Did you know that March is Colorectal Cancer Awareness Month
and well, it might not be the most comfortable subject to chat about.
You know, I'm going to because it's an important one.
Doctor Lindsay Skates, colorectal surgeon at Swedish joins me now.
Thanks for being here. Thank you for having me.
You know,
we have this idea that colorectal cancer is something
that we should only worry about when we're older.
But that's not true, is it?
That's correct.
So, colorectal cancer is actually increasing in younger populations,
which is why we've moved our recommendation for our first screening,
colonoscopy up to 45 from 50.
Ok. So first screening is
important, right?
Because what do you find in that first screening or what are you looking for?
Well, so for the first screening, we're trying to detect colorectal cancers early.
So as pre cancerous polyps or colon
cancers before they've spread to other locations
and we might do it even earlier than 45 of people are having red flag symptoms.
Yes, I know that somebody I know very closely.
Um So what should we be watching for?
What are those symptoms that you just mentioned?
Yeah.
So red flags to me would be any changes to
your bowel habits that are not normal for you.
So, diarrhea or constipation, that's not your norm,
new bleeding with bowel movements, abdominal pain,
uh weight loss that you haven't been trying for thin ribbon like stools.
Those would all be red flags that make me sit up and say, hey,
we need to update our colon's cancer screening.
So then what happens if you do find a positive screening
is I hear that sometimes when colon cancer is detected,
it's too late.
So that's actually the goal of early screening with colonoscopy
is that we can find things when we're still treatable,
either endoscopically or with surgery before they've spread to other areas.
You know, II
I also think that there's an important
distinction because I think we say colorectal and they think it's the same thing.
But how about rectal cancer? And how is that different? That's a great question.
So many people think colon cancer and rectal cancer are one and the same.
But to me, as a colorectal surgeon,
they're actually very different because
they have different treatment algorithms.
Um So many of the symptoms overlap, but that be said rectal cancer,
people often complain of urgency like they have to go to the bathroom
right now or they'll go and they feel like they don't evacuate completely.
Um
For colon cancer,
we typically treat it with a combination of chemotherapy
plus or minus surgery depending on the stage.
Rectal cancer often includes radiation as part of the treatment pathways.
So, when you say surgery
with colorectal cancer is that uh include removing
part of the large or small intestine.
So typically part of the large intestine,
uh and then we would remove the nearby lymph
nodes and blood vessels in that area as well.
Ok. Just to make sure nothing is spreading. That's right. Get that out clean.
It's right.
Um
So you've kind of already told us the importance of colonoscopies,
but a lot of us are a little squeamish about them.
Um
I, I remember when I went into it, I was like, oh, the colonoscopy,
it's really not that bad y'all, I'm telling you.
But what are some of the myths and alternatives for
people who really don't wanna go through the whole process?
Yeah, I totally get that. People are squeamish about it.
It's very invasive that's in a sensitive area of your body.
But that being said colonoscopy has saved many,
many lives by catching things that are pre
cancerous or an early cancer before it spread.
Um
So the worst part of it is definitely the bow
prep. Yeah, everyone hates the prep. I mean, it was not that bad.
Yeah, I tell people it's like a juice cleanse.
So nothing to worry about like lightest I've ever felt in my life.
Um And then during the actual colonoscopy, it's just the best nap you'll take.
It's pretty good. Some alternatives for people if colonoscopy is not right for you.
So you can do at home screen
test like a stool blood test or the Cologuard test for some people.
Ct colonography may be appropriate.
But I do want to emphasize that colonoscopy is the only screening pathway where
we can actually remove polyps or biopsy of mass if we find it.
So if you find it right, then you're taking it out, you're checking it out
and then you have a definitive answer, which I think is, is really, really good.
I think this is on a lot of people's minds lately.
Um
What are some advances in colorectal cancer care at Swedish specifically?
You mentioned that ct thing I've never even heard of that. Yeah. So ct colon
ct colonography has become more popular.
So particularly with rectal cancer,
our treatment pathways have changed recently.
So now we give chemotherapy and radiation up front
of surgery and in about 25% of cases,
people may avoid surgery at all.
And that's something called the Watch and Wait pathway.
Um
Swedish has been at the forefront of colorectal cancer care.
Our group was actually founded by a surgeon who was
the past president of the American Society of Colorectal Surgeons.
We have a long tradition of excellence.
Um We're one of the only groups in the
Pacific Northwest that trains colorectal surgery uh fellows.
So we graduate two colorectal surgeons a year
that keeps us at the forefront of education and research. Really, truly, it does.
Ok.
Before I let you go, I know that prevention is important,
but like it's hard to imagine what can help prevent that kind of cancer.
So what are some risk factors for cancer?
So definitely genetics plays a role.
So certain families are more predisposed to polyps and colon cancer.
So if you had a mom or a dad or brother, sister who had colon cancer or polyps,
you may be at a higher risk and should be screened early.
Um We do think the western diet plays a role. So
processed foods, preserved meats may increase your risk for colon cancer.
Whereas diets like the Mediterranean diet that are high
in fresh fruits and veggies may actually help.
Ok.
I have to say, I don't know if this is doctor approved.
So the prep thing I wanna go back to that really quickly
because it is a lot and you can't eat.
But you know what I found and I wanna see if you approve of this. Now,
I ate gummy bears.
Just the, the light ones,
not the orange and red because you're not supposed to have any
orange and red because I heard they were w water soluble.
Is that true? Can I eat gummy bears? Gummy bears may help.
Some people think drinking a little bit of lemon
with the prep can actually help cut the taste.
All right. So,
but talk to your doctor, don't take my advice.
Thank you so much.
It was a pleasure talking to you and Providence Swedish facility
is the largest colon and rectal clinic in the Pacific Northwest.
And you can find more information on their website
that you see on your screen right there.
Everything you need to know
this portion of New Day Northwest is sponsored by Providence Swedish.