to be in the hands of a young professional. He was polite, compliant, well-dressed, a United States citizen, had proper identification … and yet they detained him. Why?

Second: Not long before this young man was detained, a state-and-federal joint organization had distributed a confidential report to law enforcement officials across the state, a report which “depicted Christians, anti-abortionists, advocates for protecting our borders and supporters of certain political candidates as potential ‘threats’ to public safety,” according to Missouri Lieutenant Governor Peter Kinder (the report, titled “The Modern Militia Movement,” can be read in full, as released, at the bottom of this post). Forgive me, but those delineations seem broad enough to condemn just about anyone.

The young man detained had the misfortune of falling into several of their “threatening” categories: being an aide to Texas Republican Representative Ron Paul, who was on the “certain political candidates” list; being the Director of Development in the politically-involved organization Campaign For Liberty; carrying “political paraphenalia” for both previous entities, in the form of fliers and bumper stickers; and possessing $4700 in cash. Trouble is, that report was supposed to be rescinded, its content disregarded. Though originally distributed as a sensitive “Law Enforcement Only” document, an unidentified officer leaked the report to the media on March 11 and the cat was out of the bag. The following public outcry led to apologies, public condemnations of the material, and supposed retractions of the report. And yet a young man who fell into several of the categories outlined in that report was detained, with no explanation except that the cash he carried somehow made him suspect.

I’m sure a lot of shady drug and/or terror-related deals go down between the St. Louis underworld (mafia, Al Qaeda, etc.) and a twenty-five year old Christian Republican who is well employed and politically active. Yes sir, I believe someone fitting that description proves a threat to our public safety. Sounds like a terrorist to me. Looks like one, too …

Yup, that’s the face of evil if I ever saw it.

His name is Steve Bierfeldt. He graduated Magna Cum Laude from Sacred Heart University in Fairfield, Connecticut, in 2006 and then spent two years in Virginia working for a non-profit and an election campaign. Prior to the TSA intervention, he had been in St. Louis helping at a Campaign For Liberty convention where they had sold tickets and merchandise, with roughly $4700 in cash transactions. Yes, yes, I see a threatening pattern emerging … It is my belief, ladies and gentlemen, that his problems stemmed from being a conservative, working for another conservative, supporting a conservative organization touting the need for antiquities like Freedom and Liberty. Oh and he’s a Christian, too.

Tie him to the stake! Light the kindling!!

This sounds eerily like a witch-hunt. During questioning, he repeatedly asked the TSA agents if he were required by law to answer. It seems a legitimate question to me, especially if they are looking to peg me as a militant extremist of some sort, but none of them responded except with condescension, threats of arrest, “going downtown,” and confrontation with the DEA and/or FBI.

Witch! Witch!!

Bierfeldt recorded much of the interaction on his cell phone, part of which can be heard on the embedded video at the bottom of the post. And while he was eventually released, catching his plane without further hassle, I still find this story very compelling. The fact remains that he was singled out and held without good reason. It was, purportedly, because of the cash, but on no flight rules list or FAA regulation anywhere does it even hint that cash is an article to be carried in limited quantities, or that substantial quantities of it could make you suspect and a likely candidate for detention. (And what would be considered a “substantial” quantity? Where do they draw those lines?) Young Bierfeldt would have been arrested, or at least held for further questioning, if not for an apparent plain-clothes FBI agent who ordered his release. Without once checking his documents, asking him a single question, or even inspecting his possessions.

A government document advised that someone like Bierfeldt – a Christian, a Republican supporter, a political citizen – could be a threat to public safety and so he was pulled aside. I’ll be honest with you … this kind of stuff scares me. Our rights and liberties and freedoms have been so thoroughly stripped away that, truly, nothing remains but their memory. And this is only the beginning. Tighten your seatbelts; it’s going to be a long, hard ride.

A few parting thoughts and links…

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“I realize that there are people who will dismiss this kind of story as insignificant. They shouldn’t. This is very serious and should be treated as such. Anyone who knows anything at all about history knows that before a state or national government can persecute – and commit acts of violence against – a group of people, they must first marginalize the group from society’s mainstream and categorize it as dangerous. Rome did exactly that to Christians, as did Mao’s China; Hitler’s Germany did the same thing to Jews; Stalin’s Russia did the same thing to political dissenters, etc…
…This is very serious business! We are not talking about private opinions. We are talking about law enforcement agencies. And remember, most law enforcement agencies share these types of reports; therefore, how many other state police agencies have similar reports floating around?”

A quote from Chuck Baldwin’s article Missouri State Police Think You And I Are Terrorists.

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“The show-me state made the news recently when the Missouri Information Analysis Center, a state-federal law-enforcement partnership, released an inflammatory report alleging that libertarians, constitutionalists, supporters of Texas Rep. Ron Paul, and other people skeptical of powerful government should be considered as potential terrorists-in-the-making.”

A quote from the Examiner article Political activist detained by TSA for carrying cash.

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“We believe that freedom is an indivisible whole, and that it includes not only economic liberty but civil liberties and privacy rights as well…”

A quote from the Campaign For Liberty website.

You can also visit Steve Bierfeldt’s profile page and weblog on their site.

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