WEBVTT - Bonus: Colon cancer awareness: ‘I should have gotten my colonoscopy, that’s the lesson’ 0:00:05.080 --> 0:00:08.640 My mother lost her battle to cancer when she was 0:00:08.640 --> 0:00:12.280 fifty six years old, and so here I am at 0:00:12.280 --> 0:00:15.760 fifty seven. So my fifty seventh birthday was so important 0:00:15.880 --> 0:00:20.479 because I wanted to reach and bypass that milestone. She 0:00:20.600 --> 0:00:23.760 found out she had cancer right at the same age 0:00:23.760 --> 0:00:28.520 that I did at. My name is Donna Otis. I 0:00:28.560 --> 0:00:32.640 live in San Diego, California. I am a stage four 0:00:33.440 --> 0:00:40.560 metastatic cancer fighter. How do I say this without crying? Um, 0:00:40.560 --> 0:00:44.159 I'm a mom, I'm a single mom. I love life 0:00:44.680 --> 0:00:51.160 and cancer will never define me. Hi. Everyone, I'm Katie 0:00:51.240 --> 0:00:55.600 Curic and this is next question. You know, March maybe 0:00:55.600 --> 0:00:59.000 calling cancer Awareness month, but as many of you know, 0:00:59.720 --> 0:01:03.720 my mission has been to increase awareness of this second 0:01:03.760 --> 0:01:08.240 leading cancer killer every day of the year. So we've 0:01:08.280 --> 0:01:12.080 put together a special episode on this topic with the 0:01:12.160 --> 0:01:15.760 hopes that it will motivate many of you to call 0:01:15.840 --> 0:01:19.600 your doctor and get screened. As a lot of you 0:01:19.640 --> 0:01:23.720 all know, my first husband, Jay died gosh twenty three 0:01:23.800 --> 0:01:28.560 years ago. He had been diagnosed with stage four calling cancer. 0:01:28.959 --> 0:01:33.360 He battled the disease for nine months and then died 0:01:33.680 --> 0:01:38.800 at just forty two. I've been advocating for early detection 0:01:38.920 --> 0:01:43.240 ever since I even got a colonoscopy on television. I'm 0:01:43.240 --> 0:01:49.080 a little nervous that in our normal well today. I 0:01:49.160 --> 0:01:52.320 wanted to see where we are in terms of research, detection, 0:01:52.360 --> 0:01:56.240 and treatment, and also understand why our country still has 0:01:56.400 --> 0:02:00.720 such vast health disparities that leave black of Americans more 0:02:00.800 --> 0:02:04.800 susceptible to this disease than others. You'll be hearing from 0:02:05.000 --> 0:02:08.760 two of the top scientists in this area a bit later, 0:02:09.520 --> 0:02:12.600 but first I wanted to start with my friend Donna. 0:02:13.560 --> 0:02:18.240 Early detection is so important. Donna Otis is the CEO 0:02:18.360 --> 0:02:21.240 of a private golf club in San Diego, and a 0:02:21.280 --> 0:02:24.120 couple of years ago we got to talking and I 0:02:24.200 --> 0:02:29.040 learned about her calling cancer diagnosis and preparing for this episode. 0:02:29.240 --> 0:02:32.040 I asked if she would be willing to share her story, 0:02:32.560 --> 0:02:38.160 and she bravely agreed. I did not get a colonoscopy 0:02:38.240 --> 0:02:41.880 at fifty. I did one of those um colonnaise, you know, 0:02:42.000 --> 0:02:44.840 just kind of those quick tests, and nothing came up. 0:02:45.440 --> 0:02:48.080 I was in San Francisco at the time. I was 0:02:48.160 --> 0:02:53.040 fifty one, and I actually so not to get to graphic, 0:02:53.120 --> 0:02:58.079 but it's reality. I had blood in my stool and 0:02:58.960 --> 0:03:02.720 I got did eat something wrong? And so I did 0:03:02.800 --> 0:03:06.000 the let the hospital know. They sent me a kit 0:03:06.520 --> 0:03:11.280 and it came back negative. So I said okay. And 0:03:11.320 --> 0:03:17.119 then fast forward another year and I was fifty two 0:03:17.639 --> 0:03:20.840 and I noticed again it had stopped. And then I 0:03:20.919 --> 0:03:23.360 noticed again, so I went back to the hospital and 0:03:23.400 --> 0:03:27.480 they said, okay, try try another stool um sample. Tests 0:03:27.560 --> 0:03:31.960 I did that came back negative. And then one day 0:03:32.560 --> 0:03:36.240 in August two thousand eighteen, I just started to feel 0:03:36.400 --> 0:03:39.400 like my stomach wasn't right um and I was in 0:03:39.480 --> 0:03:42.440 some pain in the intestinal area. And then I said, well, 0:03:42.480 --> 0:03:44.840 let me just go see and check it out. Go 0:03:44.960 --> 0:03:46.720 to the doctors. And that's when they said, you know, 0:03:46.800 --> 0:03:49.680 let's let's do a pollnoscopy. And you know when I 0:03:49.720 --> 0:03:52.680 woke up and they said, h we see something in 0:03:52.720 --> 0:03:55.880 a little strange um. Let's let's take a look at 0:03:55.880 --> 0:03:58.680 it a little closer, and let's get a biopsy. And 0:03:59.520 --> 0:04:01.040 you know, it took a couple of months to get 0:04:01.080 --> 0:04:05.160 all the biopsies and the tests done, and I, oddly enough, 0:04:05.280 --> 0:04:08.200 I happened to be driving to Santa Barbara, UM with 0:04:08.200 --> 0:04:10.200 with a friend of mine and you know, you can 0:04:10.240 --> 0:04:13.400 open everything up on your on your chart. It's the 0:04:13.480 --> 0:04:16.840 day and age of technology now you can opt not 0:04:16.920 --> 0:04:19.800 to look at it and say I'm going to wait 0:04:20.000 --> 0:04:23.840 until the doctor preasum into the office. But everything, your 0:04:23.880 --> 0:04:29.520 test results, your CT scans, all of that comes right 0:04:29.560 --> 0:04:33.359 to your phone now. And I opened it up in 0:04:33.640 --> 0:04:41.720 clear as day, there's that word cancer. I put my 0:04:41.760 --> 0:04:44.520 phone down and I didn't want to say anything, and 0:04:44.720 --> 0:04:47.919 I opened it back up again, and not only was 0:04:48.000 --> 0:04:52.960 it cancer, but it was labeled as stage three, and 0:04:53.040 --> 0:04:56.320 I thought crap. I didn't want to call anybody. I 0:04:56.400 --> 0:04:59.159 just wanted to try and digest it. And my I 0:04:59.200 --> 0:05:01.640 went in to fight flight mode, like okay, what am 0:05:01.640 --> 0:05:04.120 I going to do with my twenty two year old daughter? 0:05:04.160 --> 0:05:06.320 She was twenty at the time, and how am I 0:05:06.320 --> 0:05:08.760 going to take care of things? And that's just that 0:05:08.839 --> 0:05:13.000 was my immediate reaction, like crap, I'm not ready. And 0:05:13.040 --> 0:05:17.920 the appointments, biopsies and CT scans that followed, Donna got 0:05:17.960 --> 0:05:22.320 more bad news. Sorry, it's now it has traveled to 0:05:22.360 --> 0:05:26.960 your liver. And then the next blow after the full 0:05:27.279 --> 0:05:30.680 um CT scan was well we think it's in your 0:05:30.760 --> 0:05:36.720 lungs too, So um I said, okay, this really can't 0:05:36.720 --> 0:05:40.200 be happening. So I went into this whole disbelief mode. UM, 0:05:40.240 --> 0:05:43.159 and then being a single mom. You know, what am 0:05:43.200 --> 0:05:45.360 I going to do with my job? And how am 0:05:45.360 --> 0:05:47.680 I gonna live? You know, just all those things come 0:05:47.760 --> 0:05:52.320 rushing through um, rushing through your head. And someone said 0:05:52.360 --> 0:05:55.440 to me, you know, Donna, you really don't know how 0:05:55.480 --> 0:05:58.919 strong you are until the only thing you can be 0:05:59.080 --> 0:06:04.160 is strong. Donna's co workers and friends rallied around her. 0:06:04.560 --> 0:06:08.560 She asked for help and gathered her village. Meanwhile, she 0:06:08.640 --> 0:06:11.599 got her treatment plan, and before she knew it was 0:06:11.680 --> 0:06:16.960 on the cancer diagnosis roller coaster ride. This started chemo 0:06:17.080 --> 0:06:20.400 in December of two thousand eighteen, and then I did 0:06:20.480 --> 0:06:25.560 chemo all the way through till September. Of My first 0:06:25.640 --> 0:06:29.120 round of chemo was okay. UM. The second round, I 0:06:29.200 --> 0:06:32.719 had a severe allergic reaction. I couldn't walk or talk. 0:06:33.000 --> 0:06:36.800 You physically cannot touch anything remotely cold, not even a 0:06:36.839 --> 0:06:41.440 door knob, this huge, painful, tingling sensation. My eyes completely 0:06:41.680 --> 0:06:44.760 shut because of the nerve endings. You go like this 0:06:44.880 --> 0:06:47.599 and you get a handful of hair. I couldn't take 0:06:47.640 --> 0:06:54.560 care of myself. I really just wanted to die. I 0:06:54.600 --> 0:06:58.480 think at that point I just said, okay, let's let's 0:06:58.480 --> 0:07:01.600 pack it up. Let's let's get anything situated, let's get 0:07:01.600 --> 0:07:05.800 a living will. And UM. I had those tough conversations 0:07:05.839 --> 0:07:10.360 with my daughter to say, listen, UM, we're going to 0:07:10.480 --> 0:07:13.000 fast track your life a little bit. You're going to 0:07:13.080 --> 0:07:16.640 have to be an adult fairly quickly here, and you 0:07:16.720 --> 0:07:21.760 forget about things like teaching your kid some of your 0:07:21.800 --> 0:07:25.360 old mom's recipes. Um, you forget to teach your kid, 0:07:25.760 --> 0:07:27.920 or you think about it like, well, I can always 0:07:28.000 --> 0:07:29.960 teach her. You know how to sew a button on 0:07:30.000 --> 0:07:33.560 a shirt. Donna found the strength as she has at 0:07:33.600 --> 0:07:37.520 every turn, and the treatments continued. I went through radiation, 0:07:37.720 --> 0:07:42.960 thirty rounds of radiation. Skin turn start extremely painful. After 0:07:43.000 --> 0:07:45.360 you leave, you have to wear a pump for forty 0:07:45.360 --> 0:07:47.920 eight hours. So you know, when you go to work 0:07:47.920 --> 0:07:50.320 and you see the tube hanging and everyone's looking at 0:07:50.320 --> 0:07:52.520 me like you're doing okay, And I said, don't feel 0:07:52.520 --> 0:08:00.160 sorry for me, don't treat any different. I've gone through 0:08:00.200 --> 0:08:04.160 two surgeries. Um. The first surgery was to remove part 0:08:04.160 --> 0:08:09.560 of my liver, to remove my rectum. The post surgery 0:08:09.720 --> 0:08:12.240 and waking up to this bag that is out of 0:08:12.280 --> 0:08:16.440 your body and you can see your intestine which is 0:08:16.480 --> 0:08:22.440 out of your body as well. Um, it's pretty difficult. 0:08:23.480 --> 0:08:25.520 And the type of clothes you have to wear, you 0:08:25.560 --> 0:08:28.440 can only wear certain very bad you know, loose and 0:08:28.520 --> 0:08:34.280 baggy clothes, and you have to time your release of 0:08:34.320 --> 0:08:36.920 your bag at a certain time because sometimes it could 0:08:36.920 --> 0:08:40.840 just really blow up. But this I made this bag 0:08:40.920 --> 0:08:47.480 define me. Um, and it took over me for for 0:08:47.640 --> 0:08:51.480 about a year. Um, pretty feeling pretty sad, feeling sorry 0:08:51.520 --> 0:08:55.520 for myself. But then um, but then my daughter said 0:08:55.559 --> 0:08:58.160 to me, but Mom, you wake up every day on 0:08:58.200 --> 0:09:00.839 this side of the world. Don't worry about the bag. 0:09:03.320 --> 0:09:07.840 And then my second surgery was in November of to 0:09:07.920 --> 0:09:11.920 do the reversal, meaning put my intestines back, get everything 0:09:11.960 --> 0:09:17.720 all attached. And then after radiation, um, you know, you 0:09:17.760 --> 0:09:21.000 do the surgery and then you go into chemo mode. Um. 0:09:21.240 --> 0:09:24.800 And so after one chemo treatment your body gets sort 0:09:24.840 --> 0:09:27.120 of immune to it, and then they shift you to another. 0:09:27.760 --> 0:09:33.600 And then the other was another strong poisonous chemo that 0:09:33.720 --> 0:09:37.800 reaked havoc um. But I had to do it, and 0:09:37.840 --> 0:09:41.440 that almost left me with complete hair loss. And then 0:09:41.520 --> 0:09:45.319 from there, you know, we're just fighting for time. And 0:09:45.400 --> 0:09:48.960 so I got the final news was not the final news. 0:09:49.080 --> 0:09:52.880 But the news was, Donna, you will never be cured 0:09:52.920 --> 0:09:56.280 of cancer. You will have to do chemo for the 0:09:56.320 --> 0:09:59.959 rest of your life until you pass. And we can't 0:10:00.120 --> 0:10:03.440 determine whether it's two or three years. Um, it's hard 0:10:03.480 --> 0:10:06.720 to say. And so you know, you keep on getting. 0:10:07.040 --> 0:10:10.520 You know, you're like one of those um those toys 0:10:10.640 --> 0:10:12.680 as a kid that's a plastic thing. It's got a 0:10:12.720 --> 0:10:14.600 base and you keep on knocking it over, but it 0:10:14.920 --> 0:10:17.600 stands right back up. Well, I felt like I was. 0:10:17.920 --> 0:10:21.079 I was one of those um but I got right 0:10:21.120 --> 0:10:25.760 back up because I had no choice. Recently, Donna got 0:10:25.800 --> 0:10:29.800 the chance to join an immunotherapy trial, which marks a 0:10:29.880 --> 0:10:34.559 new experimental face of treatment, one that's giving her and 0:10:34.679 --> 0:10:38.520 everyone who loves her hope. We're going to see how 0:10:38.559 --> 0:10:41.680 it goes. The doctor's like, hanging there, Let's just try 0:10:41.720 --> 0:10:45.520 this immuno therapy, blast out that tumor and then uh, 0:10:45.559 --> 0:10:47.319 and then we'll kind of take it from there. So 0:10:47.920 --> 0:10:54.200 here I am today, and I'm gonna live till tomorrow, 0:10:54.240 --> 0:10:58.840 and I'm gonna keep on going. This May, Donna is 0:10:58.920 --> 0:11:03.120 taking an important trip. She'll travel to Kentucky and watch 0:11:03.200 --> 0:11:07.960 her daughter graduate from college. A huge emotional milestone for 0:11:08.000 --> 0:11:12.200 both of them. That was what I was living for. 0:11:12.480 --> 0:11:16.760 That was my first target was when they gave me 0:11:16.840 --> 0:11:19.480 two years and I was like, crap, I won't be 0:11:19.520 --> 0:11:21.840 able to see her graduate and that was in my head. 0:11:22.640 --> 0:11:26.640 So um, so that's done pretty quick here in a 0:11:26.679 --> 0:11:31.480 couple of months, and then my my next target is 0:11:31.480 --> 0:11:34.559 is to to try and get to If I can 0:11:34.600 --> 0:11:37.680 get to sixty years old, that would be. That would 0:11:37.720 --> 0:11:45.840 be that's my next school. After after she graduates, we'll 0:11:45.880 --> 0:11:58.160 be right back. We begins tonight with the sudden and 0:11:58.400 --> 0:12:02.400 very tragic debt sending shot waves across the country devastating 0:12:02.400 --> 0:12:06.079 and shocking news that actor Chadwick Boseman has died at 0:12:06.160 --> 0:12:09.840 forty three after a valiant four year fight. Chadwick Boseman 0:12:09.920 --> 0:12:13.240 lost his battle with colon cancer Friday. For four years, 0:12:13.320 --> 0:12:18.000 Chadwick Boseman had been quietly fighting colon cancer, making something 0:12:18.040 --> 0:12:23.640 like seven films while enduring countless surgeries and chemotherapy. When 0:12:23.679 --> 0:12:27.920 the Black Panther actor died in August of it was 0:12:28.120 --> 0:12:31.680 devastating to those who loved him, as well as his 0:12:31.840 --> 0:12:35.800 legion of fans. It's not just a loss that we're 0:12:35.840 --> 0:12:43.040 feeling we're going to feel his absence. His absence, but 0:12:43.200 --> 0:12:46.000 his death at such a young age also put colon 0:12:46.080 --> 0:12:51.080 cancer and some grave statistics in the spotlight. One that 0:12:51.240 --> 0:12:54.040 more young people are being diagnosed with colon cancer than 0:12:54.120 --> 0:12:59.560 ever before, and two that Black Americans are more likely 0:12:59.640 --> 0:13:05.079 to get colorectal cancer and more likely to die from it. 0:13:06.080 --> 0:13:12.960 Black Americans have the highest colorectal cancer incidents and mortality 0:13:13.080 --> 0:13:18.480 rates of all racial and ethnic groups in the United States. 0:13:19.240 --> 0:13:23.160 Dr Edith Mitchell is a professor and oncologist at the 0:13:23.200 --> 0:13:27.800 Sydney Kimmel Cancer Center at Thomas Jefferson University in Philadelphia. 0:13:28.720 --> 0:13:32.520 We asked her why why is the black community hit 0:13:32.600 --> 0:13:37.920 hardest by this disease? So nobody knows for sure. What 0:13:38.120 --> 0:13:43.360 is known is there is a word called red lining. 0:13:45.200 --> 0:13:52.640 Holic is on loans and the sale of properties, so 0:13:52.920 --> 0:13:58.200 that Blacks were relegated to certain parts of the city 0:13:58.280 --> 0:14:02.800 where there may have in a higher number of factories 0:14:03.800 --> 0:14:10.400 and other carcinogens, as well as poor water quality and 0:14:10.679 --> 0:14:18.520 other socioeconomic conditions called the social determinants of health. There 0:14:18.520 --> 0:14:26.360 were fewer healthcare facilities, lack of supermarkets, drug stores, and 0:14:26.600 --> 0:14:32.400 other components of the healthcare arena. When I tell patients 0:14:33.120 --> 0:14:38.400 that I want them to eat fresh fruits and vegetables, 0:14:38.400 --> 0:14:43.120 but there are none nearby where they live, that's a 0:14:43.200 --> 0:14:48.880 social determinant of health. And consequently, all of these components 0:14:49.040 --> 0:14:55.320 contribute to the development of cancers. So if we're going 0:14:55.480 --> 0:15:01.640 to as a country change healthcare display charities, we really 0:15:01.720 --> 0:15:10.160 need to focus on not only the disease process and medications, 0:15:10.160 --> 0:15:15.880 but on lifestyle that contributes to who we are. We 0:15:16.000 --> 0:15:23.440 are who we eat, and consequently, one zip code determines 0:15:23.680 --> 0:15:28.600 more effectively and more accurately how long you will live, 0:15:29.360 --> 0:15:32.840 as opposed to your genetic code, which you inherit from 0:15:32.920 --> 0:15:38.240 your parents. So we've got to change that so that 0:15:38.360 --> 0:15:44.440 our zip code is not the greatest determining factor on 0:15:45.200 --> 0:15:50.080 the disease processes that are experienced in a community, as 0:15:50.120 --> 0:15:57.400 well as the duration of life. Dr Mitchell says it's 0:15:57.440 --> 0:16:00.720 important to highlight the fact that black men are forty 0:16:00.840 --> 0:16:04.360 seven percent more likely to die from calling cancer, partly 0:16:04.440 --> 0:16:07.800 because they are still not getting screened at the same rates. 0:16:08.840 --> 0:16:13.840 Is culture. There is also the history the Tuskegee study 0:16:14.040 --> 0:16:19.840 had only black men, it was not discussed with them, 0:16:19.920 --> 0:16:26.600 and therefore they passed on the disease to other sexual 0:16:26.640 --> 0:16:33.160 partners and therefore put really three generations at risk. So 0:16:34.240 --> 0:16:39.080 black men have a history of mistrust, and one thing 0:16:39.120 --> 0:16:44.200 that we have to instill in people is trust of 0:16:44.280 --> 0:16:50.240 the health care system. Black men prefer going to black doctors, 0:16:51.080 --> 0:16:56.840 and yet for the United States of practicing clinicians in 0:16:59.400 --> 0:17:07.399 only five percent we're black. Yet blacks constitute of the 0:17:07.480 --> 0:17:15.280 United States population. So therefore we need to develop more 0:17:15.840 --> 0:17:21.280 diverse clinicians so that there is a greater percentage of 0:17:21.320 --> 0:17:26.399 Blacks in the population. With so few black doctors, black 0:17:26.480 --> 0:17:31.439 patients don't always get the care they deserve. Implicit bias 0:17:31.480 --> 0:17:38.600 are Explicit bias really affects the interaction between the patient 0:17:39.040 --> 0:17:43.600 and the physician as well as others on the healthcare team, 0:17:44.160 --> 0:17:49.400 so that we need to understand people who are different 0:17:50.240 --> 0:17:54.439 or who may look different from us, and we have 0:17:54.600 --> 0:18:01.480 to learn how to communicate effectively with all patients. It's 0:18:01.520 --> 0:18:09.040 well recognized that in many clinical situations that black patients 0:18:09.080 --> 0:18:16.040 and other minority patients are treated differently. For example, there 0:18:16.040 --> 0:18:22.040 are studies that show that physicians and other clinicians spend 0:18:22.119 --> 0:18:28.960 less time in a examination room with a black patient 0:18:29.160 --> 0:18:34.080 as opposed to a white patient are to someone who 0:18:34.119 --> 0:18:39.439 doesn't speak English as their primary language. There was also 0:18:39.520 --> 0:18:45.440 a study UH and several studies showing that black patients 0:18:46.080 --> 0:18:51.359 did not receive the recommendations for treating an options as 0:18:51.480 --> 0:18:56.400 white patients. For example, patients who had stage one lung 0:18:56.520 --> 0:19:02.919 cancer were offered different recommend nations and not surgery as 0:19:02.920 --> 0:19:07.000 often as white patients. And of course there could have 0:19:07.040 --> 0:19:11.760 been other reasons, but for stage one lung cancer, surgery 0:19:12.840 --> 0:19:17.600 is the major treatment and can be curative. Yet the 0:19:17.600 --> 0:19:24.160 black patients were not offered surgery. Black patients are offered 0:19:24.840 --> 0:19:30.640 clinical trials less frequently, and in many cases it's the 0:19:30.680 --> 0:19:36.679 implus said bias with the assumption that black patients won't participate. 0:19:41.800 --> 0:19:48.440 So while you understand that there can be individual bias 0:19:48.440 --> 0:19:54.000 in health care delivery, there can also be institutional bias. 0:19:54.040 --> 0:19:58.560 So we really have to approach all of those topics 0:19:58.840 --> 0:20:01.919 to make sure that we have the three sixty that 0:20:02.200 --> 0:20:07.000 is a full circle of all of the potential areas 0:20:07.400 --> 0:20:12.600 where we can intervene to improve healthcare delivery. A new 0:20:12.720 --> 0:20:16.879 test is not going to change red lining are the 0:20:17.160 --> 0:20:25.399 lack of supermarkets and other potential components of the atmosphere. 0:20:25.520 --> 0:20:29.199 It's not going to get rid of the factories and 0:20:29.280 --> 0:20:33.080 the exhaust We've got to look at the whole picture 0:20:33.880 --> 0:20:39.240 and make sure that individuals living in certain zip codes 0:20:40.280 --> 0:20:48.960 are not disenfranchised from a good healthcare arena, that they 0:20:49.040 --> 0:20:53.200 have a good place to live, and making sure that 0:20:53.280 --> 0:20:59.680 the overall community is healthy. And therefore we've got to 0:20:59.760 --> 0:21:05.840 change some of the social determinants of health so that 0:21:06.480 --> 0:21:12.160 everybody has equal opportunity to live in a healthy environment 0:21:12.320 --> 0:21:19.240 and a healthy neighborhood. We have a moral imperative to 0:21:19.359 --> 0:21:23.399 fix this. Dr Charlie Fuchs is an oncologist who is 0:21:23.440 --> 0:21:27.719 now leading the hematology and oncology team at the biotech 0:21:27.840 --> 0:21:31.240 firm genem Tech. And it starts on many fronts, which 0:21:31.320 --> 0:21:36.280 is making sure that these communities have the proper access 0:21:36.280 --> 0:21:42.600 to information, education, nutrition, prevention, care, and I frankly, access 0:21:42.640 --> 0:21:46.200 to clinical trials. You know, we talked about how low 0:21:46.280 --> 0:21:49.240 the rate is in the US of patients in general 0:21:49.280 --> 0:21:52.280 participating in clinical trials. You know, you look at all 0:21:52.280 --> 0:21:57.760 these trials across the realm and it's five eight percent, 0:21:58.040 --> 0:22:02.920 maybe ten percent African American. Well, we got to fix that, right, 0:22:03.000 --> 0:22:06.800 I mean, because I was involved in a study because 0:22:06.960 --> 0:22:12.320 the common perception and in fact is that Black Americans 0:22:12.359 --> 0:22:15.679 diagnosed with calin cancer who get treated have a worse outcome. 0:22:16.359 --> 0:22:18.280 And so what we did is we looked at a 0:22:18.359 --> 0:22:23.679 large clinical trial database that enrolled African Americans and whites. 0:22:24.080 --> 0:22:26.919 And as you know, within a clinical trial, everything is prescribed, 0:22:27.400 --> 0:22:30.720 the treatment, the follow up, everything, because you've got to 0:22:30.760 --> 0:22:33.760 follow the menu because it's a clinical trial. And in 0:22:33.800 --> 0:22:37.880 the context of that clinical trial, there's no difference between 0:22:38.520 --> 0:22:41.919 white Americans and Black Americans, meaning that there is no 0:22:42.040 --> 0:22:46.080 biologic difference, and if they get access to proper care, 0:22:46.600 --> 0:22:51.520 they do just as well. So it's a moral imperative. 0:22:51.920 --> 0:22:55.640 The fix here is not complicated. It's access to care, 0:22:55.880 --> 0:22:59.160 it's access to education, it's all the things that are 0:22:59.280 --> 0:23:03.480 plainly obvious. When we come back, we'll have more with 0:23:03.640 --> 0:23:06.960 Dr Charlie Fuchs. We'll talk about the COVID effect on 0:23:07.080 --> 0:23:11.320 cancer screening as well as new research and treatment. That's 0:23:11.400 --> 0:23:34.600 right after this. I've known Dr Charlie Fuchs for a 0:23:34.600 --> 0:23:38.720 few years now. He's a trusted and respected oncologist who 0:23:38.760 --> 0:23:41.359 has worked with us at Stand Up to Cancer. He 0:23:41.520 --> 0:23:43.600 was the director of the Yale Cancer Center, but he 0:23:43.680 --> 0:23:46.720 recently made the jump to the research and product development 0:23:46.840 --> 0:23:50.040 end of the health spectrum at the biotech firm Genete 0:23:50.040 --> 0:23:53.320 Tech in San Francisco. So he is I think the 0:23:53.359 --> 0:23:56.359 perfect person to sit down and talk about where we 0:23:56.480 --> 0:24:00.119 are now with colon cancer and what the future looks like. 0:24:01.320 --> 0:24:05.639 Here we are after the pandemic or on the verge 0:24:05.680 --> 0:24:09.520 of being post pandemic, and so many people did not 0:24:09.560 --> 0:24:13.879 get screened and that is translating to a lot of 0:24:13.920 --> 0:24:18.720 cancer deaths if we don't really sound the alarm. So 0:24:19.600 --> 0:24:22.679 are you concerned about this period of time and about 0:24:22.760 --> 0:24:27.760 people putting off screening and what is the impact of that? No, Katy, 0:24:27.840 --> 0:24:31.840 I'm I'm really concerned. The fact is is that if 0:24:32.200 --> 0:24:36.680 every year American Cancer Society puts out the cancer statistics 0:24:36.720 --> 0:24:40.680 for the year, you know cancer in particular. Last January 0:24:41.000 --> 0:24:44.680 was cancer statistics, and you know, as you know, in January, 0:24:44.720 --> 0:24:46.840 we didn't know what we were about to get ourselves 0:24:46.840 --> 0:24:51.240 into with the pandemic. And I was actually interviewed um 0:24:51.280 --> 0:24:57.160 about the statistics in January which showed this progressive decline 0:24:57.720 --> 0:25:01.399 in cancer mortality decline and cancer incidents, and one of 0:25:01.400 --> 0:25:05.120 those was colon cancer. Right, We've made so much strides 0:25:05.160 --> 0:25:09.800 over the past three decades with early detection, with treatment, UM, 0:25:09.840 --> 0:25:14.479 with understanding the genetics and UM. You know, we were 0:25:14.520 --> 0:25:18.159 looking forward to continue declines. We're clearly not going to 0:25:18.240 --> 0:25:22.640 see that next year because the data are compelling. For instance, 0:25:23.640 --> 0:25:27.560 study showed that in the first three months of the pandemic, 0:25:28.480 --> 0:25:33.480 there was an eighty percent drop in cancer screening. So 0:25:33.520 --> 0:25:37.159 we're at of where we would have been the year before, 0:25:38.119 --> 0:25:40.840 and you just don't rapidly recover from that. And I 0:25:40.880 --> 0:25:43.880 can tell you, you know, what are we seeing. We're 0:25:43.920 --> 0:25:47.800 seeing people not getting screened. We're gonna be seeing sadly, 0:25:47.840 --> 0:25:51.680 people who are now presenting with cancer colon cancer at 0:25:51.760 --> 0:25:55.000 later stages, and we're going to see a backtrack. I 0:25:55.000 --> 0:25:56.719 don't think, you know, I think we need to be 0:25:56.760 --> 0:25:59.639 prepared for that reality. And what we have to do 0:25:59.720 --> 0:26:02.600 is just focus on what can we do today, which 0:26:02.680 --> 0:26:05.680 is returned to screening. And as you know, the American 0:26:05.760 --> 0:26:09.879 Cancer Society, a number of organizations, even the Biden administration 0:26:10.040 --> 0:26:13.560 is now pushing that, and we have to remind people 0:26:13.680 --> 0:26:17.000 that it is safe to go back, that it's safe 0:26:17.040 --> 0:26:20.760 to get screened, that patients who are concerned about symptoms 0:26:21.200 --> 0:26:24.280 need to follow up with their doctor. Patients who are 0:26:24.960 --> 0:26:28.880 being treated for cancers shouldn't hesitate to get get their 0:26:28.920 --> 0:26:32.640 therapy on time in its full course. And these are 0:26:32.640 --> 0:26:34.480 the things that we have to do, while at the 0:26:34.520 --> 0:26:37.359 same time we have to make sure that we enable 0:26:37.440 --> 0:26:41.119 all our researchers to continue their work despite all the 0:26:41.240 --> 0:26:44.760 complications of the pandemic. You should get your first calling 0:26:44.800 --> 0:26:48.400 oscarpy or your first calling cancer screen at at age five, 0:26:48.840 --> 0:26:53.879 according to the American Cancer Society and other organizations. Um, 0:26:53.960 --> 0:26:57.879 why was that lowered? That's exactly right, And just to 0:26:57.920 --> 0:27:01.640 be clear clear, it's age forty five for an averageous 0:27:01.720 --> 0:27:04.040 person because we could talk about what happens if we 0:27:04.080 --> 0:27:07.359 have a family history, which should be younger. But um, 0:27:07.400 --> 0:27:10.600 it was fifty, and why is it now forty five? 0:27:10.760 --> 0:27:14.760 Because as you know, there's this very alarming trend of 0:27:14.800 --> 0:27:18.320 an increase in younger people with calling cancer that is 0:27:18.440 --> 0:27:23.640 under fifty, under forty and there's only speculation as why 0:27:23.720 --> 0:27:26.120 that is. But it's rising at a rate faster than 0:27:26.160 --> 0:27:30.520 probably any other cancer that is calling cancer under age fifty. So, 0:27:30.760 --> 0:27:36.159 thank goodness, various organizations, American Cancer Society among others, have 0:27:36.320 --> 0:27:41.000 now reduced it and hopefully that will have an impact. 0:27:41.560 --> 0:27:44.960 But this trend is alarming. It's alarming, and it's also 0:27:46.000 --> 0:27:49.200 sort of maddening that you all, no offense, Charlie, haven't 0:27:49.240 --> 0:27:52.040 figured it out why this is happening. I mean, I 0:27:52.119 --> 0:27:54.840 know there's a lot of people studying this. This has 0:27:54.880 --> 0:27:58.000 been going on for a couple of years now, and 0:27:59.000 --> 0:28:02.800 why are we closer to understanding why this is happening. 0:28:02.880 --> 0:28:06.320 I've heard obesity, you know, for years that that was 0:28:06.359 --> 0:28:09.760 one of the culprits. But it seems to me there 0:28:09.840 --> 0:28:13.320 must be other things going on here, and what's taking 0:28:13.440 --> 0:28:16.560 so long to figure it out. I think it's a 0:28:16.600 --> 0:28:19.160 fair criticism. I think part of it is obesity. Now, 0:28:19.200 --> 0:28:21.760 when I say that, when I give a lecture to 0:28:21.840 --> 0:28:26.200 allay audience, I will tell you invariably I people appropriately 0:28:26.200 --> 0:28:27.720 come up to me at the end of my talk 0:28:28.240 --> 0:28:30.960 and say, much like you mentioned earlier, you know, my 0:28:31.119 --> 0:28:34.680 relative who was diagnosed at a young age was not obese. 0:28:34.800 --> 0:28:37.560 So I'm not suggesting to you that obesity is the 0:28:37.600 --> 0:28:40.800 only explanation. But I think we have to recognize and 0:28:40.880 --> 0:28:44.200 not to not the fact that obesity is a real 0:28:44.320 --> 0:28:47.600 risk factor for this malignancy. That there's no question that 0:28:47.680 --> 0:28:50.640 child had. Obesity is an issue and has been an 0:28:50.680 --> 0:28:53.360 issue over the past several decades in this country that 0:28:53.440 --> 0:28:56.440 has to be dealt with, but it's not the only answer. 0:28:56.840 --> 0:29:01.040 We recently completed analysis and I will tell you it's complicated. 0:29:01.520 --> 0:29:04.560 It's a very the people under age fifty with colon cancer, 0:29:04.840 --> 0:29:08.680 it is a very heterogeneous group, and we're trying to 0:29:08.720 --> 0:29:12.600 look at the subsets understand the genetics. Part of it 0:29:12.760 --> 0:29:16.440 is I think genetically driven, there's no question. Part of 0:29:16.480 --> 0:29:18.600 it I think has died and lifestyle and then there's 0:29:18.640 --> 0:29:20.760 an element we have to sort out. And I don't 0:29:20.760 --> 0:29:24.240 deny the fact that we have some catching up to do. 0:29:24.880 --> 0:29:27.600 In the meantime, I think, what can we do. We 0:29:27.760 --> 0:29:32.000 can make sure we're taking excellent family histories at the 0:29:32.000 --> 0:29:34.960