FDAs Approval of Resmetirom & Dr. Nguyens Colon Cancer Interview

Dr. Galati gets going tonight talking about the breaking news on the FDA approval of resmetirom, brand name (rezdiffra) and the impact it has. He continues the fatty liver conversation on the fibrosis and scaring of the liver. Dr. Galati also replays last weeks interview with Dr. Dang Nguyen on Colon Cancer and the awareness surrounding it.

Episode Transcript

(00:01):
Initialize sequence coming to you live fromHouston, Texas, home to the world's
largest medical cemarony approach phrase everything looking. This is your health First, the

(00:22):
most beneficial health program on radio withdoctor Joe Bellotti. During the next hour,
you'll learn about health, wellness andthe prevention of disease. Now here's
your host, doctor Joe Bellotti.Well, they hope you're all having a

(00:56):
marvelous Sunday evening and had a goodweekend that just passed. The weather was
not all that great, but certainlydoable. If you were off from work,
I would always say, who careswhat the weather is like? You're
not at work and you're able torecharge a little bit. And my gold
and recommendations for the weekend or reallyany day you're off is to take inventory.

(01:22):
Take stock in your health and wellness. Are you sleeping enough, getting
exercise, eating the right foods?Are you meal planning for the week?
How's the emotional status of you andyour significant others, your family and family
and people that you are all partof. We have to take inventory because,

(01:44):
as I like to say and remindyou all this good health that we
talk about, the good health thatwe strive for and that's really what you
should be doing striving for good health. We strive for financial success. We
strive for being good at our professionand the skills that we have. We

(02:05):
want to be good students. Buswe don't pay enough time to striving to
attain the best health and wellness youcan. That's why I'm here Sunday evening.
We try to steer you in theright direction and get you back on
track. So we hear every Sundayevening broadcasting from our world headquarters, Iheart's

(02:30):
seven forty ktrh out of Houston,Texas. But because of the technology in
the world we live and we arecoast to coast, we are global on
the iHeart Radio app. So ifyou like what we're saying, and you
like what you're hearing, don't forgettell your friends, colleagues, relatives wherever
they are around this globe. Sundayevening, seven o'clock your health first with

(02:57):
doctor Joe Galotti. That's me.I've been here twenty one years and have
enjoyed every single Sunday that we havebeen with you now to participate, to
participate our website Doctor Joegalotti dot com, Doctor Joegalotti dot com sogn for our

(03:17):
newsletter which goes out every weekend acrossthe country. Number two, you could
send me a message. There isa tab that says contact me and if
you want to suggest a topic thatinterests you or you think everybody else would
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(03:40):
medical direction, no matter where youlive in the country, we have really
colleagues and contacts around the country toget you into the right practitioner for whatever
your problem may be. It's allthere, doctor Joe Lotti dot com.
Send me a message, and ofcourse all of our social media be it

(04:04):
Instagram, Facebook, YouTube, Uh, it is all there, doctor Joeglotti
dot com. And of course ourpractice website which is Liver Specialists of Texas.
There is a link there that youcould find out about our liver disease
practice that we nurture when we're noton the radio. All right, So

(04:29):
for for tonight, lots lots ofthings to talk about, but some breaking
news on Thursday. And it isin regard to the FDA, the Food
and Drug Administration, their approval ofthe very first medication specific for fatty liver.
The name of the medicine is resmit aram r E S M E

(04:53):
t I R O M made byMadrigal Pharmaceuticals. The trade name the brand
name is Resdiffra Resdiffra. I'm notquite sure where they came up with that
name. Now I'll tell you whythis is a breakthrough in medicine, a
breakthrough in healthcare, breakthrough and howwe take care of our patients. First

(05:17):
of all, and for all ofyou that are regular listeners, you follow
us along on social media or mayknow me personally, you're a patient of
mine. We talk an awful lotabout fatty liver. Now, we are
not a one trick pony. Ohfatty liver, that's all he knows about.
But when you look at there areeighty to one hundred million people adults

(05:44):
in the United States with fatty liverdisease. And we've talked about this a
lot lately. That is a publichealth disaster. So if there are at
least and there may be more onehundred million people with fatty liver disease,
that is about one out of threepeople in the United States that has fatty

(06:11):
liver. So if you're sitting athome today, look around, one out
of three of you have fatty liver. If you have family members, friends,
co workers, go to work tomorrow, look around, one out of
three people are going to have fattyliver. Now you may say, big

(06:33):
deal, they've got fatty liver.Well, the big concern as a hepatologist,
as a liver specialist, is thatfatty liver has the potential to lead
to sorrhosis, which is scarring ofthe liver. When you get scarring of
the liver, you lose liver function, you go into liver failure, you

(06:57):
die, you die early, andit's a it's a very ugly death.
Decompensated liver disease due to any condition, be it alcohol or viral hepatitis,
or even fatty liver is not apretty picture. You talk about suffering,
and this is bad news. Nownot only do you develop zorrosis, you

(07:21):
are at risk for the development ofcancer. So now it's sort of two
problems. You have corrhosis and youdevelop cancer, and you may need a
liver transplant. And so the opportunitynow to have a medication available, which
we have never had up to thispoint, is really a game changer for

(07:46):
those of us in liver disease.Taking care of such patients, but also
for you, the consumer that mayhave faty liver. Now, to get
into the details of the medication thatthe drug is indicated and when a new
drug gets to the market and it'sapproved by the FDA, the FDA will

(08:07):
put into its approval certain descriptors tosay this medication is only for people above
a certain age. Below a certainage, you have to have certain other
conditions to be eligible to receive thisdrug. Well, with this particular medicine,
the res mineram, you have tohave slightly more advanced scarring in the

(08:33):
liver, and so it is specificallyapproved for patients with F two or F
three fibrosis. Keeping in mind thatthe scarring the liver is on a one
through four basis, So this isthat intermediate to moderate amount of scar tissue,

(08:54):
and the rationale there is these arethe patients that are at greatest risk
for the eventual development of soorrhosis.If you are very early in the disease,
you have time lifestyle arrangements that canbe made that you can potentially prevent
all of these complications. But thepeople that are in F two F three,

(09:18):
you're really in the sweet spot wherewe have the greatest opportunity to turn
things around. Now, if youhave F four fibrosis, which is equivalent
to cirrhosis, you are not eligiblefor this medication. So we got to
catch to people at the greatest risk, which really does at the end of
the day make sense. And sowhat we're going to do right now,

(09:41):
we're going to take a break andwhen we come back, we're going to
talk about fibrosis in the liver,the scarring in the liver. Realizing what
you need to do. If you'resitting at home tonight and you say,
gee, I think my doc toldme I had a fatty liver, this

(10:01):
is absolutely nothing to sit on.You need to get this next bit of
information really to save your life.I don't say that for any dramatic purpose,
but it is the absolute truth.All right, stay tuned, you
are listening to your Health First.I'm doctor Joe Galotti. Our website doctor

(10:22):
Jogalotti dot com. Stay tuned,will be back in a minute. Welcome
back, everybody, doctor Joe Galotti. You're tuned into your health First.
Every single Sunday between seven and eightpm Central Time, We're here to raise
your health IQ, make you betterconsumers of healthcare plan and simple. We

(10:43):
don't want to make it overly complicated. But if we get accomplished that goal
making you a better consumer, thenI can certainly rest better at night.
End of story. Our website DoctorJoegalotti dot com. Sign up for the
newsletter. All information about us,past programming podcast replays are there. Our

(11:07):
newsletter, our blog, ways ofcommunicating with me, or all on doctor
Joegalotti dot com. And a coupleof programming notes. Number one, we
have been talking about fatty liver,a new medication that was FDA approved earlier
last week that goes by the nameof Resmitiam and the trade name is Resdiffra,

(11:33):
and you will be seeing more andmore about that. I made a
brief video. It's on our YouTubepage and you could take a look at
that. It's about seven minutes whereI give an overview of the medication of
fatty liver and those that would bemost impacted by the medicine. But go
to the YouTube page and take alook at that video. The other thing

(11:56):
is by popular demand. Last weekwe had on the program doctor dang Win,
a colleague of mine, a gaesstronurologist. We were talking about colon cancer
awareness in the month of March iscolon cancer Awareness month, and so we
received a number of emails, textmessages, and so what I'm going to

(12:18):
do is replay that interview the secondhalf of the program, So stay tuned
for that, you get another doseof that. But doctor dang Win from
last week, we'll be on goingover the ins and outs of colon cancer
screening and colon cancer awareness of whatyou need to do. All right,

(12:41):
So to follow up with the conversationwe started the last segment about fatty liver
and so really really hear me outhere. If you have been told in
however a casual fashion, as ayou know, as a as an afterthought,
Oh everything looked good, but youknow your ultrasound looked like you had

(13:05):
a little bit of fatty liver.If you are one of those people,
and with your treatment team, yourdoctor, your nurse practitioner, your PA,
are really not aggressively intervening on thefatty liver. It needs to be
now for everybody that has a fattyliver. There is one bit of information
that you absolutely and when I sayabsolutely, I mean absolutely need to know,

(13:31):
and that is the amount of fibrosisthat you have or scarring in the
liver, because scarring in the liveris a result of inflammation and damage it.
It really is a way that theliver is trying to repair itself.
But too much fibrosis is no goodIt's too much of a good thing.

(13:54):
And so there are a couple ofdifferent ways of determining whether or not you
that's right, I see you sittingat home listening to your radio has excess
fibrosis in your delivery. Number one. The easiest way is to do a
FIB four calculation fib and then thenumber four. You could go online type

(14:18):
in Google FIB four calculator. Nowyou have to type in some of your
blood work and a few other measurementsand it will calculate your FIB four.
If it is above a certain number, you are at risk of having more
advanced scarring. You need to tellyour doctor about this. If you fall

(14:41):
below the threshold, then it isestimated that you don't have increased fibrosis.
The second thing is if you gofor a fiber scan. Now, this
is a sound wave test. Ittakes about five minutes to do, doesn't
hurt, and this sound wave testmeasures the stiffness of your liver. The

(15:03):
more stiff the liver is the morescar tissue. And that's where you start
getting into this F one, Ftwo, F three or F two or
F four fibrosis. You know yourF score and so many practices have a
fiber scan available. We have onein our office that we are able to
do. Now. The other testthat's a little bit more expensive, it's

(15:26):
a little bit more involved, butstill gives you good information, is a
special kind of MRI. Everyone's familiarwith MRI, where it is MR elastography.
You will get the same type ofdata on the stiffness of your liver
with an MRI. Lastly, whichless and less patients are having because we

(15:50):
have these other non invasive tests,is a liver biopsy that really is the
gold standard. And so if letme let me just back up so everybody
is on the same page here.If you have been told you have a
fatty liver or your husband, yourwife, your girlfriend, boyfriend, your
brother's, sister, cousin, coworker, the question that you have to ask

(16:15):
yourself or that person is what isthe degree of fibrosis? Are you F
one, F two, F threeor F four. That is important because
if you are F two or Fthree, you may be eligible for this
new medication which can actually reverse fibrosis. If you're F one, you're early.

(16:38):
That is good. You could workon weight loss, control of your
blood sugar, cholesterol, things likethat. If you have F four,
you are really, really in thedanger zone and much more needs to be
done if you are that person.So in a sense, that is your
homework for the night. If youhave fatty liver, find out what your

(17:00):
fibrosis score is now, as Iwas saying. And those that may be
new to the program or you're notquite sure what you're listening to. Yes,
liver disease, especially fatty liver,I believe, is a big public
health problem. But the same goesfor high blood pressure, the same goes
for diabetes, the same goes forobesity, the same goes for the fentanyl

(17:25):
crisis. But we have to raisethe bar and get excited over this.
Excited in the sense that we haveto motivate, motivate ourselves to take action.
Sitting around doing nothing is going tobe associated with lots of chronic liver
disease, poor quality of life,and a shortened life span. All right,

(17:47):
we're going to take a break,news, weather, traffic coming up
now. I'm doctor Joe Galotti,doctor Joeglotti dot com. We'll be back
in a few minutes. Every Sundayevening between seven and eight a clock,
we are here bringing everybody the bestin health and wellness. And our mission
for the twenty one years we've beendoing this is to make you better consumers

(18:11):
of healthcare and really give you agrasp of what you need to do to
stay healthy. That really is thebottom line. And so as we were
saying a little earlier in the program, the month of March is Colon Cancer
Awareness Month. I'd like to thinkthat every single month should be Colon Cancer

(18:32):
Awareness Month. And I've got onthe phone tonight a colleague of mind,
doctor dang Win, a guestro neurologistwith Texas Digestive Disease Consultants here in Houston
in the Texas Medical Center. Dangwelcome and thanks for coming on. I
think this is your radio premiere onyour health first, but nonetheless thanks for

(18:55):
coming on tonight. Thank you,good evening. That's the Gallatti. Thank
you for having me on the showtoday. Celebrate Colon Cancer Aweness month.
Will you know it's it's so important. And you know, I guess the
main thing here is an awareness andI really don't care what disease or condition

(19:19):
you're talking about. It is awareness. And from your standpoint, in all
the years that you've been doing this, what do you think is the bit
of information that is missing with regardto awareness that adults need to know.
Well, it's they have to realizethat it's very important to get colon cancer

(19:47):
screening. And it's obviously not justlimit to the munch of March which we
celebrate it, but it should applythroughout the whole year. And the most
important thing is to get screening inany way that we can, right And
and but you know, the mainthing is you have to think about it.

(20:07):
And when you look at the numbers, the numbers really are sort of
staggering. There's and this is estimatedfor twenty twenty four about one hundred and
six thousand cases of colon cancer andforty six thousand cases of rectal cancer.
And that adds up to about fiftythree thousand deaths a year. But when

(20:30):
you look at all of the cancerdeaths, certainly lung cancer leads with about
one hundred and twenty seven thousand deaths. Then number two is colon at fifty
two, then pancreas fifty and thenbreast is forty three. So while there's
so much emphasis on breast cancer,which I agree we need to have,

(20:52):
it is the fourth colon it's thefirst. It's a fourth cancer killer where
colon is numbers too, and Iwould say, dang, most people don't
understand or appreciate that number, andyou know they The other thing is colon
cancer is the third common most commoncancer world why as well, right,

(21:14):
and so it's quite common, it'sbut the number one thing is actually it's
preventable if we can detect it early. And that's why, you know,
not just being aware of it,but also starting you know, a preventative
program or a screening program is importantwithou regard to colon cancer. Right,
And along those lines, yes,I think the best approach is people to

(21:40):
realize I need to get screen Itshould be conversation with their doctor and their
family and those circles. But theother thing is that you have to realize
that you may be at risk higherrisk for colon cancer. And some of
these things include being overweight or overbeasts, type two diabetes, the diet

(22:04):
we eat, which would be youknow, typically high in red meat,
processed meats, you know, sausage, hot dogs, low fiber foods.
And the other part day is familyhistory. And I don't know if everybody
has a good sense of their familyhistory with regard to polyps or a past

(22:29):
history of cancer. Do you whatdo you think exactly? You know,
so when you look at the riskfactor, there are modifiable risk factor which
you did a very good job atnaming them, and they are non modifiable
risk factor which which are our race, you know, certain American, Indian,
Alaskan, Pacific Islanders, European juiceor higher risks. And then there

(22:56):
are personal family there are personal familyhistory and and you know it's important because
there's we don't think about it,so we don't discuss with with our parents,
with our siblings, with our kidsabout uh the family history, and
it should be a conversation. Thenit might not be an easy conversation.
And actually there are a certain societythat help us with with how to start

(23:22):
the conversations. But you know,we should sit down, our patients should
sit down. And when when wehave a chance to uh discuss with if
we're lucky enough to have parents aroundto discuss with them and talk to them
and to learn about our history.And the most important thing with colon cancer
is the first degree relative, whichare our siblings, our parents, our

(23:45):
children who have UH colon cancer.Because it really changed the age of UH
screening and the surveillant interval. Yeah, and you know a lot of it.
A lot of the times I'll talkwith patients and when the colon cancer
discussion comes up, you'll say,hey, did anybody in your family have

(24:07):
colon cancer or polyps? And you'llsay, how about your sisters, your
brother, your parents? And theyhave absolutely no idea And they say,
well, you know, I didn'task. I didn't want to get too
personal. But I think, toyour point, we really have to have
these conversations. I agree, Iagree. Yeah. So I think part

(24:30):
of it is it's and again it'snot just the colon cancer story. We
want to know are you at riskfor breast cancer, other malignancies, heart
disease, things like that. SoI think as our families get a little
bit more further and further apart,we're not living close to each other,

(24:51):
you lose touch. But if youknow that your brother had a colonoscopy for
whatever reason a month or so ago. You sort of want to know what
they found because it impacts on you, wouldn't you say? I agree,
and and and not just that?Right? You mentioned other colon can other
cancer, breast cancer, ovarian cancer, family history of these pancreatic cancer.

(25:18):
Because it's related to a it couldbe an inherent colon genetic defect that causes
a certain inheritable syndrome like the Lynzsyndrome for example, right, and familiar
adinomatis polyposis syndrome for example, whichthese if a family had these type of
genetic mutation, they're at much muchhigher risk for colon cancer. Yeah,

(25:45):
now you know the one thing,and it's it's uh, I think for
both of us, since we dothis just about every day, a pet
peeve or the conversation is, patientsactually delay themselves getting a colon before because
of the the bowel prep that theyhave to take. There is such a

(26:06):
mental block sometimes that they will tellyou I did not get it because I
did not want to take the prep. What do you say to those people
out there tonight? Well, youknow, first of all, yes,
the prep is it's bothersome, youknow, but it's doable because there are
a million and millions of people outthere that do them, and and you

(26:29):
know, if you do it rightand if your colon noscupy turned out to
be normal, you don't have todo it once every ten years, right,
and and so but to me,the most important thing to do is
actually to be able to do atest. We talked a lot about colon
cans, I mean colon osk ifyou because we're gassing terologists, but there

(26:52):
are other tests as well that helpwith colon cancer screening. Right now,
of course, if any watches TV, we're bombarded in a good way with
all of these colon guard commercials.So what's why don't you explain to everybody
what colon guard is and should theyuse it or should they not use it?

(27:15):
Well, so back up a bit. You know, there there are
two types of colon cancer screening tests. One is stool based testing and the
other one is probably direct visualization,which is the colonoscopy. The col of
guard is a stool based testing.It's a combination of both a what we

(27:37):
call a fit test, which isa stool test that to test for blood
in the stool and a DNA ormutation testing to test for malignant or pre
malignant cells or pre cancer cells inthe stool. So in the United States
it's called colo guard. You know, every test has an advantage and disadvantage,

(28:02):
but you know for the cola guardthat advantages you don't have to take
the the prep uh clean your colonnow, So in a sense it's it's
more convenient for patients. It doesn'ttake time off of work. And the
way you do a colon guard isthere's a they're gonna the company is going

(28:22):
to stand you a box, youput stool samples in there, you follow
their instruction, and you mail itaway and it will send you a results.
It's either a negative, results area positive. Results a positive meaning
there's actually pre cancer cells, thereare a positive blood blood in the stool,

(28:44):
so that would lead to further testing, and if it's negative, you're
good for three years. But theadvantage of this colon guard test really is
that number one, if it's positive, it will lead to a colonoscopy,
so it's not it lead to furtherevaluation. Number two is that it's not

(29:06):
very sensitive in developing colon polyps,which is in theory, that's what we
want to look. We want tofind something early where where the guest andogists
can remove it easily exactly. ButI would think the colon guard is valuable
in that you'd like to think thatpeople that are a little hesitant or they're

(29:29):
a little tough on time, youcould get more people screen that way versus
the colonoscopy. I definitely agree.Like I say earlier, the best test,
the best test for screening is thetest that the patient is willing to
complete according to the test instruction,right, So the best test is the

(29:51):
test that a patient is willing tocomplete and to do it correct exactly.
And people, you know, theythey are going to probably opt a little
bit more for something like the colonguard if they have these phobias about the
procedure or anesthesia, things like that. There are still some people that are

(30:12):
getting just a flexible sigmoidoscopy in theirdoctor's office, which is which is sort
of like a mini colonoscopy, onlygoing to see about a quarter or third
of the colon. What do youthink about that? I, you know,
I never I never really liked that, So yeah, I agree,

(30:32):
yes, because it's you know,there's a lot of time. There's a
lot of right side of colon cancer. I mean the cancer that that located
on the right side, the seacum, the standing coal, and the transverse
colon that the flexible sigmoidoscopy never reachesright, so it misses, in my

(30:53):
opinion, half the cancer right.I mean, it's like sending your car
in for a state inspection. Saywe're just going to check the front of
the car and not the back end. It doesn't exactly, it doesn't make
any sense. Does not last questionhere, And for those that just may
be tuning in, I'm on withdoctor dang when a guesher neurologist here in

(31:15):
Houston, A lot of patients whenwe do start that conversation saying you're forty
five years old, we need tostart thinking about screening. The first thing
they say, quite confidently, Ifeel fine. I don't have any symptoms.
I have a completely normal bowel movementor my bowel habits are fine.

(31:38):
I'm okay, leave me alone.What do you say to them, I
say, doctor Gallatti, the definitionof a screening colonoscopy is to get it
done at the age of forty fivefor avish risk patient without any GI symptoms.
Right, that's a definition of screeningcolonoscopy. There are symptoms that are

(32:01):
associated with colon cancer that a patientmight have, but for our screening tests,
you do not have to have anysymptoms. And in fact, when
we look at the data, probablyabout thirty percent of male and twenty percent
of female who undergo a colonoscopy justat the age of forty five or fifty

(32:23):
years old, who are asymptomatic,we find polyps in those patients which are
pre cancerus lesions that we needed toresect. That is true. That is
a great way to end this segment. All right, Dang, I will
put information about you on our Facebookpage as well as Texas International Endoscopy Center

(32:45):
where we do our procedures at.And as you said, step up to
the plate, get screened with oneof these screening tests that you feel comfortable
with. Dang, you did greatfor your first time. Thank you for
coming on tonight and I will seeyou tomorrow morning. Well, thank you
very much. I have a goodnight everyone, all right, and remember

(33:08):
to celebrate colon cancer screening a monthwhich is the month of March. Perfect.
Thanks so much, thank you,all right, A big thanks to
doctor dan Win. Final segment comingup of this Sunday's Your Health First.
Stay tuned, don't forget. Goto doctor Joe Galotti dot com and on

(33:31):
our Facebook page we'll have more informationabout doctor when and Colon Cancer Awareness Month.
Final segment of this Sunday's Your HealthFirst. Hope you're having a good
weekend start of the new week tomorrowMonday morning, and that you've put a

(33:57):
little bit of thought into how you'regoing to plan your week from a health
and wellness standpoint. What are yougoing to eat? What is your exercise
schedule, How is your work andfamily schedule? How that is going to
be affected by your schedule other membersof the family's schedule and meal planning?

(34:24):
Do you have to eat out?If you do think you may need to
eat out, where are you goingto go? Can you think ahead of
time and say is there a betteroption than going through drive through with your
kids and exposing them to a bunchof garbage? All right, all right?
In the final couple of minutes herewant to thank again doctor dang Wynn

(34:47):
for coming on and talking about coloncancer awareness, which during the month of
March we are thinking colon Cancer AwarenessMonth, keeping in mind that it is
the number two cancer killer behind lungcancer. And then, as I said
earlier, lung leads the pack atone hundred and twenty seven thousand, debts,

(35:10):
colon at fifty two thousand, pancreasat fifty thousand, and then breast
cancer at forty three thousand, andthen prostate at thirty four thousand. But
the main thing is to get screened, Okay. Now, the other thing
is, and I alluded to thisa little bit that people will say to

(35:34):
us, I feel fine, Ihave normal bowel movements, I'm not constipated.
I don't see blood. That reallydoes not always get you off the
hook. If you're of age fortyfive minutes older, you need to get
screened for colon cancer in one ofthe different mechanisms ranging from colon oscoby to

(35:54):
colon guard flexible sigmoid oscoby, whichwe talked about. We're really not fans
of that. You could go foran occult blood test, but again there's
better technology than that. Now.The other thing is, many times we
have a certain silliness that you arehaving abdominal pain, you're having cramps,

(36:22):
you see a little bit of bloodand stool, and you assign it to
something else. The blood and thestool, Oh, i have hemorrhoids,
the pain on the left side.I'm a little constipated, i ate too
much Chinese food, or I'm eatingtoo much cheese and I'm constipated and straining,
or I've been traveling and my bowelroutine is thrown off. We many

(36:43):
times make up these excuses almost reallyout of fear and denial. So if
you or somebody that's in your household, close friend, coworker, whatever the
situation may be, and they havethese abdominal complaints, be it constipation,
be it diarrhea, be it bloodin the stool, weight loss or weight

(37:07):
gain, indigestion, heartburn, justsort of an uneasiness of their stomach,
and you assign it to your diet. You're stressed out, you're taking too
much motren, you have an ulcer, whatever it may be. Don't ignore
it. You have to get thesethings worked up, either through your primary

(37:28):
care physician, your interness, yourkind of coologist, or if you get
sent off to a specialist such asa gastronurologist, you really really need to
get this looked at. So that'sit Colon Cancer Awareness month. You have
to be honest with yourself. Ifyou're forty five and older, you have
to answer to yourself. Have Igotten screen for colon cancer? All right,

(37:50):
that's it. I'm doctor Joe Goloti. Don't forget doctor Joeglotti dot com.
We'll see you next Sunday evening.You've been listening to your Health First
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