Transcription:
Why Are Colonoscopies So Important

Disclaimer: The medical health information provided during this program is for general information and educational purposes only, and is not a substitute for professional advice. None of the given information is for the purpose of diagnosis or treatment. Neither does this program serve as approval for any health product or brand. This program aims to enhance your personal health and wellness through the adoption of healthy lifestyles and your prompt presentation to the health professional whenever you suspect that you are ill. For treatment and professional advice, ensure you consult your physician.

Melanie Cole (Host): Welcome to Say Yes To Good Health with Memorial Hospital. I'm Melanie Cole, and I invite you to join us as we discuss colon cancer and the importance of colonoscopies. Joining me is Dr. Peter Perll. That's a fun name to say. He's a General Surgeon at Memorial Hospital. Dr. Perll, thank you for joining us. And we're talking about colon cancer and colonoscopies today. I would honored if you would tell us your story with colon cancer and let the listeners know a little bit about yourself.

Host: Bless

Peter Perll, MD (Guest): Well, I am a survivor. I was diagnosed with colon cancer in 2004, living in Mexico, Missouri. little unusual way of finding out. day I had some pain in the right lower quadrant and like any doctor, you don't want to believe that something's wrong with you, but eventually I looked like I had acute appendicitis. And they took it out and I thought, well, that's it's over with. But what they found was a cancer in the appendix and treated it as if it were a colon cancer, cause the appendix is part of the Went through treatment a resection of my right colon and subsequently chemotherapy. had multiple endoscopy's, colonoscopies. So, I feel like I have a firsthand experience of what people are going to go through. And I use that to try to alleviate their fears. Everyone is really fearful about colonoscopy, but it is the best way that we have to find precancerous lesions or early malignancies. And I was really blessed that appendix kind of flared up and I was able to catch mine early and I'm a 17 year survivor now

Host: your heart. That's totally awesome that you got it found and you were able to deal with it. And it's just an interesting story. And thank you so much for sharing that. So, colonoscopies, I'm a 57 year old woman whose mother had Crohn's and my sister and my brother. So, I've been having colonoscopies since I'm 35 years old.

So, I understand when you say they're not scary and we're going to talk about those colonoscopies Before we do, really who's at risk. And also I'd like you to tell us a little bit of some of the signs and symptoms that might send us to a doctor because Dr. Perll, I mean, hemorrhoids bleed. So we see blood in the toilet and we go, ah, ha you know, but really there's a lot of causes for these things and bloating, every woman gets bloating. So, tell us a little bit about risk factors and signs and symptoms it's something to really pay attention

Dr. Perll: Well general risk factors, you know, you talked about the age of having one. I mean, you came from a family with risk factors. You've got started early because of that inflammatory bowel disease in the family. But we recommend that most people start having colonoscopies at age 45, unless there are other symptoms. And you talked about it. If you're bleeding, don't just say that you got hemorrhoids. It probably is, but we wanna make sure. I know from a family experience, my wife's cousin had some bleeding and ignored it and she ended up having a rectal cancer wasn't recognized for a while. So don't ignore bleeding. Let us look into it. Even if you're, 30 years old, if you're coming in, because you're having some persistent bleeding, let us look into it. Pain we'll work it up. Maybe you'll need to a colonoscopy. Maybe you won't. Change in your stool. If for some reason, all of a sudden you start getting you know, difficulty moving your bowels or having small stool. There may be a narrowing in there. It may be cancer, it may be not, but we want to look into those situations. So, those are kind of like you talked about, when you're having something happen to you, don't just put it off.

I know colonoscopy sounds scary, but don't put it off because you don't want the procedure. Let us look into it. But the other risk factors, obviously the older you get, the more likely you are to have a colon cancer. So, you want to age as a risk factor, having that family history, the genetics again comes into it. Having certain syndromes, we don't see a lot of it, but there are syndromes that make you more susceptible to having colon cancer. African-Americans have a higher risk of having cancer that are obese have a higher risk of cancer Again plays into this Alcohol abuse and tobacco abuse are a problem with developing colon cancers Then our diet. We tend to eat a lot of red meat, a lot of processed meat, a

lot smoked or barbecued meat that can also higher risk of developing cancers

Host: That was such a comprehensive answer, Dr. Perll, thank you so much. Now, as we're talking about colonoscopies, you started to mention when someone should get their first one, absent of family risk factors we're talking right?

Dr. Perll: Well, it's actually been reduced down to 45

Host: So, that's what I was just getting to now, because we're hearing different things from the US Preventive Service Task Force. And so now it's down to 45 for our first baseline And then how often afterwards? I know it depends on what you find, but how often afterwards generally, is it five years,

Dr. Perll: now.

Host: we looking

Dr. Perll: Well, so you'll see different societies will have different marks of when they think things to be done. give you Dr. Perll's version, I think you have your colonoscopy. If we find nothing, I think 10 years is too long. I think five years, is more reasonable. Anywhere between there, between five and 10. I'd hate to wait 10 years and find something that maybe I would've have found earlier. Now, if you start finding polyps, especially adenomatous polyps, I think three years is something and depending on the size of them, sometimes we'll take a polyp out and it's got dysplasia. It's got abnormal cells. It's not cancer, but it's abnormal. I would say probably need to look at that even earlier maybe a year And especially if you got a big polyp That we're not able to clear everything where the pathology says That there may still be some there probably six months carcinoma in situ where the cancer is there but it hasn't broken out Those are things that need to be watched and possibly even operated on depending on the status of the pathology that you take

Host: Well, I am one of those people. I pushed and shoved my husband to get his first colonoscopy much to his Chagrin. And they

found a 2.5

centimeter polyp So, our doctor said, you know, you dodged a bullet people to get your colonoscopies and to discuss this with your physician. Let's talk about this procedure. Because personally, I think it's a peice of cake. I like lose pounds. nd It's just the prep really that everyone is so freaked out about is this prep, but those are changing now a little bit we don't have necessarily the gallon. Right. My husband got something else this last couple of weeks ago. So, what are we looking at with prep? And it's really not that hard is it?

Dr. Perll: like you said, it's well, there is the prep. Everyone's heard the horror stories. The old days you're drinking a gallon of Golightly and you can't get it down. And especially older folks tying to get them to drink that amount in a short amount of time was difficult. My prep is a clear liquid diet the day before the procedure. And that doesn't just mean water. You can have other things, but you can't have milkshakes or things like that. They're going to be, you know, something that's not clear liquids. Beef Yeah, you can have jellos, you can have other things. Then I give a couple of call them dulcolax, a couple of laxatives in the mid afternoon and then really, the prep starts in the evening my prep It's 7 you take a 12 ounce bottle of stimulate situation and then the next day to try to get you as clean as possible. Cause that's the key. I need to be able to see things.

And I want you, if you're going to go through this, I want to get a good exam. So, we give another bottle of magnesium citrate about four hours before your procedure. So, if you're scheduled at eight. You'll have to get up a little early, but if you're one of the later ones in the morning, you'll have to take it again three to four hours beforehand, that really cleans you out well, and now you're ready for the easy part and that's going for the actual procedure.

Host: Which is really a nice nap. And tell us a little bit, I mean, it is a good nap and you get the day off work, besides which, so just give us a quick brief overview of the procedure. You put us right into twilight, right. So we don't even know what's going

Dr. Perll: Correct People ask will I remember I say you're not going to remember a thing Because anesthesia is going to be monitoring you. At this hospital we give propofol Everyone thinks of it as Michael Jackson it's it is a great medicine that puts you to sleep gets you in that twilight, in that consious sedation, Gets you there quickly and you wake up quickly and you don't have the narcotic haze Cause it's not a narcotic So it's not like the old days when you got fentanyl or Demerol and versed. And you know, you wake up and you're grogged for the day. Now we still don't want you doing a lot of you know physical activity or trying to drive machinery, but because you had an anesthetic, it is an anesthetic, but it's one that, that wears off quickly. And as you said, you sleep through, you wake up. You don't remember that you probably even had the procedure.

Host: on And I bet you've heard people wake up and say, so when are you going to start Dr. Perll and you're like, I'm already done. It's really already done. And then we get lovely pictures, which is always, definitely one of my favorite parts. Right. So, afterwards, then what, you discuss, what we found. Just give us one last little brief bit of advice about why you feel it's so important that we get our colonoscopies when it's recommended. And then we'll talk about the rest of it in the next part of our show.

Dr. Perll: It's just, it is the gold standard to try to decrease your risk of getting colon cancer know that if we find adenomatous or polyps early we're we're saving you a problem or we're finding an early cancer The earlier we find an invasive cancer the better so it It is the best way for us to try to avoid colon cancers and or find something early so we can treat it as fast as possible. And it's a procedure that's it's scary but once you have it and hopefully over time, we can alleviate the fear of people that as they have it nowadays, and hopefully have a better experience. Maybe the word gets out that

Host: Well, that's what we're doing here. Cause I'm telling you listeners, it's not that bad. It's not that scary. It really is such an important as Dr. Perll said in his pearls of wisdom, you know, I had to use that today, that it is the gold standard. It's actually a preventive procedure that we have a cancer prevention. So get your colonoscopies. And to schedule that with Dr. Perll, you can call 217-357-2173. Dr. Perll, we talked about your story with colon cancer, which thank you so much for sharing. And we talked about colonoscopies, the importance of getting these colonoscopies.

And I was even telling everybody it's really not that big a deal. However, for some people, that are a little more nervous about it; there are other screening tests available. Do you want to speak about the reason why those are just really not as viable options and why it's so important to go to your physician to go see you, Dr. Peter Perll for our colonoscopy and not do those at-home kits.

Dr. Perll: Well, those at-home kits are, part of what we deal with everyday People get they see them advertised. Those tests not fullproof obviously there are ones we call false negatives even if they find one that's positive you have to go under the colonoscopy So you've taken some time and probably spent some money on. something that If you just had your screening colon you'd be done with all those tests, whether it's way up to CT colonoscopy down to fecal occult blood testing that they do. They may indicate that you need a colonoscopy and it all goes back to the top of the pyramid.

Colonoscopy is what we need to There are certain times we need to do it based on your age or your risk factors. But also, if we find something, you are going to be in the loop. Where we're going to be following you closer. We want to get those polyps out. As soon as possible before they have a chance to turn into dysplasia or turn into an invasive cancer. So the faster we can do that, the better, and don't ignore your symptoms. You know, those symptoms we talked about bleeding, abdominal pain change in your stool. Those are things that we need to act on sooner rather than later.

Host: 100%. speaking of those at-home care kits insurance in my situation has always covered colonoscopy. And for many people, now this is considered as the gold standard. This prevention, if it's the routine, colonoscopy is covered by insurance, right? So people should check with their insurance.

Dr. Perll: absolutely I it's part of

a wellness program, like getting your mammogram, if you're a woman or prostates for men. The insurance companies know that doing preventive measures and finding things earlier are much better than having more advanced disease that's going to cost a lot to treat. So yes, check with your insurance. Most of them will say, yeah, we have a screening procedure. And we work with insurance companies all the time to make sure that you're going to be covered. can't speak to that as much because I'm not on the financial side, but yes, a lot of people come in what we call for their screening colonoscopy. They have no other risk factors other than their age. it's been a period of time since their last one. So, we want to keep you at, in that loop and your primary care. A lot of times will be saying, oh, it's time for you to get one. not going to force you, but they're going to encourage it.

And I would encourage you to please come see me. Even if you feel you just don't want to have one. I just, I know I don't want to have one. Let me talk to you. Let me see if I can give you the information. I'm not going to force you either, but I want to have a chance to convince you that it's the best thing for you and your family and being healthy.

Host: Well, you're such a nice man. imagine that anybody wouldn't want to come see you So now tell what are you finding? What if you find a polyp I got them. My husband had them, a polyp. What do you do with them? Should we be nervous?

Dr. Perll: Well, polyp is basically a growth on the lining of your colon they can be hyperplastic meaning they're just, they nothing to worry It's like having little scar or something that comes off The adenomatous polyps are the ones that we are trying to get early Those are abnormal growths that can also over time it doesn't happen overnight but if you left something there for years it could continue to grow. It could become dysplastic, meaning abnormal cells or worse become a cancer that becomes invasive. And that's what we're trying get out of there. So we find polyps. Most of those adenomatous, meaning that they're that kind of pre-cancer we want to early when they're small or take them out whatever size they are. We're trying to get them out of there. I go in people say, are you going to take everything out? I said, I'm going to take everything out that I can get out safely. If I can't do that, I'm going to get a piece of it so that we have a diagnosis of what's going on in there.

So that's kind of my rationale when I get in there to take care of patients. There are cancers that we find and then we have to start the workup from. there But Most things that we see are the adenomatous or sometimes hyperplastic, you can't tell the difference when you look at them sometimes, but we're, we want to get those polyps out as fast as we can.

We want to keep the patient informed and the family what's going on we want to keep you in the system

so we don't let you

Host: Well that's certainly is true. And so, a little bit about colon cancer and you have graciously shared your story with being a colon cancer survivor with us today. But what's exciting in this field? Some of the new treatments for colon cancer as a general surgeon and someone so knowledgeable in the field, what have you seen is really exciting going on?

now

Dr. Perll: able to followup on that even if we don't want you to go ten or fifteen years without having another procedure Well the best thing is colonoscopy is really is allowing us to find cancer at an earlier stage. It's, you know, the less invasive, the better it is to try to resect cancer so that we get a clear margins and hopefully no nodes. To get it as early as stage as possible. Rectal cancers are colon cancers, but they're treated a little bit different as far as being able to get it early, radiate it. We have better chemotherapies to treat people. It's just, it's not like the old days where, you know, You're there may be some sickness associated with chemo, but it's certainly not like the old days where it's more individualized. They're gonna, work with that patient to give them the therapy and make sure that they tolerate it better than the old days. think that's the biggest thing to me is finding things earlier and trying to get people cured before they become an advanced stage you're right. There's so much going on now. They're looking at targeted therapies and the surgical intervention and so many different personalized medicine ways to go after colon cancer. But as you said, Dr. Perll, really colonoscopy, this gold standard, this prevention is just such an amazing, you know, advantage advancement in the field that we've got now today.

Host: So tell us a little bit more about diet and its role in colon cancer. And when to people about this and you know they're

coming to you for their colonoscopy, tell them, tell us a little bit about how diet can even help prevent colon cancer. And

Dr. Perll: Well, again, protective measures that you can do are physical activity. Again, we all need to become more active. We need to do activity on a routine basis, but the diet, try to have a more high-fiber with fruits and vegetables. know, having protein is good, but you don't want to just have steak and potatoes every day of your life. that, those fruits and vegetables in good portions every day is very important in keeping your colon healthy. There are some other things you can do with vitamins and even using aspirin maybe maybe preventive in colon cancer. the biggest thing is like activity and your diet. Watching, getting away from high fat and the, the amount of red meat that you're eating, is keeping your colon as healthy as possible. And getting that colonoscopy. If there is something there to find it too And you mentioned fiber just briefly. Does high fiber help to prevent colon cancer? When we're thinking about fibrous foods, some people take fiber supplements, maybe they don't go to the bathroom quite as often. It's not as easy for them to be regular. Does that help? Does that help to prevent polyps or colon

Host: cancer Yes, it does. And, you know, having a regular routine makes people feel better. As you know, a physician, I've had some resections, I have to monitor my health I tell people when they're having trouble with their bowels water people four to six glasses of water a day eat your high fiber But it's so easy to go get Metamucil Citrucel Fibercon you know, they come in pills they come in gummies Get that fiber in there so that your bowel is on a routine basis going through normally aren't static in there not having difficulty moving your bowels or having constipation issues That I agree 100 that having fiber and drinking water is probably the best thing you can do for your colon health Your colon is going to withdraw water out of things and if you don't drink enough I tell people it's going to do it's job and you're going to end up with hard constipation because the stool is just not going to move through people I don't think you need to have prescription medicines I don't think that you want to do laxatives all the time, cause that's not good for your colon then the fiber are two of the best things you can do

Yeah, because nobody wants to be constipated anyway. It's so uncomfortable We just have a minute left, Dr. Perll, your best advice for preventing colon cancer, the importance of a

Dr. Perll: the things we talked about Exersize diet but that colonoscopy depending on your risk factors may even be earlier like yourself because of your history but don't put it off Get it started Get that colonoscopy Most of the time it's going to be negative so you are going to be good for years to go For Don't Great information. What an informative show this was. Dr Perll Thank you for joining us and sharing your story and your incredible expertise with us today. To schedule a colonoscopy with Dr. Perll, please call 217-357-2173. That's 217-357-2173. That concludes this episode of Say Yes to Good Health with Memorial Hospital. For more health tips, you can always go to our website at mhtlc.org to get connected with one of our providers. Please get your colonoscopies, speak to your physician, make your appointment with Dr. Perll. It could save your life. And if you have a loved one and it's their turn, help them get this going because you know, it worked for me with my husband and it will work for you too.

Host: Just really an important message. I'm Melanie Cole. Thanks so much for listening.

Disclaimer: The medical health information provided during this program is for general information and educational purposes only, and is not a substitute for professional advice. None of the given information is for the purpose of diagnosis or treatment. Neither does this program serve as approval for any health product or brand. This program aims to enhance your personal health and wellness through the adoption of healthy lifestyles and your prompt presentation to the health professional whenever you suspect that you are ill. For treatment and professional advice, ensure you consult your physician.