Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Andre Davies, M.D., Board Certified in Internal Medicine & Geriatrics
In the month of March, we focus attention on colorectal cancer awareness. This is a disease that affects the colon (also known as the large intestine or bowel), and the rectum, (which is the portion that connects the large intestine to the anus). The colon has an important job in our gastrointestinal tract; it works to resorb fluid and nutrients back into our system, helping to form stool that we then excrete. Abnormal overgrowth of cells in our colon and rectum can become small polyps, and over time, these polyps can turn into cancer. Interestingly, colorectal cancer is the fourth most common type of non-skin related cancer in the US. Given the high prevalence, awareness is crucial to help save lives.
As a physician, I spend a lot of time in clinic talking with patients about the various risk factors of colorectal cancer. Some risk factors are not in our control, such as age and family history. The incidence of colorectal cancers increases as we age. Also, there are specific hereditary diseases, like inflammatory bowel disease, Lynch Syndrome, and familial adenomatous polyposis which predispose a person to getting colorectal cancer. A lot of the counseling I do surrounding these unavoidable “risks” involves being attentive and proactive. Once I am aware of a patient’s family history, for instance, together we can ensure the timing and frequency of screening is appropriate.
In conjunction with age and family history, lifestyle choices also factor into a patient’s colorectal cancer risk. Evidence demonstrates that a low fiber diet, deficient in fruits and vegetables and high in processed foods, is associated with higher rates of colon cancer. I work with patients to analyze what they eat and encourage them to make healthier dietary choices. Being overweight and having a sedentary lifestyle also increases risk. In addition, tobacco use is a forgotten risk factor; patients do not often connect gastrointestinal cancers with smoking. Through education, screening, and collaboration, I work with my patients to reduce these modifiable risk factors.
In addition to mitigating risk, I provide counseling about proactive screening tests. I commonly hear from patients that there is not anything currently bothering them, and so they would prefer not to do any tests. I stress the key point that we do screening tests for cancer BEFORE there are symptoms, and this strategy produces the best results and saves lives. Virtually all colon cancer develops from mushroom-like growths (called adenomatous polyps) that form on the inside of the wall of the colon. These polyps vary in size, but the larger the polyp is, the greater the likelihood that it will become cancerous. Since the majority of colon cancer grows from polyps, this makes the role of screening tests very important. Some of these screening tests include a colonoscopy, which has been the gold standard test for decades, and newer tests, such as stool DNA testing. I spend time with my patients explaining the various screening tools available, helping them understand the risks and benefits, the frequency of the tests needed, and ultimately choosing together the appropriate preventative screening.
The recommended age to start screening is 45 years old. Based on an individual’s risk factors, however, a patient may need to start screening earlier. Choosing when to stop screening, however, is less clear. Most guidelines recommend screening from 45 years old until 75 years old. After the age of 75 until 85, current literature suggests a case-by-case review of the patient to determine if screening should continue.
As a board-certified physician, I am often asked in clinic, “do I really need to do this again? “I thought I was finished with screening test.” My answer to my patients older than 75 years old is, “It depends.” Newer studies have shown that screening in adults over the age of 75 to 85 can reduce the risk of dying from colorectal cancer by more than 33% when compared to adults who did not have screening tests. On the other hand, screening tests like colonoscopies have risks. These risks include the chance of bowel perforation, potential bleeding, along with potential side effects and risk of the sedation used during the procedure. Furthermore, there are rigors and challenges posed with the pre-colonoscopy prep. When we are deciding whether to continue screening tests, we discuss the patient’s functional health status, their health goals, their previous screening history, and their risk profile. This information is then reviewed together and synthesized to make an informed decision.
Year round, and especially in the month of March, my goal is to spread awareness about colorectal cancer and the importance of screening. By focusing on prevention and early detection, we can help save lives. It is through a collaborative and patient-centered approach that we can make a significant impact on this deadly disease.
To learn more about our Internal Medicine Concierge services and Dr. Andre Davies, visit our website at GCMedicine.com. If you would like to schedule a complimentary meet and greet with Dr. Andre Davies, please email Christina@GCMedicine.com or contact our office at 239-566-3100.
Andre Davies, MD
Dr. Andre Davies is a highly qualified Ivy League trained board-certified physician in both Internal Medicine and Geriatrics. He brings a wealth of expertise and knowledge to his practice. Specializing in adult primary care for both men and women, he focuses on preventive health, managing chronic conditions such as high blood pressure, cholesterol, and diabetes. Dr. Davies excels in pre-op exams, annual physical, diabetic screenings, immunizations, cancer screenings, weight management, and nutritional deficiencies. As a fellowship trained Geriatrician, he adeptly addresses complex health issues, emphasizing cognitive evaluations and mental well-being. Dr. Davies aims to educate patients on maximizing brain function and preventing cognitive decline. With a background in various prestigious medical roles, including at NCH Healthcare Group and Northwestern Feinberg School of Medicine, he stands as one of the top providers in the area.
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