Despite being largely preventable, colorectal cancer is the third most common in the U.S., and Kentucky ranks first in the nation for incidence.

Most colorectal cancer is preventable; here’s what you need to know

Dr. Jitesh Patel

Written by Dr. Jitesh Patel, colorectal surgeon at the UK Markey Cancer Center.

Colorectal cancer is the third most common cancer in the U.S. In Kentucky, the disease is particularly bad: Our state ranks first in the nation for colorectal cancer incidence and seventh in deaths. More than 2,500 new cases of the disease are diagnosed each year in Kentucky, and colorectal cancer takes the lives of more than 800 Kentuckians annually. The good news is colorectal cancer is a largely preventable disease.

Cause of colorectal cancer

The disease originates when healthy cells from the innermost layer of the colon or rectum change and grow uncontrollably, forming abnormal tissue growths called polyps. These growths are usually benign, but they can eventually become cancerous if they aren’t removed in time.

Risk factors and symptoms

Age, genetics and lifestyle are all possible risk factors for colorectal cancer. The disease typically affects men and women age 50 and older, and people are more likely to have the disease if others in their family have had it. Additional risk factors include obesity, lack of exercise, smoking, high alcohol use, and a diet high in red or processed meat and low in calcium, fruits and vegetables.

Colorectal cancer signs are often ignored because the disease may start with few or no noticeable symptoms. Some observable symptoms include:

  • Change in bowel habits.
  • Recurrent abdominal pain or discomfort.
  • Rectal bleeding.
  • Weakness or fatigue.
  • Unintentional weight loss.

How it can be prevented

Regular screening tests, including colonoscopies, are recommended for everyone starting at the age of 50 as well as for people at a younger age who are at high risk of developing the disease. African-Americans should be screened starting at age 45. Colonoscopies can actually prevent colorectal cancer by finding the precancerous lesions/polyps, allowing your doctor to remove them before they become malignant and cause serious harm.

In addition to screenings, changing some of your lifestyle habits can help you lower your risk of colorectal cancer. Proactive lifestyle changes include exercising regularly, opting for a diet rich in vitamins and calcium, quitting smoking, and lowering alcohol consumption.

Treating colorectal cancer

Treatment depends on the stage of the cancer. Surgery to remove the cancer is usually the first and only required treatment in early stages. However, in more advanced stages, when the disease has spread into nearby tissue and organs, chemotherapy before and/or after the surgery and targeted therapy drugs may also be necessary.

Colorectal cancer is about 90-percent treatable when discovered in its earliest stages. While a colonoscopy may not be a fun experience, it could very well save your life.


Next steps:

  • Learn more about Markey’s gastrointestinal cancer team, which provides comprehensive, personalized care for cancers including colorectal cancer.
  • With other life events keeping her busy, Claudia Hall almost skipped a routine screening for colorectal cancer. She decided to keep the appointment, and it’s a decision that saved her life. Read Claudia’s story.
In 1987, Dr. John van Nagell began the Ovarian Cancer Screening Program. Now in its 30th year, the program is as successful and strong as ever.

Markey’s Dr. John van Nagell celebrates 30 years leading the Ovarian Cancer Screening Program

As a native Kentuckian, Dr. John van Nagell has always appreciated the impact UK has in the Commonwealth.

Van Nagell earned his undergraduate degree at Harvard University and his medical degree from the University of Pennsylvania, but his goal was to return to Kentucky to practice medicine.

“I always wanted to come home,” van Nagell said. “And when it came time for me to decide where I wanted to undergo further training, the University of Kentucky had just opened an outstanding new medical center.”

Specializing in gynecologic oncology – the diagnosis, research and treatment of women’s cancers – van Nagell joined UK HealthCare as a resident in 1967, about 16 years before the creation of the UK Markey Cancer Center. He’s spent his career at UK treating patients and mentoring young doctors, but his lasting legacy will likely be his research.

In 1987, van Nagell started Markey’s Ovarian Cancer Screening Program, an ongoing research endeavor that provides free ovarian cancer screenings by transvaginal ultrasound to women across Kentucky.

‘Committed as ever’

Now in its 30th year, the program has provided free screenings to more than 46,000 women and found 775 ovarian tumors and 103 malignancies. Screenings are provided to women over the age of 50 and to those over the age of 25 who have a family history of ovarian cancer.

“We’ve been able to detect ovarian cancer at an earlier stage in many women, rather than just waiting for symptoms to occur,” van Nagell said. “The survival rate of women in our program who have ovarian cancer is roughly double that of women who didn’t get screened.”

Although the use of transvaginal ultrasound as a screening method has been controversial – with critics suggesting it may lead to unnecessary surgeries – van Nagell emphasizes that newer technologies such as molecular genetic testing will help doctors identify at-risk women who could most benefit from screening. The research program has also taught physicians more about finding malignancies, van Nagell said.

“We now know, because of this screening program, that certain ovarian cysts are always benign,” he said. “What we’re saying is more research needs to be done, and we’re doing it. And if we can provide free screening along the way to an at-risk population, that’s beneficial.”

With 50 years of experience at UK under his belt, van Nagell says he remains “as committed as ever,” still dedicated to perfecting the work he began three decades ago for his patients.

“All you have to do is go back into the clinic and see one case after another of ladies coming in with advanced ovarian cancers who had no early symptoms, and by the time their symptoms developed, their disease was incurable,” he said. “And the most fulfilling part is just seeing women who didn’t realize something was wrong but had a potentially fatal disease, which we were able to detect through screening, successfully treat, and now they’re fine.”

Dr. van Nagell honored by his peers

Regularly cited as one of the “Best Doctors in America,” van Nagell recently received another major accolade from his peers. Earlier this month, he attended the 2017 Annual Meeting on Women’s Cancer in Baltimore, where he was presented with the Society of Gynecologic Oncology’s Distinguished Service Award. This award recognizes individuals who, over an extended period of time, display a continuous outstanding meritorious service in the field of gynecologic oncology.

“To be honored by your peers is very special,” van Nagell said. “And I believe that – at least in some small way – this validates what we have tried to do here, and that is to improve the early detection of a very serious disease. To me, it’s all about the lives of people who have been changed for the better by the screening program.”


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Todd Svoboda

Former Wildcat teams up with Markey experts to beat rare bone cancer

Although he rarely played, Todd Svoboda was a universally adored member of the 1993 UK men’s basketball team that made it to the Final Four, and will forever be linked to the Big Blue Nation.

Years after he hung up his basketball sneakers, Todd’s bond with UK became even stronger when he was diagnosed with a rare form of bone cancer. With the same toughness and perseverance that helped him on the hardwood, and with the help of an expert team at the UK Markey Cancer Center, Todd faced his disease head on.

Read Todd’s story and watch our video to find out how Todd is doing today.


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precision medicine symposium

Video: Markey hosts inaugural Precision Medicine Symposium

The UK Markey Cancer Center on Wednesday hosted its inaugural Precision Medicine Symposium, aimed at teaching oncology healthcare providers how to implement precision medicine into their clinical practice.

Precision medicine in cancer treatment focuses on understanding genetic mutations and using those mutations to select the best therapy for patients. Precision medicine is one of the recommendations highlighted by the White House Cancer Moonshot’s Blue Ribbon Panel. Presentations at Wednesday’s symposium included discussions about oncogenomic testing, Markey’s new Molecular Tumor Board, clinical trials and more.

Attending the symposium were more than 190 providers, including oncologists, hematologists, pathologists, radiologists, oncology nurses, researchers, pharmacists, genetic counselors, and cancer center administrators and leaders representing more than 20 different medical centers and healthcare entities across the region.

Breakout sessions allowed providers to meet in smaller groups with presenters and ask questions about precision-medicine issues, such as payment and reimbursement for Molecular Tumor Board recommendations.

The symposium concluded with a keynote speech from Dr. Shridar Ganesan, chief of molecular oncology at the Rutgers Cancer Institute of New Jersey.

“This event is so important because we want to bring precision medicine to all patients with cancer in Kentucky,” said Jill Kolesar, PhD, co-director of the Markey’s Molecular Tumor Board. “We’re bringing together clinicians and scientists to bring initiatives from the Markey Cancer Center to the entire Commonwealth of Kentucky.”

Watch a video below for more highlights from this exciting event.


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To increase the number of preventive colorectal screenings, the UK Markey Cancer Center will follow a National Cancer Institute (NCI) initiative.

Markey joins national colorectal cancer screening initiative

The UK Markey Cancer Center is joining a National Cancer Institute (NCI) initiative aimed at improving colorectal cancer screening rates among men and women aged 50 and older from racially, ethnically and geographically diverse communities.

The national Screen to Save (S2S) Colorectal Cancer Outreach and Screening Initiative is led by the NCI’s Center to Reduce Cancer Health Disparities.

Colorectal cancer is the second-leading cause of cancer-related deaths in men and women combined. Kentucky’s mortality rate is among the highest in the country, and more than 800 people in the state die from the disease each year.

Markey’s Mindy Rogers, a community health educator, will collaborate with state and regional organizations and community stakeholders throughout Appalachian Kentucky to conduct the initiative’s culturally tailored education and outreach.

“Colorectal cancer is a screenable cancer. The earlier we can find the disease, the better the chances of survival,” Rogers said. “The intent of this initiative is to provide additional community and regional resources to aid our efforts to improve cancer screening rates and save lives. The S2S effort complements many of our existing colorectal cancer outreach programs conducted by colleagues at Markey and its affiliates, the Kentucky Cancer Program and our local health departments.”

S2S stems from research recommendations from the Cancer Moonshot Blue Ribbon Panel and will be supported by the Geographic Management of Cancer Health Disparities Program Region 1 North, led by Dr. Mark Dignan, the co-leader of Markey Cancer Prevention and Control.


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A new study led by the UK Markey Cancer researchers establishes a novel link between cell polarity and cancer-associated inflammation.

UK study reveals insights into cancer-associated inflammation

A new study led by UK Markey Cancer Center researchers and published in the Journal of Cell Science establishes a novel link between cell polarity and cancer-associated inflammation.

Reactive oxygen species (ROS) are reactive molecules and free radicals derived from molecular oxygen. ROS molecules are part of the immune system’s “killing response” against microbial invasion. Using a 3-D co-culture model of breast cancer cells and monocytes, Markey researchers Ren Xu and Linzhang Li found that disruption of cell polarity is accompanied by increased ROS production, leading to increased inflammation in these cells. The increased ROS production controls monocyte/macrophage infiltration by inducing the NF-kB pathway in mammary epithelial cells. Loss of cell polarity and inflammation are hallmarks of breast cancer development.

Cancer is like a wound that never heals, characterized by the disruption of normal tissue structure and inflammation. However, it is unclear whether and how the loss of tissue organization causes inflammation. Moving forward, figuring out ways to reduce ROS levels in mammary epithelial cells is a potential strategy to limit cancer-associated inflammation and prevent cancer development and progression.

This research was funded through the American Heart Association and the U.S. Department of Defense.


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UK Markey Cancer Center and the Neuroendocrine Cancer Awareness Network will host the 2017 Neuroendocrine Cancer Patient Conference on Saturday, April 22.

Markey to host major conference on neuroendocrine cancer

For the 120,000 patients in the U.S. already living with neuroendocrine cancer, the sudden flushing or recurring stomach aches aren’t symptoms of common ailments. Sometimes they are indications of the rarely-understood neuroendocrine cancer. The UK Markey Cancer Center, in conjunction with the Neuroendocrine Cancer Awareness Network (NCAN), will host the 2017 Neuroendocrine Cancer Patient Conference on Saturday, April 22, in order to provide support and information for those dealing with this disease.

Centered around educating neuroendocrine cancer patients, family members and caretakers, the conference features presentations on recently published information by Markey specialists Dr. Lowell Anthony, Dr. Riham El Khouli and Dr. Aman Chauhan, as well as nationally known neuroendocrine expert Dr. Larry Kvols.

“Because neuroendocrine cancers are relatively rare, many cases of neuroendocrine cancer are misdiagnosed or incorrectly treated,” Anthony said. “It’s our goal to help patients across the country dealing with this disease. This conference is designed specifically for them, with useful information they can use to be an advocate for their own healthcare.”

Specific points of discussion will include the recently FDA-approved drug telotristat ethyl (Xermelo) along with other emerging therapeutics options for managing neuroendorcine tumors and cardinomas. Afternoon sessions include personal presentations from patients on their experiences with the disease, as well as a support group session.

For NCAN president Maryann Wahmann, the conference also provides an opportunity to show patients dealing with neuroendocrine cancers that they’re not alone in their battle.

“Doctors are taught, ‘when you hear hoofbeats, think horses, not zebras,’ ” said Wahmann. “But more than 12,000 times a year in the U.S., the diagnosis proves that those hooves belong to a zebra.”

The conference runs 8 a.m. – 5 p.m. on April 22 at the Griffin Gate Marriott Resort & Spa in Lexington, Ky. To purchase tickets, visit the NCAN registration page.


Next steps:

  • Thanks to our world-class treatment, research and providers, the UK Markey Cancer Center is the only NCI-designated center in Kentucky.
  • In his Making the Rounds interview, Dr. Anthony told us that working at Markey is incredibly rewarding due to its multidisciplinary approach and patient care. Read the full interview.

A routine checkup could save your life – just ask Claudia Hall

While battling a cold and trying to prepare for her daughter’s college graduation party the next day, Claudia Hall considered skipping her annual checkup with her gynecologist in May 2014. The Lexington resident figured she would simply postpone the appointment a week or two. But after finding out the next best appointment time for her was nearly three months away, she decided to go ahead with the checkup.

“I said, ‘No, I don’t want to let that go that long,'” Hall said. “And I tell you that because it saved my life.”

At the appointment with UK HealthCare OB-GYN Dr. Wendy Jackson, Hall underwent the usual tests and checks, including a digital rectal exam, generally performed on female patients over the age of 40. The exam revealed some troubling news: a large mass in Hall’s rectum.

‘A whirlwind’

Jackson made an appointment for Hall to see UK Markey Cancer Center colorectal surgeon Dr. Sandra Beck the following week. Despite the news, Hall said her weekend continued as planned.

“We went on with my daughter’s graduation – that’s something she can’t do over,” she said. “But I was in Markey that next Tuesday, and from then on it was sort of a whirlwind.”

After several rounds of testing, Hall had a diagnosis: squamous cell carcinoma. The news came as a shock to the healthy, fit mother of two who had no family history of colorectal cancer and had received a clean colonoscopy just three years before.

“I was pretty much asymptomatic,” Hall said. “The only problem I had was sort of a pain on the right side of my hip.”

At Markey, Hall first underwent one chemotherapy infusion, a round of oral chemotherapy and 30 radiation treatments over the course of six weeks, all in an effort to reduce or eliminate her tumor prior to surgery.

Team of experts works together

The tumor’s location made it tricky to determine whether its point of origin was the colon or cervix, but it was fortunate that the tumor had not spread elsewhere in her body, Hall said. However, the disease had affected such a large area of her gastrointestinal tract that much of that tract couldn’t be salvaged. After she had recovered from radiation, Hall was scheduled for a complex combined surgery to remove all the areas where the tumor had been, including the entire rectum, anus and the back of the vaginal wall. Beck, along with Markey gynecologic oncologist Dr. Rachel Miller removed the diseased areas, while UK plastic surgeon Dr. James Liau reconstructed the vaginal wall using skin and muscle from her abdominal wall.

“This surgery is not very common, but we often do combined procedures for complicated tumors like this at UK,” Beck said. “It’s great for us to have all the experts in these fields to be able to provide this level of care for our patients.”

As a result of her extensive treatment, Hall is now in remission and has been cancer-free for more than two years. The surgery has left her with one major side effect, though: a permanent colostomy, which is an opening in the body (known as a stoma) that connects the colon to the surface of the abdomen.

Dealing with such a major alteration to the body can be hard for many patients, but Hall is eternally optimistic – and realistic – about her lifelong need for the device.

“It’s been life-changing,” she said. “But I’m blessed. I’m grateful for it, because without it, I can’t live.”

Working to help others

And although the bubbly, energetic Hall describes herself as a “talker,” she says she initially didn’t share many details of her battle with cancer.

“Part of it could have been the type of cancer, because you know not everybody wants to hear it,” Hall said. “I didn’t share it with many people, just my family and a few close friends.”

In 2015, Hall joined Markey’s Patient Advisory Group, a committee of cancer survivors who meet once a month to discuss issues and offer ideas on various facets of the patient experience at Markey. Meeting other survivors and hearing their stories inspired her to be more open about her personal ordeal.

“I thought I might be able to help somebody with my story,” she said. “And I started talking about it just a little bit more here and there.”

Through her connection with the advisory group, Hall was one of a small group of patients to attend Markey’s Cancer Moonshot Summit last summer, held in conjunction with the national Summit hosted in Washington, D.C. More than 100 people attended the summit, including cancer physicians, researchers, staff, patients, caregivers, philanthropists and others who play a role in cancer care. As an attendee, Hall worked with a team of healthcare staff to discuss barriers to cancer research and care, creating a list of specific problems and suggested solutions that were sent directly to the White House for consideration.

She’s also become passionate about educating others about another procedure that has made life with the stoma a little easier – a process called irrigation, which allows the patient to regulate their bowel movements to a schedule, reducing the need for the actual colostomy bag. Now that she’s familiar with the process, she says she sometimes gets called in by her doctors to counsel other patients dealing with similar issues. Her willingness to accept the changes to her body and move forward makes her an inspiration to others, Beck said.

“No one wants to have their body altered to fight cancer,” Beck said. “But she has really taken ownership of her health and embraced the ‘new Claudia.’ She has remained positive and has always worked with us as part of her team.”

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At UK HealthCare, you’re a part of a team

The “team” aspect of Hall’s care is important ­– in total, six different specialists and their respective staffs cared for Hall throughout her treatment. From Jackson’s initial discovery and referral from Hall’s annual exam, to the chemo prescribed by Markey medical oncologist Dr. Philip DeSimone and the radiation schedule given by radiation oncologist Dr. William St. Clair, to the combined surgeries performed by Beck, Miller and Liau, Hall experienced a range of care that only the most advanced medical centers in the country can provide. As the “lead” on her care, Hall says Beck gave her a pep talk on the importance of being part of the team before treatment began.

“Initially when I went to see her – I’ll never forget this – she said, ‘We are a team here,'” Hall said. “‘I’m your coach and you’re my quarterback.’ And we really are a team at UK.”

These days, life has largely returned to normal for Hall, who still maintains an active lifestyle. She and her husband regularly boat on Lake Barkley, and she enjoys cooking, exercising and watching after her “grand-dog,” Kona. She stresses the importance of being proactive in your own healthcare, noting that knowing about any potential health risks is far better than not knowing.

“I was doing everything right, and it just happens sometimes,” she said. “But I’m very thankful I didn’t skip that appointment that day, because I’ve often wondered what would’ve happened if I’d waited.”


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DanceBlue has always been "For The Kids." "For The Kids" may seem like three simple words, but for the DanceBlue community, those words mean everything.

DanceBlue celebrates more than a decade of dancing ‘for the kids’

DanceBlue celebrated its 12th-annual 24-hour dance marathon this past weekend, raising nearly $1.8 million “for the kids.” The group’s slogan is just three simple words, but for the DanceBlue community, “for the kids” means everything.

DanceBlue is UK’s largest student-run philanthropy and has raised more than $11.5 million since 2006 in support of cancer patients, their families and cancer research.

Thanks to 12 years of DanceBlue’s fundraising, UK opened the new, state-of-the-art DanceBlue Kentucky Children’s Hospital Pediatric Hematology/Oncology Clinic earlier this month. In addition to fundraising, DanceBlue students also volunteer about 1,000 hours in the clinic each year, bringing smiles and laughter to patients and families.

“The students have a real commitment to our patients,” said Dr. Lars Wagner, chief of pediatric hematology and oncology. “They build relationships, then they work hard to raise funds to help support these very kids that they’re getting to know and care for.”

Rachel O’Farrell, a social worker in the DanceBlue Clinic, agreed and said the support patients and their families get from DanceBlue students is invaluable in their treatment journey.

“I think it’s huge to see what it means to patients and families to know that there’s a whole community standing behind them when they’re going through such a difficult experience,” O’Farrell said. “Many of our families feel very lonely, but when you know that there are 900 to 1,000 students dancing and standing for 24 hours to encourage and support your family  I think that holds a lot of meaning.”

Watch the video below to learn more about DanceBlue’s mission and how the group has helped improve cancer care for kids across the Commonwealth.


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This year's DanceBlue event raised nearly $2 million in support of pediatric cancer, with part of those funds going toward the new DanceBlue Clinic.

DanceBlue raises nearly $1.8 million for pediatric cancer patients

Nearly 1,000 UK students spent 24 hours on their feet this weekend, dancing as part of the UK DanceBlue Marathon. It was the culmination and celebration of a yearlong fundraising effort that raised almost $1.8 million for pediatric cancer patients and their families.

DanceBlue the largest student-run philanthropy organization at UK  celebrates its yearly fundraising efforts at the DanceBlue Marathon, an all-day, no-sitting, no-sleeping event that honors those affected by childhood cancer. This year’s celebration took place on Feb. 25 and 26 and included a family talent show featuring children from the clinic and an emotional memorial hour to remember those who lost their battle with cancer.

Since it began in 2006, DanceBlue has raised more than $11.5 million for the Golden Matrix Fund and the DanceBlue Kentucky Children’s Hospital Pediatric Hematology/Oncology Clinic, which is named in honor of the group. DanceBlue’s fundraising efforts over the last several years helped support the renovation of the new DanceBlue Clinic, which opened in early February.

“For the last 365 days, students at the University of Kentucky have been on a mission to fight pediatric cancer,” said Richie Simpson, the overall chair of DanceBlue. “They have come together to be a part of something so much greater than any one individual, and for the last 24 hours they have literally taken a stand against cancer. They refused to accept the realities of cancer, and they showed the families in the DanceBlue Clinic they are not alone and will never be alone as they face some of the toughest circumstances life can throw at you. It has been an honor to stand alongside students at the university who are so committed to making a difference and changing the world.”


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