Hally® Healthcast is the monthly wellness podcast from Hally health.
March is National Colorectal Cancer Awareness Month, so today we’re talking about this common disease, and – most importantly – how to catch it early or even prevent it.
Here with us is Robert Good, DO, MACOI, physician and associate chief medical officer for population health at Carle in Urbana, Illinois. Listen here, or read a quick summary in the article below.
Host: Welcome to Hally® Healthcast, the monthly wellness podcast from Hally health, your partner in helping you live your healthiest life. Every month on our podcast, we address a new topic important to your health, bringing in expert doctors, therapists, and specialists who offer advice and answer your most pressing questions.
March is National Colorectal Cancer Awareness Month. So today, we’re talking about this common disease — and most importantly — how to catch it early and even prevent it. Here with us is Dr. Robert Good, a physician and associate chief medical officer for population health at Carle in Urbana, Illinois.
Welcome, Dr. Good. It’s so nice to have you with us here today.
Let’s jump right in. We’re discussing five key things to know about colorectal cancer and prevention.
So, Dr. Good, number one, it tells us a bit about colorectal cancer, who is the highest risk of getting the disease? How common is it and how dangerous is it? Are there other risk factors I can control?
Dr. Robert Good: Colorectal cancer is a very serious disease. It’s the second most common cause of cancer deaths in America. And that’s when you combine men and women, and there’s really no gender variation. Both men and women equally get this. About one in every 25 of us develop some form of colorectal cancer at some point in your life. So it’s fairly common and it’s a very serious disease that can lead to death.
There are some things that increase that risk, however, and while our gender isn’t one of them, family history is a significant component. So we know that people who have had a family history of colorectal cancer significantly increases their risk. And I would say the other thing that really pounds that out is inflammatory bowel disease. So ulcerative colitis or Crohn’s disease are related to colorectal cancer and increases the risk of getting it.
Host: Number two, colorectal cancer is indeed something to watch out for, but tell us some good news. Tell us about preventative screenings and tests.
Dr. Robert Good: Yeah, I mean, I think that, one, if we catch colorectal cancer early, it’s a curable disease. Colorectal cancer starts almost always as small polyps that grow over a period of time, someplace between five and ten years. So if you catch those polyps, as they’re growing, before they become cancerous, you simply take them out and you can do that right through an endoscope. So that’s the goal. And to try to reduce the incidence of colorectal cancer, that’s what we’ve been doing over the last ten years. So there has been an impact. It’s still a very serious disease; we tend to find colorectal cancer at earlier stages today than we did 20 years ago before the modern era of colonoscopes, when the disease presented with obstruction of cancer, rather than finding it at the time of a polyp.
There are some things you can do to prevent it, though. We know that cigarette smoking has a strong relationship to the development of colorectal cancer. And we know that alcohol has a relationship in high amounts, and we know that certain food groups, particularly meats, which can add to increased weight, which increases the risk for colorectal cancer. So quit smoking, eat the right kind of foods and drink in moderation.
Host: Well, it’s always good to hear some encouraging information. Question number three is, can you tell us a bit about these tests? Most of our listeners, you know, have probably heard of colonoscopies, but can you explain a bit more about what those are?
Dr. Robert Good: Yeah. Like today’s world, for low risk people – okay, so you can kind of divide people into high-risk, which are those folks we mentioned before that have a family history or have a disease such as ulcerative colitis, which increases the risk for colon cancer. But for average-risk where there’s no previous history of polyps, where there’s no family history, then people can have either FIT testing, which is a fecal immunofluorescence test, or a newer test, which actually looks at DNA in our stools that might be related to cancer in the form of Cologuard. So those are two tests that can be done in the stools that are good screening tests. And then of course, colonoscopy is kind of the gold standard if we’ve measured everything against to look at the entire colon. So those tests all are fairly accurate. And for people of low-risk, that’s a good way of going about having a screening test done.
Host: Thank you so much for explaining that for us. Now, as we move on to our fourth key bit of info, is it correct that there are also at-home screening options?
Dr. Robert Good: Yeah, the Cologuard is you take your little box home and you screen, get some stool sample and send it back to the laboratory. The Cologuard test is done every three years in low or average-risk patients. The FIT testing, it has to be done every year in order to have the same efficacy as colonoscopy screening. Colonoscopy screening in average-risk people who don’t have any history, who don’t have any history of polyps, is done every 10 years. And that’s because it takes that long for a colon polyp from the time it starts to the time it becomes a cancerous polyp.
Host: And last but not least, question number five, with so many screening options, how does someone know which one’s right for them?
Dr. Robert Good: Well, I think, one, you have to talk to your doctor. That’s the assurance that people should have, is talk to your physician and find out what is the best for them. In general, people who have had high risk, that is family history, previous history of colon polyps or have inflammatory bowel disease, those folks should all have colonoscopy. That should be their screening test, and depending upon their disease or their condition as to how often that should be done. Those who are of average-risk can have either of the three, a colonoscopy every 10 years, a fecal test, either the FIT test or the Cologuard test. That’s all very useful in early diagnosis of colon cancer.
Host: Well, such good information here, doctor, is there anything else we didn’t touch on that you’d like to add?
Dr. Robert Good: Yeah, I mean, it’s all about early diagnosis and try to find it at the stage before it becomes cancerous, at the time that they’re polyps. These polyps give off DNA as stool passes over them. And that’s what some of the newer testing are trying to find, those abnormalities that then key us off to having further tests like a colonoscopy. And during the colonoscopy, the polyps can be removed and that can prevent colon cancer in the first place from occurring.
It’s a bad disease. Once it gets outside the walls of the colon, it gets to be much more difficult for us to treat. But if it stays in the lining of the colon, it is a matter of either taking out the polyp or surgically removing a region or segment of the colon and that results in a very high degree of cure.
Host: Such important information and advice. Thanks so much, Dr. Good. And thanks for all you do at Carle in Urbana, Illinois and throughout the region.
That concludes today’s Hally Healthcast. Tune in next month as we tackle yet another topic important to your health and wellbeing. And remember, Hally health is your partner in helping you live your healthiest life. Visit hally.com for resources, information, tips and much more. Let us help keep you and your family healthy and well. Thanks for listening. We hope you tune in next month.
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