Title: Healthy YOU Podcast, Episode 5: Prevention and Screening for Colorectal Cancer
Host: Frankye Myers, Chief Nursing Officer for Riverside Health System
Expert Guest: Dr. Michael Ney, Gastroenterologist with Riverside Gastroenterology Specialists
Listen to the full episode.
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.
So let's dive in to learn more about becoming a healthier You.
Well, first of all, I'd like to welcome you to the Healthy You uh, podcast. And today we're gonna be talking about preventing and screening for colon cancer. And I'm really excited that I have with me Dr. Michael Nay, gastroenterologist with Riverside Gastroenterology Specialist. Welcome Dr. Nay. How are you?
Dr. Michael Ney: Thank you. I'm great. Thanks for having me.
Frankye Myers: Yes, my pleasure. My pleasure. So let's get into. I wanna talk a little bit about colorectal cancer and screening. So first and foremost, tell me, um, how you end up specializing in, um, gastroenterology.
Dr. Michael Ney: Um, well, there's a, I guess everyone has their own path, but for me it was just, you know, basically, When I was in medical school, it just turned out to be the thing that I, uh, I liked the most, found the most interest in, and then kind of just kept being the same way as I went through.
And by the time I was done internal me medicine residency, nothing had changed. So I kept, kept on going and did, did gastroenterology, and I haven't, uh, regretted it at all. It's been a great, uh, a great career. So,
Frankye Myers: Oh yeah, I, I can recall trying to decide which area of nursing I wanted to be in, so I, I quickly knew areas that probably wouldn't be the best for me.
So what did you specifically like about gastroenterology and becoming a gastroenterologist in particular?
Dr. Michael Ney: So, um, so it's a really great, uh, area of medicine because number one, um, you get to kind of work with a really broad rate, uh, range of patients. So kind of all. Races, ages, men, women, kind of, uh, you know, e everybody From that respect, um, we get to split our time between, uh, doing, uh, lifesaving procedures as well as seeing people in clinic.
So, um, you know, the day is kind of always interesting. I'm kind of always doing something different, which is great. Um, and it's just really fulfilling, um, you know, helping people not only with gastrointestinal diseases, but. Actually, um, you know, helping just kind of the general public that are coming in for colon cancer screening.
Um, cause we can actually save lives with this procedure, which is, uh, you know, a really, uh, fulfilling part of the job.
Frankye Myers: Absolutely, absolutely. Thank you for your passion and your work, um, in this space. What is colorectal cancer? Talk a little bit about that.
Dr. Michael Ney: Yeah, so I mean, I think, I think most people have kind of some sense of what a, what a cancer is. And of course, cancers can start in, in different, uh, tissues or different organs. Um, so colorectal cancer is simply a, a cancer or an abnormal growth of, um, uh, cells, uh, that begins to, uh, grow in. The colon or the, or the rectum, which is kind of one, the, the large intestine, the continue continuous tube from the anus up to where it meets the, the small intestine. Um, and uh, basically it's just simple as that. Cancer in the colon or rectum.
Frankye Myers: Well, I know have, um, some personal. Background as it relates to colon cancer. I've had some people, uh, family members and some dear friends, and it just seems to be a very aggressive cancer. They were unfortunately diagnosed very late and are no longer with us. Can you talk a little bit about, um, what are some of the ways to, um, screen and kind of, um, be able to be on top of just early identification as it relates to colon cancer?
Dr. Michael Ney: Absolutely. So first of all, I'm sorry to, sorry to hear that about your, your family members and friends. Um, it's, it's an all too common story, um, with, with such a common, uh, cancer.
Um, so in terms of mechanisms for screening for colon cancer, um, the kind of three main things that I recommend, um, are. A form of stool testing, um, which is either a fit test or a Cologuard. Um, a fit test being a test that looks specifically for, uh, part of basically looking for blood in the stool. Um, a specific part of the, uh, of blood or a hemoglobin in the stool.
Um, a Cologuard test tests for certain, uh, abnormal DNA in the stool. So it's also a stool test that checks for DNA and also sometimes blood. And then there's a colonoscopy, which is kind of the gold standard in terms of, uh, colon cancer screening. Uh, which essentially again, is a, a long camera that we've placed, uh, you know, through the colon and to take a good careful look for anything that looks abnormal.
Frankye Myers: Okay.
Okay. I know for me, um, you know, some of the preventative things were doing your colonoscopy at a certain age point, um, and having those studies. Can you talk a little bit about that? And I think some of the age, um, restrictions as around when insurances will, uh, pay for those have changed as it relates to disease prevention and early identification.
Dr. Michael Ney: Absolutely. So, um, unfortunately over the last, um, couple of decades there's been an increasing prevalence, um, of early onset colon cancer, um, actually especially in, in African, the African American community, but, uh, throughout the entire US um, population, um, and you know, as a means for trying to help remedy that.
To at least some degree. The recommendation for colon cancer screening, uh, has gone from age 50 to age 45. Um, meaning that, , um, basically all, all insurances at this point to my understanding now, uh, we'll, we'll, uh, we'll pay for a colonoscopy starting at age 45 as opposed to 50. Um, for people who are average risk, meaning just kind of a regular person with no significant family history of colon cancer or, and, and no kind of, State that would increase their risk for having colon cancer.
Right
Frankye Myers: right. Um, I'm really thankful to having a strong relationship with my primary care physician. I think that's so important for individuals because, um, she really keeps me on top of all of those key screenings and the changes and recommendations around when they can occur, which is so important to understand. So, so thank you for clarifying that. There's some, there's a misconception. around, you know, maybe some different foods or things that you need to avoid that will decrease your risk of getting colon cancer as it relates to alcohol and all of those things, and tobacco utilization. Could you talk a little bit about that for me, dr. Ney?
Dr. Michael Ney: Absolutely. So yeah, I think there's a lot of things that we, we, we know and probably some things that we still don't know as we kind of continue to learn and research, um, this area, um, you know, there's no hard and fast rule for a way to kind of avoid colon cancer or avoid polyps. Um, there's no perfect diet.
Um, but there's a lot of things you can do that will decrease your risk, at least to some degree. So, um, you know, obviously. smoking cigarettes is bad for pretty much everything, including, uh, causing colon cancer and the development of polyps, which are the, you know, the precursors to colon cancer. Um, alcohol, um, especially in larger amounts can also increase risk for colon cancer.
So it's always with alcohol less, less is better, uh, from that perspective, or, or, or none as good too, right. Then, uh, comes the diet. So, um, basically there are certain foods, especially, um, things like bacon, um, processed meats, red meats, which can increase the risk of polyps and colon cancer. Um, can you basically recommend.
As high of a fiber diet as possible, as much kind of vegetable type product, uh, in your diet as possible, and really decreasing the red meats and especially processed meats, um, from the diet, uh, as much as possible.
Frankye Myers: Okay. . All right, great, great. And then obviously the one that I struggle with the most myself is the weight and including that physical exercise. And every time I feel like I've reached my target zone, the B M I parameter for obesity changes. So can you talk a little bit about weight and, and the impact that it has on. Oh, go again.
Dr. Michael Ney: So, um, I, I, I think there, you know, BMI is, um, you know, u very useful, but it's not perfect, right? So, I mean, everyone's body is a little bit different.
So it's, it's not like a hard and fast rule that exactly this BMI is, is perfect for every person. But generally speaking, we're looking for a BMI between 18 and a half and 24.9 to be considered a healthy body weight for most people. Um, If you can kind of maintain a healthy body weight, that significantly decreases the risk of a myriad of illnesses and diseases, including all sorts of cancers to include, uh, colon cancer and polyps.
Um, certainly, you know, when I do, I do a lot of colonoscopies and I, and I see a lot more polyps in people who are overweight. So I, that risk continues to increase the further you get away from, from the normal bmi. So, you know, Having a BMI of 27 is a lot better than having a BMI of 37 or 47. So it's kind of, it's all kind of, uh, graded in that way, but certainly trying to aim to have, you know, uh, a healthy BMI with healthy diet, kind of, which we've already kind of discussed, uh, as well as regular exercise can decrease your risk of developing colon cancer, but also all sorts of other cancer.
Frankye Myers: Okay. Very, very good. Uh, as it relates to some of the rich factors that we can't control, and we've talked about some of those. As it relates to ethnicity and some of those things, um, talk a little bit about type two diabetes. I know that's something that is really prevalent in my family. Um, I actually was pre-diabetic several years ago and was able to get on top of it and now have a A1C that is within normal range. So would you talk a little bit about, um, diabetes?
Dr. Michael Ney: Yeah. So, so basically diabetes is, is all part of the. The idea of kind of metabolic syndrome. So metabolic syndrome goes along, uh, for a lot of people. Uh, well in general with, uh, a high bmi, high cholesterol, uh, high, uh, you know, basically centripetal obesity, meaning kind of a, a larger belly.
Um, and, and those sort of things. Um, Diabetes type two diabetes is kind of interesting cuz it kind of falls in between the can control and cannot control categories. Cause you know, there's a lot of genetic, uh, components, uh, but also a lot of, uh, lifestyle components that go with that. So it kind of fits in with this idea of regular exercise, eating a healthy diet and, and maintaining a healthy body weight.
You kind of look at some of these, these risk factors that are, that are kind of really fully, you know, completely out of somebody's control, uh, which would be things like your family history. So basically, um, How many people in your family have been diagnosed with colon cancer, especially as a first degree relative?
So your, your sibling, your child, or your parent. Um, that's kind of one of the biggest risk factors for developing, uh, colon cancer. Of course, if somebody has a known genetic disease that causes colon cancer, so something like, um, Familial autonomous polyposis, uh, SAP syndrome or Lynch syndrome. Um, those, those are two, um, you know, genetic diseases that cause colon cancer.
And we, you know, we have special guidelines for those sort of people. Um, as well as we kind of alluded to previously. Um, you know, certain, uh, ethnic groups, uh, especially such as African Americans, are gonna increase risk for, uh, colon cancer, likely for some genetic reasons and some socioeconomic reasons.
And, Potential, maybe stigma that may be around having a colonoscopy. There's all sorts of reasons that maybe at play with that. Uh, but it all kind of centers back on. Need to do the appropriate screening, or in the case of somebody who's at significantly increased risk surveillance in, in, in individuals, um, that, uh, are appropriate, uh, uh, for for it, for it.
Frankye Myers: I'm glad, I'm glad you mentioned that. Uh, why is the colonoscopy the preferred method? Um, and. Also there's a lot of, um, angst, uh, as it relates to having a colonoscopy done. Um, I had mine at 45 and I don't remember it right. And so, um, you know, I know people kind of dread the prep was the hardest part, , uh, of the procedure.
The rest I don't remember. So, um, would you talk a little bit about that?
Dr. Michael Ney: Yeah. So whenever, whenever I, um, see patients, especially when it's their first colonoscopy, I kind of congratulate them on already, already having completed the hardest part of the test, which is the prep. So, um, exactly as you said, uh, it's really a colonoscopy for 99% of people is really not a big deal at all.
Um, you know, you're under certain types of sedation. Uh, most people don't remember the procedure at all. Certain people choose not to even have sedation cuz it's really. A particularly painful procedure. They'd rather kind of watch it on the screen and see what's going on. I know when it comes time for mine, that's what I'm gonna be doing.
So I can kinda like micromanage what the, what the other, uh, gastro to making sure they don't miss any polyps. Um, but um, but yeah, it's really not a bad procedure for almost every person that has it. Um, rarely there's people that have the procedure kind of under lighter sedation that may have some discomfort and we can always then increase the sedation to a different type for them next time.
Uh, be more comfortable in those rare circumstances. Uh, but yes, definitely the prep is extremely important because we need to be able to see properly in there. Um, but, uh, that, that's kinda the worst part. It kind of sucks, sucks to do the prep, of course, but. Um, I think the colonoscopy is the best, uh, test, uh, because it's kinda like a one stop shop if you, uh, undergo other sorts of testing, uh, such as the stool testing, like we talked about.
Those tests are not quite as sensitive or not quite as good at picking up colon cancer or advanced polyps. Um, and when they do, you basically then have to have a colonoscopy to actually address that issue. So a colonoscopy is kind of like a one stop shop. You come. , you actually can prevent the development of cancer with colonoscopy.
So it's, it's, it's, it's kind of the one screening test that exists that not only screens for cancer after it's already happened, but actually that can prevent the cancer by removing the cancer cells or, or kind of pre-cancerous type of cells, I should say, prior to them turning into a cancer. So by removing polyps.
Frankye Myers: Definitely, it sounds like the colonoscopy is definitely more comprehensive, um, and, um, could detect things that you clearly would wanna know earlier than later. Exactly. Well, Dr. Nay, that is very helpful. Um, I'm really, um, just appreciative of your passion and all the work that you're doing in this space.
Is there anything else, uh, that you think would be helpful as we continue to educate, um, our patients, families and the communities that we serve as it relates to colon cancer, um, prevention and also screening .
Dr. Michael Ney: I'll just say, um, you know, it, it breaks my heart every time that I diagnose a colon cancer in, in, in an individual, especially when it's, uh, a case that probably would've been prevented if they would, to have followed the guidelines in terms of, you know, having a colonoscopy at the correct age or some sort of colon cancer screening.
If you're scared of having a colonoscopy and kind of want to just try to get away with just doing a fit test or a cologuard. Completely fine. Everybody just needs to get colon cancer screening of some kind. Um, you don't wanna be one of these people that, that regret, you know, doing this once every 10 year test, um, you know, and then end up having a colon cancer.
It's, it's really not worth it. And make sure that, especially if you're an individual who's had colon cancer, um, or history of, uh, you know, advanced polyps that you make sure you let all of your family know as well that they would be at increased risk and, and should be getting their, um, colonoscopy.
Frankye Myers: Absolutely. Great information, great feedback. You heard it here. Get your screening. Uh, thank you so much.
Dr. Michael Ney: I appreciate it. Have a nice rest of the day.
Frankye Myers: You too.
Thank you for listening to this episode of Healthy Youth. We're so glad you were able to join us today and learn more about this topic. If you would like to explore more, go to riversideonline.com.
