Colorectal Cancer Awareness

Speaker 1: Welcome to Bench to Bedside, a weekly series of live conversations about recent advances in cancer from the research bench to treatment at the patient's bedside. And now, your host and the Director of the University of Kansas Cancer Center, Dr. Roy Jensen.

Roy Jensen: Welcome, and good morning to Bench to Bedside. Today with me is Dr. John Ashcraft, who is a colon and rectal surgeon at the University of Kansas Cancer Center. Also joining us this morning is Dr. Dan Dixon, who is the Co-Leader of our Cancer Prevention and Survivorship program. We're live inside the inflatable colon. Dr. Dixon, can you walk us through the colon and tell us what you're seeing here?

Dan Dixon: Sure. Welcome to our inflatable colon. This is used to illustrate to patients what they might be seeing, or what their doctor might be seeing when they undergo a colonoscopy. In the majority of people that get a colonoscopy, what'll be observed is normal colon tissue. It'll be smooth and pink and have a shiny appearance to it. But in about 30% of people, what the gastroenterologist will see will be a polyp. Now, these polyps, even though they're not cancer as we think of cancers, they're a precursor to cancer. So typically what'll happen is the gastroenterologist will cut this out and a cancer will not be able to form from that. Now, if that's left alone over a period of years what can happen is, it can develop into a malignant polyp. This malignant polyp usually will be larger and will have blood vessels in it, also. And if that's left unchecked, over time this can turn into colon cancer. Really, the goal in colon cancer prevention is to try to take out the precursors, the polyps, before they can turn into a colon cancer or an advanced colon cancer, which can spread to the liver, and that's where people become very sick and can die from this disease. Another thing that your gastroenterologist might detect is that, if you have a disease called inflammatory bowel disease, and one part of inflammatory bowel disease illustrated here is Crohn's disease, is where inflammation is occurring in the colon. This actually puts a person at a higher risk for developing colon cancer. So all these things together allow your doctor to tell you whether or not you're going to be at high risk and to really remove the things that are going to develop into colon cancer before they get to that stage.

Roy Jensen: If you're just joining us, we've been inside an inflatable colon talking about colorectal cancer and how screening can help prevent the disease. Pauline Horton is here, as always, to take your questions. And remember to share this link with people you think might benefit from our discussion. Use the #BenchToBedside. Dr. Dixon, thank you very much for taking us on the tour of the inflatable colon this morning. And now joining me is Dr. John Ashcraft, who again is a colon and rectal surgeon here at the cancer center. Dr. Ashcraft, why should people care about colorectal cancer screening?

John Ashcraft: Roy, you know as well as I do, it's an important cancer in our world, especially in the United States of America. One in 20 people will get colorectal cancer, if we look at a lifelong risk factor. What we see is that it's the third leading cause of colon-related deaths in the United States, and what we believe, through careful screening like Dr. Dixon just described, is that we can save 60% of these patients from colon-related deaths if we can do the colonoscopy in a timely manner.

Roy Jensen: So, what you're saying is that many colorectal cancers are preventable?

John Ashcraft: I think so. The technique that we use is a colonoscopy. A colonoscopy like Dan showed is to get in there and get those polyps out, get them out before they turn into that pre-malignant stage or that malignant stage. And if, God forbid, you do have a colon cancer, to catch it early so that we can cure the patient with a surgery.

Roy Jensen: Very good.

John Ashcraft: What we're seeing is that the rates of colon cancer deaths are decreasing across the country, and we strongly believe that's related to screening.

Roy Jensen: So, if you're just joining us, we're talking with Dr. John Ashcraft, who's a surgical oncologist and surgeon for the colon and rectum about cancer screening, and the fact that there are certain disease signs and symptoms to be aware of. So Dr. Ashcraft, maybe we could talk about that a little more. What are the recommendations for screening, and what are some of the signs and symptoms of this disease?

John Ashcraft: Sure. Screening, we typically for most usual patients, will start at 50 years of age. If you have a risk factor like a strong family history or you have inflammatory bowel disease, or even a genetic condition, you may have to be screened earlier. We know that. Patients that need to be screened or that have a higher risk are patients who have a history of adenomatous polyps, patients who have a history of colon and rectal cancer, themselves, patients who have inflammatory bowel disease like Dr. Dixon said, Crohn's disease, ulcerative colitis, those patients are at higher risk. And we can forget the patients who have genetic history that they know of, like our Lynch Syndrome patients and familial adenomatous polyposis patients.

Roy Jensen: So, what are some of the signs and symptoms of colorectal cancer?

John Ashcraft: Sure. The risk factors that we see, or the signs that we see, can sometimes be very vague. It can be diarrhea, it can be constipation, it can be bright red blood in your bowel movements, or even dark black bowel movements if it's on the beginning side of the colon. Other things we'll see is bloating, unintentional weight loss, and abdominal pain. These symptoms, although they might come with a typical gastroenteritis, or somebody might have a stomach bug, but these are symptoms that are going to last beyond days. If you see those symptoms, you really should seek your medical provider.

Roy Jensen: All right. Pauline Horton is here to take your questions, so please make sure that, if you have any questions, to put those online, and we will answer them throughout the course of the day. So, our live broadcast is now ending, but we want to encourage you to again continue this conversation, and we're always happy to interact with you on Facebook. I want to thank our guests this morning, Dr. Ashcraft and Dr. Dixon, and also our inflatable colon, which was courtesy of Prevent Colorectal Cancer Group. Please join us next week when we will be broadcasting live from the Fred Hutchinson Cancer Center. Thank you. That's all.