Kaiser Permanente hosts online discussion on colorectal cancer

With March being Colorectal Cancer Awareness Month, Kaiser Permanente (KP) East Bay HouseCalls hosted an encore presentation of ‘Let’s Wipe Out Colon Cancer!’ to help the community understand more about their health. 

Members of the Latino community attended the online discussion about colon cancer (CRC) and the importance of screening tests and early detection because of CRC being a leading cause of cancer death among Latinos.

The presentation was part of KP’s HouseCalls program, where health experts host a discussion every six weeks to help members learn how to prevent and manage health conditions. 

The HouseCalls program was originally created for communities experiencing a gap in their healthcare with the goal of creating conversation around making healthy lifestyle choices, self-advocacy and best practices to prevent chronic disease.

Throughout the online discussion, KP physicians were available to answer questions from the community directly in the online chat, including the speakers translating the conversation in Spanish.

CRC usually begins as small clumps of cells called polyps that form inside the colon. Polyps are usually not cancerous, but there is still a possibility that they can turn into CRC over time.

Doctors recommend regular screening tests to help find polyps in the colon and remove them, due to polyps often not causing any symptoms. When patients do experience symptoms, it often depends on the cancer’s size and where it is located in the large intestine.

It’s reported that rates of colorectal screening are significantly lower in Latinos (52%) compared to white people (61%), according to the American Cancer Society. 

CRC symptoms can include:

• A change in bowel habits, like frequent diarrhea or constipation

• Rectal bleeding or blood in the stool (feces)

• Ongoing stomach discomfort, such as cramps, gas or pain

• Tiredness

• Weight loss

Screening for CRC typically starts around the age of 45 for patients presenting symptoms, but recently there has been concern with younger people beginning to experience CRC. During the online presentation, healthcare experts shared concerns of CRC trending in younger patients.

“We're seeing this in really young patients in their 20s, 30s or early 40s. While our colon cancer screening typically starts at age 45, these patients present with the symptoms. The most important symptom is rectal bleeding,” Dr. Rosa Valadao continued.“This may not be everyone's fan favorite, but looking at your stools, looking when you wipe and not ignoring something that's in front of you [is important]”

Estimated rates have increased by 2.4% per year from 2012 to 2021 for people younger than 50 years old, according to the American Cancer Society.

A common challenge doctors seem to face is patients feeling uncomfortable going through the colonoscopy procedure. Patients who go through a colonoscopy procedure tend to not remember the procedure, but Dr. Andres Turner told CALÓ News that it's the preparation phase that makes patients anxious. 

“I like to meet my patients where they're at and explore what sorts of anxieties they're having. So really ask questions and help to answer them as honestly as I can,” said Turner.

Due to the invasive nature of this procedure, doctors welcome the conversation about the patient's reasoning for not wanting to go through these procedures.

Turner pointed out that because of the level of respect the Latino culture has for doctors, oftentimes patients don’t express their concerns or discuss why they feel uncomfortable about going through with screenings. 

If patients feel uncomfortable about the idea of colonoscopy, KP also offers alternative methods for its members to screen for rectal bleeding symptoms at home, such as a Fecal Immunochemical Test (FIT). 

“A polyp may cause no symptoms at all. Bleeding may be the only symptom. And even then, the amount of blood is so small that you couldn't see it, it could be microscopic. That's the power of the FIT test. It can find even tiny amounts of blood,” said Dr. Christian Lee-Rodriguez.

KP members could put a small sample of stool in either a tube or card that comes with the kit and they are able to receive the results right away. If any result of blood is found, it is recommended to call your doctor as soon as possible.

Another alternative would be taking a stool test, which is a series of tests conducted on a stool sample to help diagnose certain conditions, like CRC.

Although it is important to know that once the doctor validates that blood was found in the stool test, it would be recommended that the patient goes through with the colonoscopy procedure. Often patients would like to repeat the stool test, over concerns that it was an “initial positive”.

Doctors recommend not to repeat the stool test because if the second test comes out negative, that does not mean the first positive is inaccurate. If blood is found in the stool, a FIT test will not work and the patient will need a diagnostic type of evaluation exam to determine the result.

“The unfortunate truth about colon cancer is that they don't bleed all the time. We feel lucky when they do bleed. We've caught them early enough that we've captured a microscopic amount of blood,” said Valadao.

CRC is probably one of the most treatable and preventable forms of cancers that we have in modern medicine. Valadao said it has the highest rates of survival and the highest opportunity for prevention.

By following a healthy diet that is low in animal fats and high in fruits, physical activity or limiting alcohol would help decrease the likeness of CRC, studies suggest.