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What Do You Need To Know About Colorectal Cancer?
March is colorectal cancer awareness month. In this episode, Dr. Aaron Carr leads a discussion on this very common but preventable cancer, and the preventable steps you can take health-wise to decrease your chances.
Featuring:
He is certified by the American Board of Surgery and holds specialty certifications in fundamentals of laparoscopic and endoscopic surgery. He is a member of the Society of American Gastrointestinal and Endoscopic Surgeons, the American Society for Metabolic and Bariatric Surgery, and the American College of Surgeons.
Dr. Carr is a surgeon with Athens General and Colorectal Surgeons in Athens, GA.
Aaron Carr, MD
Dr. Carr specializes in general, foregut and bariatric surgery. He earned his bachelor’s degree in physics, Magna Cum Laude, from the University of Alabama in Birmingham, where he was also a NASA Space Center Grant Scholar. He went on to receive his medical degree from the University of South Alabama College of Medicine in Mobile, and to complete his residency in categorical general surgery at Atlanta Medical Center, where he served as chief resident in 2012.He is certified by the American Board of Surgery and holds specialty certifications in fundamentals of laparoscopic and endoscopic surgery. He is a member of the Society of American Gastrointestinal and Endoscopic Surgeons, the American Society for Metabolic and Bariatric Surgery, and the American College of Surgeons.
Dr. Carr is a surgeon with Athens General and Colorectal Surgeons in Athens, GA.
Transcription:
Caitlin Whyte (Host): This is Mission In Action, a podcast from St. Mary's Healthcare in Athens, Georgia focusing on patient-centered care under our mission to be a transforming healing presence within our communities. I'm Caitlin Whyte. March is colorectal cancer awareness month, but why does colorectal cancer or CRC have its own month for awareness? Well, it's the third, most common form of cancer and one person every 10 minutes dies of colon and rectal cancer, but it is preventable. Joining us to discuss colorectal cancer and care is Dr. Aaron Carr, a General Surgeon at St. Mary's Healthcare. So Doctor, we're talking about colorectal cancer today. To start us off, just what is this type of cancer?
Aaron Carr, MD (Guest): That's a good question. So, colorectal cancer is a cancer that occurs in the last portion of your intestines. It's known as a colon and rectum. And it's approximately the last five to 10 feet of your intestines. The purpose of the colon is to absorb water. So, that it then forms stool, which then it's kind of gross, but then it exits your rectum. And so any cancer that occurs in that area is called colorectal cancer. And the most common type of colorectal cancer is known as adenocarcinoma.
Host: So then how does this cancer occur?
Dr. Carr: There's different theories, but the prevailing theory is that you have changes within the lining of the colon that occur and then cause more rapid growth of those cells. And it seems to occur in a process where it develops into what is called a polyp, which is an abnormal growth in the lining of the colon and there are different types of polyps, but certain polyps then can develop into cancer. So the theory is, and it's, and there's a lot of good data on this, that the way the colon, colon cancer develops is it generally starts as a polyp and then eventually develops into the cancer. The difference though, is that the timeframe on when that occurs can vary with different people.
Host: So tell me why should I care about colorectal cancer, if I think maybe it's not going to happen to me?
Dr. Carr: Right? That's that's a good question. I think a lot of people, that's a very common sentiment. I think a couple of things, I think people don't realize like how frequently it occurs. And to me, the biggest thing is, is that most of the colon cancer cases are probably preventable. And so as a surgeon, a lot of times, you know, I see the cancer in patients where maybe they didn't have adequate screening. And the cancer's progressed to a point where it's very difficult to treat and many times ends people's lives, prematurely.
And so to me, that's the, that's the biggest thing I like to tell people is that the main impetus I think is that generally it's preventable, if you follow the proper steps for screening, but just to give you an idea of for people. So if you're over age 45 and you have no increased risk factors for colon cancer, the chances of you having a colon polyp are somewhere between 25 to 30%.
So that's a high number of people who have polyps, which most of those eventually become cancer. And so those are some of the thoughts I like to share with patients about, you know, why we should, but it is it's, it's one of the top three causes of cancer death in the United States. That's equivalent to one person, every 10 minutes dying of colon and rectal cancer. And it's a shame because most of those are probably preventable.
Host: Absolutely. So then what are some symptoms we can watch out for that might signal colorectal cancer?
Dr. Carr: So I think this is kind of speaks to the difficulty with colorectal cancer is that unfortunately, most of the symptoms occur once the cancer has progressed to a larger size. So, the types of symptoms that some people may or may not be aware of is, you know, change in bowel habits like constipation and diarrhea. Some people talk about the change in the caliber of their stool. Other people can notice like rectal bleeding. Anemia is another one, which is found on routine blood work and then unexplained weight loss and fatigue.
So those are the symptoms once you have colon cancer, and generally those symptoms are once it's become much larger to the point of actually giving symptoms, but prior to the cancer becoming larger, most people do not have symptoms. And so that's another reason to make sure that you get your screening tests done. Because again, you do not develop symptoms with colon cancer until it is enlarged significantly.
Host: Well, then what factors can increase my risk for colorectal cancer and how can I prevent it in general?
Dr. Carr: So what factors increase your risk. So age is definitely one. And so anyone over age 45, you'll see two different numbers, 45 and 50, but anyone over age 45, men or women, men have a slightly increased risk compared to women. We don't know why, but it does seem that there are, there may be certain racial backgrounds, like African-Americans tend to have an increased rate of colorectal cancer, other factors, a really important one is that you have a family history of colorectal cancer, or you could have a personal history of colon polyps.
So those are the main risk factors. Other medical conditions that can increase your risk is obesity, smoking and Type 2 diabetes, in addition to consuming excess amounts of processed meat and excess alcohol intake. So, a lot of those are kind of common sense things, as far as what you would expect would increase your risk for colon cancer.
So then the question is what can you do to prevent it? I think the number one thing is speaking to your doctor about getting screened. And so that way you can catch it early, but as far as things that you can do, engage in physical activity, at least walking 30 minutes a day, the recommendation is to eat like a whole food diet where you have a diet high in vegetables and certain fruits, with the focus being increasing your fiber intake in your diet. And then again, decreasing any type of processed meats is generally a good idea. In addition to what we mentioned earlier about making sure you get screened at age 45, unless you have a history of colon cancer in your family, that point you should talk to your primary care doctor and they may recommend having a screening test earlier. I know some people who have to have a screening test in their twenties or thirties because of that risk.
Host: Now I know Cologuard seems to be more advertised today. Can you tell us about that and how a patient would know if they could use this screening tool versus a more traditional colonoscopy?
Dr. Carr: Right. That's a great question. A lot of people, because of the advertisements, a lot people will come in with questions about Cologuard. And I think it's a great thing to kind of know, you know, when do you use Cologuard, when do you use colonoscopy? There are advantages and disadvantages of both. I think it is kind of confusing if you're reading on your own so I think the most important thing is to talk to your primary care physician about that, and then they can kind of give you some direction.
So one way of looking at it, and it's kind of, let's look at kind of the advantages and disadvantages of Cologuard and then advantages and disadvantages of colonoscopy. So Cologuard, what it does is it detects abnormal DNA in your stool. And it can be DNA can be either an abnormal polyp or cancer. And so you have to, they send you a kit at home and you can take it at home and then you get a stool sample and you send it back for analysis. It works well with that, it can detect again, cancer and pre-cancer. And so then the recommendation is that you have to do the Cologuard test every three years.
Okay. So that's how the Cologuard works. You compare that to a colonoscopy. A colonoscopy is a little more involved where you have to be on liquids the day before your test, you have to do a bowel prep to clean your colon out, which a lot of people, it can be difficult. You have to be sedated for it. So you lose about a day of work.
So those are some of the things about the colonoscopy. The advantage of the colonoscopy is you're actually directly looking at the mucosa under a magnified lens, and it's considered the gold standard of screening tests, considered the best and most thorough screening test. And then with a colonoscopy, if you have an adequate colonoscopy without polyps, the recommendation is that you can do once every 10 years, unless you have other factors that would make it more frequent. So, that those are kind of the differences. So, then what are the indications? So, Cologuard, you should not do it if you have an increased risk of colon cancer. So if you have family members who have had colon cancer, or if you have a personal history of polyps, you should not do that and go with the colonoscopy. The other thing that's really important is if you have any of those symptoms that we talked about earlier, like bleeding or any abnormal symptoms, you need a colonoscopy and a Cologuard would not be, would that be an adequate screening in that case.
So those are some of the, the advantages and disadvantages of each procedure. And when you may want to consider one over the other.
Host: Well, Doctor, wrap it up for us here. If someone's listening, maybe they have some of these symptoms. Maybe they're interested in getting a test. What is the next step for them?
Dr. Carr: So the next step for them is to talk with their primary care physician so that they can then refer them to it's generally either a gastroenterologist or a general surgeon who typically performs screening colonoscopies, or if the primary care doctor thinks that they're a candidate for another test, like Cologuard, they can also prescribe that.
So that's the, I think that's the take home message of what to do. If you're having symptoms do that earlier. If you're age over 45, go ahead and get the screening test scheduled as well. But again, colorectal cancer is a very common cancer. It can be deadly. Fortunately it is preventable in most cases when we take appropriate screening procedures and practices.
Host: Well, thank you so much for your time Doctor. We appreciate the work you do so, so, much. The general surgeons at Athens General and Colorectal Surgery, part of the St. Mary's Medical Group are highly skilled and experienced in performing colonoscopies and surgeries to treat colorectal cancer. You can learn more about us online at St.Mary'shealthcaresystem.org. Please also remember to rate and subscribe to our podcast and share it on your social channels. This has been Mission In Action, a podcast from St. Mary's Healthcare in Athens, Georgia, focusing on how we provide patient-centered care under our mission to be a transforming healing presence within our communities.
Thanks for listening.
Caitlin Whyte (Host): This is Mission In Action, a podcast from St. Mary's Healthcare in Athens, Georgia focusing on patient-centered care under our mission to be a transforming healing presence within our communities. I'm Caitlin Whyte. March is colorectal cancer awareness month, but why does colorectal cancer or CRC have its own month for awareness? Well, it's the third, most common form of cancer and one person every 10 minutes dies of colon and rectal cancer, but it is preventable. Joining us to discuss colorectal cancer and care is Dr. Aaron Carr, a General Surgeon at St. Mary's Healthcare. So Doctor, we're talking about colorectal cancer today. To start us off, just what is this type of cancer?
Aaron Carr, MD (Guest): That's a good question. So, colorectal cancer is a cancer that occurs in the last portion of your intestines. It's known as a colon and rectum. And it's approximately the last five to 10 feet of your intestines. The purpose of the colon is to absorb water. So, that it then forms stool, which then it's kind of gross, but then it exits your rectum. And so any cancer that occurs in that area is called colorectal cancer. And the most common type of colorectal cancer is known as adenocarcinoma.
Host: So then how does this cancer occur?
Dr. Carr: There's different theories, but the prevailing theory is that you have changes within the lining of the colon that occur and then cause more rapid growth of those cells. And it seems to occur in a process where it develops into what is called a polyp, which is an abnormal growth in the lining of the colon and there are different types of polyps, but certain polyps then can develop into cancer. So the theory is, and it's, and there's a lot of good data on this, that the way the colon, colon cancer develops is it generally starts as a polyp and then eventually develops into the cancer. The difference though, is that the timeframe on when that occurs can vary with different people.
Host: So tell me why should I care about colorectal cancer, if I think maybe it's not going to happen to me?
Dr. Carr: Right? That's that's a good question. I think a lot of people, that's a very common sentiment. I think a couple of things, I think people don't realize like how frequently it occurs. And to me, the biggest thing is, is that most of the colon cancer cases are probably preventable. And so as a surgeon, a lot of times, you know, I see the cancer in patients where maybe they didn't have adequate screening. And the cancer's progressed to a point where it's very difficult to treat and many times ends people's lives, prematurely.
And so to me, that's the, that's the biggest thing I like to tell people is that the main impetus I think is that generally it's preventable, if you follow the proper steps for screening, but just to give you an idea of for people. So if you're over age 45 and you have no increased risk factors for colon cancer, the chances of you having a colon polyp are somewhere between 25 to 30%.
So that's a high number of people who have polyps, which most of those eventually become cancer. And so those are some of the thoughts I like to share with patients about, you know, why we should, but it is it's, it's one of the top three causes of cancer death in the United States. That's equivalent to one person, every 10 minutes dying of colon and rectal cancer. And it's a shame because most of those are probably preventable.
Host: Absolutely. So then what are some symptoms we can watch out for that might signal colorectal cancer?
Dr. Carr: So I think this is kind of speaks to the difficulty with colorectal cancer is that unfortunately, most of the symptoms occur once the cancer has progressed to a larger size. So, the types of symptoms that some people may or may not be aware of is, you know, change in bowel habits like constipation and diarrhea. Some people talk about the change in the caliber of their stool. Other people can notice like rectal bleeding. Anemia is another one, which is found on routine blood work and then unexplained weight loss and fatigue.
So those are the symptoms once you have colon cancer, and generally those symptoms are once it's become much larger to the point of actually giving symptoms, but prior to the cancer becoming larger, most people do not have symptoms. And so that's another reason to make sure that you get your screening tests done. Because again, you do not develop symptoms with colon cancer until it is enlarged significantly.
Host: Well, then what factors can increase my risk for colorectal cancer and how can I prevent it in general?
Dr. Carr: So what factors increase your risk. So age is definitely one. And so anyone over age 45, you'll see two different numbers, 45 and 50, but anyone over age 45, men or women, men have a slightly increased risk compared to women. We don't know why, but it does seem that there are, there may be certain racial backgrounds, like African-Americans tend to have an increased rate of colorectal cancer, other factors, a really important one is that you have a family history of colorectal cancer, or you could have a personal history of colon polyps.
So those are the main risk factors. Other medical conditions that can increase your risk is obesity, smoking and Type 2 diabetes, in addition to consuming excess amounts of processed meat and excess alcohol intake. So, a lot of those are kind of common sense things, as far as what you would expect would increase your risk for colon cancer.
So then the question is what can you do to prevent it? I think the number one thing is speaking to your doctor about getting screened. And so that way you can catch it early, but as far as things that you can do, engage in physical activity, at least walking 30 minutes a day, the recommendation is to eat like a whole food diet where you have a diet high in vegetables and certain fruits, with the focus being increasing your fiber intake in your diet. And then again, decreasing any type of processed meats is generally a good idea. In addition to what we mentioned earlier about making sure you get screened at age 45, unless you have a history of colon cancer in your family, that point you should talk to your primary care doctor and they may recommend having a screening test earlier. I know some people who have to have a screening test in their twenties or thirties because of that risk.
Host: Now I know Cologuard seems to be more advertised today. Can you tell us about that and how a patient would know if they could use this screening tool versus a more traditional colonoscopy?
Dr. Carr: Right. That's a great question. A lot of people, because of the advertisements, a lot people will come in with questions about Cologuard. And I think it's a great thing to kind of know, you know, when do you use Cologuard, when do you use colonoscopy? There are advantages and disadvantages of both. I think it is kind of confusing if you're reading on your own so I think the most important thing is to talk to your primary care physician about that, and then they can kind of give you some direction.
So one way of looking at it, and it's kind of, let's look at kind of the advantages and disadvantages of Cologuard and then advantages and disadvantages of colonoscopy. So Cologuard, what it does is it detects abnormal DNA in your stool. And it can be DNA can be either an abnormal polyp or cancer. And so you have to, they send you a kit at home and you can take it at home and then you get a stool sample and you send it back for analysis. It works well with that, it can detect again, cancer and pre-cancer. And so then the recommendation is that you have to do the Cologuard test every three years.
Okay. So that's how the Cologuard works. You compare that to a colonoscopy. A colonoscopy is a little more involved where you have to be on liquids the day before your test, you have to do a bowel prep to clean your colon out, which a lot of people, it can be difficult. You have to be sedated for it. So you lose about a day of work.
So those are some of the things about the colonoscopy. The advantage of the colonoscopy is you're actually directly looking at the mucosa under a magnified lens, and it's considered the gold standard of screening tests, considered the best and most thorough screening test. And then with a colonoscopy, if you have an adequate colonoscopy without polyps, the recommendation is that you can do once every 10 years, unless you have other factors that would make it more frequent. So, that those are kind of the differences. So, then what are the indications? So, Cologuard, you should not do it if you have an increased risk of colon cancer. So if you have family members who have had colon cancer, or if you have a personal history of polyps, you should not do that and go with the colonoscopy. The other thing that's really important is if you have any of those symptoms that we talked about earlier, like bleeding or any abnormal symptoms, you need a colonoscopy and a Cologuard would not be, would that be an adequate screening in that case.
So those are some of the, the advantages and disadvantages of each procedure. And when you may want to consider one over the other.
Host: Well, Doctor, wrap it up for us here. If someone's listening, maybe they have some of these symptoms. Maybe they're interested in getting a test. What is the next step for them?
Dr. Carr: So the next step for them is to talk with their primary care physician so that they can then refer them to it's generally either a gastroenterologist or a general surgeon who typically performs screening colonoscopies, or if the primary care doctor thinks that they're a candidate for another test, like Cologuard, they can also prescribe that.
So that's the, I think that's the take home message of what to do. If you're having symptoms do that earlier. If you're age over 45, go ahead and get the screening test scheduled as well. But again, colorectal cancer is a very common cancer. It can be deadly. Fortunately it is preventable in most cases when we take appropriate screening procedures and practices.
Host: Well, thank you so much for your time Doctor. We appreciate the work you do so, so, much. The general surgeons at Athens General and Colorectal Surgery, part of the St. Mary's Medical Group are highly skilled and experienced in performing colonoscopies and surgeries to treat colorectal cancer. You can learn more about us online at St.Mary'shealthcaresystem.org. Please also remember to rate and subscribe to our podcast and share it on your social channels. This has been Mission In Action, a podcast from St. Mary's Healthcare in Athens, Georgia, focusing on how we provide patient-centered care under our mission to be a transforming healing presence within our communities.
Thanks for listening.