Maggie McKay (Host): Welcome to Conversations Like No Other, presented by Valley Health System in Paramus, New Jersey. Our podcast goes beyond broad everyday health topics to discuss very real and very specific subjects impacting men, women, and children. We think you'll enjoy our fresh take. Thanks for listening. I'm your host, Maggie McKay.

Today, we have with us gastroenterologist, Dr. Sita Chokhavatia, and Antoneta Lamo advanced practice provider, to discuss colon cancer screening and Fast Track Screening Colonoscopy Program. Antoneta , let's start with you. What is the number one thing you want people to know about colon cancer screenings?

Antoneta Lamo: So, the number one thing we want people to know about colon cancer screening is that it can truly save your life. Colon cancer is preventable and treatable if caught early. So, you can have precancerous growths in your colon called polyps that you might not even know about. It's important to remove these polyps when they're small and benign before they have the chance to grow and spread to other parts of the body.

Dr. Sita Chokhavatia: And I agree completely with you, Antoneta , because if you catch a cancer in the early stages, it's very easily treatable. And if you catch a polyp and remove the polyp, you've actually prevented cancer. So, it's not just screening, it's also preventing colon cancer.

Host: And why does screening start at the age of 45 rather than 50 now?

Antoneta Lamo: So, it was found that people younger and younger were being found to have colon cancer, and thus the age was reduced from screening at 50 to age 45.

Dr. Sita Chokhavatia: And all the societies, as Antoneta said, have started asking people to start their screening for colon cancer at age 45. It used to be 50, but the United States Preventive Services Task Force, the American College of Gastroenterology and the American Cancer Society also recommend that colon cancer screening begin at 45. Forty-five is now the new 50.

Host: And what lifestyle habits can reduce someone's risk of colon cancer?

Antoneta Lamo: So, a big way to reduce the risk of colon cancer is to quit smoking. In addition, you should follow what's called a Mediterranean diet. So, this means eating less processed foods like sweets and red meat, and eating more beans, nuts, vegetables, white meat, and white fish.

Dr. Sita Chokhavatia: As Antoneta points out, health is wealth, so you want to have healthy living. And that includes exercising anywhere from 30 minutes three times a week to a total of 150 minutes or five times a week. And avoiding processed foods, specifically red meat. And increasing fiber, so that's fruits, vegetables. Eating lean meat, moderation in alcohol. A healthy lifestyle helps you stay healthy and it helps your prevention of cancer.

Host: Is colon cancer truly preventable through screening? Because I always wonder because, for instance, both my parents had colon cancer, so I just wonder about that. Is it truly preventable?

Antoneta Lamo: So, yes, it is. Because as we mentioned earlier, you can remove those precancerous polyps before they turn into colon cancer. So, colonoscopies don't just detect cancer, they can also prevent it.

Dr. Sita Chokhavatia: And that's absolutely true. So, colon cancer is one of the most preventable cancers. And also, if you think about other cancers such as breast cancer, prostate cancer, the screening test actually find cancer. Colonoscopies per se find polyps. And when the polyps are removed, you've prevented cancer because it's a polyp to carcinoma sequence. So, absolutely, yes.

Host: That is reassuring. Just an aside, sometimes they say, "Okay, you don't have to come back in five years." And I think, "Five years? That seems like a long time between when you have it in your family. What do you think?

Dr. Sita Chokhavatia: So, I can say this from the research that's been going on for at least three, if not four decades, and they found that there's an adenoma to carcinoma sequence. It takes anywhere from seven to ten years for a polyp to turn into cancer, which is why when you have your initial. Colonoscopy and it's completely normal, the recommendation is then to come back at 10 years for a followup for screening purposes. Now, that changes if you've had a polyp that was taken out and that turns out to be either adenoma or different kinds of pathology, in which case your doctor is going to have you come back sometimes every five years, maybe even three years. And if it's an advanced polyp, you might even come back at a year's interval. So, It all depends upon the polyp pathology, and it depends upon whether it is a completely clean colon. And that kind of speaks to the fact, and Antoneta will absolutely speak to this, the preparation. If it's not a clean prep and the doctor doesn't get a good look, then all bets are off. So, yes, 10 years is good. And those are the guidelines that have been put forth by the societies, such as American College of Gastroenterology, the American Gastroenterology Association, as well as the American Society for Gastrointestinal Endoscopy.

Host: What is one thing you wish people knew about colonoscopies?

Antoneta Lamo: So a lot of patients think that they're going to have pain. But in fact, they're completely painless. You're asleep during the procedure and you won't feel a thing. Most patients wake up from anesthesia saying it was the best nap of their life, is what we've always heard.

Host: So true. What is the biggest misconception about colonoscopies, do you think?

Antoneta Lamo: I think most people think that if you're feeling fine and you're not having symptoms, that you don't need a colonoscopy. In fact, colon polyps that are an early cancer can develop in your colon silently and without any symptoms. So if you're experiencing symptoms, it actually could mean that the cancer has gotten worse. And it's harder to cure at that time. So when you are feeling fine, you're not having symptoms, that's the time you get your colonoscopy. Some alarm symptoms to look out for would be blood in your stool, pencil-thin stools, diarrhea and constipation that last more than a few weeks, feeling like your bowel isn't completely emptying. Those would be signs that you should go to your doctor.

Dr. Sita Chokhavatia: Absolutely. As Antoneta mentioned, those are signs, we call them red flags, or alarm symptoms. If you don't have any symptoms, it does not mean that you don't need a colonoscopy, because screening by definition is when you don't have any symptoms.

Host: And Dr. Chokhavatia, walk us through a colonoscopy if you would.

Dr. Sita Chokhavatia: Okay. So, Maggie, you're going in for your colonoscopy because it has been determined that you've called Antoneta who's gone through and deemed you appropriate to have your first colonoscopy ever. If you had them before, obviously, your experienced in this. The day before your colonoscopy, you will have your prep, which Antoneta would walk you through or the doctor's office would walk you through. The doctor would go over all the preparation that you must do the day before. Usually, the prep is of your preference. But as we know, by and large, it's usually based on your insurance. So, the insurance pretty much calls what preparation you will end up getting.

Most of the time, you will have your procedure in the morning, at which point you will not be eating or drinking anything, so it's nothing by mouth after midnight. If it's an afternoon procedure, they might allow you to have something first thing in the morning, but you have to be absolutely sure and confirm with your doctor as to whether you can or cannot take anything.

You will be dropped off at the facility where you're getting your procedure done by your escort. You can come in on your own, but somebody must pick you up. So, you must have somebody lined up, whether it's a family member, a friend, to pick you up after your procedure is done, and this is for your own safety.

Once you're in the procedure area, after you're checked in, the nurse will then give you a gown. You change into that gown. She will evaluate you and then start your IV. The doctor then comes in and makes sure that everything is as they had prescribed and as, you know, you are fit for your colonoscopy. They will bring you into the procedure room. At which point, the anesthesiologist will also talk to you, evaluate you, and give you your anesthesia. It's called monitor anesthesia care. So, it's really conscious sedation. It's not deep anesthesia.

Once you are under, the procedure lasts about 10 minutes or so. It depends upon whether you're completely clean. The doctor has to put in more wash during the procedure if there are multiple polyps in there to be removed, how difficult those are. But once you are done, and the reason it's a minimum of 10 minutes is there's quality guidelines that we take to look at the entire colon, very detailed, and make sure we do not miss any polyps. So, complete colonoscopy may take up to 10 minutes. After you are done with the procedure, you are wheeled out into the recovery area, at which point, you wake up very quickly within five to ten minutes at the most, if not within the procedure room itself. And the nurse will then give you a light kind of refreshment. It's not a heavy meal or anything. But once you're awake and you eat something, your ride will pick you up, And then, you're okay to go home.

The thing to remember though is you can go back to your daily activities, but you do not want to go back to work because you're going to be feeling so good. As Antoneta said, it's the best sleep ever and you wake up so refreshed, you want to go and conquer the world. You do not want to do that. You want to take it easy that day, have your meals, and then go back to work the next day. Once the pathology results are back, the doctor will have told you what they found right after you wake up in the post procedure area, recovery area, but then they will also make sure that you get the information if there were any pathology results. If it was a completely normal colonoscopy, it'll be see, "You back in 10 years."

Host: I always think besides the prep, the hardest part is getting out of bed after, because you're so relaxed. You just want to keep sleeping. It's like, "Don't throw me out, let me stay here all day." My friends always say, "I don't want to get one." I'm like, "Are you crazy? It's so preventable. If you don't, you're just being foolish. And there's nothing to it." Like years ago, okay, you had to drink that awful grape stuff. But now, you can do like MiraLax, right? Or whatever. I mean, all doctors are different of course. But if you could convince someone listening to schedule a colonoscopy, what would you say?

Antoneta Lamo: So, we would say that our goal is to prevent colon cancer or catch it early before it spreads to other parts of your body. People rarely regret getting a colonoscopy, but most people will regret waiting too long for that colonoscopy. The prep is honestly the hardest part, but a good prep means that the doctor can get a good look at your colon and it reduces the chance of missing any polyps. So, that one day of doing a prep, that minor inconvenience is worth the procedure that could truly save your life. Because really, you know, we're in healthcare because we want people to live long, happy, healthy lives. And the way to do that is honestly through prevention.

Dr. Sita Chokhavatia: And Valley has an excellent program. It's called the Fast Track Colonoscopy. It saves you that appointment with the doctor. You just have to pick up the phone, (201) 389-0808. Antoaneta is always willing to talk to you. Make sure that you meet the criteria for colonoscopies. She will connect you with the physician of your choice. A lot of patients do have preferences. And I find a lot of women want women physicians. And a lot of patients have word of mouth and want to go to a specific doctor. If those doctors are part of our program, gastroenterologists, colorectal surgeons, Antoneta makes every effort to make sure that the scheduling is done with a person of their choice as well as the day and time of their choice if it's available. So, Antoneta, why don't you tell them all about this wonderful program that you've been spearheading and taking us onwards and forwards.

Antoneta Lamo: Great job, Dr. Chokhavatia. That was perfect. But yes, we help patients that have no real medical problems or many medical issues. They're not experiencing any symptoms. We help them schedule the day of their colonoscopy rather than having to do that initial consultation that you would have to do normally.

So, our goal is to prevent any barriers of people getting their colonoscopy, and that's why the Fast Track Screening Colonoscopy program was created at the Valley Hospital. I also want to note that most if not all commercial insurances will cover a screening colonoscopy at a hundred percent because it's considered preventative. So, that's really important.

Host: And can you just tell us a little bit about why this program is so crucial?

Dr. Sita Chokhavatia: So, the Fast Track program at Valley has been crucial in spreading the word, increasing awareness for colorectal cancer screening, as well as educating the community, inclusion of minorities into the screening process because oftentimes they miss out on the screening process. Recognition of all the work that the Fast Track Program and the colonoscopy interventions have done for screening, the American College of Gastroenterology has recognized the program and Valley Hospital for their SCOPY Awards. And Antoneta has been spearheading this, trying to even increase the inclusion of the 45-year olds for the screening process. And even this year in 2025, we were the recipients of one of the SCOPY awards at their annual meeting.

Host: Thank you both so much for sharing your expertise today. We really appreciate it.

Dr. Sita Chokhavatia: Thank you, Maggie. And thank you, Antoneta.

Antoneta Lamo: Thank you so much.

Host: Again, that's Dr. Sita Chokhavatia and Antoneta Lamo. For more information about Valley's Fast Track Screening Colonoscopy Program, please visit valleyhealth.com/fasttrack. Thanks for listening to Conversations Like No Other, presented by Valley Health System in Paramus, New Jersey. For more information on today's topic or to be connected with today's guest, again, please call 201-614-6130, or you can reach Antoneta at 201-389-0808. And again, you can email valleypodcast@valleyhealth.com.