right 21 minutes after 8 o'clock thank you for tuning in the subjects you need to know about
but don't like talking about is colorectal cancer you don't like to talk about any cancer right but
it's colorectal kind of one of those things like they all made it the guy saying right
we don't like to talk about dr. Rajesh and Kewanee is on the phone he's a colorectal
cancer expert and the associate professor of medicine of gastroenterology and hepatology
and at the medical and the medical director of quality for the northwestern medicine digestive
health center II March happens to be colorectal cancer awareness month which I didn't know and
colorectal cancer is the topic the importance of screening the trends the signs of symptoms
the diagnosis and the treatments and I think the screening is is probably the most important focal
point dr. Rajesh and kiss Ronnie good morning sir thank you for being on the show thanks for
having me and I really appreciate you giving us an opportunity to talk about this important
issue you're welcome where are you right now were you calling from I'm in Chicago at North Western
medicine and I'm excited to be talking to you right before March 2 colorectal cancer awareness
month so has the the tests changed at all in the years that you've been doing this so things have
changed quite a bit in the last decade and in fact in one case with colonoscopy which I think many of
you are aware of which is the tests that we use to identify polyps and prevent you've really made a
large focus on trying to ensure that the highest quality colonoscopy is delivered to our patients
and during that same time we've had some competing technologies including a stool test that you may
have heard of which are also there to detect colon cancer and try to prevent colon cancer
death and so it's really changing it clearly is the it's the the colonoscopy does it and I don't
any other way to ask this but the the scope or the camera not go deep enough and that's why the stool
test is necessary no the extra colonoscopy is an excellent test and it gets through the colon and
find the vast majority of polyps and prevents the vast majority of colon cancers the issue we had
really getting to make sure that all patients get screened and despite that the fact that
colonoscopy is not very difficult we still can't get every patient screened and so it's important
to give patients options and for our patients who don't wish to undergo a colonoscopy we do offer
stool based testing the primary difference for that stool testing is better at detecting colon
cancer whereas colonoscopy is better preventing colon cancer and so it is a discussion and now
what are some of the symptoms because sometimes things can look like something else when they're
really not so in general I am glad you asked that question in general we don't want to wait
for symptoms but it's important to be aware of symptoms that may occur and the most common
symptom you hear about is blood in the stool and this is important for us to think about as we find
that some younger people are getting colon cancer before the ages where we recommend screening so
if you're having frequent blood in the stool or change in your stool habit even if you've been
screened for colon cancer before or you're below the age where we generally recommend screening
it's very important to talk to your primary care provider or see a Gastronauts to see if you might
need a colonoscopy I don't know that this would be across the board kind of a question but I'm
just another Florida might have different rules than the other states but are the the screenings
covered by insurance that's a great question screening is in general covered by insurance the
only time that screening is generally not covered by insurance is if you're having a colonoscopy
for symptoms in which case there is often a copay and also if you get a stool based test
and it's positive and then you get a colonoscopy that's often not covered by insurance as well but
screening cost in general is covered by insurance but obviously you need to talk to your insurance
provider and before the colonoscopy are there any ratings out there on physicians as to who
would be the best to do this that's a that's a great question the transparency around physician
quality isn't where we always want it to be what I advise patients and that's one of my passions what
I advise patients is that simply ask your doctor some of the important questions that we know exist
for colon cancer screening in terms of colonoscopy which is how often do you find precancerous polyps
in the colon they should be finding polyps 25% of time at least during their colonoscopies and how
often do you get a complete colon examination when I get a colonoscopy with you a physician
who is committed to high-quality colonoscopy will know how well they're performing and can you share
those metrics with you as a patient and I think that's a very important thing to talk to either
ask your primary provider or your gas neurologist can a woman who is pregnant have this test we
initiate these blood in the stool or anything yeah that's a good question on most of the time blood
in the store during pregnancy is it's unrelated to any colon issue it's more related to hemorrhoids
but we do have women who need colonoscopy during pregnancy for other reasons such as colitis and
there are ways to see if we do that we try to avoid doing anything in pregnancy if we if we
can avoid it but almost anything can be safely done if a polyp is found how long does it take
before you can determine if it's cancerous or not so we remove polyps during a colonoscopy
in general most polyps would take years to turn into cancer but some high-risk polyps can turn
into cancer within a year or two we send them off for analysis to find out if they're precancerous
or not we usually know that back within a couple of days and that will impact when I as a gastrula
gist would tell you to come back for your next colonoscopy okay is there anything that we do
lifestyle wise that causes the the polyps the formate maybe maybe this would be the
non cancerous one yeah that's a great question the real the real issue we think is that we're
changing how we live our lives in general we're a little bit more relying on processed foods and red
meat which tend to increase our risk of colon cancer we don't exercise as much as we like to
and we're a little more sedentary than we used to be and we had a higher history of smoked you
know luckily that's going down but that's also a risk and so what I like to tell patients is all
the things that if you saw your regular doctor they told you to tell you to do to prevent heart
disease and other cancers also prevents colon cancer so it's really just important to live in
sort of a high quality healthy life and that will help us reduce the risk of colon cancer
really good information doctor can I allow a phone call to come through I see the phone
ringing of course okay dr. Rajesh kiss Ronnie is our guest good morning thank you for calling
you're on the air with the doctor yes thank you doctor you reach your 80s should you still be
gamescreen that's a wonderful question at some point we like to tell people that the risks of
a colonoscopy although very small outweigh the benefits and if you're in your 80s and you've
had prior normal colonoscopies we don't think that there's any value in continuing to put you through
the colonoscopy procedure so it's important to also stop screening for colon cancer at a certain
age and in general 80s we would not recommend colonoscopy as long as you've had one before
I'm very good thank you for the clock do we have to have a day of fasting prior to the test yeah
we've actually made some strides in that as well and we've been able to adjust the diet before a
colonoscopy where you don't actually have to fast you can just eat foods that are low residue the
day before the colonoscopy and and so still be able to eat some of the foods you like the day
before the colonoscopy but you still need to do the bowel preparation the night before okay doctor
do you want to leave us with the website so people can learn more please thanks and we're happy to
have you come visit us at DHCD nm0 RG where you can learn more about colon cancer screening okay
doctor thank you for being on the air thank you for what you're doing you're obviously making the
world a better place I appreciate the opportunity thank you you're welcome we'll be right back