- 1 week ago
In this month’s Stay Well Health Chat, Andrew Salciunas sits down with Maulik Shah, MD, a gastroenterologist at Virtua Health, to discuss colorectal cancer prevention, screening, and digestive health. Dr. Shah explains why doctors are seeing colorectal cancer diagnosed in younger adults, what symptoms you should never ignore, and why a colonoscopy is the most effective way to prevent colon cancer by identifying and removing precancerous polyps.
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00:00Hello, everybody. Welcome into another Virtua Stay Well Health Chat. I'm Andrew Salchunas from
00:0897.5 The Fanatic. You can hear me every day, Monday through Friday, 6 a.m. to 10 a.m. I'm the
00:14host of Kincaid and Salchunas. And when I'm not yelling and screaming about the Philadelphia Eagles
00:19or crying about the Sixers or the Flyers, I do like to take care of my own personal health. And
00:24that's why I'm always privileged every single month to be able to talk to a different member
00:28of the Virtua Health team. And this week, I'm really excited because this is something that
00:33I know very personally. I have a lot of friends and family members that deal with colorectal
00:40issues. And so that's why I'm really excited to welcome in Dr. Malik Shah, who is a gastroenterologist
00:46at Virtua Health in South Jersey. He specializes in treating digestive health issues and in the
00:51detection and prevention of colon cancer. Of course, food is one of the big, powerful tools
00:57for a lot of stuff, right? We talk about new year, new me. Happy new year, everybody. I'm going to
01:02start eating right. I'm going to start exercising right because I want to look good for the beach. I
01:06want to look good for the summer. But sometimes we've got to think about the inside and not just
01:11how we look on the outside. Dr. Shah, good afternoon. How are you doing today?
01:16Good, good. Good afternoon, Andrew.
01:18I mean, it's amazing, right? We always think about our health in terms of how people see us,
01:24right? And something like colorectal cancer or anything when it comes to our colon. That's all
01:29on the inside. We've got to start thinking about that as well. And I'm glad that we get to talk
01:34about that because it's starting to pop up more in younger people, it seems. We know actor James
01:40Vanderbeek, who a lot of people know him from Dawson's Creek. I'm more of a varsity blues person.
01:45There was somebody in Philadelphia, an Eagles trainer, actually. Joe Opello was diagnosed
01:49with colorectal cancer at just the age of 38. Thankfully, beat cancer is doing well. But I
01:56want to talk about the age and how we can prevent colon cancer because it can obviously happen at
02:02any point. But I feel like there is this belief that cancer is not going to affect me until I'm
02:07older. Can you speak more on that, Doc?
02:09Yeah. So interestingly, you bring up some good points. The actual society, the American Cancer
02:15Society actually reports that about one in five people diagnosed with colorectal cancer
02:20are now under the age of 55, which I mean, it's a pretty big statistic there. But going back to
02:26your question, yeah, there's clear evidence-based ways to reduce the risk of colon cancer. And the
02:31most important is screening. What I mean by that, so colon cancer is highly preventable because we can
02:37find and actually remove precancerous polyps before they turn into cancer. For average risk,
02:43adult screening should begin at age 45. Screening should start earlier if you've had actually a
02:49family history of colon cancer, chronic GI symptoms, for example, rectal bleeding,
02:54changing bowel habits, or unexplained weight loss. But then at the same time, lifestyle also matters,
03:01right? So a diet high in fruits, vegetables, whole grains, and fiber, while limiting red and
03:08processed meats lowers risks. Regular exercise, maintaining a healthy diet, as well as avoiding
03:17smoking and limiting alcohol all help. So, you know, it's a combination of two things, right? So
03:22prevention really comes down to two things, getting screened on time and also adopting healthy habits.
03:28When we do both, colon cancer is one of the most preventable cancers we have.
03:32So you mentioned family history. And if there is family history, maybe you want to get started
03:38screening earlier. Does it have to be family history? Or could somebody say, you know what,
03:42maybe this is best for me? I know 45 is the recommended age. But do you see, you know,
03:48patients that come in at an earlier age just because they may see certain symptoms? Because
03:53I feel like a lot of people just go, oh, I'm not 45 yet. This can't be happening to me.
03:56Yeah. So interestingly enough, we do see that. Obviously, that's kind of when we discuss some
04:03of their symptoms in a sense. You know, there are some symptoms that are considered like alarm
04:07symptoms that, you know, prompt us to kind of think about, you know, what might be going on and
04:12if it's something more concerning. You know, some of those more concerning symptoms, you know,
04:15rectal bleeding, like I mentioned, change in bowel habits, whether it's diarrhea or constipation that
04:21acutely changes. Like if they were having regular bowel habits and now all of a sudden they've
04:25developed one or the other. Unexplained weight loss, that's significant. You know,
04:29there are a whole host of symptoms that are also obviously concerning for which we consider alarm
04:35symptoms, like I said, to where it would prompt screening even earlier. But, you know, at that
04:39point, it would be more of like a diagnostic situation. So I know that there are positive
04:45foods that we could take into our body to help this. And you mentioned staying away from certain
04:50things like like processed meats and a lot of red meat. What if I want to have a steak? Like I don't
04:56want to have to worry about having a steak. But I also understand that I probably shouldn't have a
05:01steak seven days a week. So what is like that fine line where we think about, all right, treating
05:07ourselves, but also worrying about our health for multiple reasons, right? Whether it's colorectal
05:11cancer, weight loss, right? That's always the big thing, especially in the new year. So is there
05:16like a fine line that you would say from your own personal studies, all the information that you
05:20have for somebody that might like to eat a lot of meat, likes to eat, go to the deli and get a hoagie?
05:25Is there a fine line in terms of how often you can eat these foods? Or is it something that you
05:29believe you should just stay away from altogether? So, I mean, based on the data and the literature,
05:35I mean, obviously, there's something that's kind of the that's evidence based what the literature says,
05:40but then, you know, in all practicality, how closely can patients actually follow that? So,
05:44you know, obviously, the literature and the evidence does say to kind of completely stay
05:49away from it and cut it out as much as possible. But, you know, from a practical standpoint, I think,
05:55you know, probably once a month, if that would probably be okay, you know, obviously, it's all
05:59the good and fun stuff. So it's completely hard to avoid sometimes. Now, you mentioned at one point,
06:05smoking is smoking and alcohol a factor when it comes to our colon, and trying to avoid colorectal
06:12cancer as well. Yeah, so with smoking, as well as increased alcohol use, we do we do actually see
06:21an increased risk of polyp formation, which obviously, that's a precursor to, you know,
06:26if it is a precancerous kind of polyp, obviously, that's kind of a precursor to colon cancer.
06:31Now, can you tell me, we all know about colonoscopies, or at least I hope everybody knows,
06:35and if not, obviously, get your colon check. What is Cologuard? Something that I don't know about,
06:40so this is why I turned to the expert here. Is that something that you should use instead? What is
06:45it? So Cologuard is actually a stool test that you do at home and mail into the lab.
06:52It's for people at low risk, it does have a 92% cancer detection rate. So you know, if you're low
06:59risk, your doctor, primary care doctor or gastroenterologist might offer you this option.
07:04However, for the general population, colonoscopy is still the most thorough and the gold standard
07:09for screening. Your doctor can see the entire colon at that time during the procedure to detect
07:14signs of cancer. And at the same time, they can remove precancerous polyps before they turn into
07:19cancer. If a Cologuard is positive, though, I should add, a colonoscopy is the next step that,
07:25you know, a positive Cologuard does require a colonoscopy thereafter to kind of figure out why that's
07:30the case. And then another caveat is that if a patient does have a personal history of colon
07:36polyps, a Cologuard is not recommended as a screening or surveillance test. In that situation,
07:42colonoscopy is the only test that should be done as a follow-up for surveillance.
07:47Now, one of my favorite things about the team at Virtua, not just the incredible doctors like
07:52yourself, but just everything about Virtua, trying to be innovative, trying to be, you know, next step.
07:57The amount of these Virtua Stable Health chats that I have done over my years here at 97.5 The Fanatic,
08:03I always hear Virtua is the first in the area to do this. Virtua is the first in the area to do that.
08:08What is smarter colonoscopy with GI Genius? What is that that Virtua has to offer?
08:15So, GI Genius is a newer technology that we use at Virtua to improve the accuracy of your colonoscopy.
08:22It's actually an AI tool that's used during colonoscopy that analyzes the live video feed
08:28to help identify polyps in real time, including small or flat ones that are easy to miss. It serves
08:34as almost like a second set of eyes for the gastroenterologist, improving adenoma detection
08:39and helping prevent colon cancer. So, studies actually show that it reduces missed polyps
08:44by up to 50% while still relying on the physician's expertise for all the clinical decisions.
08:50So, the doctor is still kind of doing all the clinical work and making the decisions,
08:54but this just is almost as a second set of eyes. So, that's kind of the neat thing.
08:58I know this is sort of out of nowhere, but I'm curious, going back to some things you talked
09:04about at the very beginning, the youthful age that we're starting to see more and more people
09:08have this. What is your belief or the studies that you have read over the years when you're going to
09:13school? We are seeing an uptick or I should say maybe a downtick in terms of the amount of the actual
09:19age of a patient. What is it that we are seeing that has caused this?
09:26So, you know, it's a couple different things. Honestly, you know, number one, obviously, I feel
09:31like people are getting screened more. So, it's being found at a, you know, younger age more. But
09:37at the same time, you know, the jury's almost still out. There's still studies being done as to why
09:43younger and younger people are getting diagnosed. But in my opinion, obviously, we look at all the
09:48risk factors, right? What are the highest risk factors? So, obviously, family history of colon
09:52cancer, smoking. In today's day and age, I feel like a lot of the food is more processed a lot of
09:59times. So, when we think about diet, you know, the increased process nature of the foods can also
10:05contribute to some of the polyp formation risk factors. Well, listen, everybody should get
10:11screened. I know that's the message that you hear all the time, especially when you start hitting that
10:16age 40 area, 45 years old. And of course, if you do have a family history, and if you are looking
10:21for somewhere to get screened, Virtual Health is always the place that I will endorse. I'll tell
10:25you to go there because I love the entire team there. If you want to connect with Dr. Shaw or any
10:30of the gastroenterologists at Virtual Health, or if you just want to schedule a colonoscopy, you go,
10:36you know what? I think I need to do this now. Visit virtua.org. Doc, I really appreciate the time
10:41today. It's very informative, and it's something that just needs to get done. And if you could send
10:47maybe one more message as we sign off here, I feel like there are men that are afraid to do this.
10:56And I hear the stories all the time. They put it off. They put it off. And then all of a sudden,
11:01it becomes too late or maybe the recovery time or the process to recover is much longer. Is there
11:07a message that you could send to somebody right now that may be hesitant to get a colonoscopy
11:12because they don't want to or they're afraid? So like I said, going back to, you know, there's
11:20not anything nice about any type of cancer specifically, but colon cancer is almost, you
11:25know, I would say 99% almost preventable by the means of a colonoscopy and getting screened
11:30in early and getting these polyps removed in a sense, right? So overall, you know, it's pretty
11:36easy, pretty straightforward test. At the least, I would say, you know, check in with your
11:40gastroenterologist or primary care doctor, have the conversation. And, you know, overall, it's
11:46pretty easy. It's not as kind of big to do. Obviously, there's a lot of rumors around about
11:51the prep. People get discouraged with the prep process. Overall, even that's not the end of the
11:56world. It's definitely doable. You know, I think the first step is just having that conversation with
12:01your primary care doctor or gastroenterologist. Get screened and we could definitely prevent colon
12:06cancer in that standpoint. I appreciate that, doc. Thank you so much today. Thank you as always to
12:11you and the entire team at Virtua. Again, get your screening. Check out Virtua.org. So many great
12:16gastroenterologists there at Virtua, but of course, my man, Dr. Saul is tremendous as well. So check
12:21him out. Thank you so much, doctor. I appreciate the time to see you. Thank you, Andrew.
12:23Thank you, Andrew.
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