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Colorectal Cancer Screening

Mar 17, 2013|

March is colorectal cancer awareness month. The Roswell team discusses screening options.

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Automatically Generated Transcript (may not be 100% accurate)

This is Roswell rookie by Roswell Park Cancer Institute. Your team opinion or your total options. Your host him -- and welcome back to Roswell incident comprehensive look at all aspects of cancer care treatment diagnosis and research. From a comprehensive source Roswell Park Cancer Institute here in Buffalo, New York. Good morning I'm too -- anger and we're here at Roswell park today to talk about colorectal cancer we'll talk about. How screening is so important how screening really does save lives and we've got some great examples to talk about here. And it is colorectal cancer month this month of October. And go with us to do open the discussion today is doctor Stephen American and assistant professor of oncology in the department of surgical oncology here at Roswell park. Doctor American thank you being here appreciate it thanks for having me all right and this this is your month so we're gonna -- focus on. And the disease that you spent so much time with and it's a serious one and in a very prevalent one -- we'll hear with you today we've got Debbie burns. Debbie you're colorectal. Cancer survivor and very powerful and great story to tell today so thanks for being here cheering appreciated extra point -- Do you know doctor -- community you know it's it's rudimentary for you but I mean. People hear about colorectal cancer. But let let's just do the basics as far as in what -- -- sure well. Colorectal cancer it's their third most diagnosed cancer in the United States. And about 90% of diagnosis. Occurs after the age of fifty. There's been a considerable decrease in the new. In the incidence of colorectal cancer. And pretty much that's due to appropriate screening measures specifically colonoscopy. Is this grey we're here today to talk about screening and why screening works and and how screening can really save lives. But I guess screening is never as good as you would want to be in years in your business so to speak. -- where we met with screening for colorectal cancer it seems to me that we hear a lot about it and that it's becoming. Maybe commonplace is too strong but at least something that's part of the conversation with our primary position. Absolutely it is nice I think we do see that any improved. Or decreased rates of incidence but we need to do better that there's no question. And I think you know having months light. Colorectal awareness month to just get the word out there. How events you know sponsor these events and just increase awareness is one of the most important things that we can possibly do. They're number of cancers out there that don't have. Screening as good -- screening measures as quote colorectal cancer. The fifty encouraging thing with colorectal cancer is that there is a screen you know we talk about breast cancer obviously there's an an annual screen for that. For prostate cancer we have indicators that that people can. Have completed tests that they can have completed so with colorectal cancer. We're fortunate in that that area of cancer that there is a screen. But the important thing is that you get it done. And I guess in the big focus here today is that. Knowing about colorectal cancer early really affects the outcome short. And you know we know from -- Happy geologic and so population studies and and just going out there and and surveys studies. That about 40% of the population still aren't getting -- colorectal cancer screening. And we also know that it works in one of the largest studies to date which actually came out this past year in the New England Journal Madison. Showed that there was a reduction of about 50%. In colorectal cancer deaths. Over a decade and half if you have appropriate colonoscopy is with -- -- -- perform -- your preventing. About 50% reduction in death from colon cancer. By having that procedure and removal of polyps so there's no question more and more data comes out showing the benefits of this. So anyway that we can possibly increase awareness. Any way that we can potentially. You know decrease some of the resistance to getting one or possibly even an embarrassment to getting on these. You know for whatever reason. Anyway that we can improve the rates of getting this this screening measure performed. It's something we've got to them and we have a success story. You know -- -- today and and and others many that I see almost every. You mentioned that politics to me and I think he either ourselves or we know some inner family hero a friend or someone we work with. He's gone through a call and ask being very often we'll hear. I'm fine I don't have to go back for five years they've removed some polyps and and -- were not cancerous they weren't any you know great concern but the removed for a reason. If you didn't have that colonoscopy and you have those polyps that can be concerned on the road for -- -- Right but we do know is that there are some -- polyps that really don't have malignant or cancerous potential. But then narrow -- types of polyps that do and -- removed. Early on it may very well prevent cancers from forming in the future. We see that there is usually a steady progression of normal lining of the -- -- the lining of the colon. Two then some changes that occur within the cells that -- the lining of the colon that. Form polyps in these overgrown its if you well. And then those over gross thing continue to grow and learn some different tricks. And learning those different tricks of start to reconvene within the wall is then now when it's called. A cancer there are some precancerous cells that are in there and -- remove -- at all -- ultimately potentially who will prevent cancer from forming in that area. Perry and we're gonna get to Debbie here but I went you know who come back to you and I wanna know who should be being screened when should we be being screened. And what are the different risk factors for different sectors of the population we'll get to that. In just a moment with you doctor American -- burns is good enough to be here today -- colorectal. Cancer survivor -- welcome once again. You you don't tell your story when you were when you first found out that that you were dealing with this. Okay. Well it I was six months before my fiftieth birthday I wasn't feeling well and this is handing out. The symptoms of mine bowel habits changing. So I went to her -- her and -- colleges and first they thought maybe it was just I need more -- my time but since I was close to fifty. Which is when the recommended screening is safe and let's do the colonoscopy. And it I was diagnosed with stage four. Rectal cancer. That he had metastasized to my lungs and later on had metastasized to my -- And that would just five years ago this march it's march 5. And done. Lets you know frightening when you're the word cancer and it's kind of like an out of body experience and away. Race to sought treatment immediately in a handgun tumor removed from -- colon. And I went for lung surgery here Roswell with directory under mere -- again later on down the road I had some liver lesions on my doctor Boris who shot. -- -- -- And it was and two rounds of chemotherapy. And say him and he had cancer sense. January of 2010. And I still go for it biweekly treatment -- drug content Aston -- keeps the tumors that -- that might develop. Because it chokes off the blood supply to them and I'm so grateful to be here because I beat the statistics. And they just want to let people know that there is hope when you do get diagnosis and that is scrimmage you might first think. And improve things that you sure are. Then maybe congratulations on doing so well thank you that's terrific terrific news obviously. When you were diagnosed it -- you're at a stage where it already metastasized right there was a small spot them a long. And then it had grown you know it went from -- both -- -- of. Cited hip surgery actually three times and doctor Americans can get into you know who should be tested when they should be tested different parts of the population that maybe more prone to this. Prior to this diagnosis -- you any indication whatsoever that that you should have been you know -- there's you know fifty should you have. Now there's been no family history on that whatsoever and no one in my family has -- and I am a large family. So it was quite a shock and -- like -- -- it wasn't feeling well -- month or two. And then they went in and that's from the colonoscopy review them. The results and not so nine the very much an advocate for people getting screened. You know with their fiftieth birthday I don't wait don't put it off. I. You know trying to. Make people aware of you know how important it is because they find something they can treat it and you can beat it. Com before it gets to you know. Higher -- to metastatic. Situations like links. Hey you're in your great example because you're beating you beat as. You know at a stage beyond where a lot of people might be found. You know you know where it went there might be detected with a very colonoscopy at the age of fifty or maybe. Shortly there after doctor nurse and she did what I guess you hope everyone does their health. Is changing -- noticing something different you know of their their their physical nature something's changed. And instead of saying I'll wait. I'll wait -- way she did something she went to see someone and hopefully got in there and it appears she did. Within a -- period of time right. -- com right there's definitely one direction you go -- for getting colonoscopy which is just screening measures. But clearly if there's any symptoms. With regards here GI function whether that increased amount -- new diarrhea more constipation. More blood -- your school. Weight loss new abdominal pains and things like that that you can really find a reason for and it's usually symptoms that. I'm often just don't get better obviously. We're all entitled to get us stomach bug you know we got a little fever as we get some Donald -- maybe potentially diarrhea vomiting. But those usually get better after couple days it's those symptoms that kind of linger a little bit longer and you know -- and I think it's a bit of denial. It's fear that people maybe don't get checked out and speak to their primary and then often get referred to yes -- -- for something like that. Whatever it is it is is exactly what should be done if you have your symptoms that just really are getting better and and something that you know you can explain. You know just. Have a conversation with your primary care. You know song it's so often that something just gets put off all I need some more -- needs some -- that. But it just if it you know all of a sudden. These -- symptoms come up and they just don't go away after that time. You know just go Clinton and have a conversation and investigate a little bit you have your your own advocate. We as humans and particularly men they don't think if you admire and that gender side that I think we do try to rationalize we try to figure things out and answer our own questions. But I guess -- you know that the -- take away here is that if something lingers if it changes and in in isn't getting better on its own. As was the case with -- Seeks. Medical counsel and advice which is exactly what she did what we need to know what do we need to know other than the fact that. For the most part if you're fifty years of age or older. You should probably. Get tested -- be screened I should say. What are we need to know about her family about. You know our our person that is important when it comes to screening for colorectal cancer. Well about. 75%. Of all colorectal cancer. Is what we call a sporadic form. Meaning it often is it just pops up almost like bad luck. Point 5%. Colorectal cancer is there is something potentially hereditary genetic that kind of thing going on maybe within the family okay. But again the majority of cases are just sporadic forms. There are. We categorize based on risk. With regards to how we screen. So there's an average. Risk patient. Which like you mentioned fifty years old is usually when we recommend again as I mentioned before because about 90% of cancers. I do start at the age. After the age of fifty. Com but some don't you know 10% of cases like for example that's that's the case there. But that's why for -- patients we usually recommend around me the age of -- with no previous history of polyps are no family history. And like that. -- increased risk patience these are people that have history. Foreign policy in the past so they've had a well the past. Or they also have some family history as well. Or other conditions that increase their risk of form colorectal cancers such as the inflammatory bowel disease like Crohn's Disease -- class. And then there are high risk patients. Previous colon cancers. Also. Patients that have. Cancers within in the family that have been diagnosed as being hereditary. Or genetics at jazz. FHP for example which is familial and those of us how poses. -- -- rooms something like that these are some drums and conditions that are within families that often even. Go on. Generation after generation. So those are the patients also that Harris and depending on where you fall within those categories. Changes the algorithm or recommendations with regards to screen. So real important to see your primary physician in your primary positions gonna walk you through. They should be walking you through. You know when you should be getting tested and then you'll you'll see that appropriate professional you are listening to Roswell this. Today talking about colorectal cancer. Important to do that in this month that is colorectal cancer awareness month this month of march. And -- screening really the focus of what we're talking about today and when screening comes up for colorectal cancer we obviously talk about. The colonoscopy and you know women. C. I've never met a woman who enjoys. Mammogram I've never met a guy who likes going to their annual physical and they and for the you know that digital rectal exam we don't like these tests. But the colonoscopy for whatever reason. Hence this this cloud surrounding it that -- -- you've got to go for that you know you can go on your own someone has to drive view. Is -- American you can explain you know what the colonoscopy is and why it's important. But -- no one better than you can tell us why it's so important and really. It's much ado about. Very little right -- is exactly. It's extremely important I mean it saved my life. On me and had a handed down earlier. You know -- -- events so far along in the cancer. But hey you know it's -- one of those tasks that in your right it has this cloud over it but it's. Relatively painless I mean years and dated in this twilight type of situation and before you know at the test this hour and it's just so important and I try to tell everyone I know he needs new people -- meet. Gets your colonoscopy. If he had done so don't tell. Yeah and you can delay for you know any reason you don't even need to step and one of those cases right you know family you before you were fifty years of exactly -- -- older and you know there was no reason for you did it just that we knew about. Exactly. And none. You know it's just the way it was but for you know anybody out there who is fifty year to be and don't be afraid just. Content make that phone call. And get an appointment for colonoscopy and it's it's still be over with before you know it. And you have the peace of mind or you'll Null if any treatment and then you can be a survivor. And like that evolution is virtually pain free if. Not I -- not hit mine yet I will soon. But you know I'm told you know by anybody who's had them done. You know they really flaky I don't know when I was sort of. Exactly it's that there really the test itself as a non event I mean there isn't crap to it the day before to clean your system now. But again you can save your life and don't be afraid it's you know be your own -- can't get out there and to -- Doctor American and humor in my you've oversimplifying it or is the colonoscopy. Well it is a you know high tech in an invasive tests. Relatively simple from the patient's side things. It is I mean. We already mentioned that the benefits from a preventative standpoint. -- it is preventive tests. We are able to -- polyps and removed them. It's also diagnostic. Like for -- case for example going -- now it's maybe just. You know hemorrhoids and why I'm having bleeding more of those kind of things and you go in there you find something biopsies and the -- he comes back as a cancer. But then it is also even therapeutic in some cases there are sometimes when. Very early stage cancers. And that -- only invaded within the first layer of the -- Colin can be removed and discount likely. And those are some techniques that. Are being used its specialized centers like at Roswell for example. Where we used techniques called in this topic you coastal protection. Or and this topic so you coastal I think section. Where these techniques. Allow us to remove early stage tumors actual invasive cancers and just optically. Without patients having to go -- to get. Radical operations. Pittsburg select cases but it is can even be done in those circumstances that's why it's so important. To get this screening done because not only is I can mention preventative and diagnostic but also even potentially. Therapeutic. We talk about the call -- -- you call an athlete gets all the press when it comes to colorectal cancer but there are other -- to there are other screens that. Folks like you can rely on and use as tools. Some of them relatively new or at least certainly not heard about coach can you talk about those short. There are certain tests. That are kind of structural based. Meaning like a colonoscopy. Or more like an invasive procedure. Where. Scope. For example like a colonoscopy the cameras placed into the rectum -- goes all around. The entire -- the left side across the transverse colon on the right side of the -- Down -- level -- -- woman that's a full colonoscopy. But there are also some other tests like a flexible -- -- for example which is just and so. The start of the or the bottom of the left -- that's the same way and and most colon cancer start there but. There are -- plenty of other cancers that sort in other locations the cold and so that's why it's not as complete. And an accurate. And really is able to pick up all cancers and all polyps and things like that. -- there are also some other tests that can be performed such as a CT Colin I'll repeat or your virtual colonoscopy. And that's a CT scan. That's done in very very thin slices all throughout the entire colon -- pick up any possible polyps. -- and then there are also some other tests of like fecal testing. Sometimes obviously fecal blood testing can be done if if -- tumors leading you can pick up that but also not. Very accurate a 100% for our colon cancer and there are some other things that potentially lead to bleeding. -- -- from. -- down not be in your school. And there -- some other tests that more and more people are starting to look at looking at proteins within the stool looking genes within this dual. Looking. Different markers within the blood. But you know all of these things all of these tests that I mentioned. The end result is something suspicious. Is picked up or something bizarre. Ultimately it's recommended that you get your full colonoscopy and so although any screening measure is better than none. Ultimately the gold standard is colonoscopy. So if you can just. Get that done. That would be the best. And like did you know is that he's characterized it really is much ado about I won't say nothing at all that certainly it's age you know it's no different from. If you don't the importance and in the reason why women get mammograms than in men have an annual digital rectal exam or you know any other number of screens that. The pap -- you know that we're aware of with the cancer diagnosis and and and detection. You know Debbie so much of what people like you do the importance of what you do after you beat this thing. And gotten through you know a tremendous ordeal emotionally and physically is spread the word. And is -- it's almost viral you glow in the community you're telling your family your friends in in today you know on the radio and follow all across the Internet. You know people how how important this is in in along the way get some support to an end really young nephew who's demonstrating that support we can now race. Yes I do I am James earnings thirteen year old student at west Seneca west metal. And he is participating in the going involved for box and march 27 in his school. So he's out there raising awareness raising money funds to help. Research. And he's done this before her first birthday he took donations for cancer and -- birthday present so. It it you know giving someone in your family directly affected by it. I think brings it home to a lot of people and he and actually went out and did something about it. So excited to go there march 27 and watch the and shaping -- young suit. You know and they say it's viral and here you've got this young man who's who's spreading the word now you know. You know colonoscopy when he turns fifty which is light years from now. And maybe that the standard may be different and who knows but and it won't before and it's in this is commonplace and he's spreading the word amongst his friends as friends families as parents. You know as friends parents and I mean it really is a viral. Approach to spreading the word yes I'm very proud of him. Taking in this effort and I'm doing something about something that needs help. Aren't good for him I understand some pretty tough hockey players hit healthy as he alongside. Doctor Erica. Certain things can stand in the -- from someone getting -- colonoscopy it's an expensive procedure. Some people -- an insurance. What are some of the the reasons. Obviously that's that's probably one of them but. That stand in the way from someone just following that simple advice that -- you're our our prescribing and you know when we're fifty get that done. Those are important issues that the associate economics standpoint. A lot of times if people don't have insurance. They also don't have a primary care physician. So somebody that is going to keep reinforcing these important preventive screening. Studies like colonoscopy. I'm so that that's some important issues that we have to address as you know society. The country to get the word out and and you know that you that the term viral is exactly that so even if these people don't have insurance or they don't have primary care physicians and people. That can inform them of these. There is -- that's why the the awareness and getting the word out and getting viral music using social media. And even if they don't have insurance they probably have a FaceBook account or Twitter account. So that's why nowadays it's so important and why in some ways those patients may very well be going. I am learning more about it and and getting that colonoscopy done when they should be. Because of things like so I think that's great and and events like ball for box and and other things are are just so wonderful that increasing that awareness and getting word out. And and also survivors as being the advocates I mean we can be. Led by a veteran group like that thing. Immediately in you know we really shouldn't be worried about the -- -- I think that's what stands in the way am I can get -- done because what he has. What doctor American tells me I've got something would have he tells me that I have a policies concerned about. But what if could save your life right because absolutely getting this -- up right. And you know that's exactly and if -- think the listeners can hear the spectrum. Of something like colon cancer from. Prevention as we continue to go on and even mention. But also early stage disease and even being like I mentioned before therapeutic removing those tumors. In cases where unfortunately it has grown a bit. More advanced to the point where it goes through the wall and potentially even to some surrounding lymph nodes then also techniques and no and I treatments which again short can be performed. With minimally invasive techniques such as -- Roscoe. And then also unfortunately for. Even I cases like metastatic disease as we hear there is still treatment and shore. Available for these patients so. I think you know what we're talking about today is so crucial and so important but most of the time it all starts with. -- colonoscopy. And you know getting used to cure and survivorship. All often starts with a colonoscopy -- you just get it done. Right exactly I think what people need to be afraid of is the fear of not doing it. Just do it and you'll know where you stand and you can do something about it with the new drugs that are out there and all the treatments at the doctor mentioned. You know you can be. A survivor and do something about it do it today -- pick up the phone coming back. Thanks for being here and thanks for sharing your story and glad you're doing well thank you Kerry that is steady burns of colorectal cancer survivor. Here at Roswell park cancer institute and that kind enough to share her story today thanks again -- doctor -- American. Appreciate your time today to my country thanks from me on her doctor Americanism assistant professor of oncology in the department of surgical oncology here. At Roswell park. March is colorectal cancer awareness month if you'd like to know more. -- you can log on to DR Roswell website. Roswell park dot org that's the basic website if you wanna go to Roswell park dot org. Forward slash awareness all sorts of information for you there and if you don't prefer to make a phone call. You can always do that to -- free at 877 ask our PCI that is 877275. -- Seven. Listen to Roswell this Sunday mornings at 630 young WB EN. -- by Roswell Park Cancer Institute -- team opinion for your total options on line at Roswell this god of war. Hanging. And hanging. Then.