Special Issue: Colon Cancer Awareness - UCLA Health...COLON CANCER SCREENING OPTIONS Colon cancer is...
Transcript of Special Issue: Colon Cancer Awareness - UCLA Health...COLON CANCER SCREENING OPTIONS Colon cancer is...
THE CHECKUP | CO LO N CA N C E R AWA R E N E S S U C L A H E A LT H .O R G | 1 - 8 0 0 - U C L A- M D 1
A colonoscopy should be repeated every 10 years so that any polyps can be removed before they turn cancerous. If any polyps are found, the colonoscopy may be repeated sooner. A FIT should be completed annually.
DO NOT WAIT FOR SYMPTOMS
Patients should not wait for symptoms, such as blood in their stool or changes in their bowel habits, to screen for colon cancer. “This cancer is so common that we want to screen the entire population,” says UCLA Health gastroenterologist Dr. Lynn Connolly.
Talk to your primary care physician or gastroenterologist about which test is right for you. Once a colonoscopy order is placed in the system, you can call 310-825-7540 to schedule your procedure, or you can request a FIT Kit at your next primary care or gastroenterology appointment.
Find out more:
uclahealth.org/colon-cancer-screening
COLON CANCER IS THE THIRD MOST
diagnosed cancer and the second leading cause of cancer-related
death for men and women in the United States. But there is good news. Unlike other types of cancer, colon cancer has a greater than 90% cure rate if it is found early. The best way to be proactive and to detect and remove benign growths before cancer forms is for everyone to schedule and complete a routine colon cancer screening test.
THERE ARE SEVERAL WAYS TO SCREEN FOR COLON CANCER
UCLA Health recommends that patients either have a colonoscopy or complete a stool-based test at home.
A colonoscopy is an outpatient procedure that is performed at a surgical center or hospital. During the procedure, the patient is sedated so that a gastroenterologist can look inside their colon using a small instrument that has a light and camera attached, called a colonoscope. Using a colonoscope, the
physician can find small growths, known as polyps. While most polyps are benign, some can become cancerous over time. Removing polyps during a routine colonoscopy is the best way to prevent colon cancer.
A fecal immunochemical test (FIT) is a stool-based test that can be completed at home. The patient will need to collect a stool sample and then drop the kit off at a UCLA Health office or mail it to a lab for testing. If any blood is found in the stool, it is considered a positive result, and a diagnostic colonoscopy is required.
MOST PEOPLE SHOULD BEGIN SCREENING AT 50
According to the U.S. Preventive Services Task Force, most people should begin screening for colon cancer at 50. African Americans, who have a higher risk of being diagnosed with colon cancer, should begin screening at 45. Anyone with a family history of colon cancer should discuss their ideal screening timeline with their physician.
HOW COLON CANCER SCREENING CAN SAVE LIVES
Special Issue: Colon Cancer Awareness
THE CHECKUP | CO LO N CA N C E R AWA R E N E S S
EVERY AVERAGE-RISK
person who is 50 or older should be regularly screened for colon cancer. Yet 1 in 3 people have not taken
this crucial step to protect themselves and support their long-term health.
UCLA Health is committed to changing that, and getting more patients to complete a colonoscopy or stool-based screening test. Here is how we plan to achieve this goal:
More locations. UCLA Health patients no longer have to travel to Westwood or Santa Monica to see a digestive disease specialist. We now have gastroenterologists available to see patients in 10 locations throughout greater Los Angeles, with two more offices opening this year.
Convenient options. UCLA Health patients can now have a colonoscopy performed at one of our outpatient surgical centers in West Hills, Santa Clarita or Torrance. Physicians can also perform this procedure at UCLA Health hospitals in Westwood or Santa Monica, or in some cases, at an outside surgical center. Our team can help you schedule this procedure at the time and place that is most convenient for you.
Resources and support. Our gastroenterologists work closely with dietitians, genetic counselors and surgical oncologists to ensure that every patient receives support tailored to their specific needs.
UCLA Health also provides additional resources, both online and in person. We recently launched a website that details everything you need to know about colon cancer screening, prevention and treatment. We are also hosting dozens of informational events tied to our colon cancer campaign.
Get involved and share your story through social media by using the hashtag #UCLAColonChampion.
P R ES I D E N T ’S M ESSAG E
OUR COMMITMENT TO COLON CANCER PREVENTIONJohnese Spisso, President, UCLA Health
PREVENTIVE CARE
PICK A TEST, GET IT DONE COLON CANCER SCREENING OPTIONS
Colon cancer is highly preventable and treatable. Yet more than 140,000 people are diagnosed with—and more than 50,000 people die from—colon cancer each year in the United States. The key to improving these statistics is to ensure that every person completes a routine colon cancer screening, which can stop the disease before it starts. The following graphic compares two common screening tests recommended by UCLA Health physicians.
WHAT IS IT?
COLONOSCOPY FIT
Colonoscopy is the preferred colon cancer screening test. It takes 15 to 30 minutes to complete, during which time the patient is sedated so that a doctor can examine the inside of their colon for precancerous polyps.
The fecal immunochemical test (FIT) is a non-invasive stool-based test. Patients collect their sample at home and send it to a lab. Any blood in the stool requires follow-up colonoscopy.
HOW MUCH DOES IT COST?
Varies by insurance. Screening colonoscopies are typically less expensive than diagnostic tests, which are ordered because of symptoms.
Free or low cost option
WHEN SHOULD IT REPEATED?
Every 10 years, if normal
Annually
WHERE IS IT PERFORMED?
Outpatient surgical center or hospital
The patient’s home
ARE THERE ANY RISKS OR NEGATIVES?
Complications are rare but include bleeding, infection and bowel wall injury. You will need to miss a day of work, and have someone available to drive you home. Prep to clean out your bowels may be unpleasant.
No physical risks. Compared to colonoscopy, there is a slightly higher chance that the test misses a cancer. If the test is positive, a colonoscopy is required.
WHO IS A GOOD CANDIDATE FOR THIS TEST?
Most people are good candidates for a colonoscopy. It is the best way for doctors to find and remove precancerous polyps. It also allows doctors to look at the entire colon, and find other early signs of disease.
This is a great option for patients who are hesitant about colonoscopy. Testing must be completed every year, and a positive result must be followed up with a colonoscopy.
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Kells Jesse and his wife, Sylvia Castillo-Jesse, shop for produce at the Mar Vista farmer’s market.
KELLS JESSE, A PRODUCTION
designer who lives in Venice, says that in recent years, he and his
wife, Sylvia, have made major lifestyle changes to prioritize their health. They optimized their nutrition and now eat a mostly vegan, plant-based diet; incorporated more exercise into their routines; and last spring, scheduled their routine colon cancer screening tests.
While Jesse had his first screening right at 50, the doctor who removed some precancerous growths called polyps, told him to return for a follow-up test in three years. Unfortunately, life got in the way, and he waited an extra two. “I work a lot and lead a busy life,” he says, “so I always had an excuse to put it off.”
In April, he finally got a referral from his primary care physician to see Dr. Mary Farid in Santa Monica. At his
appointment in June, they discussed his overdue colonoscopy and some other GI issues, and then scheduled the procedure. When Dr. Farid performed the colonoscopy in September, she saw a suspicious-looking lesion that she couldn’t easily remove. “I wasn’t 100% certain it was cancer,” she says. “But we definitely needed to rule it out.”
She removed a small tissue sample to biopsy, which pathology later confirmed was adenocarcinoma. Jesse was shocked by his diagnosis. “When I
heard the word ‘cancer,’ I couldn’t grasp it,” he says. His wife jumped into action, and worked with Dr. Farid to schedule a CT scan to make sure the cancer had not spread. Dr. Farid also referred Jesse to a surgeon who could remove the lesion.
On many fronts, Jesse was lucky. While the CT scan showed a slight shadow on his liver, a follow-up MRI concluded that it was nothing to worry about. Then, after the diseased section of Jesse’s colon was removed in October, pathology confirmed the cancer had not invaded his colon’s walls or spread to his lymph nodes.
Based on these findings, Jesse was told that he did not need chemotherapy and could consider himself cancer-free. After an emotional few months, he says he couldn’t be happier with the results. “This experience changed my life.”
Now, he wants to change other peoples’ lives too by sharing his story. “Friends always ask me if I had any symptoms,” Jesse says, “and the answer is no. But that’s just the point. You don’t want to wait for symptoms. You want to catch colon cancer early so that you can be cured.”
‘You don’t want to wait for symptoms. You want to catch colon cancer early so that you can be cured.’
PAT I E N T STO RY
COLON CANCER CURED DUE TO ROUTINE SCREENING
U C L A H E A LT H .O R G | 1 - 8 0 0 - U C L A- M D 1
U C L A H E A LT H U P DAT E
WHERE TO FIND DIGESTIVE DISEASE DOCTORS
DIGESTIVE DISEASE SPECIALISTS,
called gastroenterologists, diagnose and treat medical
conditions that affect the GI system and can cause nausea, abdominal pain or trouble swallowing. They are also the physicians that perform colonoscopies and diagnose and treat colon cancer.
As part of UCLA Health’s expansion throughout the greater Los Angeles region, we have added digestive disease doctors who are part of the integrated Vatche and Tamar Manoukian Division of Digestive Diseases to many community practices. These physicians are available to discuss colon cancer screening options. They also perform colonoscopies at UCLA hospitals and outpatient surgical centers.
The adjacent map details where you can find gastroenterologists in your area. Your primary care physician can provide a referral to a GI specialist if necessary. Find out more: uclahealth.org/gastro
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Santa Monica
Santa Clarita
Oxnard
Burbank
Torrance
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DIGESTIVE DISEASES LOCATIONS
1. Beverly Hills 8641 Wilshire Blvd., Suite 210 310-855-7002
2. Burbank 2625 Alameda Ave., Suite 300 818-843-9020
3. Encino 15503 Ventura Blvd., Suite 170 818-461-8148
4. Porter Ranch 19950 Rinaldi St., Suite 300 818-271-2400
5. Santa Clarita 25775 McBean Pkwy., Suite 214 661-255-2420
6. Santa Monica 1223 16th St., Suite 3100 310-582-6240
7. Thousand Oaks 100 Moody Ct., Suite 200 805-418-3500
8. Torrance 2780 Skypark Dr., Suite 125 310-530-8013
9. Westlake Village 1250 La Venta Dr., Suite 211 805-494-6920
10. Westwood 100 Medical Plaza, Suite 205 310-208-5400
Want to discuss colon cancer screening options with your primary care physician? If you are an established patient, you can now directly schedule primary care appointments through the UCLA Health patient portal. Here’s how:
D I G I TA L D I G EST
DIRECT SCHEDULING NOW AVAILABLE
Try this new feature: my.uclahealth.org
1Sign into the
patient portal at my.uclahealth.org
or launch the MyChart app
2Select
“Schedule An Appointment” from the quick
links
3Click “Self
Schedule an Appointment”
from the available options
4Pick which
UCLA Health provider you want to see
5Select a day
and time that works with your
schedule
6Fill in some
details about your visit
7Confirm that the
appointment details are
correct, and hit “Schedule”
THE CHECKUP | CO LO N CA N C E R AWA R E N E S S U C L A H E A LT H .O R G | 1 - 8 0 0 - U C L A- M D 1
FEATURED SPECIALTY
CANCER GENETIC COUNSELORSApproximately 5% to 10% of colon cancers are heredi-tary, which means that a genetic risk was passed from parent to child. If someone in your family has been diagnosed with colon cancer—specifically a parent or sibling—let your physician know. You may be referred to a genetic counselor, who can provide a personalized risk assessment to help you and your physician better understand your genetic risk for being diagnosed with colon cancer. This information will help them optimize your colon cancer screening plan.
Where: Bowyer Oncology Clinic 200 UCLA Medical Plaza, Suite 120Phone: 310-825-5287More info: uclahealth.org/colorectalsurgery
SANTA CLARITA
25775 McBean Pkwy., Suite 115Valencia, CA 91355Phone: 661-255-2420Hours: Monday – Friday: 6:30 am– 3:30 pmParking: Free parking availableWeb: uclahealth.org/santa-clarita
Colonoscopies and other outpatient gastrointestinal procedures can now be performed in three convenient UCLA Health locations outside of Westwood and Santa Monica. After your primary care physician or gastroenterologist orders your procedure in the system, call 310-825-7540 to schedule your appointment.
WEST HILLS
7320 Woodlake Ave., Suite 320West Hills, CA 91307Phone: 818-436-7686Hours: Monday – Friday: 8 am – 5 pmParking: Free parking available Web: uclahealth.org/west-hills
TORRANCE
2780 Skypark Drive, Suite 125Torrance, CA 90505Phone: 310-530-8001Hours: Monday – Friday: 8 am – 5 pmParking: Free parking availableWeb: uclahealth.org/torrance
F E AT U R E D S P EC I A LT Y
DIGESTIVE DISEASES NUTRITION
Two registered dietitian nutritionists, Nancee Jaffe and Janelle Smith, lead the digestive diseases nutrition team. Both provide dietary support to patients with various GI disorders, including colon cancer. Referrals are not required, but some patients might require authorization. Follow-up sessions are offered in person or remotely via telemedicine.
Westwood: 100 Med Plaza, Suite 345; 310-206-6279 Santa Monica: 1223 16th St., Suite 3100; 310-582-6240More info: uclahealth.org/gastro/nutrition
P R AC T I C E S P OT L I G H T
GI PROCEDURE UNITS
CHAIR, DEPT. OF MEDICINEAlan M. Fogelman, MD
COO, AMBULATORY AND COMMUNITY PRACTICESFarah Elahi, MBA
VICE CHAIR, DEPT. OF MEDICINE COMMUNITY PRACTICESMatteo Dinolfo, MD
VICE CHAIR, DEPT. OF MEDICINE, COMMUNITY PHYSICIANS NETWORKMark S. Grossman, MD
WRITER AND EDITORAnne Machalinski
DESIGNSean Noyce, Noysky Projects
PHOTOGRAPHYReed Hutchinson PhotoGraphics
Copyright © 2019 by UCLA Health. All rights reserved
Contact The Checkup via email: [email protected]
C L I N I CA L U P DAT E
COLONOSCOPY TIMELINEWHAT TO EXPECT
BEFORE, DURING AND AFTER YOUR PROCEDURE
START HERE 9
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SCHEDULE YOUR PROCEDURE
n After your primary care physician places an order in the system, you can schedule your colonoscopy by calling 310-825-7540. Make sure someone is available to drive you home, and remember to take the day off work.
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3 DAYS BEFOREn Start a low-residue diet and limit high-fiber foods.
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2 DAYS BEFOREn Pick up your bowel prep medication from a pharmacy, per your physician’s orders. Confirm your ride home.
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1 DAY BEFOREn Follow bowel prep instructions to clear out your colon before your procedure, and stick to a clear liquid diet. If your colon is not completely emptied prior to the procedure, there is a chance that the doctor will miss an abnormality.
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BEFORE THE PROCEDURE
n Stop drinking clear liquids 2 hours before your procedure.
n Wear something comfortable to your appointment.
n Check in to the hospital or outpatient surgical center.
n Change into a gown, and have an IV placed by a nurse.
n Meet with your physician and your anesthesioloigst to go over the procedure and ask any final questions.
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n Undergo anesthesia and be put in a twilight sleep to minimize discomfort.
n Your physician will use a thin, flexible tube with a light and
DURING THE PROCEDURE6
AFTER THE PROCEDURE
n You will be observed in a recovery room until the anesthesia wears off.
n When you are discharged, you must have an adult accompany you home, even if you take a cab. Staff must be able to contact this person prior to your procedure.
n You can resume your normal diet, unless otherwise directed.
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ONE DAY AFTERn Return to work.
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1-2 WEEKS AFTERn You will receive biopsy results within a few weeks of your procedure. Your physician will also let you know the recommended time frame for your next colonoscopy.
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camera attached, called a colonoscope, to look inside your colon for abnormalities.
n Your physician will remove polyps and abnormal tissue, which will be sent to a pathology lab for testing.
n The procedure takes 15 to 30 minutes, and the entire appointment takes 2 to 3 hours.
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