He keeps a healthy diet, rarely has medical complaints and has little time to drop by the doctor's office, so like many Americans over 50, Ted Mathias just didn't get around to taking one of modern medicine's most significant examinations.
In January, the 54-year-old finally went in for his first colonoscopy. To his shock, doctors found a tumor in his lower bowels. And when they operated, they very likely saved his life.
He has a prolific anti-cancer crusader to thank for his good fortune.
March is Colorectal Cancer Awareness Month, and 58-year-old Edel Blumberg of Reisterstown — a volunteer recovery coach with the American Cancer Society — is doing what he does best: using his personal story and engaging personality to tell others of the dangers of colorectal cancer and the simple steps they can take to reduce them.
A three-time survivor himself, Blumberg persuaded Mathias to have the procedure, just as he has done, by his reckoning, for about 100 people — three of whom proved to have cancer.
A human whirlwind with a shaved head and edge-of-profanity humor, Blumberg keeps, in effect, a full-time schedule speaking in public, running an advocacy nonprofit, heading charity events, reaching out to the newly diagnosed, and collaring friends, relatives and strangers, all in order to share a message as clear as he is blunt.
Colorectal "cancer is one of the most treatable forms of cancer if you catch it early," he said moments before he enters a local TV studio for a live interview one early morning. "If you don't, it's deadly. Get tested. Don't let my story become your story."
Colorectal cancer — cancer that involves the colon (basically the large intestine) or rectum — is the third most commonly diagnosed cancer in the United States, according to the American Cancer Society, and the second leading cause of cancer death.
It strikes about one American in 20, including men and women in roughly equal measure. More than 90 percent of those diagnosed are age 50 or older, the cancer society says.
Those who have affected parents, siblings or children run a higher risk, as do those with a history of gastrointestinal problems such as ulcerative colitis or Crohn's disease, researchers say.
The cancer society projects about 133,000 new cases and more than 49,900 deaths by colorectal cancer in the U.S. this year. About 2,300 of the new cases — and 830 of the deaths — would be in Maryland.
If doctors catch colorectal cancer early, the prognosis is good. If it's diagnosed at stage I (when the malignant cells are still inside the colon wall) a patient is 92 percent likely to survive five years, the current definition of a cure.
If it's found at stage II, when cells have just penetrated the muscle wall, the odds are 78 percent; at stage III, when they've affected lymph nodes, they're 60 percent.
Stage IV, where cancer cells involve other organs, is a more desperate story: The odds plummet to 8 percent.
Physicians say everyone over 50 should have a colonoscopy, a diagnostic procedure that requires preparation a day in advance, sedation and the insertion of a colonoscope but is the gold standard in colon cancer prevention.
Patients not in a high-risk category who are found healthy by the tests generally can wait 10 years for the next one, said Dr. Andrew Rosenstein, chief of gastroenterology at University of Maryland at St. Joseph Medical Center and a clinical instructor in medicine at the University of Maryland School of Medicine.
If risk factors are present or an exam detects polyps, more frequent intervals ofsurveillance are recommended, Rosenstein said.
Just 65 percent of American adults are getting screened according to those guidelines, according to the cancer society, which is running a campaign to raise that number to 80 percent by 2018.
Blumberg, to his embarrassment, was once one of the slacker minority. The mistake nearly cost him his life.
Growing up in Pikesville, he was a cantankerous kid and star athlete, but things changed at 13. He was diagnosed with colitis, a form of inflammatory bowel disease that can cause pain, urgency, bloody diarrhea and more.
A year later, he was found to have Crohn's disease, another chronic and severely painful inflammatory bowel disease.
The disorders are severely disruptive — "I spent most of my time looking for the bathroom," Blumberg said — and because they involve parts of the anatomy few relish talking about, many sufferers try to hide their conditions from friends and family.
Not so incidentally, they also increase one's risk for colorectal cancer.
For the next three decades, Blumberg said, he vacillated between squarely facing the problems (getting screened annually and more) and trying to pretend, to himself and others, that they didn't exist.
On occasion, he'd go months or years without serious pain, periods that led him to conclude, falsely, that his problems were over. During one four-year period he even skipped colonoscopies altogether.
"People get into remission and feel better, and they want to pretend it goes away," Rosenstein said. "That happens all the time: 'I don't have to do my screenings.' But inflammatory bowel disease doesn't go away. As a patient, you have to stay committed to your own health."
Despite his history, Blumberg said, he grew complacent. That came to a shocking end in 2003 when doctors found a stage III tumor in his colon. He had cancer.
He underwent surgery, then entered what he calls a "nightmare" period of chemotherapy. In 2006, the news got worse. Physicians found a stage IV malignancy in his colon.
With an 8 percent chance of surviving, he sat down and wrote a farewell letter to his wife and two daughters. Another operation and a thousand hours of even harsher treatments followed.
He pulled through, but seven years after that, a colonoscopy revealed a small cluster of pre-malignant cells, a so-called dysplastic associated lesion, a growth that can progress to colon cancer so quickly that Rosenstein, his doctor, urged a total removal of the colon, known as a colectomy.
Today, Blumberg wears a colostomy bag, an external sack that collects his solid waste. He'd once viewed such a fate as "my worst nightmare." But in Rosenstein's telling, Blumberg quickly reinterpreted it as a rare opportunity — a chance to become, in effect, a human warning sign.
Since 2006, he has pulled back from his former life as an insurance executive, to emerge as one of the 30 men and women who work in the Mid-Atlantic region as "recovery coaches" with the American Cancer Society, according to Carol Brice Hirsch, the president of Within Reach, a private nonprofit that helped create the program.
Hirsch points to the "Semi-Colon Crawl," a 5K charity walk Blumberg runs in Owings Mills that draws hundreds of people each year. She mentions the weekly radio show he had for years, the TV interviews he does every March, his relentless willingness to speak with anyone about his life and decisions.
Mostly, she said, he's an inspiration because he has gone about as far as one can go down the colon-cancer road and still be alive to tell about it.
"As Edel says, he doesn't just talk the talk; he walks the walk. And that makes all the difference," she said.
Ted Mathias agreed. Last fall, his partner, Marcy Emmer, attended the "Crawl" and began pestering Mathias to get tested. A few weeks after that, they ran into Blumberg socially, and he raised the subject again.
Mathias, a software engineer, made his appointment. It's not known how much time he'd have had before his tumor went stage IV. He now faces six months of chemo and possibly radiation therapy, not to mention regular screenings for the rest of his life.
Doctors set his survival odds at 80 percent. "I'm lucky in so many ways," he said.
At 7:45 a.m., a station manager for Fox 45 TV enters the lobby to greet Blumberg. He heads into the studio and takes a seat under the lights. The cameras roll.
"It's [Colorectal] Awareness Month," interviewer Amber Miller said. She peppered him with questions, and Blumberg told his story again. Another Ted Mathias could be watching.