MARK LEWIS: Hi, my name is Dr. Mark Lewis. I'm a gastrointestinal oncologist. I'm the sort of doctor you never want to satisfy because when you come into my office, it means you will have cancer, and in my office, meaning you will have colon cancer. Why is that this relevant? It's relevant because colon and rectal cancer are affecting younger and younger people. If you have a look at this, it doesn't mean it's definitely going to occur to you, but there are a number of things you need to know.
First, age isn't as protective as we once thought or hoped. It is entirely possible to get colon cancer under the age of 45, so how do you recognize when to fret? Well, you recognize your body higher than anyone else since you live in it 24/7, so when you are experiencing latest onset abdominal pain and cramping, especially if you go to the toilet, it will probably be worrying.
Blood within the stool normally indicates hemorrhoids. But that's hard to assume, and so the barrier may be very low – I understand it's uncomfortable – to seek advice from your GP and even ask for a rectal exam. There are also stool tests you possibly can do at home, not only for blood, but in addition for precancerous DNA within the stool, that may really inform you whether you wish a colonoscopy now or whether you possibly can watch it.
And finally, your loved ones history matters. It's about you and in addition the genes you've inherited. So when you know that folks in your loved ones have had colon cancer across the age of fifty, we might normally take about 10 years off that and begin screening you even sooner than your peers. So, to sum up, screening is ideally about protecting you, but diagnosis is about the issues you discover in your personal body, so the 2 can work together to present you one of the best possible end result. I wish you one of the best of health.
MARK LEWIS: Hi. My name is Dr. Mark Lewis. I'm a gastrointestinal oncologist. And I'm here to speak about some changing trends in colon cancer, and what they mean for patients, and the way patients can advocate for themselves. We're here at the most important cancer conference of the 12 months, and there are 4 abstracts or presentations that specifically address the changing trends in colon cancer.
One thing that should be said right at first is that many individuals consider cancer normally as a disease of old age. Cells multiply and undergo cycle after cycle, in order that they usually tend to accumulate defects over time. And that is mostly true. Perhaps most worryingly, we will now not make that assumption about age and the likelihood of developing colon cancer, because all 4 studies have shown us, in their very own way, that things are getting in the fitting direction for patients over 50, but within the incorrect direction for people under 50. I do know that's scary, and I don't need to create panic here. I need to inform you what you possibly can do about it.
One of the things we discovered doing these studies was attempting to search for demographic cues. OK. It's one thing to say you're young, you're under 50, which is traditionally the age we screen for colon cancer. What are you able to do beyond that? I feel the group that's most in danger is women. So when you have a look at the common age of all my patients in my practice, the common age of all my patients with GI cancer is 68. And yet one in seven of my patients is a young adult with colon cancer, and I actually see more women than men.
And what I see time and again – and it is a hindsight bias on my part – is that they've problems. They have abdominal or pelvic pain. Sometimes they even have bleeding during bowel movements. And yet they're told they've a gynecological problem.
I might say to young women specifically, please advocate for yourself. If you seek advice from your doctor, say your GP or your gynecologist, and you will have an issue that seems out of proportion to what you recognize about your body and your cycle, then it needs to be investigated. I can't inform you how repeatedly I actually have seen young adults with colon cancer – and that is my job – who've been told, quite dismissively, that it's just hemorrhoids. They're too young to have cancer. Unfortunately, that sentence now not carries any weight.
So what are you able to do? Well, to begin with, as I said, you're the expert on your personal body. You know what patterns are abnormal in you and may seek medical attention for them. Secondly, you need to know your loved ones history. There is certainly a heredity component at play here.
And as a general rule, we take the youngest person in your loved ones affected by colon cancer or rectal cancer. We subtract at the very least 10 years from their age. And we ask you to start out screening from that time. This is different from the suggestion for the final population. You may know that in recent times now we have lowered the common age for risk screening from 50 to 45.
Now, at age 45, with none medical information or risk, you possibly can go to your doctor and have a colonoscopy. Why is that this so effective? Colonoscopy is maybe the one cancer screening tool now we have that can also be preventive. For example, if a young woman starts getting mammograms at age 40, the mammogram can show her that there's a problem, equivalent to a tumor forming within the breast. It doesn't really eliminate the issue. It just identifies it. Colonoscopy can do each.
A colonoscopist, normally a gastroenterologist, sometimes a surgeon, very rarely a family doctor, can each see and take away a polyp. And by doing so, they interrupt the polyp's disease process. It cannot turn out to be cancerous whether it is faraway from your body. So, to sum up: know yourself, know your loved ones, and know at what age you need to start screening.