Title: Healthy YOU Podcast, Episode 26: Exploring Trends of Colorectal Cancer in Younger Adults
Host: Frankye Myers, Chief Nursing Officer for Riverside Health System
Expert Guest: Jamila Wynter, M.D., gastroenterologist with Riverside Gastroenterology Specialists
[00:00:00] Frankye Myers: From Riverside Health System, this is the Healthy You Podcast, where we talk about a range of health related topics focused on improving your physical and mental health. We chat with our providers, team members, patients, and caregivers to learn more about how to maintain a healthy lifestyle and improve overall physical and mental health.
[00:00:18] So let's dive in to learn more about becoming a healthier you.
[00:00:28] Alrighty, I am really excited to have in the Healthy You studio today with me Dr. Jamila Wynter, Fellowship trained gastroenterologist with Riverside Gastroenterology Specialists. Welcome.
[00:00:43] Jamila Wynter: Thank you so much for having me, Frankye. I'm excited to join you and to talk about a very important topic of colon cancer, especially in the younger population.
[00:00:51] Frankye Myers: Absolutely. Well, thank you for taking time out of your busy schedule to talk with us a little bit today.
[00:00:56] Jamila Wynter: Of course.
[00:00:57] Frankye Myers: So this episode, we're going to be diving into exploring trends of colon cancer in younger adults. Okay. Okay, so a little background. Over the past couple of years, we have unfortunately heard more about younger adults.
[00:01:12] Jamila Wynter: That's right.
[00:01:12] Frankye Myers: Those in their 20s, 30s, and 40s being diagnosed with colon cancer. And in 2020, actor Chad Boseman, did I say his name right?
[00:01:21] Jamila Wynter: Yeah, I think that's right.
[00:01:23] Frankye Myers: Died at the age of 42 after a four year battle with colon cancer. Um, the incident of colorectal cancer in young adults is on the rise, so we will be chatting with you about that and look forward to hearing, you know, just around symptoms and disease prevention and health promotion.
[00:01:42] So, tell me why you decided to pursue a career in this particular specialty.
[00:01:49] Jamila Wynter: Absolutely. And so for, for those that you don't know, um, for those of you who don't know, gastroenterology is a field of, um, basically taking care of digestive and intestinal problems. More common causes, uh, for you to see GI include acid reflux disease, um, Crohn's, ulcerative colitis, just to name a few.
[00:02:10] The reason why I decided to go into the field of gastroenterology is actually a very exciting field and every single day is very different. So it's. Mostly office based. Okay. So I have the fortune of talking with patients and basically following them throughout their life. Like there's a lot of continuity of care.
[00:02:29] Oftentimes I feel like I'm Um, patient's primary care provider, right? Right. Um, look at the whole picture. Exactly. Look at the whole picture. There's a lot of chronic diseases in, um, GI. Okay. But then another day I can just be doing routine endoscopy and colonoscopy, where I feel like it's one of the most important parts of the field, which is, um, prevention of colon cancer.
[00:02:48] Okay. And then another day, um, I can be in the hospital doing life saving procedures on patients who are coming in with gastrointestinal bleed, for example. So I chose the field, um, because it's just very exciting and the day to day is, it can be very different. And the most important thing is that, you know, prevention of colon cancer is the mainstay of the field.
[00:03:08] Frankye Myers: Okay. Okay. Very good. Yeah. So you get, you get all of that excitement. Exactly. All aspects. Yeah. What is colon cancer?
[00:03:18] Jamila Wynter: Right, so colon cancer is, the name suggests it's cancer in the large intestines or colon, right? So the large intestine makes up the colon and the rectum and so that basically just when abnormal cell growth occurs in that location and unfortunately can lead to really bad and poor outcomes similar to other cancers of the body.
[00:03:40] Frankye Myers: Okay. Is, uh, family history associated with? Yeah. Is it gender?
[00:03:47] Jamila Wynter: Yeah. So, um, no, that's a great question. I know we're going to delve a lot into this, but we do have an understanding of the risk factors for colon cancer. And I would say about maybe 50 percent of patients who are diagnosed with colon cancer, it's due to, uh, an identifiable risk factor.
[00:04:06] And those include, um, male gender. So men are slightly increased risk than their female counterparts. Older patients are, again, a slight increased risk. And, uh, lifestyle. So people who smoke cigarettes, um, Very high alcohol consumption. Okay. And then diet is a big piece of this as well. So a diet that's high in red meat and processed foods.
[00:04:33] So those patients are at an increased risk of colon cancer than the general population. And there are other chronic diseases. that I won't get too much into, but like inflammatory bowel disease, you may have seen that like on commercials. Right, right. So like Crohn's, ulcerative colitis, and then there is a genetic component, which um, can be a little bit complicated to understand.
[00:04:55] Okay. I'll say Less than 5 percent of cases are linked to a genetic cause that we understand as it is today. Okay. Um, there are some genetic components like Lynch syndrome, um, and FAP, which is familial added adenomatous polyposis. Okay. Um, but outside of that, we don't really fully understand the genetic piece.
[00:05:18] Okay. Um, but we do think it does increase one's risk as well. There's more studies being done to understand that.
[00:05:24] Frankye Myers: Exactly. Okay. So we always hear about high fiber diet.
[00:05:28] Jamila Wynter: Yes. Very important.
[00:05:29] Frankye Myers: Um, yes. How important is that?
[00:05:31] Jamila Wynter: So again, we don't, it's not fully elucidated, but the assumption is when you have a high fiber diet, um, you're more, more likely to have normal bowel movements, um, and it regulates your bowels and it.
[00:05:46] It probably decreases the amount of toxins, um, that occur in the gastrointestinal tract. So we said that a diet that's high in fiber also reduces the risk of colon cancer. And fiber, um, you can find that in natural foods, veggies, uh, fruits. oatmeal. Um, very important for one for different grains, whole grain foods.
[00:06:08] Yeah, very important for, um, again, colon health.
[00:06:12] Frankye Myers: Absolutely. And water intake.
[00:06:14] Jamila Wynter: And water intake. Keeps everything moving. Absolutely. And that's the case for everything. Right.
[00:06:18] Frankye Myers: So if you know if you like red meat and you're eating those foods, the more that you can keep that.
[00:06:23] Jamila Wynter: Keep going. Keep moving. Keep moving the better.
[00:06:26] Frankye Myers: Okay, okay. So talk a little bit about, more about the digestive tract, and specifically polyps. Yes. Because I know people in my family that have had polyps. And they've been detected early.
[00:06:39] Jamila Wynter: Perfect, yep.
[00:06:40] Frankye Myers: What is the significance of early detection of polyps?
[00:06:45] Jamila Wynter: That's a great question. And that's actually the most important question, to be honest with you.
[00:06:49] So, um, so the reason why Procedures like colonoscopy are so important because it's not only diagnostic, right? So it helps diagnose is something like colon cancer. It's actually a preventative measure. And the reason for that is because there are these things called polyps. So polyps are a precursor to colon cancer.
[00:07:10] So there are benign, meaning non cancerous, but they have, they are pre cancerous. So they have the potential, it's just abnormal tissue that grow in the colon, that have the potential to grow into cancer over, decades, um, years of life. And so a colonoscopy, um, is a tool where we go in to the rectum and the colon with a camera, but we're able to remove polyps at the time of the exam.
[00:07:40] And so then if we take that tissue out, that means that if it's no longer there, that means that that won't grow into colon cancer. Um, down the road. So that is the importance of a screening test, like colonoscopies, is because it prevents the, the growth of, of polyps.
[00:07:58] Frankye Myers: Right. That, that's really great information because sometimes people think, well, they're benign.
[00:08:04] Right. They're not an issue. Right. You know, I had a colonoscopy. I'm not going to do the next one. Right. But to your point. It can become, and you don't want to be that percentage that it becomes cancerous.
[00:08:15] Jamila Wynter: An important note, um, is that if you do have a history of polyps, that means you unfortunately have a risk of developing more polyps.
[00:08:25] So that's why it's important to get that follow up colonoscopy, and, and probably more, more frequent than the usual 10 year gap that we would recommend for someone with no polyps or no family history. So, even if we remove Um, polyps that you have at that exam, you may have other polyps that grow in different areas kind of later down the road.
[00:08:47] Okay. So that's important to, to mention.
[00:08:51] Frankye Myers: So I know over the years the screening times have changed and why is, I think that's great because that must As we're talking about there earlier the younger generation now, we're seeing a presentation earlier.
[00:09:04] Jamila Wynter: So yes, so Prior to 2021, the United States Preventative Task Force, which is like the governing body of guidelines, um, recommended that we get colon colon cancer screening at age 50.
[00:09:20] If you are an average risk person, meaning no family history and no other kind of symptoms. Right. Um, unfortunately we've seen a trend, um, since 1995 that every year the risk or the incidence of colon cancer increases about 3 percent in patients who are actually younger than 50. So early on site colon cancer has significantly increased over the years.
[00:09:48] Um, there, We think they're, it's probably tied to the risk factors I had mentioned earlier. Um, but because of those numbers, um, that governing body, the Unit, uh, United States Government Task Force suggests that we should be screening earlier. Okay. Right? So now the screening age is 45 years old, and that's important.
[00:10:08] You know, to discuss, because a lot of people in the community still think the age is 50. Right. But it's actually 45 now. Absolutely. Um, but the reason for that change is that we've seen an increase, um, in incidence in the younger population, unfortunately. And
[00:10:23] Frankye Myers: it's so important to have that relationship with your primary care.
[00:10:27] Um, I know that, um, for me, it really keeps me on track with those screenings and the changes in the timeframe. Mm hmm. Um, and I've had a baseline colonoscopy. And I think there's huge misconceptions around how it being painful. I don't remember a thing. Right. So the medications are wonderful. Um, and I lost a couple of pounds in preparation, so it was a win win.
[00:10:52] Um, what are some of the signs and symptoms, um, in an effort to educate our viewers that they should be looking for, um, as it relates to, um, this disease?
[00:11:05] Jamila Wynter: Right. So, um, the most important thing That if anyone gets from this talk is if you see a change in your body that is Abnormal or you know, not normal to you.
[00:11:17] Please seek medical care, right? And so Early onset colon cancer, when it's diagnosed, unfortunately, it's diagnosed at a very late stage, and that's because younger people, um, you know, they, they are, they're less likely to seek medical care if there are changes that they've noted in their body, compared to maybe, Older folks.
[00:11:40] Okay. And so specifically to colon cancer. Actually, there was a study that came out that the four signs That are present when patients are diagnosed with early onset include rectal bleeding. So Bleeding coming from the rectum, especially when you're having a bowel movement, a lot of young folks say, Oh, this is likely benign.
[00:12:03] It's from constipation. It's from hemorrhoids. And I'm gonna be honest with you. Majority of the time it is. But you don't want to be that percentage of a patient that That, that ultimately becomes something more concerning. So I always say if you have rectal bleeding, do not assume that it's something benign unless you get a full evaluation from either your primary care doctor or a specialist like a gastroenterologist.
[00:12:27] It's very important. The second sign is a change in bowel habits, right? And so, um, you know, there are people who have always been constipated all their life or always had diarrhea, but this is like, a change that is, um, that's different, right? Oh, I've, I've had an abnormal bowel movement all my life and all of a sudden I feel blocked up.
[00:12:47] Okay. That is something to, to get evaluated. Okay. And then, um, anemia is the third. So iron deficiency anemia, that is unexplained, right? So it's common for young women to be anemic for other reasons. Like, um, our menstrual cycles or pregnancy, fibroids, other reasons, right? But if you are having anemia on your Routine blood tests that are otherwise not explained by anything else.
[00:13:14] You need to get that, you need to get evaluated. And then I would say lastly, um, abdominal pain. So stomach pain that again is out of the ordinary for you. That these can be signs of something else going on and, you know, for, for you to seek care.
[00:13:30] Frankye Myers: Okay. Um, are there specific markers? that are explored in, um, confirming cancer?
[00:13:39] Jamila Wynter: Yeah, no. Colon cancer? Yes, there are. So, um, the gold standard of, again, uh, therapeutic, or sorry, I should say preventative and diagnostic, um, of colon cancer is the colonoscopy. So the, what we do is when we go in, let's say someone comes in and they are having these symptoms that I mentioned. I perform a colonoscopy.
[00:14:01] It is a, an abnormal growth. Physically in the colon. Okay. So what I do is I take a sample or a biopsy and then we go and send that off to the pathology lab.
[00:14:13] Frankye Myers: You're able to do this at the time? At the time of the exam.
[00:14:17] Jamila Wynter: At the time of the exam oftentimes we'll know. Okay. Just by direct visualization of what's going on.
[00:14:23] Okay. But the conformatory process may take anywhere from three to five days. Where we send that tissue off to a pathology lab. They look at it under the microscope. And based on the findings there, they can confirm that, um, the cells are malignant or cancerous.
[00:14:39] Frankye Myers: Right. Are there cells that are more aggressive?
[00:14:42] Yes. I, I know individuals who, uh, unfortunately are no longer with us and I know others who have had better outcomes. Right. What determines?
[00:14:54] Jamila Wynter: Right. Right. Right. So, um, so I think there are two and there's two pieces to that. The first is just going back to polyps, which again, remember, as I mentioned, are benign, but precancerous.
[00:15:10] There are not all polyps are made the same. There are polyps that are benign, benign, meaning they actually don't have any propensity of developing into cancer. They're adenomas that, um, are at risk of potentially developing into cancer. And then there's another type of, um, polyps called, this is a little technical, but adenomas or villus.
[00:15:34] type that is a slightly increased risk of developing to cancer. So it's important, pathology is very important. So when we see these under the microscope, it kind of signals to us how frequent people need to get their screening or surveillance colonoscopies. So I want to, that's one piece. But when you are.
[00:15:53] unfortunately diagnosed with colon cancer. Um, there are stages to that. Okay. And, um, that unfortunately is usually based on the time in which a patient presents. Okay. And oftentimes they present too late and they're at a stage three or stage four, which is pretty, pretty advanced. And so I would say timing is important and I will say, I would be remiss to say, um, Patients who are of, um, different racial ethnic black backgrounds have a when they present are at a risk of having, um, a higher stage or advanced colon cancer.
[00:16:33] So patients of African American descent, um, African descent, um, unfortunately do present at a later stage. And I think that has more to do with environment than genetics. So unfortunately, having Less access to health care or maybe screenings. Exactly, or like knowledge of the disease process. So, things that, um, you know, I'm particularly interested in as well as understanding that difference.
[00:17:01] Frankye Myers: Yes. Yes. Absolutely. Well, this is going to help. Yeah. I hope so. bridge some of those, um, gaps as it relates to information and understanding. So get your screenings.
[00:17:11] Jamila Wynter: Yes. So important. Get screened. Absolutely.
[00:17:13] Frankye Myers: Um, what are, um, some lifestyle changes, um, that we can encourage our young or adults to participate in, um, to help prevent colon cancer?
[00:17:25] Jamila Wynter: Absolutely. So just going back to those risk factors, minimizing those risk factors. So. You know, quitting smoking, um, reducing alcohol consumption. Very important. Making sure you have a well balanced diet that's high in fiber, minimizing the amount of red meat you eat, minimizing the amount of processed foods, increasing more natural foods, foods that come from the earth.
[00:17:51] Um, and I don't think I mentioned this earlier, but, you know, living a sedentary lifestyle or, you know, being inactive increases your risk of colon cancer and other cancers. So being physically active is important. Um, and I think overall, if you're having symptoms, getting evaluated.
[00:18:12] Frankye Myers: Yes, yes. Thank you so much.
[00:18:14] Of course. This has really been great information. Awesome. Is there anything that you feel is important to leave with our viewers before we conclude today?
[00:18:22] Jamila Wynter: Um, I, again, the colonoscopy, it's such a, a vital part of the screening process. Um, About 25 percent of colon cancer cases are preventable. Meaning if we had known about them years prior and done a colonoscopy and taken out a polyp, that would never have led to a colon cancer down the road.
[00:18:46] So I'll tell my, you know, tell the audience. Make sure you get screened at age 45 if you're an average risk, meaning no family, history of colon cancer, and you're asymptomatic having those symptoms. It's very important. But then the last piece is if you are having symptoms, of those symptoms I mentioned, rectal bleeding, weight loss, anemia, changing bowel habits, please, please, please make sure you get evaluated, um, and talk with your primary care doctor because you may need to see a specialist, like a gastroenterologist.
[00:19:16] Absolutely.
[00:19:16] Frankye Myers: Dr. Wynter, if somebody wants to reach out to you directly, um, please tell them how they can get in contact with you.
[00:19:25] Jamila Wynter: So, I'm a physician at the Riverside Health System. Um, you can find my bio on the Riverside, uh, website and contact our GI office in the Port Warwick location.
[00:19:41] I also have social media. You can find me on I guess, used to be known as Twitter, now X. Yes, yes. Uh, Dr. Jam Wynter, and I'm also on Instagram at that same handle, Dr. Jam Wynter.
[00:19:54] Frankye Myers: Well, I am two years new to this area, and I will be looking, um, for you to do my next colonoscopy and screening and then also looking at partnering with you in the future as it relates to how do we get out in the community, especially in those areas that we know are high risk to further educate, um, in our community efforts.
[00:20:15] So thank you so much for your time. Thank you so much for having me. And for your passion, um, around the work that you're doing and the difference you're making. Thank you so much.
[00:20:24] Jamila Wynter: Thank you.
[00:20:27] Frankye Myers: Thank you for listening to this episode of Healthy You. We're so glad you were able to join us today and learn more about this topic.
[00:20:34] If you would like to explore more, go to RiversideOnline.com.
