It's March. And that means it's the national month for Brain Injury Awareness, Endometriosis Awareness, Nutrition Awareness, Eye Health and Safety Awareness, Multiple Sclerosis Awareness, Sleep Awareness, Problem Gambling Awareness and my favorite, for the purposes of The Cancer Blog -- Colorectal Cancer Awareness.

Colorectal cancer -- cancer of the colon or rectum -- is a disease that affects both men and women and is preventable nearly 90 percent of the time.

Starting at age 50, men at women at average risk for the disease should get screened. Those with increased risk, like African-Americans who typically develop colorectal cancer at younger ages, should be screened even earlier.

Screening -- by way of fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy -- is critical because colorectal cancer often occurs with no symptoms. Symptoms do sometimes present themselves in the later stages of the disease and include rectal bleeding, bright red blood in or on the stool, change in bowel habits, stools that are narrower than usual, general stomach discomfort, diarrhea, constipation, frequent gas pains, unexplained weight loss, constant fatigue, and vomiting. Persistence of any of these symptoms for more than two weeks warrant an immediate visit with a health professional.

Treatment for this disease, which strikes about 153,000 people and causes about 52,000 deaths each year, includes surgery, radiation, and chemotherapy.

In the spirit of this National Colorectal Awareness Month, experts recommend remembering these important points:

• Colorectal cancer can be prevented.
• Screening for the disease can identify polyps -- grape-sized growths in the colon and/or rectum -- that can be removed to prevent cancer from developing.
• The magic age for screening is 50 -- unless you have an increased risk for the disease.
• Colorectal cancer is treatable.
• Regardless of your age, know the risk factors, know the symptoms, and know your family history.
• Talk with your health professional about colorectal cancer and your own risk for the disease.

Women in England are not showing up for their annual pap tests. And their absence from this critical screening opportunity is increasing their risk of cervical cancer -- a cancer that is curable if detected early.

New figures reveal that 660,000 women between the ages of 25 and 29 are invited for screening in England. Nearly 80 percent of these women accepted their invitations and reported for their tests in 1995 -- but only 69.4 percent did so last year. Women aged 30 to 34 are also down in attendance -- by about 800 women per week. Essentially, this means about 2,000 women each year who have pre-cancerous cells are missing the chance for early detection and diagnosis.

The Department of Health, now investigating the falling figures, attributes the decline to perhaps a not-so-successful screening program, discomfort about the procedure, or fear that the experience will be embarrassing.

Battling cancer can at times feel like slowly paddling upstream against currents that are both forceful and unforgiving. Sometimes reprieve comes only when we find others in the same boat, others submerged in their own rough waters, others who truly know what it's like to navigate a dreadful disease.

I am lucky -- in an odd sort of cancer way -- because I had breast cancer. Many women have breast cancer. And while this really is a horrible fact, it makes for a great sea of support. At times when I felt I was drowning in cancer, I reached for my lifeguards -- the women who paddled before me, the women paddling alongside me -- and they coached me, guided me, saved me from one the worst side effects of cancer. Isolation.

I have rarely felt isolated in my cancer journey and as a result, I have not thought much about this lonely cancer consequence. But I am thinking about it now -- thanks to a reader who has courageously shared her story with me, in hopes of locating someone in her same boat, in hopes of creating connections with other survivors who share the challenges of her disease.

Tanya has anal cancer. She was diagnosed one year ago -- during a routine colonoscopy -- with squamous cell carcinoma in-situ in her anal canal, on the wall between the anus and vagina. Previous abdominal discomfort, much like dull menstrual pain, preceded Tanya's screening but she was sure it was due to menopause. She was 53 at the time.

But it wasn't menopause. It was cancer. And it was devastating for Tanya who was spared radical surgery in exchange for a combination of radiation and a chemotherapy called the Nigro Protocol. First came a mitomycin push followed by four to five days of 5-Fluorouracil. Radiation came next -- for six weeks -- and then Tanya endured another round of the same chemotherapy regimen.

"The treatment was brutal," Tanya says. "By the end of the sixth week, I was in a lot of pain, especially since the affected area had a lot of traffic and could not exactly be decommissioned and allowed to heal."

Although she was told by her oncologist she tolerated her treatment well, Tanya says it was pure hell.

Tanya's treatment ended in March and an August biopsy revealed she is doing just fine. Her cancer appears to be gone. What is not gone, however, is the discomfort that still plagues her -- both physically and emotionally. And while the physical scars are simply terrible -- she feels pain during urination and bowel movements and is currently unable to have intercourse with her knight-in-shining-armor husband -- the emotional isolation is overwhelming distressing.

"I have not shared this experience with too many people since I feel awkward discussing that part of my anatomy and because the condition is so uncommon," Tanya says. "I would, however, be most grateful to discuss any or all of this with someone who has been through the same experience."

If you have been in Tanya's same cancer boat, have paddled similar waters, or know someone with whom she might connect, please consider contacting this brave survivor at sultana@cyberight.net.

Sometimes all it takes is a small gesture to warm the heart of a cancer patient. It doesn't take anything huge. It shouldn't cause any stress or discomfort. And it shouldn't require a whole lot of thought. It should be simple. Simply simple.

A whole lot of small gestures spread a whole lot of cheer my way when I was knee-deep in cancer treatment and needed a lift. Cozy socks kept my feet and my spirits toasty. A package of brownies sweetened my sour days. Flowers brightened my dining room and my state of mind. Books left on my doorstep delivered knowledge and wisdom and a bit of humor to my world.

The options for spreading sunshine are endless. The list of possibilities could go on and on. Here is just a start -- a small list of small gestures that can make a dreary day downright delightful.

Give a hug
Send a handwritten letter
Make a homemade card
Write a poem
Give a journal
Deliver a candle
Make a home-cooked meal
Arrange for food delivery
Babysit children
Play with children
Drive to appointments
Go wig or hat shopping
Visit during chemotherapy sessions
Give something comfy -- socks, pajamas, hat
Do grocery shopping
Accompany to lunch, dinner, movie
Take a walk
Attend church
Have a picnic
Go fishing
Make a donation to favorite charity
Walk, run, volunteer, raise funds in honor of your special someone

Be specific in your gesturing. Trade a comment like "let me know if I can do anything" for "I'm going to come over and wash and clean your car on Saturday." Vague offers are rarely successful -- cancer patients are not likely to recall every general offer they receive and then manage them all into a schedule. It's just too much to consider in the midst of turmoil. But an offer that comes to life right before them is easy. It's effortless. It is truly a gift. A simple, priceless gift.

Testicular cancer, cancer in one or both of the testicles, usually occurs in young men and will strike about 8,250 of these men this year. About 370 men will die.

A man's lifetime risk of developing this cancer -- that typically shows up in only one testicle -- is 1 in 300, securing it as one of the less common cancers in the United States. The chances of dying from testicular cancer are 1 in 5,000, making it one of the most curable forms of cancer. Yet it is still the most common form of cancer in men ages 15-34. It is also a cancer commonly characterized by denial and embarrassment. As a result, it is one of the least mentioned cancers.

I have a new friend who is a new breast cancer survivor. She is surviving a new diagnosis, a recent lumpectomy, and the moments leading up to another surgery to further investigate the margins surrounding the tumor removed from her breast. She is surviving the first phase of her breast cancer journey. A phase full of uncertainty and fear and panic. A phase so new and so fresh and so raw, her mind is whirling. A phase that has her grasping for any bit of direction she can find as she navigates a terrifying, unfamiliar road.

My friend is a young wife and mother whose worries are consuming her. She e-mailed me today and asked if I ever have moments when I look at my young children and worry that cancer will take me from them while they are young. She asked if I have always been so sure I will be okay. And so I replied with this candid cancer confession.

I didn't know what was coming when I plopped myself down in the waiting room of an Ear, Nose, and Throat clinic yesterday -- which is a good thing. Had I known what doctors would do to me, I may have run the other way. I may have learned to live with the pain I was experiencing each time I swallowed food. But I waited patiently, aware that doctors would "scope" my esophagus, mildly certain the procedure could be uncomfortable, completely unprepared for the full "scope" experience.

I swallowed a pill on Friday night -- not even a whole pill, just a half of one pill -- and it hurt when it went down my throat. I've had the feeling before, a sensation like the pill got stuck, but the discomfort has always gone away within a few hours. This time, it lasted. It hurt to swallow saliva. It hurt to swallow food. It just hurt. So after three days, I took myself to the clinic -- with the subtle worry that cancer was settling in my esophagus.

I know rationally that every ache and pain I experience is not cancer. But I've had cancer. And so I constantly battle a nagging fear lodged deep in my head that reminds me cancer is always a possibility, that cancer is often a shocking outcome of a routine little test for a simple little health concern.

I do not have cancer. I do not have cancer of the throat, voice box, esophagus, or stomach. That's the good news. The scope revealed -- via a tiny camera that traveled through my body -- nothing but healthy tissue. That makes me happy. The test did not make me happy.

I now know the scope is a long, thin tube that enters the body through one nostril. Ouch. It travels into the throat. Ouch. The patient swallows when it reaches the throat to assist in maneuvering it down further. Ouch. The scope then makes its way past the voice box, though the esophagus, and into the stomach. Ouch. Ouch. Ouch. The travels are all displayed on a monitor, and I actually got a glimpse of these body parts -- during the split second when I was able to control my gagging, loosen my grip on the arms of the exam chair, and open my clinched eyes. So I saw for myself that everything looks healthy -- just before the tube was pulled right back through all these parts, leaving me with a very sore throat.

Now that I am home and have talked with a few people, I hear that some patients are unconscious for this procedure. They are completely unaware of the horrors of the scope. I got a few sprays to numb my nose and throat and drank a thick cocktail of lidocaine -- but I did not get the luxury of unconsciousness. And in the end that is okay. I got to see what was happening. I got to hear the doctor's revelation that nothing major is wrong. I got to witness the wonder of medical technology. I got to prove to myself that I can handle a little discomfort in exchange for a clean bill of health. And I got to learn that I have a bit of acid reflux. And now I have to squash that nagging fear that reminds me of the literature out there suggesting a link between acid reflux and cancer.

Screenings for colorectal cancer offer more than a chance for early treatment -- they offer the chance to avoid cancer completely. The disease usually starts with growths called polyps that can take a decade to turn cancerous. If polyps are found and removed, cancer can be avoided altogether. Yet many are avoiding the screening. And polyps that go undetected can turn to a cancer that can lurk silently in anyone -- especially during middle age and beyond. And black Americans are especially at risk.

Almost 42 million Americans over the age of 50 are not getting checked for colorectal cancer -- the nation's No. 2 cancer killer. Perhaps it's the financial burden that comes with the life-saving procedure. Now in five states, a government-funded program is offering free testing for the poor. But still, many will fall through the cracks in many states. And while Medicare pays for screenings, this federal program is for people 65 and older -- a long wait for someone at age 50 who needs the test but does not have insurance.

Perhaps it's the part of the body under study that steers people away. Perhaps it's the manner in which the test is performed -- a long, flexible tube is used to visually inspect the colon -- that turns heads in the wrong direction. While the financial burden is a valid deterrent, other worries or fears should be put to rest. The test is not all that bad, says one doctor who had a colonoscopy himself. The worst part of the whole experience may be the liquid mixture that is consumed prior to the test that cleans out the system -- minor discomfort really in the scope of the alternative. Cancer.

Colonocopies are recommended just once every 10 years. And nearly 60 percent of deaths from colorectal cancer can be prevented if each person over the age of 50 finds some way to make this screening happen. And if not this screening, there are other options -- like a fecal test that is done annually but is more more affordable and can be quite effective too. So consider your options. And make a choice.

It seems like common sense to me -- that lifestyle choices can affect a person's risk for contracting cancer -- but apparently, many people are not aware of this. Or they are aware but are not heeding the advice that might just save them from this life-threatening disease. According to Carolyn "Bo" Aldige, president of the Cancer Research and Prevention Foundation, in Alexandria, Va., it's not undiscovered treatments and therapies that are key to fighting off cancer -- it's likely that the toll cancer takes can be reduced by lifestyle changes and routine screenings. Aldige reports that nearly half of all cancer deaths are preventable. And she urges us to consider these facts.

• Smoking is the most preventable cause of death in the United States and causes nearly one in five deaths, killing about 438,000 Americans each year. Yet 45 million adults still smoke -- 23 percent of them men and 19 percent of them women.
• Poor nutrition, inactivity, and obesity account for one in three of the 564,830 deaths from all cancers. Experts say that excess calories cause mutations that start genes traveling down pathways that cause cells to divide out of control -- and that's what cancer is. According to Aldige, if each person could magically acquire the perfect body mass index, there would be a whole lot less colorectal, breast, and prostate cancers.
• It requires little time and not much discomfort for certain screenings that can detect cancer at an early enough stage that it can be successfully treated. There are already screenings for breast cancer, colon cancer, prostate cancer, testicular cancer, cervical cancer, and skin cancer. And soon, there may be a simple screening for lung cancer too.
• A diet rich in nutrients and vitamin supplements helps maintain health and prevent cancer.

There are some highly effective defenses against cancer -- but they require some attention and effort on the part of each individual. Not everyone will make health-conscious choices -- some for reasons out of their control (lack of access to screenings, for example) and some for reasons I personally do not understand. But maybe that's because I have already had cancer and I know that I don't ever wish for it to return. So for that reason alone, I plan to adhere to the considerations listed above. It seems like common sense to me.

Before my radiation for breast cancer, I heard horror stories about the treatment. I heard that I might be extremely tired and severely burned and that I might feel generally unwell for the time it would take to completely zap any and all traces of cancer surrounding my breast. But my own radiation wasn't all that bad -- and really, the worst part of the whole therapy for me was the drive to and from the cancer center every day for seven weeks. It was a hassle, a nuisance, a bother. There were other small annoyances throughout the course of my radiation, but they were minimal -- thanks to some secrets that were shared with me along the scorching path of radiation and beyond. And here are seven of them.