Summary:
Dr. Mark Lewis is a gastrointestinal oncologist who is here to address the changing trends in colorectal cancer that are affecting younger and younger people. He explains that age is no longer as protective as once thought and colorectal cancer can occur before the age of 45, when screening typically starts. Dr. Lewis advises people to pay attention to their bodies and seek medical attention if they experience abdominal pain, cramps, or bloody stool. Additionally, understanding family history and genetic predisposition is important in determining when to start screening.
Dr. Lewis specifically urges young women to advocate for themselves if they feel that their symptoms are being dismissed by doctors. He warns that the phrase “you’re too young for cancer” no longer carries any weight. He encourages everyone to have a colonoscopy, which is both an early detection and prevention tool for colorectal cancer. Dr. Lewis concludes by emphasizing the importance of taking charge of one’s own health.
Engaging Piece:
Colorectal cancer is a topic that many people avoid talking about. It’s an uncomfortable and often frightening subject, but it’s one that needs to be addressed. Dr. Mark Lewis is a medical professional who understands this disease better than most. He has seen firsthand how colorectal cancer is affecting younger and younger people, and he knows that early detection is crucial to successful treatment.
Dr. Lewis’s advice is simple but powerful. You know your body better than anyone, so pay attention to any changes or abnormalities. If you experience symptoms like abdominal pain, cramps, or bloody stool, don’t be afraid to speak up and seek medical attention. And if you have a family history of colorectal cancer, make sure that you know when to start screening.
Perhaps the most important thing that Dr. Lewis emphasizes is the need for young women to advocate for themselves. Women are at an increased risk for colorectal cancer, and their symptoms are often misdiagnosed as gynecological issues. It’s important for women to trust their instincts and fight for their health.
Despite the discomfort that comes with discussing colorectal cancer, it is a topic that needs to be addressed. Dr. Lewis’s advice is sound, and his guidance can help to protect young people from a disease that is becoming increasingly common. So be proactive, take charge of your health, and don’t let fear or embarrassment keep you from seeking the care that you need.
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MARK LEWIS: Hello, my name is Dr. Mark Lewis. I am a gastrointestinal oncologist. I’m the kind of doctor you never want to meet because if you’re in my office it means you have cancer and my office specifically means you have bowel cancer. Why is this relevant? It is relevant because colon and rectal cancer is affecting younger and younger people. Now, if you’re seeing this, that doesn’t mean it’s meant to happen to you, but there are a few things you should know.
Number one, age is not as protective as we once thought or hoped. It’s absolutely possible to get colorectal cancer before the age of 45, which is when we get screened now. So how do you know when to worry? Well, you know your own body better than anyone, you inhabit it 24/7. So if you have new abdominal pain and cramps, especially when you go to the bathroom, that can be worrisome.
Presence of blood in the stool is usually hemorrhoids, however it’s hard to assume that and therefore have a very low threshold (I know it’s uncomfortable) to talk to your primary care provider and ask for even a rectal exam. There are also at-home stool tests you can do, not just for blood, but for precancerous DNA in your stool that can really tell you, hey, do I need a colonoscopy right now or is it something I can look at?
And finally, your family history does matter. It’s about you, it’s also about the genes you inherited. So if you know that people in your family have had colorectal cancer in their late 50s, we’d typically subtract about 10 years from that and start testing you even earlier than your peers. So all in all, putting this together, screening is about protecting you ideally, but diagnosis is about looking into the issues you discover in your own body so that both can come together to give you the best possible outcome. I wish you the best of health.
MARCO LEWIS: Hello. My name is Dr Mark Lewis. I am a gastrointestinal oncologist. And I’m here to talk about some changing trends in colorectal cancer, what they mean for patients, and how patients can advocate for themselves. So we’re here at the biggest cancer conference of the year, and there are four abstracts or presentations that specifically address the changing tides of colorectal cancer.
So one thing that needs to be addressed right away is that many people think of cancer in general as a disease of aging. Cells replicate and go through one cycle after another. So they are more likely to accumulate failures over time. This is generally true. Perhaps most worryingly, we can no longer make that assumption when it comes to age and the likelihood of getting colorectal cancer, because these four studies in their own way showed us that we’re seeing things headed in the right direction. for patients over 50 but very much in the wrong direction for people under 50. And I know it’s scary, and I’m not here to be scary. I am here to tell you what you can do about it.
So one of the things these studies found was trying to look for demographic clues. OK. So it’s one thing to say you’re young. You are under 50, which is traditionally when we screen for colorectal cancer. What can you do beyond that? The group that I think is most at risk are women. So in my practice, if you take the average age of all my patients, the average age of all my GI cancer patients is 68 years old. And yet, 1 in 7 of my patients is a young adult with colorectal cancer, and I see more women than men.
And what I see happen over and over again, and this is hindsight on me, is that they’ve had problems. They have been having abdominal or pelvic pain. Sometimes they have even had bleeding with the passage of stool. And yet they tell them that you have a gynecological problem.
I’m here to tell young women in particular to please stand up for your rights. If you’re talking to your doctor, say, your primary care doctor or your gynecologist, and you have a problem that seems out of proportion, that doesn’t seem to fit with what you understand about your body and your cycle, that warrants investigation. I can’t tell you how many times I’ve seen a young adult, and again, this is what I do, but with colorectal cancer who’s been told, dismissively, that this is just hemorrhoids. You are too young to have cancer. Unfortunately, that phrase no longer carries any weight.
So what can you do? Well, A, like I said, you’re the expert, the content expert, on your own body. You know which patterns are abnormal for you and should be consulted with medical care. B, you must know your family history. There’s quite an inheritance component here.
And as a general rule, we take the youngest person in your family affected by colon cancer or rectal cancer. We subtract at least 10 years from his age. And we ask that you start testing at that time. This is different than the recommendation for the general population. You may be aware that, in recent years, we have lowered the average risk detection age from 50 to 45 years.
So now, at 45, with absolutely no other medical information or risk, you can go to your doctor and you can have a colonoscopy. Why is it so powerful? Colonoscopy might be the only screening tool we have for cancer that is also prevention. If a young woman, for example, starts having mammograms at age 40, a mammogram can tell her that there is a problem, such as a breast mass. It doesn’t actually eliminate that problem. She just identifies him. Colonoscopy can do both.
A colonoscopist, who is usually a gastroenterologist, sometimes a surgeon, very rarely a family medicine doctor, can see a polyp and remove it. And by doing so, you’ve interrupted the disease trajectory of that polyp. It cannot become cancer if it is removed from your body. So, in short, him get to know himself, get to know his family, and know at what age to start getting tested.
MARK LEWIS: Hello. My name is Dr Mark Lewis. I am a gastrointestinal oncologist. And I’m here to tell you about some changing trends in colorectal cancer. Colorectal cancer is not fun to talk about, and it is occurring in younger and younger people. So the traditional age of detection for this disease was recently lowered from 50 to 45 years. But what do you do as a young person, especially if you are not yet 45?
You need to know your family history. You need to know if you have family members who have had colorectal cancer and at what age. That can tell you when your doctor will start evaluating you. You also need to know your own body. Once again, I know this is not nice. But blood in the stool is not always hemorrhoids. And many, many people, even their doctors, presume hemorrhoids when, in fact, they need to look further.
And finally, I’ll just say that, unfortunately, there is no such thing as “too young for cancer.” This is no longer and, in fact, probably never has been a disease of aging. And we have never seen more cases of colorectal cancer in people this young. It’s the only demographic, people under the age of 50, where this disease is increasing and becoming more deadly, not less common and less deadly. So take care and defend yourself.
https://www.webmd.com/cancer/asco-2023-special-report/20230606/colorectal-cancer-trends?src=RSS_PUBLIC
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