As we honor Colorectal Cancer Awareness Month, what do you want our patients and families to pause and remember?
Colorectal cancer is the second leading cause of cancer death in the United States, and expected to claim over 50,000 lives in 2023. I want to remember those patients who have lost their lives to this terrible disease and give tribute to the thousands of patients each year who participate in clinical trials in order to improve our treatments. I also want to mention that, despite the prevalence of colorectal cancer, half of the cases can be attributed to lifestyle risk factors, such as smoking, poor diet, high alcohol consumption, physical inactivity and obesity. Lastly, with routine screening, many colorectal cancers can be cured before they even start.
How do you collaborate with other specialties at Smilow Cancer Hospital to care for your patients?
Treating a patient with cancer takes a team. At Smilow, I work daily with gastroenterologists, surgeons, radiation oncologists, radiologists, pathologists, palliative care providers, nutritionists, social workers, research staff and the absolute best nursing staff in the world. We meet regularly, either as a group or in individual conversations, to determine the best treatment plan, manage complications and support the psychosocial needs of each patient.
I am inspired by the patients who are cured of their disease; I am inspired by the courage each patient demonstrates in the face of uncertainty and discomfort; I am inspired by the collaborations with my colleagues to optimize and personalize care for each patient; and I am inspired by the continuous need for better and less toxic treatments.
What advances have made the biggest impact in the treatment of patients with colorectal cancer over the last five years, and what is the outlook for colorectal cancer in the next five years?
In the past 5 years, we have seen tremendous advances in our understanding of the biology of colorectal cancer, which has allowed us to develop more targeted, non-chemotherapy treatment options. We are fine-tuning our existing treatments to determine when we need to be more or less aggressive with our approach to achieve cure. Over the next 5 years, I expect further advances in our molecular understanding of colorectal cancer and progress in expanding the benefit of immunotherapy to a larger group of patients. I am optimistic these advances will lead to better outcomes and more cured patients.
What are some of the biggest challenges you face when treating patients with colorectal cancer?
Despite all of the progress we have made, for an individual patient with advanced colorectal cancer, there are still limited treatment options. Many of these treatments come with side effects that can persist long after a course of therapy has been completed. To make progress we need newer drugs and greater participation in clinical trials. The other challenge is that despite clear improvements in the incidence and mortality of older patients with colorectal cancer, in patients under 50 years old the incidence is increasing at an alarming rate, nearly twice that of 25 years ago. The reasons for this remain unclear, but early detection is a necessity.
Screenings via colonoscopies and other testing is a critical tool to catch colorectal cancer early when most treatable. How do you encourage patients to participate in regular screenings?
It cannot be overstated that colorectal cancer can be cured before it starts with routine screening. For the average population, the age to start screening is 45. It could be earlier if you have other risk factors or a family history. It requires ongoing education to our communities to get this message out. There are less invasive options as well that can be discussed with your primary care provider or gastroenterologist. Ultimately, any type of screening is better than no screening!