Colon cancer is the second leading cause of cancer-related death in the U.S., according to the American Cancer Society. With regular screening, colon cancer can be found early, when treatment is most effective.
Listen in as Eduardo Miranda, MD explains that early detection may mean a chance at a longer, fuller life, and in many cases, screening may even prevent colon cancer.
Selected Podcast
Get the Facts on Colorectal Cancer
Featured Speaker:
Eduardo Miranda, MD
Eduardo Miranda, MD is a local Hematologist/ Oncologist and Medical Director of Oncology for Doctors Regional Cancer Treatment Center. Transcription:
Get the Facts on Colorectal Cancer
Melanie Cole (Host): According to the American Cancer Society, colorectal cancer is the third most common cancer diagnosed in the United States, excluding skin cancers. My guest today is Dr. Eduardo Miranda. He’s a hematologist/oncologist and medical director for oncology at Doctors Regional Cancer Treatment Center. Welcome to the show, Dr. Miranda. Tell us about colorectal cancer, and what you want people to know as the first bit of information that you find most important.
Dr. Eduardo Miranda (Guest): Yes, that this type of cancer is preventable or also can be detected at a very early stage that could be cured.
Melanie: So, who is at risk for colorectal cancer?
Dr. Miranda: Everybody is basically is at risk because we live in a country where we have one of the main risk factors which a diet high in animal fat intake. So, everybody’s at risk but there are also certain individuals that are even at higher risk of getting this cancer that have family members that had this cancer, also most than one first degree family member with this type of cancer. So, there is a familial type colon cancer also.
Melanie: So, it does run in families. What can we do as far as screening. There is a screening available for this cancer, yes?
Dr. Miranda: Yes. The main screening form is a colonoscopy, doing the test that examines the colon at length, which is typically recommended at age 50 for both men and women. If there is an individual that has family members with colon cancer, then it’s recommended at an even earlier age, perhaps five years before the age that individual--that the relative contracted this cancer. So, sometimes we recommend it to certain individuals at the age 40 or 45. So, it depends on the situation.
Melanie: And how often should they have a colonoscopy?
Dr. Miranda: If the test is completely normal, that they don’t find any abnormalities, no polyps, no nothing, then usually it’s not repeated until 7 to 10 years later--if it’s normal. But, if they found polyps, it can be recommended to be repeated as soon as 2 to 3 years after.
Melanie: And, what might be some symptoms that people might notice that would send them to a doctor in the first place?
Dr. Miranda: Many symptoms. Bleeding is one of them. Also, a change in the pattern, what we call the “bowel habits”. If there is, let’s say, new development of constipation or if the person feels bloated, discomfort in the abdomen. But, sometimes there are no symptoms until the cancer has already spread. So, that’s why it’s important to do the testing, the colonoscopy as recommended. But, in terms of the symptoms particularly for this cancer, I just told you, what we call a “change in the bowel habit”. Suddenly, they become more constipated or they have episodes of diarrhea, there is blood in the stools, discomfort in the lower abdomen. Those are some of the symptoms that sometimes patients complain about.
Melanie: Dr. Miranda, if someone is diagnosed with colorectal cancer, what are some of the first lines of defense? What do you do first for them in treatment?
Dr. Miranda: Once the person is found or diagnosed with colon cancer, the first question is, “Is this operable?” So, we refer them to a surgeon to remove the main tumor. That’s going to give us information about the stage of the cancer, how advanced it is. And then after that, we also conduct some tests like CT scan of the abdomen to make sure that it hasn’t spread to the places like the liver. We also obtain blood tests, some of the tests that we call “tumor markers”. And, that indicates, if they are elevated, that there might be cancer somewhere else. So, the first reaction that we have once we diagnose this cancer is “Well, can we remove it, can we operate on this cancer?”
Melanie: And, then what happens? Is there generally chemotherapy or radiation? What else goes along as an adjunct to surgery?
Dr. Miranda: Yes. That all depends on the stage of the cancer. Once it’s removed, we’ll have about three pieces of information. Number one, what was the depth of invasion of the cancer in the wall of the intestine? That’s one aspect that we take into consideration. The other one is if the lymph nodes were involved, if the cancer had spread to the lymph nodes from around the colon. And the third is, if the cancer has spread to their organs such as the liver. So, in that way, we have the stage. We have four stages, one through four. So, typically for Stage One, surgery is always needed. Stage One is when the cancer is localized to the colon, and it had barely started invading the muscle wall of the colon. Stage Two is when it has invaded the whole thickness of the wall of the intestine but had not spread to the lymph node. And then, Stage Three, when it has spread to the lymph nodes. Stage Four, when it has spread to the organs such as the liver. So, for Stage One and Two, typically, it’s just surgery. We don’t normally do treatment or chemotherapy after the surgery. For Stage Three when it has spread to the lymph nodes, then we have to have additional treatment after surgery which is a form of chemotherapy. And for Stage Four, obviously, besides removing the main tumor, most of the time it’s done, then we have to definitely do some other treatment such as chemotherapy and some of the other new agents that are available now. So that also [inaudible].
Melanie: Are you using targeted therapy for colorectal cancer?
Dr. Miranda: Yes. Yes, we do. And there are different forms. One of them is a medication called “Lumilixima” that cuts down or stops the formation of new vessels, which is how the tumors grow. First they lay the circulation for the tumor to grow after that. The medication inhibits the formation of this vessel. That’s one of them. There’s another one, it’s an antibody called “Cetuximab” which we use when the cancer has a particular mutation called KRAS mutation. So, we do that also. So, those are forms of targeted therapy for this cancer.
Melanie: And so, Dr. Miranda, to wrap up. In just the last few minutes, what should people with colorectal cancer be thinking about when seeking care, and give some information about the importance of screening and prevention.
Dr. Miranda: Yes, well, for screening, we should all know to do a colonoscopy because we’re all at risk. To do colonoscopy at age 50, even if we don’t feel anything, even if we’re feeling well, it’s important to do it. So, first is to do early detection. Also, to think about prevention. We know that this cancer is more common in places where the diet is high in animal fat. Then, we should change our diets in a way that we also consume vegetables, fruits, and less fat, less fried food. That can help us prevent this cancer also. Also, there are other factors that have been recognized as possibly reducing the risk of this cancer such as exercise. If we maintain physical activity throughout our lives, also. So, first to do things that we know that can reduce the risk of getting this cancer. Then, take active measures to try to detect it early such as doing a colonoscopy. And, be aware of this cancer, too, that some of the symptoms that can come of this cancer are not just attributed to other things like a bad diet. Sometimes patients can have symptoms for a while, for months, and they think it’s something else. Like pain in the abdomen, bloating, discomfort, and they treat it that it’s something else. Well, think about the possibility of colon cancer also.
Melanie: And, why should they come to Doctors Hospital of Laredo for their care?
Dr. Miranda: It’s a hospital that has been, in this area, I would say, very proactive in terms of the different aspects of cancer care prevention and treatment. The hospital is accredited by the American College of Surgeons colleague group meaning that it meets a level of quality measures that are important for cancer care. We have a multidisciplinary or there’s a multidisciplinary approach to cancer treatment. It’s not just one physician making decisions. It’s a team of physicians. So, those are very good reasons to seek attention for these type of cancers at Doctor’s Hospital.
Melanie: Thank you so much for being with us today. You're listening to Doctors Hospital Health News with Doctors Hospital of Laredo. For more information, you can go to www.ichoosedoctorshospital.com. That's www.ichoosedoctorshospital.com. Physicians are independent practitioners who are not employees or agents of Doctors Hospital of Laredo. The hospital shall not be liable for actions or treatments provided by physicians. Doctors Hospital Laredo is directly or indirectly owned by a partnership that includes physician owners, including certain members of the hospital medical staff. This is Melanie Cole. Thanks so much for listening.
Get the Facts on Colorectal Cancer
Melanie Cole (Host): According to the American Cancer Society, colorectal cancer is the third most common cancer diagnosed in the United States, excluding skin cancers. My guest today is Dr. Eduardo Miranda. He’s a hematologist/oncologist and medical director for oncology at Doctors Regional Cancer Treatment Center. Welcome to the show, Dr. Miranda. Tell us about colorectal cancer, and what you want people to know as the first bit of information that you find most important.
Dr. Eduardo Miranda (Guest): Yes, that this type of cancer is preventable or also can be detected at a very early stage that could be cured.
Melanie: So, who is at risk for colorectal cancer?
Dr. Miranda: Everybody is basically is at risk because we live in a country where we have one of the main risk factors which a diet high in animal fat intake. So, everybody’s at risk but there are also certain individuals that are even at higher risk of getting this cancer that have family members that had this cancer, also most than one first degree family member with this type of cancer. So, there is a familial type colon cancer also.
Melanie: So, it does run in families. What can we do as far as screening. There is a screening available for this cancer, yes?
Dr. Miranda: Yes. The main screening form is a colonoscopy, doing the test that examines the colon at length, which is typically recommended at age 50 for both men and women. If there is an individual that has family members with colon cancer, then it’s recommended at an even earlier age, perhaps five years before the age that individual--that the relative contracted this cancer. So, sometimes we recommend it to certain individuals at the age 40 or 45. So, it depends on the situation.
Melanie: And how often should they have a colonoscopy?
Dr. Miranda: If the test is completely normal, that they don’t find any abnormalities, no polyps, no nothing, then usually it’s not repeated until 7 to 10 years later--if it’s normal. But, if they found polyps, it can be recommended to be repeated as soon as 2 to 3 years after.
Melanie: And, what might be some symptoms that people might notice that would send them to a doctor in the first place?
Dr. Miranda: Many symptoms. Bleeding is one of them. Also, a change in the pattern, what we call the “bowel habits”. If there is, let’s say, new development of constipation or if the person feels bloated, discomfort in the abdomen. But, sometimes there are no symptoms until the cancer has already spread. So, that’s why it’s important to do the testing, the colonoscopy as recommended. But, in terms of the symptoms particularly for this cancer, I just told you, what we call a “change in the bowel habit”. Suddenly, they become more constipated or they have episodes of diarrhea, there is blood in the stools, discomfort in the lower abdomen. Those are some of the symptoms that sometimes patients complain about.
Melanie: Dr. Miranda, if someone is diagnosed with colorectal cancer, what are some of the first lines of defense? What do you do first for them in treatment?
Dr. Miranda: Once the person is found or diagnosed with colon cancer, the first question is, “Is this operable?” So, we refer them to a surgeon to remove the main tumor. That’s going to give us information about the stage of the cancer, how advanced it is. And then after that, we also conduct some tests like CT scan of the abdomen to make sure that it hasn’t spread to the places like the liver. We also obtain blood tests, some of the tests that we call “tumor markers”. And, that indicates, if they are elevated, that there might be cancer somewhere else. So, the first reaction that we have once we diagnose this cancer is “Well, can we remove it, can we operate on this cancer?”
Melanie: And, then what happens? Is there generally chemotherapy or radiation? What else goes along as an adjunct to surgery?
Dr. Miranda: Yes. That all depends on the stage of the cancer. Once it’s removed, we’ll have about three pieces of information. Number one, what was the depth of invasion of the cancer in the wall of the intestine? That’s one aspect that we take into consideration. The other one is if the lymph nodes were involved, if the cancer had spread to the lymph nodes from around the colon. And the third is, if the cancer has spread to their organs such as the liver. So, in that way, we have the stage. We have four stages, one through four. So, typically for Stage One, surgery is always needed. Stage One is when the cancer is localized to the colon, and it had barely started invading the muscle wall of the colon. Stage Two is when it has invaded the whole thickness of the wall of the intestine but had not spread to the lymph node. And then, Stage Three, when it has spread to the lymph nodes. Stage Four, when it has spread to the organs such as the liver. So, for Stage One and Two, typically, it’s just surgery. We don’t normally do treatment or chemotherapy after the surgery. For Stage Three when it has spread to the lymph nodes, then we have to have additional treatment after surgery which is a form of chemotherapy. And for Stage Four, obviously, besides removing the main tumor, most of the time it’s done, then we have to definitely do some other treatment such as chemotherapy and some of the other new agents that are available now. So that also [inaudible].
Melanie: Are you using targeted therapy for colorectal cancer?
Dr. Miranda: Yes. Yes, we do. And there are different forms. One of them is a medication called “Lumilixima” that cuts down or stops the formation of new vessels, which is how the tumors grow. First they lay the circulation for the tumor to grow after that. The medication inhibits the formation of this vessel. That’s one of them. There’s another one, it’s an antibody called “Cetuximab” which we use when the cancer has a particular mutation called KRAS mutation. So, we do that also. So, those are forms of targeted therapy for this cancer.
Melanie: And so, Dr. Miranda, to wrap up. In just the last few minutes, what should people with colorectal cancer be thinking about when seeking care, and give some information about the importance of screening and prevention.
Dr. Miranda: Yes, well, for screening, we should all know to do a colonoscopy because we’re all at risk. To do colonoscopy at age 50, even if we don’t feel anything, even if we’re feeling well, it’s important to do it. So, first is to do early detection. Also, to think about prevention. We know that this cancer is more common in places where the diet is high in animal fat. Then, we should change our diets in a way that we also consume vegetables, fruits, and less fat, less fried food. That can help us prevent this cancer also. Also, there are other factors that have been recognized as possibly reducing the risk of this cancer such as exercise. If we maintain physical activity throughout our lives, also. So, first to do things that we know that can reduce the risk of getting this cancer. Then, take active measures to try to detect it early such as doing a colonoscopy. And, be aware of this cancer, too, that some of the symptoms that can come of this cancer are not just attributed to other things like a bad diet. Sometimes patients can have symptoms for a while, for months, and they think it’s something else. Like pain in the abdomen, bloating, discomfort, and they treat it that it’s something else. Well, think about the possibility of colon cancer also.
Melanie: And, why should they come to Doctors Hospital of Laredo for their care?
Dr. Miranda: It’s a hospital that has been, in this area, I would say, very proactive in terms of the different aspects of cancer care prevention and treatment. The hospital is accredited by the American College of Surgeons colleague group meaning that it meets a level of quality measures that are important for cancer care. We have a multidisciplinary or there’s a multidisciplinary approach to cancer treatment. It’s not just one physician making decisions. It’s a team of physicians. So, those are very good reasons to seek attention for these type of cancers at Doctor’s Hospital.
Melanie: Thank you so much for being with us today. You're listening to Doctors Hospital Health News with Doctors Hospital of Laredo. For more information, you can go to www.ichoosedoctorshospital.com. That's www.ichoosedoctorshospital.com. Physicians are independent practitioners who are not employees or agents of Doctors Hospital of Laredo. The hospital shall not be liable for actions or treatments provided by physicians. Doctors Hospital Laredo is directly or indirectly owned by a partnership that includes physician owners, including certain members of the hospital medical staff. This is Melanie Cole. Thanks so much for listening.