It was cancer.

Worse yet, it was stage four colon cancer. It doesn't get any worse than that.

Had we caught it in stage one or stage two, the doctors would have had options. Even if we had caught it in stage three, she would have had a fighting chance.

But stage four colon cancer was Randee's death sentence. And while she battled courageously and remained optimistic in the months that followed, she knew what the outcome would be.

I'll never forget that day when we returned home from the doctor's office after getting the final verdict. My brave wife broke down in tears, sobbing, "I'll never see my grandchildren."

It was the day my heart was broken.

It was the spring of 2002 when she was diagnosed. She would be gone by that fall.

We learned much about the deadly disease in that six-month period—that colon cancer is 90 percent preventable through early screening and detection, that screening for polyps should begin at age 50, that people with a family or personal history of colon cancer or polyps should be tested earlier.

Randee was 52 years old when she was diagnosed, and she had a family history of the disease.

We just didn't know.

As it turns out, our lack of information and knowledge about the disease had a tragic end. But the greater tragedy is that it didn't have to end that way.

Early detection is the key to combating colon cancer. What's more, many doctors insist that no one should lose their life to the disease—that it is preventable as long as it is detected in its pre-cancerous form.

"My suggestion is that we actually talk about colon cancer elimination," says Dr. Richard Adrouny, a Monte Sereno resident and Los Gatos oncologist. "This is a disease we could truly eliminate."

"This is actually a preventable disease," agrees Dr. George Fisher, an oncologist at Stanford Hospital. "It's a disease that hasn't been popular to talk about, whether it's because of the part of the anatomy that's involved or the testing that's used."

"It's not pleasant to think about it, and for some people the concept of a colonoscopy is out of the question," he adds. "But if we can get over that hurdle to get that test, we can diagnose it early. The more we can get the word out, the more families we will be able to save from this.

"If we can prevent this disease, I'll be happy to be put out of business."

The city of Monte Sereno is doing its part, and more. The Monte Sereno City Council, at the request of Dr. Adrouny and Gay Crawford of the American Cancer Society, has taken a bold, major step.

Monte Sereno a leader

Monte Sereno became the first city in the nation to step forward and pledge to become a colon cancer-free zone.

Councilman Mark Brodsky worked with Dr. Adrouny to turn the concept into a reality.

"I walked him through the city process," says Brodsky. "We weren't going to start subsidizing everybody. We just wanted to provide more moral support."

"What we offered was a free pass to put together a plan," says Brodsky of the council's approval of the project. "What we sent to the city manager was to do whatever he needs to make this happen."

Brodsky was open to the concept because of a personal experience with the disease.

"A friend—my big brother from my fraternity—went to the doctor with a bleeding hemorrhoid that wasn't healing," recalls Brodsky. "It turns out he had a tumor the size of his fist."

Doctors were able to remove the tumor and save his life, but Brodsky gained an understanding of the disease that can be a killer.

"Awareness is the real big benefit," he says. "This program will cost us nothing to do something right. Now people can talk about this. Now it's clear that when you're 50 you must do this."

"We need someone like Richard, who is a zealot," Brodsky says of Dr. Adrouny.

It was Adrouny who took the message to the Monte Sereno City Council.

"We were approached by Dr. Adrouny, who made a presentation to our council, asking us to be a pilot city for the study of colon cancer awareness," says Monte Sereno City Manager Brian Loventhal. "The council was receptive and embraced the idea of being a conduit of information for our citizens."

Monte Sereno is a small, homogeneous community, with an older, more affluent population. Its population is just under 3,800, and of that 25.8 percent is over age 65—the county average is 9.5 percent. Adrouny and the American Cancer Society saw the city as an area they could get their arms around well enough to get the program off the ground.

"God bless Monte Sereno, because they started this," says Crawford. "It's our hope to start with one community in a grass-roots effort, then go from one community to the next."

The snowball effect would grow the effort to a level that could eventually lead to the eradication of this horrible disease. And it appears that the snowball is rolling.

The town of Los Gatos stepped forward with a proclamation delivered by Mayor Steve Glickman to support the project, and the city of Saratoga has taken it one step further.

Mayor Ann Waltonsmith read a proclamation from the city at its March 3 council meeting in support of the American Cancer Society and Colorectal Cancer Awareness Month, and further indicated that the council would agendize the item for discussion of a possible colon cancer-free zone at a later date.

"We've been issued a challenge by the city of Monte Sereno, asking all cities to take up the fight," she said. "We urge all employees and residents to become aware."

Community Hospital of Los Gatos and Good Samaritan Hospital already have. The two health-care facilities have pledged to become cancer-free zones and will participate in a screening program this month.

Hospitals join the zone

"We're participating," says Daniel Doore, CEO at Community Hospital. "What we're trying to do is to get [employees] to pledge participation in the program personally."

"We've done some preliminary work with people," he adds. "People are interested, they're excited about it. They think it's a good thing to do."

Bill Piche, CEO at Good Samaritan Hospital, also has his staff on board.

"As health professionals, they all see a need for this," says Piche, referring to the hospital's 2,000 employees and 800 doctors on its medical staff. "Sixty percent of our employees are in the risk category, and that's a significant number."

"We're trying a variety of awareness and educational means to make sure the word is out regarding the wonderful preventability of this disease," adds Piche, who credits Dr. Adrouny, Crawford and the American Cancer Society for getting the program started. "This is going to be an ongoing campaign, a lifestyle-modification activity. The opportunity for prevention is just incredible."

Piche understands the need for colon cancer screening, especially considering the results of a medical-screening activity provided to retired doctors at Good Samaritan.

"We offer a wellness program for retired medical staff, offering a panel of screening activities," he says. "In 2003 alone, we picked up three cancers that the physicians didn't know they had.

"They came in and said that they wouldn't have picked this up without the screening. It just shows you that it can even happen to people at the top of the pyramid in medical knowledge."

Knowledge is the key

Nick Tuttle of Los Gatos suffered a fate similar to that of Randee.

Nick was in his late 50s when he was diagnosed with colon cancer. The disease shows no mercy for those who are tested too late—he was given 14 to 16 months to live.

But Nick was a fighter. Despite the fact that the cancer had already metastasized and had invaded his liver, as it had in Randee's case, Nick fought courageously to survive and had an active life for more than 27 months. The end came swiftly on the day after Thanksgiving last year.

"He had no regrets in life, except one," says his 34-year-old son, David, "that he hadn't been tested earlier."

But there are no symptoms for this deadly disease, no signs. It's a silent killer.

"He grew up as an only child, and he internalized a lot of things," David says. "And the way he fought this disease was internal. We didn't know how much he was suffering."

Nick was suffering not only from the effects of the cancer, though. He was also dealing with an internal struggle over his failure to get the test.

"He was so mad at himself for not getting a colonoscopy," adds David. "But like most men, he went to the doctor about every two years, and every time he'd get a clean bill of health. That's what was so frustrating for him. He just didn't recognize what he should have done. He was a very smart man, and he felt he should have been smart enough to realize it."

Marvin Kohn of Saratoga didn't realize the importance of early testing either. But Marvin is one of the lucky ones, if it's possible to call a colon cancer victim lucky. Still, he is a survivor.

Marvin was in his 70s before he was ever tested for colon cancer, and then it was almost by accident. He tested positive, and the degree of his illness had already reached stage three.

"My former primary care physician, and I emphasize former, never suggested that I get tested," says Kohn. "I'm 72—I should have been tested two, probably three times."

"It was a very weird circumstance," he adds. "My primary care physician was more concerned with my allergies, so he sent me to an allergist. The allergist said, 'You don't look right.' "

Tests determined that Kohn was anemic. The cause: blood seeping from his tumor.

"If it hadn't been for my allergist, I never would have known it," Kohn says of his cancer. "I owe him a great debt of gratitude."

Kohn was diagnosed in August of 2003, and he underwent colon surgery in September. He has one session remaining in his chemotherapy program.

His advice to others: "Get that damn colonoscopy," he says. "This is a life-saving procedure, even though the preparation is lousy."

Getting support from others

Kohn is a member of the colon cancer support group that meets each week at the American Cancer Society offices on Bascom Avenue under the direction of facilitator Linda Ankeny, clinical program manager of oncology services at Community Hospital.

"We had something similar about a year ago, at the request of our medical director, but it wasn't successful," says Ankeny. "But the American Cancer Society expressed a need, and the hospital was willing to partner with them."

Ankeny meets weekly with the group of cancer victims, who run the spectrum.

"Most of them have had their surgery," she says. "Some are in their treatment and others are through with their treatment. Some have just been diagnosed and some are two years out. But most of them are in the advanced stages."

All of the support group participants, though, share one common theme.

"They become the voice of the colon cancer screening process, because they know how important it is," she says.

Ankeny does, too.

"If I hadn't had it done," she admits, "I would have been one of my patients." She didn't realize that colon cancer had been in her family, but because of early detection, she did not fall victim to the disease.

Her support group members were not so lucky.

"They can talk to each other and relieve each others' anxieties," says Ankeny. "As a group facilitator, I'm there to lend support, and to make sure no misinformation is given out."

That's a goal shared by the American Cancer Society, and there's been much progress made in recent years regarding public awareness of the disease and the screening process.

"There has been an explosion of interest in colon cancer," says Crawford. "And research interest has followed suit."

"It's really a story of hope about the incredible leap of knowledge in the last 10 years," she adds. "Maybe we can change the course of this disease."

Word seems to be spreading fast, and Piche believes that it's just the beginning.

"Good Sam employees come from all over, as far away as the Central Valley," he says. "We have the potential for awareness that will extend well beyond Monte Sereno, Los Gatos and Saratoga."

The awareness effort has already reached doctors' offices.

"This was an area that even family practice and internal medicine overlooked," says Dr. Fisher. "Now it's becoming part of routine care. It's a topic people are no longer afraid to discuss."

The effort now is to get more cities, businesses and organizations to join the cancer-free zone program started in Monte Sereno.

Police chief joins effort

The American Cancer Society approached Los Gatos­Monte Sereno Police Chief Scott Seaman in hopes of getting the department to become a satellite zone along with the two local hospitals.

"It was in support of Monte Sereno and the cancer-free zone that I joined them," says Seaman. "And also, I did it for myself."

While the Los Gatos­Monte Sereno Police Department has not yet joined the movement as a unit, Seaman has discussed the program with individuals in the department. He was surprised at how many indicated that they had friends and family members who had been victims of the disease.

"This was my own personal choice," says Seaman of his decision to get the colonoscopy. "It was surprising how easy it was. It was just a breeze. It's something I genuinely would recommend to people in that age range."

Dr. Adrouny knows the routine all too well. And as an oncologist, he understands the concerns of his patients.

"The biggest problem is the preparation—taking the purgative that cleans out your bowels," he says. But the procedure is well worth the temporary discomfort.

"In early detection, with proper screening, we can predict the precursors before they become malignant," he says. "The polyp is a benign growth of which we believe that 90 percent of cancers grow. And we can remove that pre-cancerous polyp and remove the risk."

Dr. Adrouny became an expert in the field when University Press of Mississippi approached him about writing a book, Understanding Colon Cancer.

"At the time I had no particular expertise in that area, but I would see it routinely as part of my practice," he says. "As a result of the book, I got more interested in the topic of colon cancer."

"Then the idea popped into my head that this is truly a preventable disease," he adds.

It wasn't that much later that concept of a colon cancer-free zone was born.

"This idea has been kicking around for a while," says Dr. Adrouny. "And Monte Sereno—a small community, well educated, older population—sort of fit a picture of a community that we could really get a handle on."

The goal of the program is spelled out in the American Cancer Society mission statement for a colon cancer-free zone:

"Our mission is to increase public awareness of colon cancer and to help reduce the incidence of this disease to the lowest rate possible in each community where we launch this program."

The major goals are to increase public awareness of colorectal cancer and to encourage adults over age 50 to get the proper screening. Monte Sereno is carrying the torch.

"Monte Sereno deserves the credit for accepting this challenge—for having the foresight and wisdom to take this on," praises Dr. Adrouny. "It's a great community service, and Monte Sereno is going to be challenging its neighboring communities to become zones as well."

But the effort goes far beyond any challenges or zones—the underlying goal is to eradicate this silent, deadly disease now ... before any other good, caring people like my wife, Randee, and Nick Tuttle miss an opportunity to share the lives of their grandchildren.

EARLY DETECTION THE KEY FACTOR TO PREVENTION OF COLON CANCER

March is Colorectal Cancer Awareness Month, and the American Cancer Society is supporting the effort through a unique grass-roots effort to get communities, churches and organizations to proclaim themselves a Colon Cancer Free Zone, an awareness campaign to educate people that the disease is preventable with early screening.

Quick facts about colon cancer:

* Colon cancer affects both males and females equally.

* Colon cancer is 90 percent preventable when detected in its early stages.

* Screening is one of the best ways to prevent colorectal cancer.

* Screening for polyps should begin at age 50.

* Polyps can be removed before they become cancerous.

* People with a family or personal history of colon cancer or polyps should be tested before age 50.

Community Hospital of Los Gatos and Good Samaritan Hospital have scheduled a series of free lectures. Events remaining in the series:

* March 9, 7­9 p.m., in the auditorium at Good Samaritan—Dr. Peter Youn will lead the discussion.

* March 23, 6:30 p.m., in conference room 1 and 2 at Community Hospital—Dr. Richard Coughlin will discuss nutrition, and Dr. George Fisher will discuss clinical trials.

* March 30, 6:30 p.m., in conference room 1 and 2 at Community Hospital—Dr. Richard Adrouny will discuss medical treatment and genetics, and Sally Tally, R.N., will discuss ostomy care.

Good Samaritan Hospital is located at 2425 Samaritan Drive. For information, call 408.559.2011 or visit www.goodsamsj.org. Community Hospital of Los Gatos is located at 815 Pollard Road. For reservations call 1.888.257.5476 or visit www.communityhospitalLG.com.

The American Cancer Society is located at 1715 S. Bascom Ave., No. 100, Campbell. For more cancer information, visit http://www.cancer.org or call 1.800.227.2345.