All Episodes

March 26, 2025 14 mins

Colorectal cancer is one of the most preventable yet deadly cancers if left undetected. Dr. Nicole Powell, DNP, a family nurse practitioner at MedLink Winder, shares key facts about this common condition.

She explains how colorectal cancer develops from small polyps that can become cancerous and highlights a critical update: screening now starts at age 45 instead of 50 due to rising cases in younger adults.

Dr. Powell breaks down screening options, from at-home tests like FIT (yearly) and Cologuard (every three years) to the gold-standard colonoscopy, which detects and removes polyps. She also addresses common barriers to screening and highlights free Cologuard testing for qualifying MedLink patients.

Early detection saves lives—when caught early, survival rates are significantly higher. Don’t let fear or embarrassment stop you. Talk to your provider about the best screening option for you and take charge of your health today.

Mark as Played
Transcript

Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Tangela (00:04):
Welcome to this special episode for Colorectal Cancer
Awareness Month.
Today we're joined by Dr NicolePowell, a family nurse
practitioner with a Doctor ofNursing Practice degree.
She's part of our MedLinkWinder team and is here to break
down everything you need toknow about colon cancer what it
is, why screening matters andthe different ways to get tested
.
Let's dive in.

(00:24):
To kick things off, I'd like towelcome Nicole.
Nicole, can you also start offby explaining what colon cancer
is and how it develops?

Dr. Nicole Powell (00:33):
Thank, you so much, tangela, for having me.
Yes, colon cancer, also knownas colorectal cancer.
You may see it as CRC screeningon some documents.
It's a colon.
It's a cancer that occurs inthe colon or rectum, which are
parts of the digestive system.
It usually starts from smalllittle clumps or cells called

(00:55):
polyps, and over time, thesepolyps can become cancerous.
It's one of the most commontypes of cancer worldwide and
that is why we like to make surethat we're screening for it.

Tangela (01:07):
Okay, and can you kind of explain exactly why this
screening is so important?

Dr. Nicole Powell (01:15):
Yes, so its prevalence varies by region.
There are influential factorssuch as age, genetics, diet,
lifestyle.
However, it is generally morecommon in our developed
countries.
So early detection is key,because if we detect something
early, it's easier to treat.
So if we detect pre-cancerouspolyps or early stage cancer

(01:37):
before symptoms develop, itgreatly increases the chances of
successful treatment and cureincreases the chances of
successful treatment and cure.

Tangela (01:49):
Okay, and you kind of mentioned age a little bit.
So what age should individualsstart getting screened for colon
cancer, and are there anyexceptions?

Dr. Nicole Powell (01:56):
Yes, so there's a couple of different
ages that you'll hear out there.
The US Preventative Task Forceand the CDC have a couple of
different ages, but the age thatwe've started using now is 45,
recommended for everybody.
There are some exceptions, likeyou said, which are you have a
very high incidence of coloncancer in your family or someone

(02:20):
in your family at an early agehad colon cancer.
We would want to screen yousooner.
Someone in your family at anearly age had colon cancer.
We would want to screen yousooner.
If you were to come into theoffice with certain complaints,
like you had a change in yourbowel habits or your stool all
of a sudden was a very differentconsistency and there wasn't a
reason for it like a diet changeor certain medications that can
cause that, we would beconcerned and we may do some

(02:42):
screening.
Or if, like, the size of yourstool has changed so all of a
sudden it's very skinny and itcomes out like a ribbon almost,
those are things that would makeus want to send you to a
specialist to be screened.
And at that time it's notreally screening.
We're looking more for a reason, so it's more of diagnostic
testing at that point.

Tangela (03:02):
Okay, and some of these screening methods that are
available for colon cancer, andwhat are their pros and cons?

Dr. Nicole Powell (03:11):
So I don't.
Personally, I don't thinkthere's any cons, but there are
some that you know patientsprefer over others.
Of course, patients prefer theless invasive ways of screening.
So those are like our fit kitthat we do a lot at our offices
here, and when you have polypsit can cause bleeding in the
colon.
So when we see blood in thestool we may be able to quote,

(03:37):
unquote, kind of assume thatthey're polyps.
But it could be other things.
So the screening does not meanthat you have polyps.
The screening does not meanthat you have cancer.
It just means that we detectedblood.
Blood can also come from otherthings, such as you were
constipated and had a littlebleeding with hemorrhoids or
something like that.
So it may not be at all relatedto cancer.

(04:02):
So we do use that test as ascreening method, but it is not
something that directly means ohmy gosh, this person now has
cancer.
We just want to make sure thatthen we look further to see why
are we having this bleeding?
Another test that we do is theCologuard test, which that
screens.
That one is a little morespecific and that is looking for
the DNA.
It's like a DNA-based screeningkit and that one is a lot more

(04:24):
specific, so it's not justlooking for blood like the Fit
Kit.
If that one comes back positive, we would then send somebody to
get a colonoscopy because again, we want to know why is it
positive.
And with these tests we havefound that when they do get the
colonoscopy the person doing thecolonoscopy most of the time
looks even more carefullybecause they're knowing there's

(04:44):
a reason why this test waspositive and they're trying to
find the reason why it waspositive.
So those tests are really good.
With the FIT kit, you have to dothat one every year.
If it's negative, those testsare really good.
With the Fit Kit, you have todo that one every year if it's
negative.
With the Cologuard, if it'snegative, we screen you every
three years, unless somethingcomes up in between that time.
With the colonoscopy, that isstill considered the gold

(05:10):
standard because they actuallygo inside with a camera and they
can see everything.
If they see polyps at that time, they can remove polyps at that
time.
So that is consideredpreventative.
Even they can remove a polypbefore it becomes cancerous.
And then we prevented that fromproceeding to anything worse
With the colonoscopy.
It depends on what they see.
That will kind of give you thetime that you need to come back.

(05:32):
So if they see several polypsor something concerning, they
may tell you three or five years.
If they see nothing at all andyou have a very low risk of
colon cancer, you may get sevento 10 years before you need to
come back.

Tangela (05:46):
So how does regular screening improve survival rates
and reduce mortality associatedwith colon cancer?

Dr. Nicole Powell (05:54):
So when we detect colon cancer early, the
five-year survival rate issignificantly higher than those
that we diagnose in later stages.
So if we find cancer that'sstage one, it's way easier to
treat than cancer that is atstage four or cancer that is now
spread to surrounding parts ofthe body.
So screening helps us catchthings earlier because we're

(06:16):
just checking for stuff.
There isn't any issues, you'renot having any symptoms, so it
gives us the best likelihood offinding something at a lower
stage if we find something, andbeing able to treat it sooner.

Tangela (06:29):
What are some common barriers that you find to colon
cancer screening and how canthey be overcome?

Dr. Nicole Powell (06:38):
With our Fit Kit and our Cologuard.
The biggest barriers that I'veseen, even most recently with
patients, is they don't want tohave to mess with their stool at
home.
Both of those require them touse a little device that kind of
touches the stool.
And we provide the patientswith gloves and all of those
things, but it's still just.
They really don't want to be athome playing in their poo so to

(07:00):
speak.
So those are hard sometimes toget people to complete.
Also, when you come back withthe fit kit you're walking back
into the office and you'redropping off stool and anybody
else who has done that.
They kind of know what you'reat the office for.
So there may be a littleembarrassment attached to that.
For that reason sometimes wecan get patients to buy into the
Cologuard because they stillhave to do the kit at home but

(07:23):
the Cologuard is picked up fromyour house so you're not having
to go out in public with a bigbox kind of showing off to the
world that you had colon cancerscreening.
So those are the barriers forthat.
I see in my patients just mepersonally that I have more
barriers trying to get people toget their colonoscopy because
they don't want the invasiveprocedure, they're afraid to go

(07:45):
to sleep.
They heard from a friend thatthe prep is really difficult to
take on and very uncomfortable.
I myself have not had acolonoscopy but my sister, she
recently had a colonoscopy andshe told me that the prep was
not uncomfortable.
She just did not enjoy drinkingthat much Gatorade flavored
drink.
That was her most, that was herbiggest complaint about it.

(08:07):
But the actual prep was notvery uncomfortable, but it's
necessary because they want tomake sure that your colon is as
clean as possible so that theycan see everything.
So those are the biggestbarriers that we see.
Some of them are also financialaid.
So if somebody comes back, ifsomebody comes to us and they've
received a fit kit and they'resliding fee and the fit kit
comes back positive and we say,oh gosh, we need you to go get a

(08:31):
colonoscopy.
That is a big charge for themto take on if they're a cash
paying patient and we do havesome financial aid resources.
Right now, at the time of thispodcast, we do have free
Cologuard for our cash pay andsliding fee patients and that is
a huge discount that ExactSciences and Cologuard has been

(08:51):
very, very gracious to give us.
And that is more.
It is a more specific test.
So hopefully we're able tocapture people more accurately
that way and not have to send somany people to get a
colonoscopy.
But when that one comes backpositive, we still want them to
get that colonoscopy and thatcan be quite expensive for some

(09:11):
patients, especially if they'recash paid.

Tangela (09:14):
Well, that's awesome.
I did not know that.
You mentioned a little bit ofthe prep process.
Can we go a little bit more indepth?
I'm just curious.
Maybe talking about it maybealleviate some of that worry.
So what is the preparationprocess look like?
I know you mentioned the bigdrink, which I've seen people

(09:37):
talk about all the time, butwhat is a little bit more?
What else is that?
What else is there to that?

Dr. Nicole Powell (09:44):
Yeah, so it really depends on who's doing
the procedure.
But most recently what I'veseen for most of my patients for
their prep has been a solutionof Miralax mixed with yellow
Gatorade, because they don'twant you to have like a red
drink or a purple drink orsomething that may skew the
results or skew what they'relooking at, and they have you

(10:06):
drink large, large amounts ofthis for several hours.
Most of the time it's a wholeday prior to your procedure.
So most people are wanting tohave their colonoscopies done
early in the morning becausethey've been doing this prep.
Some I've seen 12 hours, someI've seen 24 hours.
So it really varies, probablyper person and per that for the

(10:28):
surgeon or the person doingtheir procedure, per their
preference.
But again, like for thepatients, I see it's 12 to 24
hours.
Lots of this Miralax mixed inwith Gatorade, which Miralax is
a stool softener.
It helps bring more water intothe gut to soften your stool, so
it's really just trying toclean you out.
It's not intended to causeexplosive diarrhea or any of

(10:50):
those things, but I'm certain attimes it can, depending on how
you react to the solution or ifthey give you one of the other
solutions that is a little moreaggressive, so I can see how
people would not look forward tothat.
However, it's so necessary andso needed for us to make sure
that we give them the best viewof everything, so that we get
the most accurate results.

Tangela (11:12):
Do you know if there are any specific recommendations
from organizations like the CDCor USPSTF regarding colon
cancer?

Dr. Nicole Powell (11:23):
screening.
So the CDC is recommendingadults ages 45 to 75 get
screened regularly, andregularly kind of is like we
talked about earlier, which isthe Fit Kit every one year or
the Cologuard every three yearsor whatever is preferred or
recommended by yourgastroenterologist for your
colonoscopy.
The US, the USPSTF has is theone who is still saying age 50.

(11:49):
However, the American CancerSociety has also adopted the age
of 45.
No-transcript no-transcript.

(12:23):
Nothing specific other thanmaking sure that we're always
for providers.
Make sure that you educate yourpatients, listen to them about
their concerns and the thingsthat are holding them back,
Because sometimes it's just amisinformation or miseducation
from something they've heardfrom friends or family members,
and we really want to dispelthose myths so that we can get
them screened.
But also, for patients, justmaking sure that they're

(12:46):
educated and helping them, youknow, linking them to resources
like the Cologuard that we haveavailable right now for patients
.
Use that as much as possibleand really drill into the
patient that this is an awesomeopportunity to save you a lot of
money to get a really greatscreening test.
I've used that a lot.
I tell people this test isusually over $500 and we're able

(13:06):
to give it to you for free.
So please take advantage of itand just helping them.
You know, leaning in to what isimportant to them staying
healthy for their family, sothat they can be around to enjoy
their life and making sure thatwe keep educating them and
hopefully they'll spread that onto their friends and family and
we'll see more people coming into get screened.
Yeah, that's the Cologuard.

Tangela (13:28):
That's amazing that we can offer that for free, you
know, because that's awesome.
Thank you so much foreverything educating our
audience and patients andanybody listening.
A little bit more on colorectalcancer.
It's very important and youknow, you gave us some
statistics.
We talked a little bit more oncolorectal cancer.
It's very important and youknow, you gave us some

(13:50):
statistics.
We talked a little bit aboutall the things.
So thank you so much for beingon the podcast.
Thank you for tuning in to theMedLink Health Connections
podcast.
We hope you found today'sepisode informative and
inspiring.
If you enjoyed the show, pleasesubscribe, rate and leave a

(14:14):
review on your favorite podcastplatform.
Remember the information sharedin this podcast is for
educational purposes only andshould not replace professional
medical advice.
Always consult with yourhealthcare provider for any
medical concerns.
Medical advice Always consultwith your health care provider
for any medical concerns.
Stay connected with us onsocial media and visit our

(14:36):
website at medlinkgaorg for moreresources and updates.
Until next time, stay healthyand take care.
Advertise With Us

Popular Podcasts

New Heights with Jason & Travis Kelce

New Heights with Jason & Travis Kelce

Football’s funniest family duo — Jason Kelce of the Philadelphia Eagles and Travis Kelce of the Kansas City Chiefs — team up to provide next-level access to life in the league as it unfolds. The two brothers and Super Bowl champions drop weekly insights about the weekly slate of games and share their INSIDE perspectives on trending NFL news and sports headlines. They also endlessly rag on each other as brothers do, chat the latest in pop culture and welcome some very popular and well-known friends to chat with them. Check out new episodes every Wednesday. Follow New Heights on the Wondery App, YouTube or wherever you get your podcasts. You can listen to new episodes early and ad-free, and get exclusive content on Wondery+. Join Wondery+ in the Wondery App, Apple Podcasts or Spotify. And join our new membership for a unique fan experience by going to the New Heights YouTube channel now!

The Breakfast Club

The Breakfast Club

The World's Most Dangerous Morning Show, The Breakfast Club, With DJ Envy, Jess Hilarious, And Charlamagne Tha God!

Fudd Around And Find Out

Fudd Around And Find Out

UConn basketball star Azzi Fudd brings her championship swag to iHeart Women’s Sports with Fudd Around and Find Out, a weekly podcast that takes fans along for the ride as Azzi spends her final year of college trying to reclaim the National Championship and prepare to be a first round WNBA draft pick. Ever wonder what it’s like to be a world-class athlete in the public spotlight while still managing schoolwork, friendships and family time? It’s time to Fudd Around and Find Out!

Music, radio and podcasts, all free. Listen online or download the iHeart App.

Connect

© 2025 iHeartMedia, Inc.