Centered on Health 7-4-24 - Health Screenings at every age with Dr. Conor O'Neill and Dr. Arayo Sokan

Centered on Health 7-4-24 - Health Screenings at every age with Dr. Conor O'Neill and Dr. Arayo Sokan

Episode Transcript

(00:01):
It's now time for Centered on Healthwith Baptis Help on use Radio. Wait
for each elbody y JS. Nowhere's doctor Jeff Tuban. Good evening,
everyone, and welcome to tonight's episodeof Centered on Health with Factors Health,
your call in medical show here onNews Radio eight forty whas. I am

(00:21):
your host, doctor Jeff Publin.We're joined by mister Jim Finn and our
studio waiting to take your calls totalk to tonight's guests. Our phone number
five oh two, five seven one, eight four eight four if you want
to call in be a part oftonight's conversation and tonight we are very fortunate
to have not one, but twoprimary care physicians today to talk to us

(00:42):
about healthcare screenings at any age.So, no matter who you are listening
to this show right now, there'sgoing to be something in this show that
pertains to you. So I amI'm hoping you're there, you're ready to
call in and ask questions. Iwant to introduce you to both doctor Connor
O'Neill and doctor Ario Chopan. DoctorO'Neill is a primary care physician with Baptist

(01:06):
Health Medical Group at Breckenridge a practicethat I am very familiar with. He's
joined us from as a graduate ofthe University of Kentucky Medical School, and
doctor Ariah Chopin also is a primarycare physician with Baptist Hospital Medical Group,
receiving his MV from the University ofKentucky Medical School as well. Both of
them are here. They're new toour community over the last couple of years

(01:29):
and are filling an enormous gap inprimary care. And we welcome you both
to the show. Thank you,Thank you for having us, and we're
glad to be here. And we'vegot both of you on. Yeah,
fantastic. So you know, I'mreally excited to have you both, And
I think the way I just kindof want to introduce you to our listeners

(01:52):
and to our audience is maybe giveyou each, you know, just a
little time to tell us about yourdecision to become a primary care physician and
kind of what you what you thinkabout primary care and why you're attracted to
it. So maybe we'll start withdoctor O'Neil, you can tell us about
you, and then doctor Choken wecan hear about you. Yeah, thank

(02:13):
you. So I had always kindof been interested in primary here and it
wasn't until I was in residency andtraining that I wanted to pursue it.
It really was the aspect of justhaving continuity and you know, establishing relationships
with patients over years to decades thatI really enjoyed and looked forward to.

(02:38):
So that was really the main reasonI wanted to pursue primary care. The
other reason was that I kind ofliked I liked every other specialty, but
I didn't love any specialty. Soprimary care kind of encapsulates all specialties in
some way. So that was amain reason that I wanted to pursue.

(02:58):
And it's it's been a good tosay as an ever since. Good talking
in doctor shoken. Yeah, forsure. You know I can echo a
lot of what doctor O'Neal I hadto say. You know, for me,
it's an interesting process, right.You know, my father is also
a primary care physician. Okay,in some way the kind of a family

(03:19):
business. But you know, intruth, it's not something that I really
thought I was going to end upin. Like when I started out in
this process so long ago, ifyou'd asked me if I was gonna end
up as a primary care position,I would have told you. But you
know, as I think, themore time I spent working with patients and
the more time I spent, youknow, studying medicine, I think for

(03:42):
me, the part that's always beenimportant is it's always been the people right,
and the opportunity to serve a communityand a group of people for a
long period of time right and makea significant difference. I don't think I'm
alone and saying that's why I wascalled to medicine, My suspicion is probably
why most of us were, youknow. And I think for me,
the best way that I found tobe able to do that, to make

(04:03):
a meaningful impact on a specific groupof people, it's through primary care.
And you know, I agree withthe doctor O'Neil. There are a lot
of things in medicine that are superawesome and cool, and I'm so happy
we have wonderful people to do thosethings, you know, But I think
it's incumbent upon each of us inmedicine to find the area that best melds

(04:26):
our skill set and our interests ina way that can bestor of our patient
population. And I think for me, primary care has been that, and
it's challenging, it's it's different,it's fast paced. Every single day is
something new, every single visit issomething new, which is you know,
had its own unique challenges, Butit's a it's great, it's fun,

(04:47):
it's it's a very cool thing tobe a part of right now. And
getting to do it with such agreat group of people like we have over
at Saint Matt's, it's just sucha unique opportunity. So I'm really thankful,
well, we are thankful that bothof you are here for sure.
And I'm going to stick with you, doctor Chokin for just a minute because
I have a whole list of thingsabout primary care I wanted to talk to

(05:10):
you guys about. I'm gonna waitbecause I want to These screenings are so
important. I want to kind ofget right into it. But before we
get with doctor O'Neil and start withour first cancer screening, doctor Chokin,
can you just describe for our listenerswhat screening actually means? And I think
you know, as one of thepeople doing the screening for one area of

(05:34):
this medical world, sometimes I feellike people don't understand what the concept of
screening is versus a diagnostic KEP,could you tell us a little bit about
that for sure. You know,screenings in many ways, This is probably
the talk I give the most,but screening. What we're doing with screening

(05:54):
is we're really trying to identify problemsthat might be coming down the road before
they be issues that are so significantthat they require such a massive intervention.
Right. So it's really about earlyidentification, early diagnosis, and giving ourselves
the best chance to fight back againstanything that might be brewing. So,

(06:16):
you know, many of these teststhat we're going to discuss our tests that
you would get while feeling healthy orrelatively normal, routine tests that we asked
our patients to go through so thatwe can evaluate for the things that don't
typically develop in a way that isvery apparent to the people who are experiencing
them. Right. So, alot of these tests are specifically designed have

(06:41):
high rates of positivity, right,So they want to catch as many people
as possible in order to identify thepeople who need an additional step of screening,
a further step of testing. Right. So, some of them are
not the most specific tests that wehave, but they do a really great
job of identifying the individuals who haveneed for further screening. So as you,

(07:04):
as we go through this talk,I'm sure you'll see that many of
these tests are tests that lead tofurther tests, and that's often a way
I think about screening is as anopportunity for us to take a peek under
the hood see what problems might bebrewing while we still have plenty of time
to address and impact those things.And and doctor o' neil, we're gonna

(07:27):
switch over to you another first thingwe're going to talk about. We're going
to have you kind of focus on. But these are it's important for our
listeners and for patients and our practicesto realize that they don't have to have
symptoms. In fact, the screeningreally is intended to get things before symptoms.
Is that is that correct? Yes? And really I mean for screening.

(07:54):
You know, that's kind of thehard part about you know, screening
tests is that you don't don't feelany you know, you're not having any
symptoms, you're not feeling worse,and so to go through a test,
a lot of people don't feel thevalue. But typically when you start to
develop symptoms of you know, thetests and diseases that we're going to discuss,

(08:16):
typically that is at a point,you know where it's not too late,
but it's later than we could haveaddressed it before. And so that's
why it's very important to make surewe're doing all of the proper testing at
you know, the certain ages,the certain risk factors, because we want
to make sure that we can addressit before before it progresses to something that

(08:37):
you know, ultimately could you know, be inevitable. And so that's really
the most important part about screening isthat you don't feel any different. You
know, you feel fine, butthere still could be something there that we
can address before it progresses. AndI think we're gonna we're going to try.
We're going to try and cover quitequite a range of screening today.

(09:00):
We're going to try and hit atleast colon and prostrate and cervical and breath
and we're going to try and touchon all of those. But I think
we're going to start, and we'regoing to start with you, doctor O'Neil,
about colon cancer screening, which ofcourse to me is very near and
dear to my heart. But ifyou could just tell us briefly kind of

(09:20):
who when do you start calling cancerscreening? And is there a time when
you stop calling cancer screening? Yes, so it actually I think it changed
in twenty twenty one, and youcorrect me if that it says right around
the year. But it was fiftyyears old that we would get, you

(09:41):
know, that would be the agethat we would scream for colling cancer.
But they had looked at the dataand sold that, you know, they
were there were a lot more peoplewho were being diagnosed younger, and so
they actually changed it in twenty twentyone to age forty five. So that
is the age of age that wetypically will screen for people who are average
risks and then after and then wescreened until seventy five years old. Now

(10:07):
you can you know, be screenedafter year seventy five and you won't have
It's really a shared decision making withyou know, the patient and the position
if they want to pursue that.There are certain individuals who may be at
higher risk of needing earlier screening,and some of those include if you have

(10:28):
a family history, which typically includesif you have a first degree relative that
was diagnosed and going cancer. Typicallywe would die or we would start screening
ten years before that first degree relativeage of when they were diagnosed. If
they were diagnosed later than you knowfifty, then we typically would start at

(10:50):
age forty because you are at ahigher risk of developing coaling cancer if you
do have family history. The otherones would be if you haven't flammatory val
disease typically like ultra drive colitis orchron disease. We typically would start colonoscopy
about eight years after they were diagnosedinitially of disease on set, and then

(11:13):
we would kind of pursue colonoscopies orin a screening method for colon cancer every
three to five years because those patientsare at a higher risk of developing colon
cancer as well. And we're gonna, I guess this go ahead. I
was just gonna say, we're gonnawe'll get into how we're gonna do that
screening. We're gonna have to takea quick break here and then we're going

(11:33):
to continue with you, doctor O'Neil. You are listening to doctor Connor O'Neill
and doctor Ario Chopin talking to usabout screening at any aid. This is
centered on health with Baptist Help hereon news radio eight forty w a as
I'm your host, doctor Jeff Publin, And if you want to call in
and ask questions about screening for anytype of cancer. Five oh two,

(11:54):
five seven one, eight four eightfour producers contents on call to take your
calling, We'll be right back.Welcome back to send it on health with

(12:15):
Baptist Help here on news radio eightforty WAKS. I'm your host, doctor
Jeff Calvin. We're talking tonight toprimary care physicians Connor O'Neill and a Ryo
Chopan, both at the Baptist HospitalMedical Group, and teaching us tonight about
screenings at any age. Right beforethe break, we started talking about colon
cancer screening and doctor O'Neill. Bythe time patients get to me, they're

(12:37):
getting a callonoscopy as their choice forcallon cancer screening, but you have to
have the conversation with them about whatthat means and what other options are.
So tell us about your approach andwhat tests you offer to people for coll
and campus screens. Yeah, sothere's a variety there's of tests for screening

(13:01):
for colon cancer. The first oneand really the gold standard that we typically
recommend is the colonoscopy. And thereason this is the gold standard and probably
one of the best screening cancer screeningtests that we have is that you're able
to get direct visualization of the colonand if there's any specific leasions that are

(13:26):
concerning for cancer, and you canactually remove those during the tests. So
it's really one of one of akind to where you can do a screening
test and then also treat it withremoving part of that pole up, assuming
that they're able to get the whole, the whole complete set. So that
is typically we typically will start againat age forty five if you're at average

(13:50):
risk and assuming that you you know, if you have no polyups or nothing
that is concerned on the colonoscopy,you don't have to get another one for
until ten years after that, sothat is a very Again there's very few
screening tests that have that duration ofnot needing another one for ten years.

(14:11):
Now, there are certain poll upsthat can specifically if you do have those
and they remove them, they recommendsooner surveillance with another colonoscope. Typically it
would be three to five years,and and there's a number of different poll
ups that can indicate which year youwould do, but we'll get into the

(14:31):
details of that, but that istypically what we would do is ten years
or three or five years if youdo have evidence of poll ups. The
next one that again i'll keep withthe most common ones, is a school
test that we it's called the colorguard often at REMART test, and so
that is one that you are ableto get a sample of your soool.

(14:56):
Usually you'll get since the material todo that and you'll you'll obtain a sample
of your stool. Then you willsend it back to this facility that where
they will test it for certain markersand they can detect DNA mutations that are
associated with colorectal cancer or pre canceras poly ups. Now, if you

(15:20):
do test positive, or if thecoal of guard ultimately does so positive,
then you do have to proceed toget into colonoscopy to further evaluate that.
The good part about that color guardis that it's obviously non invasive, which
is an ideal situation for a lotof patients. However, you know,
again it's not as ideal for treatingif you do have polyps as a colonoscopy.

(15:46):
And so those are really the twomain ones. There's a couple,
there's a few other ones. Twoother kind of direct visualization. One is
a flex flexible sigmoidoscopy that is typicallyevery five years, and that just specifically
we'll look at kind of the lowerpart of the colon where most cancers do

(16:07):
present, and it is a littleless invasive the colonoscopy. And then the
other one is a CKE colonograph.And I'll be honest, I haven't really
had many patients perform this or evenbefore uh, and so that I think
is every five years. Now.Again, I recommend strongly when I talked
about patients that colonoscopy is the mostideal. And again you can get that

(16:32):
if you don't have any findings,then you can go for ten years and
you don't have to worry about itnecessarily. Well, and you know,
I appreciate that approach, and youknow what's really nice for those listening is
that, of course, you know, we strongly recommend the colonoscopy, but
the important part is to be screened. Unfortunately there are some other options for
some reason. Colonoxopy isn't isn't rightfor you, but do get screened.

(16:55):
And thank you so much doctor O'Neilfor for explaining all that to us.
We're gonna shift gears a little doctorsoapin We're going to move into the area
of prostate cancer screening, which isalso another another important screening cancer to look
for. What is your approach andwhat do we need to know about prostate
cancer screening. Yeah, absolutely,let's get into it. Pro State cancer.

(17:18):
You know, prossate cancer is actuallythe most common non skin cancer in
men in the United States. It'sthe fourth most common tumor that is diagnosed
worldwide. So for men in theUnited States, about one in eight will
be diagnosed with prostate cancer at somepoint in their life. Those numbers are
slightly higher if like me, you'rea man of color. For African American
men, it's about one in sixof us will develop PROC high. Yeah,

(17:42):
that's remarkably high. Yeah, it'svery, very high. You know,
it's when you start to look atthe statistics, it's really easy to
understand why the screening is so important, you know. You know, and
this year alone, the American EurologicEucologication is estimating more than two hundred ninety

(18:03):
nine thousand men will be diagnosed withprostate cancer and over thirty five thousand people
will die from the So, youknow, it's a very significant thing that's
impacting a bunch of members of ourcommunity. So let's talk about it.
You know, it's interestingly prostate canceris not one of the cancers for which
the United States Preventitive Services Task Forcerecommends that we do routine screening and all

(18:25):
of our patients. But you know, this is a really unique opportunity for
your primary care provider to get apractice from shared decision making. You know,
prostate cancer screening is really an individualizeddecision. It's something that each primary
care physician would talk to each oftheir patients about. Well, the patients
for whom it's applicable, which justmale patients is only men have process at

(18:48):
this point. You know, forme, at least, my approach is
I start to look at the riskfactors. You know, for me,
men of color something we should bediscussing. Right, we know that there's
a signal, nificant increase in incidentsand men of color in this country.
We've got to talk about these things. Other than that any any individual with
a first agree relative with the historyof prostate cancer, individuals who are currently

(19:12):
smoking, these are all the kindsof people for whom there's an increased risk,
right, we should have at leastthe conversation about whether or not this
is something that we should pursue rightnow. I will also say that because
of the nature of prostate cancer asa disease, there are a significant percentage
of people for whom screening is notreally warranted. Right. You know,

(19:37):
we know that this is a slowlyprogressive cancer, and we know that this
is a cancer that it's fairly treatableand in many cases does not require urgent
intervention. Right. And so forpeople who have significant medical comorbidities, you
know, or life expectancies that areare of a sort that means that they
are more likely to have other issuesrise prior to this becoming the significant problem

(20:03):
in their life, it may notbe reasonable to pursue this, you know,
the screening strategy for them. SoI think this is a really great
opportunity for us to compare and contrast, you know, the way we talk
about colon cancer screening and the waywe talk about prostate cancer. Colon cancer
screening every patient, we've got todo it. Prostate cancer screening. This
is a more tailored approach, amore personalized approach per patient. You know,

(20:27):
the general logic, go ahead,I was gonna say, the screening
is it? The digital rectal examis it A, is it the p
S A? What? What isyour the current guideline of what to use
to screen for sure? For sure? You know. Fortunately, I think
for for both clinicians and patients,we've moved away from the digital firstal examine
the first line of testing for screeningfor prostate cancer. I think many of

(20:52):
our nations are very happy about that. Yeah, you know. The prostate
specific antigen is a blood test thatwe can and getting our patients. It's
recommended by the Urologic Association. Isthe first screening test with a level A
recommendation for evidence. So this isfor us, the first test that I
would reach for in patients for whomthis is something that they want to be

(21:15):
a part of their care plan forsome or for someone who has significant risk
factors. The recommendation is to discussthis with your patients every two to four
years, and patients who have aprostate age between fifteen and sixty nine.
But the discretion and frequency of rescreeningis left to each individual, to each

(21:37):
individual patient and their provider to determinebased on each individual's unique circumstances. Well,
we are learning a lot about takinggood care of ourselves, so we
are hearing from doctor Connor O'Neal anddoctor Arroya Royal Chokran about calling cancer screening,
prostate screening. We've got others comingup. Please stay on the line,

(22:00):
listen, call in, ask questions. This is Centered on Health with
Baptist Health here on news Radio eightforty. I'm your host, doctor Jeff
Publin. Five oh two, fiveseven one, eight four eight four.
If you want to call in andask the question, We've got a lot
more to cover. We'll be backright after this. Welcome back to center

(22:26):
it on Health with Baptist Health hereon news radio eight forty w h as.
I am your host, doctor JeffPublin, and we're talking tonight about
screening at any age and for allsorts of cancers. And we're talking with
primary care physicians, doctor Connor O'Neilland doctor Ario Chopin. We're gonna switch
gears a little bit. We've talkedabout colon cancer, We've talked about cost

(22:49):
stake cancer. We're going to switchand talk doctor O'Neil about cervical cancer,
which is it is very important obviouslyin women with cervixes, but there is
some implications for young men and HPV, and I think this is a topic
we need to hear about. Sotell us a little bit about cervical cancer

(23:11):
screening. Yeah, So typically whenwe screen for cervical cancer, the age
that we will plan to start atis twenty one and we go up until
sixty five. From twenty one totwenty nine, we typically will do a
PAP smear and if that is normalnegative, then we would just do that

(23:33):
every three years. Once we reachage thirty, we can either do the
regular PAP smear, but we canalso screen for HPV, which is what
you mentioned before, which can causecervical cancer that we know of, and
so we will depending on which testsyou get. If you get a pat

(23:55):
SERF, we do a PAS smeereand HPV testing with that PAS smear and
that's negat know we go every fiveyears. We don't have to go any
sooner. If we just do aPAP smear, we don't test for HPV
that every three years. But likeyou mentioned before, we had we know
that certain viruses, specifically the humanpapaloma virus can cause UH cervical cancer,

(24:19):
and so we have we do havea vaccine which is beneficial and we're strongly
recommending that to our patients to preventcervical cancer and the spread of that and
reduce the risk of and so wewill recommend HPV vaccines if you haven't received

(24:40):
it from as a as a childtypically is recommended first from age starting at
age eleven. You can get itup to age twenty six, and it's
two doses as a child if youget it, but typically it'll be three
doses by the time they get tous. And that's again up to twenty
six. You can get it overtwenty six twenty six years of age,

(25:02):
but that's kind of a more youknow, shared decision making depending on your
risk factors, if your immuno compromiseand have anything specifically, so again like
I said, we will it's usuallyevery three to five years after you turn
sixty five, and you you know, you haven't had any history or issues
of positive PAP smears going forward,then we typically wouldn't recommend screening. However,

(25:27):
again, if you had either apositive PAP smear in the past or
any increased risk factors, then wewould consider going forward and continuing PAP smear
testing and screening for cervical cancer.You know, and I think it's really
fascinating when you think about it.The fact that there is a linkage between

(25:51):
an infection and cancer and we havea vaccine that prevents it. Tell us
about like who are the targets forthe HPV that and at what age is
Yeah, so the game really recommendedfor both the male and females. So
we get for pretty much everyone.It's to start if we can get it

(26:14):
earlier from age eleven to twelve.And specifically, you know, there's two
kind of subtypes of this virus thatthey have found that kind of cause cervical
cancer, and so you can getthe two doses as a child, but
again you can also get three doses. But the most important part is that
this is going to prevent you know, getting cervical cancer if you're a woman,

(26:37):
but also if you're a male andyou get this HTV, you can
prevent the spread of that, whichis really probably very unique in the cancer
field that we know that a viruscancer. So that's another thing that's very
unique with this kind of cancer andscreening for it, is that we can
almost prevent it with just you know, two shots initially essentially, So that's

(27:02):
a very you know unique thing andbeneficial thing if we can address it sooner.
Amazing when you think about what we'rewhat we're able to prevent there,
Doctor Show, can you know obviouslywe could do an entire hour, two
hours, three hours on the topicof breast cancer screening, but in the
context of a general overview of screeningrecommendation for those listening, tell us about

(27:26):
where we are, what the recommendationsare for breast cancer screening, how is
it, how is it done,and who is it recommended? For sure,
absolutely, just a little bit ofbackground again, breast cancer rights in
the United States is roughly one ineight women lifetime risk, which is again
substantial twenty twenty four estimates, orthree hundred and ten thousand new cases with

(27:51):
forty two thousand new women unfortunately passingfrom breast cancer. You know, we
think about breast cancer typically as acondition that effects women, but it can
affect men, although they are verysignificantly a significantly smaller percentage of the patient
population. So when we talk aboutscreening, we're going to focus primarily on
women for this particular type of cancer. The median age at the time of

(28:15):
breast cancer diagnosis is sixty two,so that's going to inform us about how
old we are going to start thescreening and how long we're going to continue
it for. So currently, theUnited States Preventative Service Task Force recommends by
any o, which is one ofmy favorite, unnecessarily difficult word by the
word yeah. Yeah, it's agood word for as all women age fifty

(28:38):
to seventy four years. For somewomen, it's reasonable to start before fifty.
But again, shared decision making,I think we've beaten guys over that
with what that means at this point. So for some people, depending on
your independent risk factors, we maychoose to pursue it earlier. But even
in most of those patients, I'vevery rarely seen it before the age of

(28:59):
four. And for women that aresorry, go ahead, no, go
ahead, go ahead, okay.For women who are at average risk of
breast cancer, the most common typeof breast cancer screening is a mammogram,
and that demonstrates the most significant benefitfor patients between the ages of fifty to
seventy four, specifically sixty or sixtynine. That is where we see the

(29:22):
most significant mortality benefits through mammography.So let's talk about what is mammography.
What is the current discussion around it, and what are the new things that
might be coming down the pipeline inthe next five to ten years that we
might see as novel ways that wecan evaluate and screen for these conditions that

(29:44):
might give us some opportunities to evaluatepatients who might not fit into the box
of the mammogram. So, ascreening mammogram one of the most common ways
we screen for breast cancer in theUnited States. It's a test where we
use X ray pictures, typically fromtwo different angles to get a good characterization
of the tissue of the breast.Right. If we see something significant on

(30:07):
a screening mammogram, typically we reachfor a follow up from mammogram which looks
at several different angles extra views,and that's what we would call a diagnostic
mammogram. Typically that's the path thatone would follow if that's where you were
headed. But there's some other teststhat you might hear that might be used

(30:27):
in this process for screening, orif you have some specific characteristics about your
specific breast tissue, for example,if you have more dense breast tissue,
we might reach for one of thesealternate modalities. Right. So, one
of the other common ways that wescreen, although it's not typically our first
test is it would be breast ultrasound. Specifically, I reach for breast ultrasound

(30:51):
in my patients who have a moredense breast tissue. That dense tissue can
be just more difficult to characterize onmammogram. It also can help us get
you know, better pictures of suspiciousareas that we might have seen on a
screening mammogram as well. Ultrasound isnice because it helps us distinguish between like
a fluid filled mass, which likea cyst. Those things are much less

(31:15):
likely to be a cancer than asolid mass, which would mean you know,
advanced testing for their imaging depending onwhat the characteristics of that mass might
be. There are a couple ofnewer modalities coming down the pipeline. I
just want to mention these briefly.We don't have to get into it.
I just think they're super cool.So one, there is a new sequencing,

(31:37):
a new structure of MRI called abbreviatedbreast MRI or fast breast MRI,
which is a more rapid sequencing MRIthat gets another opportunity to evaluate breast tissue,
specifically in people who have more densebreasts for whom mammogram may not be
the best modality in that same patientpopulation. We can also pursue contrast enhance

(31:59):
mirmography, which is another new formof screening where we're using contrast injections to
enhance the baseline functionality of the mammogramtechnique that we've been using. So if
you hear either of these two newmodalities, I think these are the two
for which there's the best buzz asfar as new testing strategies that might be

(32:21):
coming down the pipeline. But intruth, I'd be pretty surprised if,
say, if they are outpaced thescreening mammogram, which has been a stall
wark really for us for quite sometime. Well, I think for anybody
listening, it's very obvious why weneed young educated primary care physicians in our
workforce to teach us and keep upwith all of these things. I mean,

(32:43):
this is just the amount of informationyou carry around with you guys all
day long. It's just unbelievable.We're going to take our final break here
and we're going to come back andtalk about a couple more things. You're
listening to Center on Health with BaptistHealth here on News Radio eight forty whas
our guest tonight, doctor Connor O'Neilland doctor Rio show Can talking to us

(33:04):
tonight about screening modalities and different typesof screening at any age. If you
miss any of tonight's show, downloadthe iHeartRadio app. It's free, it's
easy to use. We'll be rightback. Welcome back to center It on

(33:29):
Hew with them miel Beer on NewRadio A forty WHS. I'm your host,
doctor Jeff Publin, and we're talkingtonight with primary care physicians Connor O'Neill
and Orio show Can talking us tonightabout screening for cancers at any age.
Remember to download the iHeartRadio app sowe listen to this or any of our
previous segments and have access to allthe other features the app has to offer,

(33:52):
you know, doctor Onneil, Oneof the things that I think that
people may not think about is thatwe actually have the ability to screen for
lung cancer. And I know thatwe live in a state that has you
know, significant risk factors for this. So talk to us, what talk
to us about screening for lung cancerand how are we doing as a community

(34:13):
and getting that done. Yeah,so this is obviously very important for our
state, the state of Kentucky,and we have a very high lung cancer
diagnosis and lung cancer patient population,so we typically will we will get the
screening method for lung cancer is aCT scan, and so it's it's specifically

(34:36):
a low dose one, so it'snot high end radiation, and we start
at age fifty and patients who havewhat we call a twenty pack here smoking
history, which pack here essentially meanshow many packs over a certain amount of
years that they've smoking. So ifyou smoked one pack a day for twenty

(34:57):
years, that would be a twentypack year. If you smoke two packs
a day for ten years, thatwould be a twenty pack year essentially,
So it depends on how much andhow long you smoke, and so we
would typically get the CT scan oncea year, starting at age fifty up
until you're eighty years old. Ifyou continue to smoke, if you have
quit within the past fifteen years,then typically we would stop because your likelihood

(35:22):
of having lung cancer if you've quitand you don't have any essentially nodules that
are concerning for lung cancer is muchlower. And so again we do that
once a year, but really themost important part of lung cancer is smoking
cessation and minimize it and stopping smoking. And so there's a lot of you

(35:45):
know, different modalities that we cando to produce that, and we really
try to advocate for that instead ofobviously having to screen with a CT scan
every year, and we certainly wantto you know, reinforce that this is
again, this is screening. Weyou know, especially with something like lung
cancer, we want if we're ableto catch this really early, then that's

(36:07):
obviously ideal. So to any stigmataaround you know, feeling uncomfortable talking about
that you're smoking with your provider,we hope that you'll that you'll do that
shifting gears a little bit out ofthe cancer realm per se, but screening
as a primary care physician, doctorSho, can you talk to us.

(36:28):
We have a couple of minutes leftabout depression. I mean that that is
such an important thing and and Ithink people go to their primary care and
is this something you find people bringup to you. Do you find you
have to be proactive in assessing thisand how do you do that? Yeah?
Absolutely, you know this is inmany ways, this is the silent

(36:50):
part of almost every visit that Ihave, Right, this is some ways
of silent screening, because especially inthe last four years, I guess we're
the last four years more or less, we're seeing significant increases in depression in
every demographic right, every age groupacross the board. And so you know,
as a primary care physician, Ithink it's really incumbent upon us,

(37:13):
and in truth really for many ofour specialists as well, to be evaluating
this to some degree in almost everypatient visit. You know, from a
primary care standpoint, we have amore structured approach, there is a recommendation
for us to do routine screening eitherwith typically with one of several questionnaires that

(37:37):
we might use that can help identifypatients that might be at risk. However,
really I think at this point it'sa conversation that I'm having with almost
every patient, right, how areyou feeling? How do you feel that
you're adjusting? You know, it'sa crazy world that we're living in.

(37:57):
I think that's being clear And Iwas telling someone the other day, I'm
really ready for some precedented times.You know, we're all adjusting to this.
What is the next ten years goingto look like? How are we
going to move forward and whatever thisnew world is going to look like.
So I think a lot of primarycare physicians are taking this time to really

(38:20):
just make sure that we're checking inon each other. And whether that's using
a validated questionnaire like the PhD nineseries, or whether that's you know,
taking a more patient by patient approach. I just you know, I think
it's it's going to be more andmore important, and as we move into
the future, I think it's goingto be one of the cornerstones of primary
care. Well. I know Ican already tell just by talking to both

(38:45):
of you that you provide an environmentfor your patients to have those conversations with
you about all of these screenings,so we appreciate everything you're doing. That
wraps it up for another segment ofCentered on Health as Aptics Health. I'm
your host, doctor Jeff Publin.I want to thank our guests, doctor
Connor O'Neil and doctor Arioshocran for sharingwith us screening and I know we have

(39:06):
much more we could talk about.We'll just have to have you back.
So I want to thank our producermister Jim Ben and you the listener.
Join us every Thursday night for anotherepisode and I hope you have a great
week. We'll see you next week. This program is for informational purposes only
and should not be relied upon asmedical advice. The content of this program

(39:30):
is not intended to be a substitutefor professional medical advice, diagnosis, or
treatment. This show is not designedto replace a physician's medical assessment and medical
judgment. Always seek the advice ofyour physician with any questions or concerns you
may have related to your personal healthor regarding specific medical conditions. To find
a Baptist health provider, please visitBaptist Health dot com.