May 8, 2023 • 25 mins
Some people may think colon cancer is mainly a man's disease, but the truth is, almost as many women as men are diagnosed with colorectal cancer. Dr. Lorna Fitzpatrick, vice president of medical affairs for safety net programs and senior medical director at Excellus BlueCross BlueShield joins us for this episode of the Community Check-In to talk about the shocking reality of colorectal cancer and how screening can save lives. Whether you’re insured or not, screenings for colorectal cancer are free and very important for everyone.
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(00:03):
Welcome to excel Us Blue Cross BlueShields Community check In. Each week we
cover a specific topic featuring Excellis BlueCross Blue Shield experts. You'll get to
know our team as we discuss thelatest in healthcare, health education, and
community health. Find us at ExcelusBCBS dot com and follow on Instagram and
(00:26):
Facebook. I'm Joelomonico. Welcome tothe check in this week, and doctor
Laura Fitzpatrick is joining us again,vice president of Medical Affairs for Safety Net
Programs and the senior medical director atexcel Us Blue Cross Blue Shield. Doctor
Fitzpatrick's back with us today to talkabout a topic which is very personal to
me, my family, maybe manyfamilies, and she's here today to talk
(00:47):
about the shocking reality of colorectal cancerand how screening can be so crucial to
help save lives. Now, remember, whether you are insured or not,
screenings for colorectal cancer are free andthey're very important for you to have conversations
with your doctor about. And doctorFitzpatrick will explain in more detail as we
go through our community check in thisweek. Doctor Fitzpatrick, nice to have
(01:07):
you back, Welcome to the program. Thank you for having me. I
want to remind people, Doctor Fitzpatrickhas been with Excelli's Blue Cross Blue Shiel.
She came to them after practicing academicmedicine up in Buffalo for some twenty
years. She's board certified in pediatricsand pediatric hematology and oncology and got her
medical degree at Jacob's School of Medicineand continued your residency in pediatrics at Saint
(01:30):
Louis Children's Hospital, Washington University,Saint Louis, and then when she completed
a fellowship in Pediatric Hematology oncology atJohns Hopkins University and spent twenty years focusing
on caring for pediatric patients with braintumors. So we're gonna tap into her
oncology expertise this week. Colorectal cancershave been a part of my family for
(01:53):
generations, from grandfather to me,my sister in law. We lost colorectal
cancer earlier this year, So Ireally do want to make this conversation as
broad based and as informational as wecan to all everybody because this can impact
(02:13):
everyone. So let's talk about whatwe're going to deal with here colorectal cancer
biologically. What are we talking aboutwhen we talk about this type of cancer.
Yeah, So colorectal cancer, likeany cancer, is just one or
two cells that in your body thatstart to grow abnormally and kind of take
over and form tumors. So youreally want to in the colorectal case,
(02:36):
anywhere in the colon directal area youcan have abnormal cells developed. They start
out really small in colorectal cancer,they develop often into polyps, little small
tumors in your colon that you see, and then from there they can spread.
Many times they stay in the colon, sometimes they can spread to other
parts of your body, depending onthe stage that you are detected at.
(03:00):
It's always so important to know whatto look for signs and symptoms as well
as to if you have it,try to get screened it. Get to
try to get screened as early asyou can to prevent it from getting to
the later stages. Let's talk aboutwhat let's do factor fiction here with colorectal
cancer. Factor fiction. It onlyaffects older adults, absolutely not. I'm
(03:23):
a pediatric oncologist, as you asyou heard, I took care of some
kids with colorectal cancer when they wereten, eleven, twelve years old because
they had a very strong family historyof it. So there's some cancer syndromes
that cause colorectal cancer in early childhood. You want to know about that.
As you pointed out, your familyhistory, so critical to know that and
(03:44):
bring that to your doctor so theycan help you assess the risk. But
definitely not only in older people,even people in their thirties forties, you
know. I know they've been somefamous cases in the news recently of that,
but it's really kind of edging downa little bit, certainly in your
thirties, forties or fifties. Youwant to be aware no signs and symptoms
and go to your doctor if younotice any of them. Fact or fiction.
(04:06):
It affects men more than women now, absolutely not. I think sometimes
you know, with breast cancer,people think breast cancers the women's cancer and
colorectal cancer is the men's cancer.Fact is they can both affect both both
genders and a colorectal cancers actually almostfifty fifty. So you want to be
aware of it if you're male orfemale, that you risk for colorectal cancer.
(04:31):
When it comes to causation, familyhistory, as you mentioned, certainly
going to be very important, thatgenetics are going to be important, But
we hear of some cancers being moreenvironmental, let's say, or lifestyle based
than others. So fact or fiction, is colorectal cancer any more or less
(04:54):
pinpointed to one type of a causeor where a path to actually getting a
diagnosed that may come from. Yeah. So certainly if you're a family history
and critical important to know that andto get screened at their appropriate times.
But if you even have other riskfactors in their smoking is as a known
risk factor. Certain dietary choices thatyou make, heavy alcohol use all can
(05:15):
influence your risk of colorrectal cancers.So if you have a family history of
it and syndrome and then you youput those on top of it, you're
going to increase your risk. Butyou don't have to have a family history
to have colon cancer. So youwant to make sure you can control the
things that you can control, smoking, diet, and your lifestyle choices that
(05:38):
you have, and make sure thatyou can control whatever you can. Screening
is what we hear the most aboutwhen it comes to colorectal cancer. It's
one of the things that is themost advantageous tool that physicians have when it
comes to being able to monitor theirpatients and regular screening. Let's make it
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a two part question. Number one, when does the screening should it start?
When? When is that important timeto have those conversations with your doctor?
And number two, let's talk aboutthe screening and how it starts.
It's not just going, you know, zero to sixty. You're going to
make other steps in between before youwind up getting to say, a full
colonoscopy or something that is more invasive. Correct. So, if you're an
(06:23):
average risk, if there's no familyhistory, no major risk factors in your
in your family, you want tostart getting screened around forty five for colorectal
cancers, So forty five to seventyfive to get the screening done. If
you have a risk factor in yourfamily, or if you notice symptoms like
blood in your stool, any weightloss, things that you can't explain,
(06:44):
you might also have to be screenedor taken a look at much earlier in
life. Is colorectal cancer one ofthe more preventable types of cancers, provided
it is detected at a time whenit is relatively in its earliest stages.
Yeah, so, especially with testssuch as a colonoscopy. When you have
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that done, you might be yourdoctor might see in there there's a polop
that polyop might be precancerous. Byremoving that polyp, you're also taking away
the risk of that polyp developing intoa cancer. So certainly tests like colonoscopy
is to look at it, tolook for polyps, can help prevent it,
certainly from getting to later stages aredeveloped into full fledged cancer. Now,
(07:25):
of course, we want to makesure that we are saying screening is
not a prevention. It's not onehundred percent. There is no one hundred
percent, But having those conversations andmaking sure that those screenings are taking place
is the best first step to makingsure that you're paying close enough attention to
it. I have always understood thecolorectal cancers also tend to be okay,
(07:47):
okay, another factor of fiction.Are they more or less aggressive than other
types of cancers? Or can younot really classify any type of cancer because
it's not just a one and done. Breast cancer is this way, lung
cancer is this way, colorectal canceris this way. Yeah, all,
there's no one cancer that's a oneone shot deal that it's it's the same
for everyone. There are incredibly aggressiveforms of colorectal cancer, each tumor itself.
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You know, we talk about peoplehaving family syndromes that each to itself
might have genetic mutations that make itmore or less aggressive than others. So
your doctor will help with that tofind out some of that information with it.
But absolutely there's no one cotton dryfor everything. But colorectal can spread
quickly, it can grow very quickly, and it can spread to other parts
(08:35):
of your body for really quickly.Doctor Lana Fitzpatrick is with Exceless Blue Cross
Blue Shield. She's vice president MedicalAffairs for Safety Net Programs. They're senior
medical director, and we're talking aboutcolorectal cancers and how screenings are so vitally
important. The statistics I read,though, we're falling a little short.
I guess percentage wise, I'd loveto see it that one hundred percent of
(08:56):
adults who are of age or amedical history to be screened are getting screened,
but we're kind of falling short ofthat. Is it in your estimation?
Is it because people say, Idon't want a colonoscopy, I don't
want to have to go through that. Yeah, I think I think about
thirty thirty five percent of people thatshould be screened or not screened yet,
So getting those people into the screeningguidelines is critical. But don't forget it's
(09:20):
not just a colonoscopy, which whichyou know you can. I think the
prep for the colonoscopy is probably theharder part than it. I just my
husband just had one done and inand out. He was out back in
the car in twenty minutes. Ididn't even time to read a book it
was done, so um, soit helps, but you really there's other
things to do. Simple tests foryour stool to see if there's blood in
(09:41):
it is helpful. I think sometimesyou see on TV advertisements for fit tests
or other ones that can be donewith just a stool sample. So there
are other ways to look for itand to test to see it on a
regular basis before you have to gofor a colonoscopy, So ask your doctor
what one is right for you.And I also just want to reiterate,
as we did at the beginning ofthe program, about the costs of this,
(10:03):
because cost is certainly something that wouldkeep people away from their doctor or
asking for that test whether you're insuredor not. Screenings for colorectal cancer,
they are. They are free,and they're available, and you just have
to talk to your doctor about gettingone. And we want to make sure
that we talk about this a lotbecause it's such a vital part of monitoring
(10:24):
what's happening with this very important systemof your body. Absolutely, and I
think you know, having them freeand available to people puts an emphasis on
just how important they are. Weas a medical community really believe we can
make a difference in people's lives bygetting those screetings done early. If you're
going to get it, you're goingto get it. Let's get you caught
as soon as you can, andlet's take care of it as soon as
(10:46):
we possibly can. That's how ithappened for me. Wound up with a
condition that I couldn't explain, wentto see my doctor, got referred to
a colorectal surgeon. I started gettingcolonoscopies at age forty, and I've had
one every five years since, andum polyps have been found every time,
and I am very grateful that I'vegone back in and it's a wonderful nap.
(11:09):
You're right, it's horrible prep,but it's a wonderful nap and the
table. The table is always niceand warm for you. At least that
has been um factor fiction. Itdoesn't colorectal cancers will affect one ethnicity or
race more than another. Yeah,we've certainly found that in the forum.
(11:33):
It does definitely affect black people morethan it can other races. We don't
know exactly why it is, butI think it's a It's a combination of
things. One is access to care, access to screening so important, and
I think the COVID nineteen pandemic hasshown us what disparagers are on healthcare.
We have to work to get everyoneon equal footing, to make sure it's
available and accessible to all, andthat there's no fear of it to do
(11:56):
that. But also it could beother things, you know, environmental factors,
that act of factors that were notaware of yet that can be causing
those differences. So very important thatwe know the differences so we can work
to equalize them. And also,as you mentioned COVID there it got people
off their schedules with seeing their doctors. Some people could not get to it,
didn't feel comfortable with going in,so some very important cancer screenings may
(12:20):
have been missed. How important thenis it getting back on that habit,
getting back into that into getting thosescreenings done, even if you've had a
layoff of a couple of years pastwhen you should have had you're regularly scheduled.
Yeah, absolutely, you know,get out there and make the phone
calls and get back into screening asfast as you can, either in your
(12:41):
primary doctor's office who will see youand doing a risk assessment and refer you
for colonoscopy or something more if youneed to have it done. But just
get out there and do it.COVID nineteen. You know, people weren't
doing the procedures for a couple ofyears right or some time because of the
risk, and then on top ofit, people are not going to the
doctors. It's so important to getback into the doctor's office and have someone
(13:05):
just take a book and see itmay not just be colorectal cancer screening.
It maybe mamograms, It maybe someother types of screening that you due for.
So very important because we do knowthat we can catch them early.
Catching early makes a huge difference inyour outcomes. Yeah, And just like
with your kiddos, and having themgone in for regular checkups. And it's
the same thing with you know whatyour benchmark is and then be able to
(13:28):
know when something has changed so thatfurther diagnosis is warranted and would benefit you.
So let's talk about those screenings.We'll get to colonoscopy in a second,
but that's kind of only one smallfacet. There can be others,
non invasive starting points that a doctormay use when it comes to trying to
assess risk and trying to understand whereyou are and where your benchmark is for
(13:50):
possible you know, possible markers withinyou know, within your test results.
Yeah, correct, And like Isaid, it can be something as simple
as checking for blood in your stool. You might not see all the blood
that's in your stool. It sometimesit's invisible. Sometimes your stool can just
change a little bit different color andyou don't even pick up on it,
or you think it's normal because it'swhat you've been doing for some time.
(14:13):
So something as simple as that canabsolutely screen for colon cancer. So that's
called a fecal occult blood test.Your doctor can give you a card,
you can do it and simply testfor blood. You can have less invasive.
You know, colonoscopy is just lookingshorter parts of your of your coal
and your sigmoid colon a little lessinvasive, but they still take a prep
(14:37):
to do those tests, and there'sa DNA stool test that you can also
have done. Your doctor will helpyou decide which is most appropriate for you
based on your risk factors, yourhistory, the symptoms that you're having,
and what other your age, etcetera. I did want to point out
something that you said, and Ithink the most important screening test to me
(14:58):
is what you talked about with youlisten to your body. If something is
wrong, it's important that you checkit out. Nobody knows your body like
you do. If something is notfeeling right, looking right, anything,
make sure you go into your doctrineand have a conversation about it. Yeah,
exactly, And don't be afraid tohave that conversation, not only because
I'm embarrassed about what system of thebody I'm talking about, or I don't
(15:22):
really want to know the answer,Go and have the conversation anyway, because
I didn't want to have the conversation, and I am very grateful that I
did, because it got me ona protocol for Colonoscopy's five years earlier than
I would have normally, and possiblyeven ten years beforehand. And I shuddered
to think of what my health wouldhave been like had I not done that,
(15:46):
when it was very easy for thedoctors to identify polyps, remove them
and give me a clean bill ofhealth so that I can come back five
years and just go through the testagain. Yeah. Absolutely, And it's
just so important. It's not peopleto talk about poop or whatever may be
going on. That's never a funconversation. But we're so used to it,
right, We're so used to it. That's why we ask you standardly
(16:07):
about it when you come into theoffice to see you know, belly pain,
you know, anything that's different orusual. No one person is the
same as another person. It's soimportant if your bowel habits change, if
you're noticing blood, belly pain,anything like that, weight loss that you
can't explain, you know, anythinglike that, please make sure you go
to your doctor and have them takea look at you. It's just that
(16:30):
important. We don't mind whatever youwant to talk about. We're here to
listen. We don't mind here anythingyour doctor has probably seen worse than anything
you're going to bring in. Sobring in your worst and you might not
even make their top ten. Absolutelywith the screenings then and again, screenings
do not you know, it's notone hundred percent when it comes to anything.
(16:52):
I want to make sure that we'reclear about that. Yes, there's
always there's always a margin there whenit comes to this. But when it
comes to find those cancers in theirearliest stages, finding polyps, having them
tested, is that for most peoplegoing to be their best indication of how
they need to proceed going forward.Yes. So if you go in there
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and you find polyps, there's differenttypes of polyps. Some are more tend
to be more cancrous precancerous than otherpolyps. Your doctor will know that.
They send it to a lab,the pathologist looks at it. They tell
you what type of polyp it is, how different it is than a usual
polyp, and that helps guide whatyou need to do going forward with it.
So once you get those answers fromthe lab, they go ahead and
(17:36):
we'll set up screening for you goingforward. Occasionally you might have to go
back and get something else looked at, depending on what the answer is.
Most of the time. They cangauge when you need to come back based
on the types of polyps that youhave in there. Some people have none,
that's terrific, you still need togo back and get checked again.
If you have other polyps, they'regoing to want to see you back sooner.
Treat it like a game with yourfriends. I've heard tell that some
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very famous people, Steve Martin,Tom Hanks, Smart and Short, they
have colon oscope parties and they goto one person's house and they do their
thing, and they play cards andwatch movies, and then they go get
their colon oscopies together, and thenthey go out to breakfast the next day,
because after a colon oscopy prep,there is nothing better than going to
a diner for breakfast in my opinion. But it brings up an interesting point
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about talking about our health with otherpeople, be their friends, be their
family. To really just to makeit more comfortable to say, look,
I need to have the screening.I need to know. It's okay for
you to know, and for youto go and do this so we can
encourage others to improve their health asa community, which is really what we're
(18:42):
hoping to do overall. So criticalhaving the conversations being open about an honest
You never know when you might beout with a friend you know you mentioned
it and it might trigger someone elseto get that done. Every single individual
counts. Every single person counts.Every single time you find it poll up
at an early stage, it counts. It makes a difference in someone's life
(19:03):
and a family's life. You know, we're all related to families and other
people who love us and depend onus. You just want to get everything
done as soon as you can,so have make it a normal part of
conversation. You're screening, what doyou need to get done? Why do
you need to get it done?And just go and get it done.
Support friends with car rides if youcan, and back and forth whatever meets
to be done. It's it mightbe easy for some of us, say
(19:23):
you also have someone to drive youto this, but not true for everybody.
There may be someone elderly, orthere may be someone who just doesn't
have transportation or whatever. You wantto make sure that you reach out to
everybody and see if there's anything wecan do. Support as a community is
so important to everything we do.Before we go back and recap some of
our key points, I want tolet people know that there are aggredible resources
(19:45):
that excel As Blue Cross Blue Shieldhas not only them, but the American
Cancer Society too that you can find. It's free and available online. Where
can people start learning more before theyhave Some people like to do that research
before they have the conversation with theirdoctor. Where do they go? Yeah,
the American Cancer Society has free onlinelibrary. You can go there www
(20:06):
dot cancer dot org and get yourinformation that you need. From there,
they just give you a lot ofbased information about what cancer is, what
it may develop in as well asscreening appropriate screening for that. And then
again at excel Us here we havea lot of information. We have a
lot of medical experts on hand availablehelp develop information from the experts and really
have it available. So give usa call to or look us up online.
(20:30):
We're more than happy to help youin any way we can. This
is doctor Laura Fitzpatrick. She's Vicepresident and Medical Affairs for Safety Net Programs
and a senior medical director at ExcelsBlue Cross Blue Shield. We are talking
about colorectal cancers on this edition ofthe check in, So if case people
are just popping into the last partof our show. We just want to
go back and hit some of thosebig points that we've been talking about.
You know, colorectal cancers. Itimpacts more people, I guess than you
(20:52):
might think. There's you know,it's it is. I don't know if
it's a leading cancer, but it's. But it certainly is affecting a lot
more people than I think. Arewe are you know hearing on a regular
basis. Yeah, it's a lotmore people. It's one of the most
common cancers that we see. Andhere they in New York State alone,
we have about nine or ten thousandpeople a year who are diagnosed with colirectal
(21:14):
cancer, about fifty fifty men andwomen. So it's it's a pretty even
split. But you want to dothat. And again, you know,
every year in New York State alone, about three thousand people die from that.
We would just love to keep chippingaway at those numbers and take it
down to we can prevent or takecare of all of this editor early stage,
especially when diagnosis of it can happenearly. It can happen early.
(21:38):
That doesn't always, but it canhappen at an early stage when it can
be very I'm not going to sayeasily treatable because no cancer is easy to
treat, but it can be targetedmuch more effectively. Why don't we say
than some other types of cancers.From a personal perspective, what do you
need to you know, what don'tyou be thinking about when it comes to
(22:00):
actually having those conversations about do Ineed to talk about this with my doctor
right now? Maybe I'm not inthe age, Maybe I don't think it's
going to apply to me. Iwould say, just ask your doctor will
guide you in the right way.And the answer is not the same for
every single person. So your doctorwill know what your own personal risk factors
are, what your family history factorsare, and help guide you with what
(22:22):
to do. So it's if youhave a question, it's never the wrong
time to ask that question to provider. When you're in the office, you
know, ask them. We've talkedabout writing things down. If you have
things once, should I get excreenedfor colorectal cancer? Write it down,
you know, if something comes upat a conversation with you're out with friends,
write it down. We all havephones, almost all of us,
and just put it on there andmake sure you ask those questions when you're
(22:44):
at the doctor's office. Here shewill be more than happy to answer your
questions. And if you've gotten offyour cycle preventative screenings, they had to
be postponed because of the way thingswere, and that included things like mammogrants,
things like colin oscopies or other typesof screenings. So this is the
time where we want to remind people. Get back on track. Get back
(23:07):
into your doctor's office. If youhaven't done this in a in a bit,
gotten in front of your healthcare provider, get back in and it's okay.
If you've missed a few years,right, you can still get back
on track. Absolutely, we allhave. You know, we've all missed,
but got off track a little bit. It's time to just reset.
I do. I've ret myself alist, checklist. I check it off
as I go, for me andfor my four children, just checking what
(23:30):
needs to go. So think aboutthat too. Just write a checklist and
make sure that you get it done. You know, screenings that you need
to have done, colorectal cancer,mamograms, you know, make sure you
get them done. We can help. If you don't have a provider,
we can help with that too.Talk to family members, get everyone that
you can just rally the people,rally the troops, and get everyone out
(23:51):
there to get screened as much aswe can, and know about your family
history, if at all possible,have those conversations, even if they're off
handed conversations. Get a sense ofwhere you've come from so that you know.
I am eternally grateful that I hadthose conversations with the family members that
I did, and paid attention tomy own body when it was telling me
that something wasn't quite right, sothat I started getting screeting ahead of when
(24:14):
I probably would have normally. Butit is one of the greatest things that
I could have done for my overallhealth. And I want to publicly thank
all of my healthcare providers. Andwe want to thank doctor Lorna Fitzpatrick,
vice president of Medical Affairs for SafetyNet Programs and the senior medical director at
Excelis Blue Cross Blue Shield, forall of your expertise this week on the
check In. Thank us so much, it's great to be here. Thanks
(24:36):
for joining us on Community check In, a presentation of Excellis Blue Cross Blue
Shield at iHeartRadio. Podcasts of Communitycheck In are available on the iHeartRadio app.
Or wherever you find your favorite audiocontent. For more ways to stay
safe, healthy, and educated,visit excelus bcbs dot com and follow on
(24:56):
Instagram and Facebook
Welcome to excel Us Blue Cross BlueShields Community check In. Each week we
cover a specific topic featuring Excellis BlueCross Blue Shield experts. You'll get to
know our team as we discuss thelatest in healthcare, health education, and
community health. Find us at ExcelusBCBS dot com and follow on Instagram and
(00:26):
Facebook. I'm Joelomonico. Welcome tothe check in this week, and doctor
Laura Fitzpatrick is joining us again,vice president of Medical Affairs for Safety Net
Programs and the senior medical director atexcel Us Blue Cross Blue Shield. Doctor
Fitzpatrick's back with us today to talkabout a topic which is very personal to
me, my family, maybe manyfamilies, and she's here today to talk
(00:47):
about the shocking reality of colorectal cancerand how screening can be so crucial to
help save lives. Now, remember, whether you are insured or not,
screenings for colorectal cancer are free andthey're very important for you to have conversations
with your doctor about. And doctorFitzpatrick will explain in more detail as we
go through our community check in thisweek. Doctor Fitzpatrick, nice to have
(01:07):
you back, Welcome to the program. Thank you for having me. I
want to remind people, Doctor Fitzpatrickhas been with Excelli's Blue Cross Blue Shiel.
She came to them after practicing academicmedicine up in Buffalo for some twenty
years. She's board certified in pediatricsand pediatric hematology and oncology and got her
medical degree at Jacob's School of Medicineand continued your residency in pediatrics at Saint
(01:30):
Louis Children's Hospital, Washington University,Saint Louis, and then when she completed
a fellowship in Pediatric Hematology oncology atJohns Hopkins University and spent twenty years focusing
on caring for pediatric patients with braintumors. So we're gonna tap into her
oncology expertise this week. Colorectal cancershave been a part of my family for
(01:53):
generations, from grandfather to me,my sister in law. We lost colorectal
cancer earlier this year, So Ireally do want to make this conversation as
broad based and as informational as wecan to all everybody because this can impact
(02:13):
everyone. So let's talk about whatwe're going to deal with here colorectal cancer
biologically. What are we talking aboutwhen we talk about this type of cancer.
Yeah, So colorectal cancer, likeany cancer, is just one or
two cells that in your body thatstart to grow abnormally and kind of take
over and form tumors. So youreally want to in the colorectal case,
(02:36):
anywhere in the colon directal area youcan have abnormal cells developed. They start
out really small in colorectal cancer,they develop often into polyps, little small
tumors in your colon that you see, and then from there they can spread.
Many times they stay in the colon, sometimes they can spread to other
parts of your body, depending onthe stage that you are detected at.
(03:00):
It's always so important to know whatto look for signs and symptoms as well
as to if you have it,try to get screened it. Get to
try to get screened as early asyou can to prevent it from getting to
the later stages. Let's talk aboutwhat let's do factor fiction here with colorectal
cancer. Factor fiction. It onlyaffects older adults, absolutely not. I'm
(03:23):
a pediatric oncologist, as you asyou heard, I took care of some
kids with colorectal cancer when they wereten, eleven, twelve years old because
they had a very strong family historyof it. So there's some cancer syndromes
that cause colorectal cancer in early childhood. You want to know about that.
As you pointed out, your familyhistory, so critical to know that and
(03:44):
bring that to your doctor so theycan help you assess the risk. But
definitely not only in older people,even people in their thirties forties, you
know. I know they've been somefamous cases in the news recently of that,
but it's really kind of edging downa little bit, certainly in your
thirties, forties or fifties. Youwant to be aware no signs and symptoms
and go to your doctor if younotice any of them. Fact or fiction.
(04:06):
It affects men more than women now, absolutely not. I think sometimes
you know, with breast cancer,people think breast cancers the women's cancer and
colorectal cancer is the men's cancer.Fact is they can both affect both both
genders and a colorectal cancers actually almostfifty fifty. So you want to be
aware of it if you're male orfemale, that you risk for colorectal cancer.
(04:31):
When it comes to causation, familyhistory, as you mentioned, certainly
going to be very important, thatgenetics are going to be important, But
we hear of some cancers being moreenvironmental, let's say, or lifestyle based
than others. So fact or fiction, is colorectal cancer any more or less
(04:54):
pinpointed to one type of a causeor where a path to actually getting a
diagnosed that may come from. Yeah. So certainly if you're a family history
and critical important to know that andto get screened at their appropriate times.
But if you even have other riskfactors in their smoking is as a known
risk factor. Certain dietary choices thatyou make, heavy alcohol use all can
(05:15):
influence your risk of colorrectal cancers.So if you have a family history of
it and syndrome and then you youput those on top of it, you're
going to increase your risk. Butyou don't have to have a family history
to have colon cancer. So youwant to make sure you can control the
things that you can control, smoking, diet, and your lifestyle choices that
(05:38):
you have, and make sure thatyou can control whatever you can. Screening
is what we hear the most aboutwhen it comes to colorectal cancer. It's
one of the things that is themost advantageous tool that physicians have when it
comes to being able to monitor theirpatients and regular screening. Let's make it
(05:59):
a two part question. Number one, when does the screening should it start?
When? When is that important timeto have those conversations with your doctor?
And number two, let's talk aboutthe screening and how it starts.
It's not just going, you know, zero to sixty. You're going to
make other steps in between before youwind up getting to say, a full
colonoscopy or something that is more invasive. Correct. So, if you're an
(06:23):
average risk, if there's no familyhistory, no major risk factors in your
in your family, you want tostart getting screened around forty five for colorectal
cancers, So forty five to seventyfive to get the screening done. If
you have a risk factor in yourfamily, or if you notice symptoms like
blood in your stool, any weightloss, things that you can't explain,
(06:44):
you might also have to be screenedor taken a look at much earlier in
life. Is colorectal cancer one ofthe more preventable types of cancers, provided
it is detected at a time whenit is relatively in its earliest stages.
Yeah, so, especially with testssuch as a colonoscopy. When you have
(07:04):
that done, you might be yourdoctor might see in there there's a polop
that polyop might be precancerous. Byremoving that polyp, you're also taking away
the risk of that polyp developing intoa cancer. So certainly tests like colonoscopy
is to look at it, tolook for polyps, can help prevent it,
certainly from getting to later stages aredeveloped into full fledged cancer. Now,
(07:25):
of course, we want to makesure that we are saying screening is
not a prevention. It's not onehundred percent. There is no one hundred
percent, But having those conversations andmaking sure that those screenings are taking place
is the best first step to makingsure that you're paying close enough attention to
it. I have always understood thecolorectal cancers also tend to be okay,
(07:47):
okay, another factor of fiction.Are they more or less aggressive than other
types of cancers? Or can younot really classify any type of cancer because
it's not just a one and done. Breast cancer is this way, lung
cancer is this way, colorectal canceris this way. Yeah, all,
there's no one cancer that's a oneone shot deal that it's it's the same
for everyone. There are incredibly aggressiveforms of colorectal cancer, each tumor itself.
(08:13):
You know, we talk about peoplehaving family syndromes that each to itself
might have genetic mutations that make itmore or less aggressive than others. So
your doctor will help with that tofind out some of that information with it.
But absolutely there's no one cotton dryfor everything. But colorectal can spread
quickly, it can grow very quickly, and it can spread to other parts
(08:35):
of your body for really quickly.Doctor Lana Fitzpatrick is with Exceless Blue Cross
Blue Shield. She's vice president MedicalAffairs for Safety Net Programs. They're senior
medical director, and we're talking aboutcolorectal cancers and how screenings are so vitally
important. The statistics I read,though, we're falling a little short.
I guess percentage wise, I'd loveto see it that one hundred percent of
(08:56):
adults who are of age or amedical history to be screened are getting screened,
but we're kind of falling short ofthat. Is it in your estimation?
Is it because people say, Idon't want a colonoscopy, I don't
want to have to go through that. Yeah, I think I think about
thirty thirty five percent of people thatshould be screened or not screened yet,
So getting those people into the screeningguidelines is critical. But don't forget it's
(09:20):
not just a colonoscopy, which whichyou know you can. I think the
prep for the colonoscopy is probably theharder part than it. I just my
husband just had one done and inand out. He was out back in
the car in twenty minutes. Ididn't even time to read a book it
was done, so um, soit helps, but you really there's other
things to do. Simple tests foryour stool to see if there's blood in
(09:41):
it is helpful. I think sometimesyou see on TV advertisements for fit tests
or other ones that can be donewith just a stool sample. So there
are other ways to look for itand to test to see it on a
regular basis before you have to gofor a colonoscopy, So ask your doctor
what one is right for you.And I also just want to reiterate,
as we did at the beginning ofthe program, about the costs of this,
(10:03):
because cost is certainly something that wouldkeep people away from their doctor or
asking for that test whether you're insuredor not. Screenings for colorectal cancer,
they are. They are free,and they're available, and you just have
to talk to your doctor about gettingone. And we want to make sure
that we talk about this a lotbecause it's such a vital part of monitoring
(10:24):
what's happening with this very important systemof your body. Absolutely, and I
think you know, having them freeand available to people puts an emphasis on
just how important they are. Weas a medical community really believe we can
make a difference in people's lives bygetting those screetings done early. If you're
going to get it, you're goingto get it. Let's get you caught
as soon as you can, andlet's take care of it as soon as
(10:46):
we possibly can. That's how ithappened for me. Wound up with a
condition that I couldn't explain, wentto see my doctor, got referred to
a colorectal surgeon. I started gettingcolonoscopies at age forty, and I've had
one every five years since, andum polyps have been found every time,
and I am very grateful that I'vegone back in and it's a wonderful nap.
(11:09):
You're right, it's horrible prep,but it's a wonderful nap and the
table. The table is always niceand warm for you. At least that
has been um factor fiction. Itdoesn't colorectal cancers will affect one ethnicity or
race more than another. Yeah,we've certainly found that in the forum.
(11:33):
It does definitely affect black people morethan it can other races. We don't
know exactly why it is, butI think it's a It's a combination of
things. One is access to care, access to screening so important, and
I think the COVID nineteen pandemic hasshown us what disparagers are on healthcare.
We have to work to get everyoneon equal footing, to make sure it's
available and accessible to all, andthat there's no fear of it to do
(11:56):
that. But also it could beother things, you know, environmental factors,
that act of factors that were notaware of yet that can be causing
those differences. So very important thatwe know the differences so we can work
to equalize them. And also,as you mentioned COVID there it got people
off their schedules with seeing their doctors. Some people could not get to it,
didn't feel comfortable with going in,so some very important cancer screenings may
(12:20):
have been missed. How important thenis it getting back on that habit,
getting back into that into getting thosescreenings done, even if you've had a
layoff of a couple of years pastwhen you should have had you're regularly scheduled.
Yeah, absolutely, you know,get out there and make the phone
calls and get back into screening asfast as you can, either in your
(12:41):
primary doctor's office who will see youand doing a risk assessment and refer you
for colonoscopy or something more if youneed to have it done. But just
get out there and do it.COVID nineteen. You know, people weren't
doing the procedures for a couple ofyears right or some time because of the
risk, and then on top ofit, people are not going to the
doctors. It's so important to getback into the doctor's office and have someone
(13:05):
just take a book and see itmay not just be colorectal cancer screening.
It maybe mamograms, It maybe someother types of screening that you due for.
So very important because we do knowthat we can catch them early.
Catching early makes a huge difference inyour outcomes. Yeah, And just like
with your kiddos, and having themgone in for regular checkups. And it's
the same thing with you know whatyour benchmark is and then be able to
(13:28):
know when something has changed so thatfurther diagnosis is warranted and would benefit you.
So let's talk about those screenings.We'll get to colonoscopy in a second,
but that's kind of only one smallfacet. There can be others,
non invasive starting points that a doctormay use when it comes to trying to
assess risk and trying to understand whereyou are and where your benchmark is for
(13:50):
possible you know, possible markers withinyou know, within your test results.
Yeah, correct, And like Isaid, it can be something as simple
as checking for blood in your stool. You might not see all the blood
that's in your stool. It sometimesit's invisible. Sometimes your stool can just
change a little bit different color andyou don't even pick up on it,
or you think it's normal because it'swhat you've been doing for some time.
(14:13):
So something as simple as that canabsolutely screen for colon cancer. So that's
called a fecal occult blood test.Your doctor can give you a card,
you can do it and simply testfor blood. You can have less invasive.
You know, colonoscopy is just lookingshorter parts of your of your coal
and your sigmoid colon a little lessinvasive, but they still take a prep
(14:37):
to do those tests, and there'sa DNA stool test that you can also
have done. Your doctor will helpyou decide which is most appropriate for you
based on your risk factors, yourhistory, the symptoms that you're having,
and what other your age, etcetera. I did want to point out
something that you said, and Ithink the most important screening test to me
(14:58):
is what you talked about with youlisten to your body. If something is
wrong, it's important that you checkit out. Nobody knows your body like
you do. If something is notfeeling right, looking right, anything,
make sure you go into your doctrineand have a conversation about it. Yeah,
exactly, And don't be afraid tohave that conversation, not only because
I'm embarrassed about what system of thebody I'm talking about, or I don't
(15:22):
really want to know the answer,Go and have the conversation anyway, because
I didn't want to have the conversation, and I am very grateful that I
did, because it got me ona protocol for Colonoscopy's five years earlier than
I would have normally, and possiblyeven ten years beforehand. And I shuddered
to think of what my health wouldhave been like had I not done that,
(15:46):
when it was very easy for thedoctors to identify polyps, remove them
and give me a clean bill ofhealth so that I can come back five
years and just go through the testagain. Yeah. Absolutely, And it's
just so important. It's not peopleto talk about poop or whatever may be
going on. That's never a funconversation. But we're so used to it,
right, We're so used to it. That's why we ask you standardly
(16:07):
about it when you come into theoffice to see you know, belly pain,
you know, anything that's different orusual. No one person is the
same as another person. It's soimportant if your bowel habits change, if
you're noticing blood, belly pain,anything like that, weight loss that you
can't explain, you know, anythinglike that, please make sure you go
to your doctor and have them takea look at you. It's just that
(16:30):
important. We don't mind whatever youwant to talk about. We're here to
listen. We don't mind here anythingyour doctor has probably seen worse than anything
you're going to bring in. Sobring in your worst and you might not
even make their top ten. Absolutelywith the screenings then and again, screenings
do not you know, it's notone hundred percent when it comes to anything.
(16:52):
I want to make sure that we'reclear about that. Yes, there's
always there's always a margin there whenit comes to this. But when it
comes to find those cancers in theirearliest stages, finding polyps, having them
tested, is that for most peoplegoing to be their best indication of how
they need to proceed going forward.Yes. So if you go in there
(17:15):
and you find polyps, there's differenttypes of polyps. Some are more tend
to be more cancrous precancerous than otherpolyps. Your doctor will know that.
They send it to a lab,the pathologist looks at it. They tell
you what type of polyp it is, how different it is than a usual
polyp, and that helps guide whatyou need to do going forward with it.
So once you get those answers fromthe lab, they go ahead and
(17:36):
we'll set up screening for you goingforward. Occasionally you might have to go
back and get something else looked at, depending on what the answer is.
Most of the time. They cangauge when you need to come back based
on the types of polyps that youhave in there. Some people have none,
that's terrific, you still need togo back and get checked again.
If you have other polyps, they'regoing to want to see you back sooner.
Treat it like a game with yourfriends. I've heard tell that some
(17:57):
very famous people, Steve Martin,Tom Hanks, Smart and Short, they
have colon oscope parties and they goto one person's house and they do their
thing, and they play cards andwatch movies, and then they go get
their colon oscopies together, and thenthey go out to breakfast the next day,
because after a colon oscopy prep,there is nothing better than going to
a diner for breakfast in my opinion. But it brings up an interesting point
(18:22):
about talking about our health with otherpeople, be their friends, be their
family. To really just to makeit more comfortable to say, look,
I need to have the screening.I need to know. It's okay for
you to know, and for youto go and do this so we can
encourage others to improve their health asa community, which is really what we're
(18:42):
hoping to do overall. So criticalhaving the conversations being open about an honest
You never know when you might beout with a friend you know you mentioned
it and it might trigger someone elseto get that done. Every single individual
counts. Every single person counts.Every single time you find it poll up
at an early stage, it counts. It makes a difference in someone's life
(19:03):
and a family's life. You know, we're all related to families and other
people who love us and depend onus. You just want to get everything
done as soon as you can,so have make it a normal part of
conversation. You're screening, what doyou need to get done? Why do
you need to get it done?And just go and get it done.
Support friends with car rides if youcan, and back and forth whatever meets
to be done. It's it mightbe easy for some of us, say
(19:23):
you also have someone to drive youto this, but not true for everybody.
There may be someone elderly, orthere may be someone who just doesn't
have transportation or whatever. You wantto make sure that you reach out to
everybody and see if there's anything wecan do. Support as a community is
so important to everything we do.Before we go back and recap some of
our key points, I want tolet people know that there are aggredible resources
(19:45):
that excel As Blue Cross Blue Shieldhas not only them, but the American
Cancer Society too that you can find. It's free and available online. Where
can people start learning more before theyhave Some people like to do that research
before they have the conversation with theirdoctor. Where do they go? Yeah,
the American Cancer Society has free onlinelibrary. You can go there www
(20:06):
dot cancer dot org and get yourinformation that you need. From there,
they just give you a lot ofbased information about what cancer is, what
it may develop in as well asscreening appropriate screening for that. And then
again at excel Us here we havea lot of information. We have a
lot of medical experts on hand availablehelp develop information from the experts and really
have it available. So give usa call to or look us up online.
(20:30):
We're more than happy to help youin any way we can. This
is doctor Laura Fitzpatrick. She's Vicepresident and Medical Affairs for Safety Net Programs
and a senior medical director at ExcelsBlue Cross Blue Shield. We are talking
about colorectal cancers on this edition ofthe check in, So if case people
are just popping into the last partof our show. We just want to
go back and hit some of thosebig points that we've been talking about.
You know, colorectal cancers. Itimpacts more people, I guess than you
(20:52):
might think. There's you know,it's it is. I don't know if
it's a leading cancer, but it's. But it certainly is affecting a lot
more people than I think. Arewe are you know hearing on a regular
basis. Yeah, it's a lotmore people. It's one of the most
common cancers that we see. Andhere they in New York State alone,
we have about nine or ten thousandpeople a year who are diagnosed with colirectal
(21:14):
cancer, about fifty fifty men andwomen. So it's it's a pretty even
split. But you want to dothat. And again, you know,
every year in New York State alone, about three thousand people die from that.
We would just love to keep chippingaway at those numbers and take it
down to we can prevent or takecare of all of this editor early stage,
especially when diagnosis of it can happenearly. It can happen early.
(21:38):
That doesn't always, but it canhappen at an early stage when it can
be very I'm not going to sayeasily treatable because no cancer is easy to
treat, but it can be targetedmuch more effectively. Why don't we say
than some other types of cancers.From a personal perspective, what do you
need to you know, what don'tyou be thinking about when it comes to
(22:00):
actually having those conversations about do Ineed to talk about this with my doctor
right now? Maybe I'm not inthe age, Maybe I don't think it's
going to apply to me. Iwould say, just ask your doctor will
guide you in the right way.And the answer is not the same for
every single person. So your doctorwill know what your own personal risk factors
are, what your family history factorsare, and help guide you with what
(22:22):
to do. So it's if youhave a question, it's never the wrong
time to ask that question to provider. When you're in the office, you
know, ask them. We've talkedabout writing things down. If you have
things once, should I get excreenedfor colorectal cancer? Write it down,
you know, if something comes upat a conversation with you're out with friends,
write it down. We all havephones, almost all of us,
and just put it on there andmake sure you ask those questions when you're
(22:44):
at the doctor's office. Here shewill be more than happy to answer your
questions. And if you've gotten offyour cycle preventative screenings, they had to
be postponed because of the way thingswere, and that included things like mammogrants,
things like colin oscopies or other typesof screenings. So this is the
time where we want to remind people. Get back on track. Get back
(23:07):
into your doctor's office. If youhaven't done this in a in a bit,
gotten in front of your healthcare provider, get back in and it's okay.
If you've missed a few years,right, you can still get back
on track. Absolutely, we allhave. You know, we've all missed,
but got off track a little bit. It's time to just reset.
I do. I've ret myself alist, checklist. I check it off
as I go, for me andfor my four children, just checking what
(23:30):
needs to go. So think aboutthat too. Just write a checklist and
make sure that you get it done. You know, screenings that you need
to have done, colorectal cancer,mamograms, you know, make sure you
get them done. We can help. If you don't have a provider,
we can help with that too.Talk to family members, get everyone that
you can just rally the people,rally the troops, and get everyone out
(23:51):
there to get screened as much aswe can, and know about your family
history, if at all possible,have those conversations, even if they're off
handed conversations. Get a sense ofwhere you've come from so that you know.
I am eternally grateful that I hadthose conversations with the family members that
I did, and paid attention tomy own body when it was telling me
that something wasn't quite right, sothat I started getting screeting ahead of when
(24:14):
I probably would have normally. Butit is one of the greatest things that
I could have done for my overallhealth. And I want to publicly thank
all of my healthcare providers. Andwe want to thank doctor Lorna Fitzpatrick,
vice president of Medical Affairs for SafetyNet Programs and the senior medical director at
Excelis Blue Cross Blue Shield, forall of your expertise this week on the
check In. Thank us so much, it's great to be here. Thanks
(24:36):
for joining us on Community check In, a presentation of Excellis Blue Cross Blue
Shield at iHeartRadio. Podcasts of Communitycheck In are available on the iHeartRadio app.
Or wherever you find your favorite audiocontent. For more ways to stay
safe, healthy, and educated,visit excelus bcbs dot com and follow on
(24:56):
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