Keeping Your Colon Healthy

Intro: This is Weekly Dose of Wellness brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): Hello, and welcome to the show. I'm Deborah Howell, and today's guest is Dr. Ashkan Farhadi, a gastroenterologist and director of MemorialCare Medical Group Digestive Disease Center, and a volunteer faculty at University of California, Irvine. Welcome, Dr. Farhadi.

Ashkan Farhadi, MD: Oh, hi, how are you doing?

Deborah Howell (Host): Wonderful, thank you for joining us. Now, colorectal cancer is the third most diagnosed cancer and the third leading cause of cancer death in both men and women in the U.S. according to the American Cancer Society. So, Dr. Farhadi, what is colon colorectal cancer, and how common is it in the United States?

Ashkan Farhadi, MD: Well, colon cancer is one of the most common forms of cancers, as you mentioned, in men and women in the U.S. And I can say one out of six individuals may encounter this form of cancer throughout their lives. So, the good news is, is this is one of the few cancers that we can effectively find it in early stages and have some screening methods.

Deborah Howell (Host): Well, that certainly is good news. What are some of the risk factors for developing colorectal cancer?

Ashkan Farhadi, MD: For sure there are some genetic backgrounds in some cases that form colon cancer. It's not uncommon that we see colon cancer clusters in some families. And particularly those families are at increased risk of colon cancer, and we consider them high risk. However, the majority of cases of colon cancer, they don't have any background in their family for colon cancer. And that's very important to know that this is not something that only happens in those with some family history. And we know that there are some conditions that predispose us to colon cancer, such as obesity, diabetes, and based on some research, there are some foods that could be potential risk for forming colon cancers, such as fatty foods, and sometimes use of too much of animal products and red meat. But in general, we are not 100% sure what is causing colon cancer, besides some genetic factors.

Deborah Howell (Host): Okay. Good enough. So, let's talk a little bit about screenings. How do screenings and scheduled colonoscopies benefit people in the prevention and early detection of colon disease?

Ashkan Farhadi, MD: Well, as I said, this is one of the few diseases that it could be completely preventable. There are some growths in the colon that we call them polyps, that if we detect them at this stage while they are not even cancer, and we call them pre-cancerous tissue, we can remove it and prevent this disease. And we typically start screening at age 50. And when we do our search, we remove all the suspicious tissues that we think could be pre-cancerous tissue. And by that means we can halt the process of forming cancer altogether.

Deborah Howell (Host): And do those polyps sometimes return?

Ashkan Farhadi, MD: That's unfortunately the problem, that when we have those tissues, it's not only that tissue, but it's telling us we have a tendency of growing those tissues. And that is somewhat alarming that is telling us we have to have more frequent screening in those individuals who have these growths. But typically, even if we don't have any growth in our examination, every 10 years it's suggested that we have a screening done. The reason for that 10-year interval is we know on average it takes 10 years from the early stage of the growth to the full-blown colon cancer. And if we do our screening in that interval, we can halt the process and prevent colon cancer.

Deborah Howell (Host): Got it. Now, how frequently and at what age should we start getting screened?

Ashkan Farhadi, MD: Well, typically we start at age 50, and thereafter every 10 years we're repeating the test if there is no growth in the colon.

Deborah Howell (Host): Got it. What are some signs that you may have disease of the colon?

Ashkan Farhadi, MD: This is very important to understand that I get this question very often that, 'I have no symptoms, I have no blood in stool, I have normal bowel habit. Why should I get colon cancer screening?' And that's exactly the time that we want this test to be done, because by the time we're having some blood in stool and changes in bowel habit, which are the most common types of symptoms we encounter in colon cancer, the horse is out of the barn already. We're dealing with colon cancer, and prevention is over.

Deborah Howell (Host): What is the survival rate, sir, if colon disease is detected in its early stages?

Ashkan Farhadi, MD: As we mentioned, our prime goal is to detect colon cancer even before it forms. So in those cases, in the majority of cases that we halt the process and remove the polyp, survival is not affected at all. And the good news is, even if we detect the colon cancer in early stages, the survival is excellent. But if we are dealing with advanced cases, our management is basically damage control, and in those advanced cases, typically survival is not as good.

Deborah Howell (Host): I understand. Now if someone finds themselves with colorectal cancer, what are some treatment options available to combat the disease?

Ashkan Farhadi, MD: The mainstay of our therapy is surgery. And typically we send the patient to a surgeon, and that affected part of the colon can be removed. And if the disease is extended beyond the colon, usually chemotherapy is something that we consider in those individuals.

Deborah Howell (Host): Okay. And are there some lifestyle changes we can make to prevent colon disease? I know you mentioned fatty foods and red meats.

Ashkan Farhadi, MD: That's totally right. As I said, obesity and diabetes, which are now very common issues that we're having, are one of the mainstays of predisposing risks for this disease. So measures to control weight is very critical. And in order to do that, having a healthy meal and regular exercise are the mainstays of that strategy. And obviously, having plenty of vegetable and fruit in our daily routine and our meals are critical in reducing the risk of colon cancer. I would definitely suggest avoiding fatty meals and moderation in animal products, particularly the red meat that's recently been shown that is one of the main risk factors for many cancers.

Deborah Howell (Host): When you say moderation, two times a week, four times a week for the red meat?

Ashkan Farhadi, MD: Well, there is no exact data that I can refer to that what does that mean. And people are not ready to give up that use of animal products altogether. So I cannot give an exact number, but I will leave it to their judgment.

Deborah Howell (Host): Okay. Moderation in all things. What else do we need to know about colorectal cancer and its effects on both the patient and their families?

Ashkan Farhadi, MD: Well, as I said, this is a very common illness, and one of the few that we can completely prevail in reducing the numbers or even eradicating if we have regular and appropriate screening methods. So even though it's bad news that this is a common cancer, but the good news is we can do something about it.

Deborah Howell (Host): Got it. It's so important to get those screenings starting at age 50 and above.

Ashkan Farhadi, MD: That's true. That's correct.

Deborah Howell (Host): Talk to your spouse tonight, your sisters, your brothers, whoever you need to talk to, your kids if they're 50 or older. Get those screenings. And make sure you are not one of the six, one out of six. That's incredible. I had not realized it was that profound. Well, Dr. Farhadi, thank you so much for your time today. It's been very enlightening to have you on the show.

Ashkan Farhadi, MD: My pleasure.

Deborah Howell (Host): To learn more or to listen to a podcast of this show, please visit memorialcare.org. That's memorialcare.org. Thanks for listening and join us again next time as we explore another Weekly Dose of Wellness.