Helen Dandurand (Host): [Mic bleed] Welcome back to the Well Within Reach podcast. I'm your host, Helen Dandurand. And today I'm going to be joined by Dr. Dhara Patel, Family Medicine Provider at Riverside's Frankfurt campus to debunk some colorectal cancer myths.

My Chart Ad: Healthcare can be confusing, but thanks to your myRiverside myChart, you can easily manage not only your care, but your family's as well. With a single click, your myRiverside myChart lets you stay well connected to the same information your provider sees. You can view your health history, get test results, request prescription refills, pay your bill, or make an appointment. Manage your care from anywhere, your laptop, phone, or tablet. Learn more and enroll today at riversidemychart.org

Host: And we're back with Dhara Patel. Thank you for joining me today.

Dhara Patel, MD: Hello everyone for having me here.

Host: Of course, of course. So to get started, could you just tell us a little bit about your background?

Dhara Patel, MD: Okay. So my name is Dhara Patel. I'm a Board Certified Family Medicine Physician, originally from Orland Park, Illinois. I did my residency in California, currently working at Riverside Medical Group, Frankfurt Campus as a family medicine physician.

Host: Awesome. Awesome. Sounds good. So let's get into it. Go ahead with the colorectal cancer myths. So myth number one that I have here is that only people with a family history of colon cancer are likely to get it.

Dhara Patel, MD: That's not really true. So, anyone can get colon cancer. It's mainly based on risk factor. So, there is modifiable risk factor, which includes smoking, obesity, inactivity, heavy alcohol use, or red meat consumption, which is like 500 gram per week.

Or the non modifiable risk factor is family or personal history of colorectal cancer, or advanced adenomas .

Personal history of inflammatory bowel disease or personal history of hereditary polyposis syndrome. So, anyone based on the risk factor can get the colorectal cancer.

Host: Gotcha. Okay, myth number two then, that colon cancer is only something that typically older men need to worry about.

Dhara Patel, MD: That's not really true. Everyone with the risk factor, as we discussed, the modifiable and the non modifiable risk factor can get it. So not just older men can get it. It's not like that.

Host: Yeah, why is that? Is it typically more like older men get it than usual? You know so why is that kind of the stigma or people think that?

Dhara Patel, MD: I feel like people have stigma that as you get older you're prone to get more disease. And younger healthy individual think that oh I'm out of the risk factor so I'm not going to get it so that's why colorectal cancer is prevented at screen to catch it earlier.

Host: Got it. Got it. Okay, my next one is that screening is only necessary, which you kind of just said this, but screening is only necessary for individuals with symptoms.

Dhara Patel, MD: No, so screening is done as a preventative and there are two guidelines based on USPSTF guidelines and American College of Gastroenterology. They actually modified their screening guidelines earlier last year. Now they said that you need to start screening at the age of 45 to 75 years. So, after 75 years the decision is mainly based on the individual on patient life expectancy and adverse outcome risk. So, the screening is recommended at the age of 45 to 75.

Host: What was it before the age, before they changed it?

Dhara Patel, MD: Before it was 50.

Host: Got it. So it's getting lower and so it's something that, you know, everyone needs to be thinking about and just preventatively making sure that you're good.

Dhara Patel, MD: Yeah.

Host: All right, we're going to take a quick break, to talk about finding a primary care provider. Riverside knows that health is your greatest asset and that your primary care provider is your partner in health. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare.

All right, and we're back with another myth. This one is, colonoscopies are difficult procedures to undergo?

Dhara Patel, MD: Yes, definitely. It's a little difficult procedure to undergo, but it has its pros and cons. So the cons is, of course, operator dependent, bowel prep that patients don't like to do, sedation. The complication is 4 to 8 per 10,000. But the benefit is it's one step. It's a diagnostic and a therapeutic screening modality. So I definitely encourage everyone doing colonoscopy.

Host: Yeah, so that one's kind of, I mean, maybe myth not totally debunked. It is a little bit difficult, but it is one day and it's better to be, right, safe then sorry, you know.

The next one is having a colon or rectal polyp means that I have cancer and need surgery.

Dhara Patel, MD: No, that's not true. So, it depends on what type of polyp you have and what is found during colonoscopy. So, 50 percent of polyps found are hyperplastic polyp. They're benign. So, they don't really increase the risk of colorectal cancer. And it depends on the size of the polyp.

It is less than 10 millimeter, then you pretty much repeat your colonoscopy in 10 years. There are two types of polyps. It's a low risk polyp and a high risk polyp. So the low risk polyp is based on the size and number. If it is one or two small less than 10 millimeter tubular adenoma or small sisal serrated polyp, which is less than 10 millimeter without dysplasia, then you repeat your colonoscopy in five to 10 years.

Now we talk about the high risk polyps, which is 3 to 10 tubular adenomas or villus featured high grade dysplasia, then you have to repeat it in three years. So, it depends on what type of polyp is found during colonoscopy, which require further evaluation.

Host: Yeah, okay, cool. So it's not necessary that if there is a polyp there, that could mean, you know, it could just be something to keep an eye on and it's better to do that earlier so that your provider is in tune with your health and what's going on with your body so you can make the right choices for you.

So, if someone thinks that they need to get screened, they haven't yet, they're in that age category what steps should they take to make that happen?

Dhara Patel, MD: So the first thing first, I would definitely encourage patients to go to their primary care doctor, make an appointment, get their annual and do the preventative care. So colon cancer screening is done in multiple ways. So there is one step that we talked about is a colonoscopy, which is done by, you need a referral to your gastroenterology doctor. The other one, there are other two types that we can do it. It's a fecal test, it's a stool test that's done every yearly. And third type we do it is Cologuard, which a lot of people have heard over the news. It's a DNA testing. They test the DNA in your stool. And if it's negative, it's done every one to three years. So the advantage for the stool test is, of course, it's non invasive. It's done quick.

It's an easy um, patient kind of wants to do that. But the disadvantage is if for some reason the stool test comes back positive, then the ultimate test that is done is colonoscopy.

Host: Gotcha. Cool. Is there anything else that you feel like you'd like to add about colon cancer, colon cancer screenings?

Dhara Patel, MD: Yeah, so the last thing I would like to add is I want to educate the patient and the community that colorectal cancer is the third most common cancer in the United States and it's ranked second for the cancer related death. So earlier detection through screening, removal of precancerous polyps with colonoscopy and changing the modifiable risk factors will help.

And that's why I encourage patients to see their primary care doctor and get those preventative measures done.

Host: Absolutely, you know, if there's a way, a chance that you could, you know, help yourself out and keep yourself healthier longer, know what's going on with your body, you should absolutely take that chance.

Yeah, and that's why primary care is so important. Thank you for joining us today, Dr. Patel.

Dhara Patel, MD: No thank you for having me. It was wonderful.

Host: Yes. Of course, and thank you listeners for tuning in to the Well Within Reach podcast brought to you by Riverside HealthCare. For more information about screenings, visit riversidehealthcare.org.