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Speaker 1: Hi, everyone, Welcome back to UCLA Health'smetically speaking. I'm your host,

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Speaker 1: doctor Eve Glacier. Colorectal cancer is one of the most

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Speaker 1: preventable cancers we face, and yet in twenty twenty six,

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Speaker 1: more than fifty five thousand people in the United States

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Speaker 1: are expected to die from it. And what's especially alarming

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Speaker 1: is what we're seeing in younger adults. Colorectal cancer is

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Speaker 1: now the leading cause of cancer death in people under fifty.

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Speaker 1: These are staggering and heartbreaking numbers for disease where screening

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Speaker 1: can truly change outcomes and in many cases, prevent cancer

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Speaker 1: before it even starts. So if you've been putting your

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Speaker 1: screening off, waiting for a symptom or the right time,

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Speaker 1: consider this your nudge. It's Colorectal cancer Awareness Month and

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Speaker 1: we're turning awareness into action. Today. We're going to break

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Speaker 1: down what screening really means, how to choose the option

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Speaker 1: that best fits you, what symptoms you should never wait for,

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Speaker 1: and how to get past the real life barriers so

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Speaker 1: this actually gets done. And to help us do this,

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Speaker 1: I'm joined by an incredible duo and two of my

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Speaker 1: favorite professional nudgers. Katie Kirk is back with US award

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Speaker 1: winning journalist, advocate, co founder of Stand Up to Cancer,

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Speaker 1: and the person who changed how Americans think about corectal

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Speaker 1: cancer screening. And we're also joined by my USDLA Health colleague,

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Speaker 1: doctor Fulo may gaserentrologist, health equity researcher, and someone who's

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Speaker 1: been working to redesign care so everyone can get screened

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Speaker 1: and get the follow up they need. Katie Fulla, welcome,

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Speaker 1: thank thank you.

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Speaker 2: For having us, so happy to be here, happy to

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Speaker 2: be here with Fulla and with you again, Eve, thank

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Speaker 2: you for bringing attention to this important issue. I can't

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Speaker 2: think of anything more important, especially it given that it's

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Speaker 2: Coorectal Cancer Awareness Month.

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Speaker 1: Absolutely before we dive in, I'd love to just have

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Speaker 1: a minute so everyone can meet our guests, even though

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Speaker 1: they probably already know a lot about you. But if

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Speaker 1: you don't mind, I'd love for you to share why

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Speaker 1: this work matters so much to each of you and Katie,

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Speaker 1: your advocacy, I think most people know, is deeply personal,

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Speaker 1: and you've talked openly about losing your husband Jay to

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Speaker 1: go on cancer when he was only forty two, and

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Speaker 1: how that changed how you wanted to really use and

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Speaker 1: leverage your platform. My question, just to start is when

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Speaker 1: you think about him, and you think about young people

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Speaker 1: today who are busy, and they're very young, and they

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Speaker 1: say i'll do it later, what do you want them

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Speaker 1: to most understand?

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Speaker 2: Well, gosh, when I think about him, I mostly think

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Speaker 2: about everything he's missed. You know, I have a grandson

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Speaker 2: now named Jay, who's going to be two this month.

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Speaker 2: My daughter is pregnant with the second child, Ellie. My

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Speaker 2: other daughter is in Charlottesville, Virginia getting her pH d

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Speaker 2: in history, and I know he'd really get a kick

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Speaker 2: out of that, and they'd have a lot to talk about.

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Speaker 2: But you know, graduations and weddings and milestones that sadly

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Speaker 2: he couldn't be there for. So I always think about

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Speaker 2: that first and foremost. And then I think about the

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Speaker 2: fact that he was forty one when he was diagnosed,

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Speaker 2: and I remember I treated it as a sort of

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Speaker 2: intrepid journalist and did research right away. And one of

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Speaker 2: the things I learned that back then, thirteen percent of

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Speaker 2: calling cancer patients were under the age of fifty, and

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Speaker 2: I was furious, thinking, what are these people expendable? You know,

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Speaker 2: there's no screening recommendation. I don't think many internists or

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Speaker 2: family doctors necessarily imagine that a young person at least

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Speaker 2: back then could be showing signs of coorectal cancer. And

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Speaker 2: you know, now very much on my mind, Eve, as

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Speaker 2: with Fola, is this alarming increase of coorectal cancer among

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Speaker 2: people under the age of fifty. The screening age was

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Speaker 2: lowered by the American Cancer Society a couple of years

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Speaker 2: ago to forty five. Unfortunately, one in five people under

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Speaker 2: the from forty five to fifty are getting screened, So

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Speaker 2: we really need to get that word out that it

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Speaker 2: is now forty five. But what I'm concerned about is

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Speaker 2: all the cases I'm hearing people in their thirties, forties,

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Speaker 2: some even in their twenties who are being diagnosed with

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Speaker 2: this disease. So that's I'm thinking from a public health perspective,

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Speaker 2: how we a get the word out about forty five,

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Speaker 2: but also how we address all these young people who

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Speaker 2: are being diagnosed, and how we come up with potentially

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Speaker 2: different kinds of screenings that can be used that are

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Speaker 2: less expensive, less invasive, and make sure that these young

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Speaker 2: people in the prime of their lives have their colorectal

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Speaker 2: cancer detected early when it's most treatable.

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Speaker 1: And also have access to that screening. And before we

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Speaker 1: get into all that, full I'd love to hear a

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Speaker 1: little bit about you. I mean, you're a gaster entrologist,

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Speaker 1: you still see patients all the time, but you're also

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Speaker 1: a health equity researcher. I'd love it if you could

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Speaker 1: tell us what exactly that means. And really, I mean,

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Speaker 1: I don't think I've even ever asked you this. Why

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Speaker 1: have you decided to commit, you know, really your energy

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Speaker 1: to colon cancer prevention and then especially this early onset work.

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Speaker 3: Absolutely, First of all, thank you for having me.

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Speaker 4: It's here, and I have to say, it's amazing to

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Speaker 4: be here with this fierce advocate.

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Speaker 3: On this amazing stage.

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Speaker 4: You know, I really consider you one of our first

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Speaker 4: advocates in corectal cancer.

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Speaker 3: It's an honor to be here with you.

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Speaker 4: Today, and I just want to thank you for continuing

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Speaker 4: to raise awareness about this disease. As you mentioned, my

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Speaker 4: name is Fulla May. I am a physician at UCLA.

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Speaker 4: I spend some of my time taking care of patients,

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Speaker 4: but actually the majority of my time running my lab,

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Speaker 4: and my lab is a clinical research lab that focuses

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Speaker 4: on colarectal cancer. We try to understand why people get

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Speaker 4: and die from colorectal cancer. We try to make sure

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Speaker 4: that as many people as possible get screened for colarectal cancer,

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Speaker 4: and we also try to make sure through our health

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Speaker 4: equity work, that everyone has access to screening regardless of

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Speaker 4: their income, their race, their ethnicity, where they live in

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Speaker 4: the United States. So a lot of our research is

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Speaker 4: really focused about working in community health centers and under

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Speaker 4: resource settings or under resource parts of the country to

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Speaker 4: make sure that people have access to screening tests.

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Speaker 3: You asked me the why.

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Speaker 4: I've always been really fascinated by diseases that.

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Speaker 3: Impact the digestive system. And when I went into training.

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Speaker 4: For gaser entrology, really just happened across corectal cancer as

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Speaker 4: a public health problem, and around that time I actually

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Speaker 4: found out that it also impacts my family. So I

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Speaker 4: didn't know it, but I was one of these people

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Speaker 4: who had colorectal cancer in my family and no one

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Speaker 4: was really talking about it, and that really solidified my

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Speaker 4: career path for me.

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Speaker 1: Why do you think no one was talking about it.

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Speaker 4: I think there's a real stigma about cancer in general.

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Speaker 4: And then I think when they're cancer. Does that affect

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Speaker 4: intimate parts of the body, like the colon, like the rectum.

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Speaker 4: There's some level of embarrassment, maybe even at a level

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Speaker 4: of not understanding are even self blame that can make

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Speaker 4: people uncomfortable talking about it. And I think that in

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Speaker 4: my family it took us a long time to feel

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Speaker 4: comfortable talking about the disease that affected my grandfather. That's

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Speaker 4: very different now and we're very open about it and

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Speaker 4: we're all screened, which is great.

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Speaker 1: Well thanks to the work that both of you do.

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Speaker 1: I thought it would be great to just take a

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Speaker 1: moment and really define what screening is because I think

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Speaker 1: just even just not we were talking about speaking in

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Speaker 1: plain language, it's really I think if you're not in

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Speaker 1: the medical world, even the definition of just screening can

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Speaker 1: be a little bit confusing. So quick definition moment. What

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Speaker 1: does screening actually mean? And why do we want to

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Speaker 1: see people when they feel fine?

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Speaker 3: So screening? Oh yeah, yeah, I'll start.

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Speaker 1: Yeah.

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Speaker 4: Screening is a preventive health effort to reduce the potential

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Speaker 4: impact of a disease, and in the setting of cancer,

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Speaker 4: we screen to either find polyps of the colon before

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Speaker 4: they turn into cancer, or to find cancer early enough

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Speaker 4: that we have the best chances.

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Speaker 3: Of curing the individual of it.

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Speaker 4: We're really fortunate in colorectal cancer that screening allows us

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Speaker 4: to both prevent colorectal cancer by finding polyps, and it

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Speaker 4: also allows us to early detect co directal cancer and

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Speaker 4: other cancers that we screen for. We're mostly just looking

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Speaker 4: for early signs of the cancer, but here we have

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Speaker 4: the extra benefit that we can find polyps in the

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Speaker 4: colon and take them out before they transform exactly.

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Speaker 1: And Katie, I'm sure you hear this all the time

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Speaker 1: when people say, wait, I don't have any family history, right,

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Speaker 1: I'm good, Or my bowel movements are normal. I mean,

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Speaker 1: I'm sure you could tell us why that's such a

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Speaker 1: religious assumption.

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Speaker 2: Yes, the most colorectal cancer cases are sporadic. I think

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Speaker 2: fully correct me if I'm wrong, But I think it's

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Speaker 2: like seventy five to eighty percent of colorectal cancers have

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Speaker 2: no family history. So I always say no family history

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Speaker 2: is no guarantee. But I think what's really amazing about

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Speaker 2: the colon is it's almost like it's like a package. Right,

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Speaker 2: you know, you can obviously have early detection for other

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Speaker 2: cancers like breast cancer for example, and I had early

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Speaker 2: stage breast cancer a couple of years ago. But with

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Speaker 2: colorectal cancer, if you're able to catch it early as

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Speaker 2: full as said, and you see these polyps that could

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Speaker 2: or couldn't develop into cancerous gross and you're able to

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Speaker 2: remove them during the process of a colonoscopy if they

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Speaker 2: haven't penetrated the colon wall through the lymph nodes, which

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Speaker 2: is kind of like the gateway. Tell me if I'm

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Speaker 2: saying this right full, then if it permeates the colon

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Speaker 2: wall through the lymph notes, then it becomes systemic disease

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Speaker 2: and can be stage three. And then stage four is

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Speaker 2: of course when it metastasizes on other organs. Most you

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Speaker 2: usually deliver the lung things like that. But it's just

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Speaker 2: this genius way because it's encased if you will, and

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Speaker 2: you know, I I don't want to convert it to

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Speaker 2: a sausage, but it kind of is encased in this

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Speaker 2: outer part of the colon. And that's why it's so

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Speaker 2: critically important that people get screened. And you mentioned symptoms.

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Speaker 2: You know, people need to be keenly aware of symptoms,

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Speaker 2: particularly because we're seeing these cases prior to people turning

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Speaker 2: the age of forty five, which is the age of

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Speaker 2: baseline screening, ten years before your first line relative. By

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Speaker 2: the way, for example, Ellie and Carry my daughters, Jay

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Speaker 2: was diagnosed when he was forty one. They both are

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Speaker 2: getting screened at thirty one. Carrie just turned thirty, so

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Speaker 2: she'll get screened at thirty one. Ellie has already been screened.

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Speaker 2: So it's just really important that you get screened when

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Speaker 2: you're feeling well, which is so counterintuitive for people. I

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Speaker 2: think they think, well, I feel fine, nothing's wrong with me.

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Speaker 2: But that's the way this cancer operates. By the time

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Speaker 2: you're symptomatic, oftentimes the cancer has advanced, sadly. So if

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Speaker 2: you have blood in your stools, you need to see

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Speaker 2: your doctor right away, and if the doctor says it's

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Speaker 2: just a hemorrhoid, you need to find another doctor to

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Speaker 2: really check it out. If you have a change in

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Speaker 2: your bowel habits, like your bowel movements look different, I

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Speaker 2: know it's you know, I feel totally comfortable talking about

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Speaker 2: this stuff because you know that kid's book Everybody Poops.

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Speaker 2: Everybody poops. It's sort of like everybody. Most the vast

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Speaker 2: majority of people have colon's and we have to take

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Speaker 2: care of them as much as any other part of

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Speaker 2: our bodies. But you know, unexplained weight loss, bloating, any

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Speaker 2: kind of like just not feeling right, sort of in

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Speaker 2: your digestive trap. You need to talk to your doctor.

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Speaker 2: And that's why screening is so important. But again, I mean,

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Speaker 2: I hope we spend a lot of time because to me,

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Speaker 2: even full of what's the real conundrum is what do

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Speaker 2: we do about these younger patients? As we said, they predicted,

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Speaker 2: I think later this year, corectal cancer was going to

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Speaker 2: be the number one killer of men and women under

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Speaker 2: the age of fifty. And it happened. Soon happened, and

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Speaker 2: they thought, so what do we do from a public

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Speaker 2: health policy to get screening or to get better screening,

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Speaker 2: or make it more accessible to people. And and secondly,

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Speaker 2: the big question I've been asking is why the hell.

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Speaker 1: It happens on this that's my new I mean I

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Speaker 1: think that, yes, it happened a couple of years ago,

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Speaker 1: you know, forty five being the new you know, fifty,

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Speaker 1: But I think it's still a surprise for everyone. But

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Speaker 1: they're early onset corectal cancer. I mean, it's very, very alarming,

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Speaker 1: and of course Jay was only forty one forty two

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Speaker 1: fulla what what is driving this? I mean, do you

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Speaker 1: what are your thoughts about what's going on? And how

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Speaker 1: do we, to your point, Katie, talk about it so

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Speaker 1: that young people hear it and we drive them to screening.

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Speaker 1: But we're not panicking them.

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Speaker 2: Yeah, but this is the this is the problem. They're

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Speaker 2: they're they're not being told to get screened.

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Speaker 3: Right, and they haven't been told because it's a big change.

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Speaker 3: We're telling the mass shift well, but.

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Speaker 2: A lot of people. I mean, this is this is

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Speaker 2: why we have so much wood to chop when it

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Speaker 2: comes to this issue. But first I think we should

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Speaker 2: talk about why it's happening, and then we can talk

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Speaker 2: about what needs to change.

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Speaker 3: From absolute health absolutely.

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Speaker 2: Because why it's happening is super fascinating.

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Speaker 4: To me, and I think it's really important to recognize

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Speaker 4: that this is a major shift. So when I was

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Speaker 4: in medical school, which wasn't that long ago, we taught

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Speaker 4: medical students that colorectal cancer was the disease you saw

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Speaker 4: people and when they're seventy.

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Speaker 1: Or eighty a retirement.

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Speaker 4: Kay, Yes, it was an old man's disease. Let's just

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Speaker 4: be honest. That's what we called it, and it is

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Speaker 4: not how we need to teach about colorectal cancer now.

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Speaker 4: When I'm teaching my medical students now, I tell them

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Speaker 4: that if you see concerning symptoms like the symptoms that

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Speaker 4: Katie just mentioned, you need to be thinking about this

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Speaker 4: disease even in a thirty year old, a forty year old,

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Speaker 4: and a fifty year old. And that epidemiologic shift, that

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Speaker 4: population shift, is why the story is very different than

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Speaker 4: it was in the nineteen eighties and the nineteen nineties.

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Speaker 3: Right, the history change so fast it change.

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Speaker 4: It's affecting men and women, it's a checking young people.

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Speaker 4: It's being diagnosed at very late stages when we have

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Speaker 4: very little opportunity to cure those individuals.

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Speaker 3: So these shifts.

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Speaker 4: In how the disease is presenting has really caused us

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Speaker 4: to shift how we think of the disease and also

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Speaker 4: how we manage it. I think Katie just drops some

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Speaker 4: really important pearls and I like to think of them.

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Speaker 3: As the three rules.

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Speaker 4: There are three rules about how we protect ourselves from

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Speaker 4: colorectal cancer, and we talk about screening and symptoms. Number one,

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Speaker 4: know your family history. If you've got a mother, father, brother,

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Speaker 4: and sister first degree family history of colorectal cancer, you

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Speaker 4: get screened at age forty are ten years below the

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Speaker 4: age of the earliest fan or member's diagnosis. The second

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Speaker 4: rule is, if you don't have a family history, you

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Speaker 4: get screened at forty five, And as mentioned, that was

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Speaker 4: the new guideline that came in twenty twenty one. Okay,

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Speaker 4: as a result of this epidem logic shift. The third

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Speaker 4: thing is the symptoms. And this is where the early

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Speaker 4: onset story comes into play, because when you're talking about

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Speaker 4: people who are under the age of forty five, we're

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Speaker 4: no longer in that screening age, right, So what are

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Speaker 4: we paying attention to in that group? And in that group,

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Speaker 4: we have to pay attention to the symptoms. People who

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Speaker 4: have new and persistent abdominal pain, new and persistent diarrhea,

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Speaker 4: are constipation. People who are experiencing gi discomfort that is

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Speaker 4: not going away, not just kind of like a viral

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Speaker 4: gastintritis over the weekend, but something that's lasting weeks and

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Speaker 4: weeks and weeks. This warrants us to get medical attention

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Speaker 4: and explain weight loss. And that's when it's really bad.

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Speaker 4: When we see iron deficiency, low blood counts, unexplained weight loss,

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Speaker 4: those are usually signs of pretty spread disease. So we

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Speaker 4: want to be paying attention to symptoms even before that.

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Speaker 4: But of course as well, and the workup for that

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Speaker 4: should be a colonoscopy, and as alluded to, you should

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Speaker 4: be talking to your doctor and specifically saying is a

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Speaker 4: colonoscopy something that we should be considering, right?

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Speaker 1: And I just want to bring up a point too,

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Speaker 1: because you mentioned hemorrhoids and you're mentioning I think younger

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Speaker 1: and younger people, and I think so much is about

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Speaker 1: not dismissing or normalizing pain or symptoms, right. I mean,

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Speaker 1: if you're a young woman and you're like, oh, I

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Speaker 1: also have heavy periods, I'm iron deficient. I mean, it's

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Speaker 1: just a wake up call for everyone to say, like, no, no, no,

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Speaker 1: don't hang your hat too quickly on what you think

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Speaker 1: is a diagnosis. And you're saying, advocate, get a new

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Speaker 1: doctor if you don't feel like you're being listened to.

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Speaker 3: And those are the biggest mimickers.

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Speaker 4: The biggest mimickers are women who have heavy mensis who

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Speaker 4: are told that they're iron deficient because of their mensis.

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Speaker 3: And then also people who have hemorrhoids. Yes, so people

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Speaker 3: who've had some.

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Speaker 4: All amounts of blood in their stool from hemorrhoids are

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Speaker 4: often those are those symptoms are often just attributed to

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Speaker 4: hemorrhoids when they actually warrant fur their investigation. So exactly,

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Speaker 4: those are the things that we need to be paying

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Speaker 4: attention to in young people.

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Speaker 2: But what's frustrating for me, you guys, is this isn't enough.

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Speaker 2: You know, it's not enough to say be aware of

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Speaker 2: your symptoms. It's not enough to say find a gastro entrologist.

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Speaker 2: It's it just isn't enough to stop this alarming increase

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Speaker 2: of colorectal cancer. So for me, it's like, and I know,

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Speaker 2: epidemiological studies it's a very hard they're really hard to do,

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Speaker 2: take years and years, and but I am desperate for

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Speaker 2: scientists so much so that I'd love to form a

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Speaker 2: new dream team at Stand Up to Cancer really looking

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Speaker 2: at this issue because they're now early on set cancer

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Speaker 2: coorectal cancer departments and virtually every medical sound now because

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Speaker 2: of the alarming number of people who are being diagnosed

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Speaker 2: with this disease. But you know, just being aware of

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Speaker 2: the symptoms. I just get frustrated because yes, yes, at

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Speaker 2: the very least we have to be aware of the symptoms.

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Speaker 2: We also have to educate doctors to really understand this

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Speaker 2: is happening at a very alarming rate and they cannot

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Speaker 2: completely dismiss that idea that this person could have early

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Speaker 2: stage or tragically late stage colorectal cancer because so many

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Speaker 2: I think, as Fuller will tell you, so many of

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Speaker 2: these people who are young, because they have been dismissed,

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Speaker 2: or because they themselves have dismissed the symptoms, they aren't

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Speaker 2: being diagnosed very late at stage four because it's just

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Speaker 2: not within sort of the realm of possibility for their

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Speaker 2: physicians or for themselves. So yes, yes, yes we have

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Speaker 2: to be aware of symptoms and people have to be aggressive,

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Speaker 2: but we have to do more.

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Speaker 1: So what's on that list for you? That more? I

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Speaker 1: mean tell us about you know, stand up to cancer too.

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Speaker 1: I mean, what can research do, what can we as

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Speaker 1: doctors do? What should the public be doing well?

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Speaker 2: I mean, first of all, I think we need to

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Speaker 2: support science. I think we need to collaborate. There is

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Speaker 2: a lot of work going on, and we can talk

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Speaker 2: about this eve because this to me is really kind

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Speaker 2: of some of the most interesting things if I want

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Speaker 2: to geek out on science of why this is happening.

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Speaker 2: So I think we need to support the research about that,

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Speaker 2: and then hopefully as things become apparent, we can educate

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Speaker 2: people about these things, change their behavior whatever is happening,

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Speaker 2: you know, figure out how to avoid it. But I

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Speaker 2: think we should talk about all the theories because it's fascinating.

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Speaker 1: Fool to tell us. I mean, everyone wants to know this.

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Speaker 4: I mean, Katie wants to get to the why, and

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Speaker 4: we all want to know why this is happening, right.

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Speaker 3: And I think you're right.

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Speaker 4: It isn't enough to screen because we know that's only

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Speaker 4: going to catch people who are of screening age. And

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Speaker 4: it isn't enough to just wait for symptoms because many

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Speaker 4: times this cancer is asymptomatic.

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Speaker 3: So what are we doing beyond that?

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Speaker 4: You know, we can talk about lifestyle modification, and that

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Speaker 4: lifestyle modification is really dictated by what we think is

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Speaker 4: causing this. And right now we just have a lot

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Speaker 4: of theory. We do not have a case as we

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Speaker 4: had with lung cancer, where there is the smoking.

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Speaker 3: Gun it's causing this cancer.

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Speaker 4: In fifty percent of cases, We don't, unfortunately, have that

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Speaker 4: for colorectal cancer. What we probably have is a combination

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Speaker 4: of environmental factors that in conglomerate are making us more

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Speaker 4: predisposed predisposed to this condition. And then I think certain

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Speaker 4: families have genetics in there that when thrown into this

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Speaker 4: environmental risk basin, they're more likely to develop this disease.

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Speaker 4: And many of us and science are working furiously to

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Speaker 4: understand the whyse is it what we eat? There's a

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Speaker 4: lot of data right now about highly processed food or

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Speaker 4: ultra processes.

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Speaker 2: That was sham I think, and I met the author,

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Speaker 2: Would you author it too? No? No, but I was

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Speaker 2: very excited to meet him. But I do I do

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Speaker 2: have a bone to pick with him because I don't

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Speaker 2: think ultra processed foods alone can be I don't think

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Speaker 2: daring increase. But tell us about that study that was

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Speaker 2: in jam A last November.

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Speaker 4: Yeah, So this study was really helpful because we've been

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Speaker 4: getting tips of information from science over time, and we've

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Speaker 4: known to date that UH diets that are high and

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Speaker 4: fat is, particularly animal fat, process meat, red meat, those

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Speaker 4: are things that we've always considered as risk factors for colorectal.

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Speaker 2: Camps like Delli meats like hot dogs.

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Speaker 1: And your chart cuter.

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Speaker 2: I'm sorry, I she was looking love a chartrea play.

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Speaker 4: They don't like to hear me say reduce your alcohol

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Speaker 4: in your chart Couterye, exactly so. But so we've had

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Speaker 4: some tips and Andy Chans paper that came out recently

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Speaker 4: at ultra processed food did provide evidence looking at women's

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Speaker 4: specifically in the Women's Nurses study that when you have

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Speaker 4: a greater intake of these highly processed foods, and these

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Speaker 4: are foods you should think about highly as things that

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Speaker 4: are things that are packaged and ready to eat, food

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Speaker 4: that does not look.

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Speaker 3: Like it's normal form.

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Speaker 4: Okay, so milk and butter are processed, right, we have

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Speaker 4: to do some processing to make them consumable by humans.

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Speaker 4: But things like processed foods are things where they've actually

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Speaker 4: broken down the extra components of the food and also

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Speaker 4: added additives, glues, synthetics, preservatives to make it tasty and

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Speaker 4: ready to eat and also sit on the shelf. So

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Speaker 4: we think that the more of those you consume, it's

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Speaker 4: adding to this kind of meyu where you are more

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Speaker 4: predisposed to developing colorectal cancer. So there's definitely a lot

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Speaker 4: of data about diet. There are also a lot of

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Speaker 4: concerns about other environmental exposures. We have the synthetics that

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Speaker 4: we use in our clothes and our food prefoss as

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Speaker 4: we call forever chemicals, and we started using those products

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Speaker 4: more in the nineteen thirties, forties, fifties, and that's right

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Speaker 4: around the time where we see the birth groups where

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Speaker 4: we therese people who were born and around that time

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Speaker 4: nineteen fifteen ninety sixty went on to live into their forties.

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Speaker 4: And then that's the group where we started to see.

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Speaker 2: That would be like on site my husband was born

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Speaker 2: the birth Yeah. So but there are other things. Let's

436
00:23:15,800 --> 00:23:18,159
Speaker 2: talk about some of the other theories full because I

437
00:23:18,160 --> 00:23:21,040
Speaker 2: think it's so interesting. I mean, and again I think

438
00:23:21,600 --> 00:23:24,320
Speaker 2: some of these have not been born out scientifically. But

439
00:23:24,440 --> 00:23:28,960
Speaker 2: people are looking at the over over prescription of antibio antibiotics.

440
00:23:29,200 --> 00:23:32,480
Speaker 2: That's another big one that that perhaps it's affecting the

441
00:23:32,520 --> 00:23:37,800
Speaker 2: bacteria and microbio our microbiome, right, that's one thing they're

442
00:23:37,840 --> 00:23:38,600
Speaker 2: looking at.

443
00:23:39,119 --> 00:23:41,960
Speaker 4: Because I think about that as microbiome as a risk

444
00:23:42,000 --> 00:23:42,560
Speaker 4: factor in.

445
00:23:42,520 --> 00:23:45,600
Speaker 1: Itself, just breaking down with the microbactics.

446
00:23:45,680 --> 00:23:48,280
Speaker 2: Yeah, I always think about the microbiome, and I try

447
00:23:48,320 --> 00:23:50,919
Speaker 2: to picture it. I always have a heart, very catchy sounding,

448
00:23:50,960 --> 00:23:53,160
Speaker 2: but how do we actually that thing?

449
00:23:53,320 --> 00:23:55,439
Speaker 4: I mean, I think of it as the coral reef

450
00:23:55,520 --> 00:23:58,280
Speaker 4: of oh I love tracked, right, So like in a

451
00:23:58,359 --> 00:24:06,199
Speaker 4: coral reef, there's different types and it's your entire g

452
00:24:06,280 --> 00:24:08,560
Speaker 4: I track. You even have microboom in your mouth?

453
00:24:08,920 --> 00:24:13,520
Speaker 2: Yeah, right, Well that's why heart disease with two decay disease.

454
00:24:13,920 --> 00:24:17,840
Speaker 1: That's another We did a whole session on that mouth

455
00:24:17,960 --> 00:24:18,840
Speaker 1: is just its open wound.

456
00:24:19,800 --> 00:24:23,280
Speaker 2: Sorry, micro get very excited talking about this.

457
00:24:23,560 --> 00:24:28,080
Speaker 4: In particular, the microbiome are that environment of micro biobes

458
00:24:28,080 --> 00:24:31,719
Speaker 4: that live in your colon are probably implicated in colorectal cancer.

459
00:24:32,040 --> 00:24:34,719
Speaker 4: And there's kind of two diverging theories here. There are

460
00:24:34,760 --> 00:24:38,000
Speaker 4: people who think that it's the environment and the mixture

461
00:24:38,040 --> 00:24:41,400
Speaker 4: of things you have in that like what is your

462
00:24:41,560 --> 00:24:44,600
Speaker 4: balance of good and bad microbes? And then there are

463
00:24:44,640 --> 00:24:48,159
Speaker 4: other people that think that it's more specific microbes that

464
00:24:48,320 --> 00:24:52,480
Speaker 4: have a causal effect, a cause and effect causing cancers.

465
00:24:52,800 --> 00:24:54,840
Speaker 4: So we don't know which way or if it's a

466
00:24:54,840 --> 00:24:56,119
Speaker 4: combination of those things.

467
00:24:56,160 --> 00:24:57,400
Speaker 3: But basically what.

468
00:24:57,320 --> 00:25:01,359
Speaker 4: We understand is anytime we disrupt that beautiful coral reef

469
00:25:01,400 --> 00:25:06,240
Speaker 4: that homeostasis there, we put our colon in a state where

470
00:25:06,280 --> 00:25:09,360
Speaker 4: it has a likelihood of developing a colorectal cancer.

471
00:25:09,400 --> 00:25:12,480
Speaker 2: So what about this whole theory which I don't really understand,

472
00:25:12,480 --> 00:25:15,920
Speaker 2: but I read about it about E. Coli col a

473
00:25:16,680 --> 00:25:20,639
Speaker 2: particular bacteria that exists in some people really from a

474
00:25:20,760 --> 00:25:22,520
Speaker 2: very young You help me understand that.

475
00:25:22,680 --> 00:25:26,440
Speaker 4: So, there are a few bacteria that are implicated in cancers.

476
00:25:26,680 --> 00:25:29,320
Speaker 4: The most common one I think you're thinking you're thinking

477
00:25:29,320 --> 00:25:33,200
Speaker 4: about is H. Pylori, which usually is implicated in gastric cancers.

478
00:25:33,800 --> 00:25:36,720
Speaker 2: That's in your stomach, different, different, Okay.

479
00:25:36,880 --> 00:25:39,480
Speaker 4: H Pylori is something that you can get infected with.

480
00:25:40,160 --> 00:25:42,800
Speaker 4: It can grow in your body since a child, right,

481
00:25:43,200 --> 00:25:45,880
Speaker 4: and when you're later in life, in your sixties, seventies,

482
00:25:45,880 --> 00:25:46,760
Speaker 4: and eighties, it has a.

483
00:25:46,720 --> 00:25:48,119
Speaker 3: High risk for gastric cancer.

484
00:25:48,359 --> 00:25:50,520
Speaker 4: So we often will test people for this and then

485
00:25:50,560 --> 00:25:54,160
Speaker 4: we can eradicate it by giving you a set of antibiotics.

486
00:25:54,160 --> 00:25:56,200
Speaker 2: Why, well, some people have it and some people don't.

487
00:25:56,240 --> 00:25:58,399
Speaker 4: So it's a lot about where you live. So there

488
00:25:58,400 --> 00:26:01,600
Speaker 4: are certain parts of the world where they each By Laura, really,

489
00:26:01,680 --> 00:26:05,399
Speaker 4: that's the guy who I think also, Yeah, they're parts

490
00:26:05,400 --> 00:26:07,760
Speaker 4: of the world where this age pilor is just everywhere.

491
00:26:07,800 --> 00:26:10,200
Speaker 4: It's in the food you eat, it's it's walking around

492
00:26:10,200 --> 00:26:12,359
Speaker 4: in the communities that you live in. So those people

493
00:26:12,400 --> 00:26:15,560
Speaker 4: are more likely to be inhabited with that bacteria, and

494
00:26:15,600 --> 00:26:17,439
Speaker 4: for some people you live with it forever and it

495
00:26:17,440 --> 00:26:20,440
Speaker 4: does nothing, but unfortunately, for a small percentage of people

496
00:26:20,480 --> 00:26:22,199
Speaker 4: it can go on to cause gastric cancer.

497
00:26:22,520 --> 00:26:23,480
Speaker 3: So now we're.

498
00:26:23,280 --> 00:26:26,119
Speaker 2: Looking for talking about gastric stomach cancer stomach.

499
00:26:26,840 --> 00:26:29,160
Speaker 4: So the question is, is there like an aged Pylori

500
00:26:29,520 --> 00:26:33,760
Speaker 4: like bug of the colon that's implicated for coorectal cancer.

501
00:26:33,800 --> 00:26:36,920
Speaker 4: Recently there is a species of E. Coli that has

502
00:26:36,960 --> 00:26:40,240
Speaker 4: shown up in some colorectal cancers, but it certainly does

503
00:26:40,280 --> 00:26:42,520
Speaker 4: not explain what we're seeing because it's not in all

504
00:26:42,600 --> 00:26:43,680
Speaker 4: coorectal cancers.

505
00:26:43,680 --> 00:26:46,320
Speaker 2: Can you test for H. Pylori? Is that am saying

506
00:26:46,560 --> 00:26:48,879
Speaker 2: you can? And you can? And if so, should it

507
00:26:48,920 --> 00:26:57,640
Speaker 2: be tested and and sort of kind of eradicating sort

508
00:26:57,720 --> 00:27:01,040
Speaker 2: of solely on because if there's chance, isn't it kind

509
00:27:01,040 --> 00:27:02,800
Speaker 2: of like a polyp like you never know, so you

510
00:27:02,840 --> 00:27:04,000
Speaker 2: probably should get rid of it.

511
00:27:04,119 --> 00:27:06,720
Speaker 4: So for right now, in many parts of the world,

512
00:27:06,880 --> 00:27:09,760
Speaker 4: particularly Asian countries, they do test regularly.

513
00:27:09,840 --> 00:27:11,320
Speaker 3: Yes, they scream for H.

514
00:27:11,400 --> 00:27:14,720
Speaker 4: Pylori, and they do eradicate it with these antibiotics because

515
00:27:14,920 --> 00:27:18,000
Speaker 4: they have a higher likelihood of getting gastric cancer in

516
00:27:18,000 --> 00:27:20,919
Speaker 4: these parts of the world. We don't test everyone.

517
00:27:20,560 --> 00:27:21,560
Speaker 3: In this country for H.

518
00:27:21,600 --> 00:27:24,600
Speaker 4: Pylori, But in my practice, and I'm sure everybody else,

519
00:27:24,680 --> 00:27:27,640
Speaker 4: is when we have people who've immigrated from East Asia,

520
00:27:27,880 --> 00:27:31,280
Speaker 4: our families who've immigrated from parts of South America. Even

521
00:27:32,160 --> 00:27:34,679
Speaker 4: some people will even say in big urban cities like

522
00:27:34,760 --> 00:27:37,800
Speaker 4: Los Angeles, when you have patients with a certain set

523
00:27:37,840 --> 00:27:39,520
Speaker 4: of symptoms, we should be testing for H.

524
00:27:39,600 --> 00:27:43,160
Speaker 3: Pylori. But again, that's more about gastric cancer. And that's so.

525
00:27:43,200 --> 00:27:46,159
Speaker 2: Interesting because I know that when people who live in

526
00:27:46,200 --> 00:27:51,439
Speaker 2: Asia come to the US and adopt a more American diet,

527
00:27:52,040 --> 00:27:56,280
Speaker 2: they often they're calling cancer rates go way up. And

528
00:27:57,480 --> 00:28:01,200
Speaker 2: I remember reading and maybe this is wrongful for gastric

529
00:28:01,240 --> 00:28:05,520
Speaker 2: cancer or stomach cancer in Asian communities that they think

530
00:28:05,560 --> 00:28:10,199
Speaker 2: it might have to do with fermentation or is that

531
00:28:10,560 --> 00:28:13,680
Speaker 2: something there, or is that because they're not getting colon

532
00:28:13,720 --> 00:28:15,960
Speaker 2: cancer because of fermentation. I don't know that.

533
00:28:16,320 --> 00:28:20,040
Speaker 4: I think for Asian countries, the biggest risk factor is

534
00:28:20,040 --> 00:28:22,720
Speaker 4: that H. Pylori living in your gut for a long

535
00:28:22,720 --> 00:28:26,200
Speaker 4: period of time and causing gastric cancer, but it doesn't

536
00:28:26,200 --> 00:28:27,400
Speaker 4: have a protective.

537
00:28:26,960 --> 00:28:28,560
Speaker 3: Effect for colorectal cancer.

538
00:28:28,920 --> 00:28:31,480
Speaker 4: They screen for gastric cancer, but they also screen for

539
00:28:31,520 --> 00:28:33,920
Speaker 4: colorectal cancer. And what I would say is really interesting

540
00:28:34,000 --> 00:28:38,200
Speaker 4: with this early onset epidemic, and we said that's just

541
00:28:38,240 --> 00:28:41,360
Speaker 4: the study of trends over time, is that we're seeing

542
00:28:41,360 --> 00:28:42,760
Speaker 4: it in many different countries.

543
00:28:42,800 --> 00:28:44,160
Speaker 3: This is not a US problem.

544
00:28:44,200 --> 00:28:47,600
Speaker 4: And really going back to talking about colorectal cancer and

545
00:28:47,640 --> 00:28:51,160
Speaker 4: young people, the highest rates are like in Australia, New Zealand,

546
00:28:51,240 --> 00:28:54,720
Speaker 4: as you mentioned, Puerto Rico we see really high rates,

547
00:28:54,720 --> 00:28:57,959
Speaker 4: and then in the coastal United States. So again to

548
00:28:58,040 --> 00:29:00,440
Speaker 4: the why, it's also a question is is there a

549
00:29:00,520 --> 00:29:05,120
Speaker 4: regional component of this? Are there certain environmental exposures that

550
00:29:05,160 --> 00:29:07,920
Speaker 4: you have depending on where you live in the world.

551
00:29:08,320 --> 00:29:11,640
Speaker 4: Those are other theories. Those are coming with the diet,

552
00:29:11,760 --> 00:29:15,880
Speaker 4: with the microbiome, with the theories about metabolic disease and obesity.

553
00:29:16,000 --> 00:29:17,880
Speaker 1: There's a society now too.

554
00:29:18,040 --> 00:29:20,400
Speaker 2: There's also some other theories that I think are worth

555
00:29:20,440 --> 00:29:24,000
Speaker 2: mentioning it because I think they're just interesting. One is microplastics,

556
00:29:24,600 --> 00:29:28,960
Speaker 2: that somehow the prevalence of microplastics in our diet. You know,

557
00:29:29,080 --> 00:29:32,000
Speaker 2: now we're finding them everywhere ever, finding them in the brain,

558
00:29:32,040 --> 00:29:36,520
Speaker 2: we're finding them and developing fetuses microplastics, and that that's

559
00:29:36,560 --> 00:29:42,200
Speaker 2: somehow that's disrupting the almost viscous uh kind of coding

560
00:29:43,320 --> 00:29:46,880
Speaker 2: of the microbiome and of the intestines, and that they're

561
00:29:46,960 --> 00:29:50,200
Speaker 2: irritating it, and that that might be something to look at.

562
00:29:50,320 --> 00:29:54,080
Speaker 4: Right absolutely, so that fits into the theory that there

563
00:29:54,120 --> 00:29:58,920
Speaker 4: are environmental toxins, are carcinogens that are leading to this

564
00:29:59,080 --> 00:30:02,480
Speaker 4: increase in color rectal cancer in young people. So microplastics

565
00:30:02,520 --> 00:30:05,080
Speaker 4: is something that has been looked at. It's actually microplastics

566
00:30:05,080 --> 00:30:08,560
Speaker 4: are actually implicated in many diseases as well as colorectal cancer.

567
00:30:08,880 --> 00:30:11,600
Speaker 4: The problem with microplastics is that the way that we

568
00:30:11,680 --> 00:30:15,080
Speaker 4: have produced things in our society, from food, sofa as

569
00:30:15,120 --> 00:30:19,600
Speaker 4: too and furniture to clothing, they're almost unavoidable.

570
00:30:19,560 --> 00:30:21,240
Speaker 1: And we don't have a test to measure them.

571
00:30:21,160 --> 00:30:23,560
Speaker 3: Right now measure them and we also I.

572
00:30:23,520 --> 00:30:26,320
Speaker 2: Think there are tests, I just don't think they're real,

573
00:30:26,360 --> 00:30:27,560
Speaker 2: commercial available.

574
00:30:27,520 --> 00:30:30,280
Speaker 4: Are validated, and we can't say that again that that's

575
00:30:30,320 --> 00:30:33,080
Speaker 4: the smoking gun and that's why I keep coming back

576
00:30:33,120 --> 00:30:37,239
Speaker 4: to this is probably a combination of factors that you

577
00:30:37,280 --> 00:30:40,200
Speaker 4: are exposed to, probably not when you're forty, probably in

578
00:30:40,200 --> 00:30:43,240
Speaker 4: your adolescence or even in your twenties, which is that's

579
00:30:43,280 --> 00:30:46,080
Speaker 4: really colorectal cancer in your forties.

580
00:30:46,200 --> 00:30:46,680
Speaker 3: I did ask.

581
00:30:46,760 --> 00:30:49,960
Speaker 2: I mean mention of course that I think is super

582
00:30:50,000 --> 00:30:52,640
Speaker 2: interesting because I'd love to hear what Fola thinks about this.

583
00:30:53,120 --> 00:30:55,320
Speaker 2: So we just had our stand up to cancer scientific

584
00:30:55,360 --> 00:30:58,840
Speaker 2: summits in a whole day on early on set cancers,

585
00:30:58,880 --> 00:31:01,680
Speaker 2: because there are seventy cancers that are on the rise

586
00:31:01,760 --> 00:31:05,200
Speaker 2: in people under the age of fifty, and colorectal cancer

587
00:31:05,240 --> 00:31:08,560
Speaker 2: is one, Breast cancer is another. Non smoking lung cancer

588
00:31:09,200 --> 00:31:12,640
Speaker 2: is another. And I'm so interested in all of these things.

589
00:31:12,720 --> 00:31:19,600
Speaker 2: But I think one thing that I heard is something

590
00:31:19,720 --> 00:31:24,959
Speaker 2: about screens. Now, the reason I mentioned this is and

591
00:31:25,000 --> 00:31:28,040
Speaker 2: it was kind of just sort of mentioned, but I

592
00:31:28,120 --> 00:31:32,200
Speaker 2: wondered what you knew about this, this idea of our

593
00:31:32,280 --> 00:31:38,800
Speaker 2: constant use of screens that perhaps in and of itself

594
00:31:39,520 --> 00:31:44,520
Speaker 2: isn't a factor. Maybe it is, but how it disrupts

595
00:31:44,560 --> 00:31:49,120
Speaker 2: the circadian rhythms and kind of sleep, and how our

596
00:31:49,280 --> 00:31:54,600
Speaker 2: interaction with technology and the impact it's having on our

597
00:31:54,640 --> 00:31:59,800
Speaker 2: sleep cycles may be something that needs to be looked at.

598
00:32:00,600 --> 00:32:03,400
Speaker 4: And I think this is cute and I think that

599
00:32:03,480 --> 00:32:07,000
Speaker 4: this is fascinating because mechanistically this could be happening so

600
00:32:07,040 --> 00:32:08,120
Speaker 4: many different ways.

601
00:32:07,960 --> 00:32:11,040
Speaker 1: Right, so there are different conditions, and there are some.

602
00:32:11,000 --> 00:32:13,840
Speaker 3: People who think it's actually the cell phone itself.

603
00:32:13,440 --> 00:32:20,040
Speaker 2: In your right and some sort of brains right exactly discounted.

604
00:32:19,720 --> 00:32:22,040
Speaker 3: So that theory was very popular for a while.

605
00:32:22,160 --> 00:32:24,200
Speaker 4: Again, we have no evidence that a cell phone in

606
00:32:24,280 --> 00:32:27,680
Speaker 4: your pocket is causing colorectal cancer, but people were.

607
00:32:27,600 --> 00:32:28,200
Speaker 3: Looking into that.

608
00:32:28,560 --> 00:32:31,320
Speaker 4: And then also, as Katie's mentioned, is it the light

609
00:32:31,560 --> 00:32:34,200
Speaker 4: from the phone are using these devices that's throwing off

610
00:32:34,240 --> 00:32:37,240
Speaker 4: our cir Katie and rhythm. We know that sleep patterns,

611
00:32:37,280 --> 00:32:41,320
Speaker 4: the amount of sleep stress levels can be related to

612
00:32:41,440 --> 00:32:44,000
Speaker 4: cancer risk. Because so that's a theory. And then also

613
00:32:44,200 --> 00:32:48,440
Speaker 4: let's talk about physical inactivity. One of the strongest associated

614
00:32:48,520 --> 00:32:52,600
Speaker 4: factors with colorectal cancer is physical inactivity. So the more

615
00:32:52,680 --> 00:32:55,400
Speaker 4: exposure we have to screens and screen time, the more

616
00:32:55,440 --> 00:32:57,080
Speaker 4: time that we're sending at home on.

617
00:32:57,160 --> 00:33:01,160
Speaker 3: A screen very much. And who's on screens.

618
00:33:01,200 --> 00:33:03,920
Speaker 4: It's the adolescence, it's the twenty year olds. These are

619
00:33:03,960 --> 00:33:07,080
Speaker 4: the people who twenty years later are getting colorectal cancer.

620
00:33:07,200 --> 00:33:11,000
Speaker 2: So there's really different mechanisms for your phone all the time.

621
00:33:11,040 --> 00:33:13,880
Speaker 1: Right, Yes, so I'm taking all I know. Well, I

622
00:33:13,960 --> 00:33:15,480
Speaker 1: mean I have to answer. I mean thinking about my

623
00:33:15,680 --> 00:33:17,920
Speaker 1: teenage daughters, right, I'm thinking about all of our friends,

624
00:33:18,360 --> 00:33:20,240
Speaker 1: you know hearing this. If someone's like listening to the

625
00:33:20,280 --> 00:33:22,920
Speaker 1: three of us talk, I would be panicking right now. Yeah,

626
00:33:22,960 --> 00:33:24,640
Speaker 1: because because a lot of the things that we're talking

627
00:33:24,680 --> 00:33:27,560
Speaker 1: about to right, like the microbiome, which we're even struggling

628
00:33:27,680 --> 00:33:30,880
Speaker 1: to you know, visualize, people are gonna be asking, oh

629
00:33:30,920 --> 00:33:32,720
Speaker 1: my gosh, like what can I do about this? Or

630
00:33:32,880 --> 00:33:35,640
Speaker 1: I'm already twenty you know, is my microbiome or my

631
00:33:35,880 --> 00:33:39,000
Speaker 1: exposures already in place? And what's in my control? Do

632
00:33:39,080 --> 00:33:42,200
Speaker 1: I have access to food that's not highly processed? So

633
00:33:42,600 --> 00:33:44,520
Speaker 1: I mean, just to make it a little bit practical too,

634
00:33:44,840 --> 00:33:47,320
Speaker 1: not only so people don't panic, but what should we

635
00:33:47,400 --> 00:33:50,360
Speaker 1: be telling our young people and the people that love them?

636
00:33:51,000 --> 00:33:52,920
Speaker 4: And this is I think what Katie was getting back

637
00:33:52,960 --> 00:33:55,360
Speaker 4: to as well, is what else can we do beyond

638
00:33:55,480 --> 00:33:58,680
Speaker 4: talking about screening and symptoms? And I think that they're

639
00:33:59,280 --> 00:34:02,280
Speaker 4: right now. We're searching for those main pillars of advice

640
00:34:02,360 --> 00:34:04,960
Speaker 4: that we can give to people. I do not want

641
00:34:05,000 --> 00:34:06,640
Speaker 4: to set up alarms and I don't want people to

642
00:34:06,680 --> 00:34:08,440
Speaker 4: be panic. And I think when you talk about cancer,

643
00:34:08,560 --> 00:34:11,840
Speaker 4: unfortunately we have that impact. This is why people sometimes

644
00:34:11,880 --> 00:34:13,120
Speaker 4: don't like me at their dinner.

645
00:34:12,960 --> 00:34:17,640
Speaker 2: Dabs, but earth at their boards.

646
00:34:19,200 --> 00:34:20,160
Speaker 3: Don't invite that one.

647
00:34:21,360 --> 00:34:23,680
Speaker 4: But I think what I want to say is that

648
00:34:24,400 --> 00:34:27,240
Speaker 4: we just have to think about things in moderation. Okay,

649
00:34:27,320 --> 00:34:29,560
Speaker 4: So when you hear me talk about there is a

650
00:34:29,680 --> 00:34:33,240
Speaker 4: risk between red meat and colorectal cancer, I'm not saying

651
00:34:33,360 --> 00:34:36,359
Speaker 4: cut out all red meat. I'm saying, instead of having

652
00:34:36,400 --> 00:34:38,560
Speaker 4: red meat every night of the week, maybe have it

653
00:34:38,680 --> 00:34:39,200
Speaker 4: once a week.

654
00:34:39,480 --> 00:34:39,760
Speaker 2: Okay.

655
00:34:40,239 --> 00:34:43,880
Speaker 3: When I'm saying alcohol is one of these things.

656
00:34:43,719 --> 00:34:48,480
Speaker 4: That's associated with all cancers, including colorectal cancer, I'm not

657
00:34:48,640 --> 00:34:52,000
Speaker 4: saying that you need to be alcohol free in your life,

658
00:34:52,320 --> 00:34:55,800
Speaker 4: but maybe think about reducing down to alcohol just on

659
00:34:55,880 --> 00:34:58,799
Speaker 4: the weekends or once or twice a week. These are

660
00:34:58,880 --> 00:35:03,760
Speaker 4: things that you can do to optimize your lifestyle without.

661
00:35:03,840 --> 00:35:07,200
Speaker 1: Removing all the phones and those feel those feel actionable exact.

662
00:35:07,440 --> 00:35:09,279
Speaker 2: I think there are a few other things though, I

663
00:35:09,400 --> 00:35:15,239
Speaker 2: mean physical inactivity. Obviously exercising everyone needs to be on

664
00:35:15,320 --> 00:35:19,399
Speaker 2: their phones less our mental health, certainly young people. If

665
00:35:19,480 --> 00:35:23,800
Speaker 2: you read The Anxious Generation by Jonathan Height and what

666
00:35:23,960 --> 00:35:26,440
Speaker 2: schools across the country are doing to have no phone

667
00:35:26,880 --> 00:35:30,960
Speaker 2: school days. That's kind of something they can do. Also,

668
00:35:31,320 --> 00:35:35,320
Speaker 2: I do think there are certain household products. Maybe we

669
00:35:35,400 --> 00:35:38,000
Speaker 2: can get you a list, because one of the presenters

670
00:35:38,120 --> 00:35:42,280
Speaker 2: at our scientific summit who works for runs this organization

671
00:35:42,400 --> 00:35:44,440
Speaker 2: called Silent Springs.

672
00:35:44,680 --> 00:35:46,879
Speaker 1: And she does, yes, yes, she does.

673
00:35:47,120 --> 00:35:50,360
Speaker 2: She does a lot of early onset breast cancer. And

674
00:35:50,480 --> 00:35:53,319
Speaker 2: she had a list of household products that you really

675
00:35:53,400 --> 00:35:54,120
Speaker 2: should avoid.

676
00:35:54,280 --> 00:35:55,359
Speaker 1: And that's education too.

677
00:35:55,560 --> 00:35:57,280
Speaker 2: Yes, And I'm going to get her to write something

678
00:35:57,360 --> 00:35:59,880
Speaker 2: up in our newsletter about that. I have actually assumed

679
00:36:00,040 --> 00:36:02,560
Speaker 2: they are coming up. But also I do think there

680
00:36:02,600 --> 00:36:07,920
Speaker 2: are ways that I don't think you can completely avoid microplastics,

681
00:36:08,160 --> 00:36:10,280
Speaker 2: even full of, but I do think there are ways

682
00:36:10,760 --> 00:36:14,120
Speaker 2: that you can try to reduce them. You know, there

683
00:36:14,120 --> 00:36:17,279
Speaker 2: are certain things that you know, take out containers that

684
00:36:17,360 --> 00:36:20,440
Speaker 2: you should try to avoid, you know, the heat things

685
00:36:20,520 --> 00:36:25,400
Speaker 2: don't heats and plastic exactly. And I don't know what

686
00:36:25,560 --> 00:36:28,240
Speaker 2: the bottom line is. There was so much controversy about

687
00:36:28,320 --> 00:36:31,520
Speaker 2: like black spatulists, you know, and how they were made

688
00:36:31,560 --> 00:36:33,640
Speaker 2: out of micro chants and how bad they were, and

689
00:36:33,719 --> 00:36:35,759
Speaker 2: then the Atlantic said they're bad, and then they said

690
00:36:35,800 --> 00:36:38,759
Speaker 2: they're not, but I yeah, they attracted it, right. But

691
00:36:38,880 --> 00:36:42,160
Speaker 2: I do think if you can try to reduce the

692
00:36:42,239 --> 00:36:45,600
Speaker 2: amount of sort of plastic in your in your world.

693
00:36:46,200 --> 00:36:49,680
Speaker 2: And then again, you know what Fulla was saying, eat

694
00:36:50,160 --> 00:36:52,359
Speaker 2: whole foods, eat foods that are.

695
00:36:53,040 --> 00:36:56,560
Speaker 4: From the earth, like you don't minimize your ultra processed food.

696
00:36:56,600 --> 00:36:58,279
Speaker 4: I mean, I'm guilty of it as well. My little

697
00:36:58,280 --> 00:37:00,400
Speaker 4: protein a rite in the morning comes in a and

698
00:37:01,000 --> 00:37:03,800
Speaker 4: I'm often thinking about what I can replace that with.

699
00:37:04,000 --> 00:37:06,200
Speaker 3: Even if I can replace that half the days.

700
00:37:06,440 --> 00:37:09,279
Speaker 2: What's really hard though, you know, like, God, it's hard

701
00:37:09,320 --> 00:37:12,040
Speaker 2: to be healthy these days, you guys, because now I'm

702
00:37:12,160 --> 00:37:15,239
Speaker 2: sixty nine, and of course I have osteopenia and I

703
00:37:15,400 --> 00:37:19,880
Speaker 2: have to keep my bones strong. So all my friends

704
00:37:19,960 --> 00:37:22,720
Speaker 2: and everybody's saying you got to eat protein. So I'm like, Okay,

705
00:37:23,120 --> 00:37:25,440
Speaker 2: where do I give a protein from meat? And then

706
00:37:25,480 --> 00:37:27,279
Speaker 2: I'm like, but I can't eat too much red meat,

707
00:37:27,640 --> 00:37:29,800
Speaker 2: So where am I going to get? Eating rams? And

708
00:37:29,920 --> 00:37:32,280
Speaker 2: some people say, like I should be having one hundred

709
00:37:32,320 --> 00:37:34,360
Speaker 2: and twenty five grams of protein to day because I

710
00:37:34,400 --> 00:37:36,320
Speaker 2: weigh one hundred and twenty five. I'm like, there's no

711
00:37:36,480 --> 00:37:39,120
Speaker 2: way I'm going to be able to eat that much overwhelming.

712
00:37:39,760 --> 00:37:42,640
Speaker 1: So what I'm hearing you both say, because you guys

713
00:37:42,719 --> 00:37:45,960
Speaker 1: both have this gastro intestinal lens, is the advice, the

714
00:37:46,040 --> 00:37:48,279
Speaker 1: advice that you're giving, that's all doctor Kirk or a

715
00:37:48,320 --> 00:37:51,719
Speaker 1: doctor Kurk. What this advice that you're giving that does

716
00:37:51,840 --> 00:37:54,319
Speaker 1: feel controllable and doable are the same things that we're

717
00:37:54,320 --> 00:37:57,160
Speaker 1: thinking about in terms of your cardiovascular health, right, definitely

718
00:37:57,239 --> 00:38:00,120
Speaker 1: keeping your heart healthy, right, other cancer vice factors. So

719
00:38:00,640 --> 00:38:03,399
Speaker 1: the things that against feel doable at least a little

720
00:38:03,400 --> 00:38:06,840
Speaker 1: bit in our control about our nutrition, our diet, our lifestyle,

721
00:38:07,000 --> 00:38:10,320
Speaker 1: sleep screens, right, you know, all of those kind of hygiene.

722
00:38:10,840 --> 00:38:14,320
Speaker 1: Those are things that feel very doable and very very helpful.

723
00:38:14,400 --> 00:38:17,240
Speaker 1: Wall we're putting money in research, stand up to cancer

724
00:38:17,600 --> 00:38:18,600
Speaker 1: into figuring this out.

725
00:38:18,960 --> 00:38:19,520
Speaker 3: Absolutely.

726
00:38:19,560 --> 00:38:21,560
Speaker 4: And that's what I try to remind people is that

727
00:38:21,640 --> 00:38:24,359
Speaker 4: when we're saying, you know, make sure that you watch

728
00:38:24,400 --> 00:38:28,240
Speaker 4: your diet, and when we reduce your alcohol, eliminate tobacco,

729
00:38:29,160 --> 00:38:32,600
Speaker 4: try to eat healthy physical activity, it's not just for colorax.

730
00:38:32,920 --> 00:38:33,200
Speaker 3: Good for you.

731
00:38:33,360 --> 00:38:35,400
Speaker 4: This is going to be everything from your brain to

732
00:38:35,560 --> 00:38:39,520
Speaker 4: your feet, as in your health from your cardiovascular preventing

733
00:38:39,680 --> 00:38:42,600
Speaker 4: other cancers. So I think that these are things that

734
00:38:42,680 --> 00:38:44,560
Speaker 4: we all need to be teaching our children and our

735
00:38:44,600 --> 00:38:47,480
Speaker 4: adolescents and also adopting for ourselves and are going to

736
00:38:47,480 --> 00:38:49,640
Speaker 4: be good for the full body, mind and soul.

737
00:38:50,120 --> 00:38:52,560
Speaker 1: I mean, I know you've brought so much awareness and

738
00:38:52,640 --> 00:38:55,120
Speaker 1: we really want to intend this to go into action,

739
00:38:55,280 --> 00:38:59,160
Speaker 1: and then you're reminding me both it's the education, but

740
00:39:00,040 --> 00:39:02,960
Speaker 1: even just the screening though. I mean, I think people

741
00:39:03,880 --> 00:39:06,320
Speaker 1: delay again whether they have you know, they're like, I

742
00:39:06,320 --> 00:39:09,839
Speaker 1: don't have any symptoms, but tell us like, screening makes

743
00:39:09,880 --> 00:39:12,319
Speaker 1: a really big difference in how people do. So we're

744
00:39:12,360 --> 00:39:16,759
Speaker 1: talking about genetic testing, but screening, screening for colon cancer.

745
00:39:16,560 --> 00:39:18,160
Speaker 2: It is the difference between life and death.

746
00:39:18,320 --> 00:39:19,400
Speaker 3: It's absolutely so.

747
00:39:19,600 --> 00:39:23,000
Speaker 1: All those heartbreaking numbers, right, all those heartbroken families, right,

748
00:39:23,520 --> 00:39:24,839
Speaker 1: this is going to make a dent in that if

749
00:39:24,880 --> 00:39:26,600
Speaker 1: you get screened, not to mention your own life.

750
00:39:26,680 --> 00:39:30,080
Speaker 4: Well, especially in a disease that's largely very symptomatic. Yes,

751
00:39:30,200 --> 00:39:33,200
Speaker 4: screening can be everything. Screening can be the difference between

752
00:39:33,280 --> 00:39:36,320
Speaker 4: life and death. Yes, And we're so fortunate and colorectal

753
00:39:36,360 --> 00:39:39,240
Speaker 4: cancer that we have many ways to screen. So Katie

754
00:39:39,320 --> 00:39:41,879
Speaker 4: did her colonoscopy on live TV.

755
00:39:42,120 --> 00:39:48,640
Speaker 5: And two, I'm not that brekful of well, I should

756
00:39:48,640 --> 00:39:53,320
Speaker 5: say they telecasted Katie's colonoscopy.

757
00:39:54,239 --> 00:39:57,200
Speaker 3: In two thousand exactly where I mean, everyone probably thought

758
00:39:57,200 --> 00:39:58,560
Speaker 3: you were a little crazy when you did it, but

759
00:39:58,680 --> 00:40:02,320
Speaker 3: she saved lives. Because we call that the Katie Kirk Effects.

760
00:40:02,680 --> 00:40:07,359
Speaker 4: That she did this on TV, national television, our rates

761
00:40:07,400 --> 00:40:10,840
Speaker 4: of screening went up by twenty percent, the best intervention

762
00:40:10,960 --> 00:40:11,359
Speaker 4: we've had.

763
00:40:11,520 --> 00:40:14,160
Speaker 2: It was from such a pure place because you know,

764
00:40:14,640 --> 00:40:17,840
Speaker 2: I had learned so much during the course of Jay's illness,

765
00:40:18,719 --> 00:40:22,800
Speaker 2: and I knew that people didn't feel comfortable talking about

766
00:40:22,840 --> 00:40:26,800
Speaker 2: state cancer. I knew that a lot of people couldn't

767
00:40:26,800 --> 00:40:32,040
Speaker 2: even pronounce colonoscopy, much less get one. So I felt

768
00:40:32,239 --> 00:40:35,680
Speaker 2: like it it would be criminal if I didn't share

769
00:40:35,800 --> 00:40:38,680
Speaker 2: with this huge platform I had at the time, all

770
00:40:38,800 --> 00:40:41,759
Speaker 2: that I had learned about this disease with an audience

771
00:40:41,960 --> 00:40:45,560
Speaker 2: that you know, trusted me and knew that it was

772
00:40:45,640 --> 00:40:48,640
Speaker 2: coming from a very personal place.

773
00:40:48,880 --> 00:40:52,160
Speaker 4: Absolutely, and many people have done that since to try

774
00:40:52,600 --> 00:40:54,880
Speaker 4: to spread awareness. But I think that was the beginning

775
00:40:54,920 --> 00:40:57,520
Speaker 4: of that, and I love that because, especially at the time,

776
00:40:57,600 --> 00:41:00,560
Speaker 4: colonoscopy was the main test we were using to screen.

777
00:41:01,000 --> 00:41:02,480
Speaker 3: Now we have many different options.

778
00:41:02,920 --> 00:41:05,480
Speaker 4: Not everybody can take a day off of work to

779
00:41:05,560 --> 00:41:08,960
Speaker 4: get a colonoscopy. Not everyone has access to an escort,

780
00:41:09,000 --> 00:41:11,520
Speaker 4: which is someone to take you to the procedure and home.

781
00:41:12,440 --> 00:41:15,359
Speaker 4: Some people are fearful of having a procedure where you're

782
00:41:15,400 --> 00:41:17,960
Speaker 4: put asleep and an instrument is put into your backside.

783
00:41:18,400 --> 00:41:21,439
Speaker 4: So it's fortunate that we have other tests for people

784
00:41:21,480 --> 00:41:23,960
Speaker 4: who fall into those categories and who want to be

785
00:41:24,040 --> 00:41:27,120
Speaker 4: screened but don't think colonoscopy is for them, and that's

786
00:41:27,160 --> 00:41:30,279
Speaker 4: when we can really recommend these stool based tests. One

787
00:41:30,320 --> 00:41:32,400
Speaker 4: of them is called the fecal immuno chemical tests or

788
00:41:32,440 --> 00:41:35,200
Speaker 4: the FIT test. One of my favorite screening tools because

789
00:41:35,200 --> 00:41:37,800
Speaker 4: it's cheap, it's easy, you can do at home, and

790
00:41:38,200 --> 00:41:40,759
Speaker 4: at home, you open the kit. You actually it tells

791
00:41:40,800 --> 00:41:44,319
Speaker 4: you how to safely and cleanly collect a small sample.

792
00:41:44,080 --> 00:41:45,600
Speaker 3: Of your stool from the toilet bowl.

793
00:41:46,040 --> 00:41:48,200
Speaker 4: You package that up in a vial and you can

794
00:41:48,239 --> 00:41:50,720
Speaker 4: actually mail that in or walk that into your doctor

795
00:41:51,080 --> 00:41:53,440
Speaker 4: and we can test that for signs of cancer or

796
00:41:53,600 --> 00:41:55,840
Speaker 4: signs of these polyps, these pre cancers.

797
00:41:56,239 --> 00:42:00,000
Speaker 3: Such very cold guard is a little bit differ.

798
00:42:00,560 --> 00:42:02,879
Speaker 4: What they've done is they've taken that fit test, which

799
00:42:02,920 --> 00:42:05,080
Speaker 4: is actually looking for blood in the stool, which is

800
00:42:05,080 --> 00:42:07,719
Speaker 4: a sign of cancer or polyps, and they've combined that

801
00:42:07,880 --> 00:42:11,319
Speaker 4: with a genetic or DNA component. Okay, so coul guard

802
00:42:11,440 --> 00:42:13,880
Speaker 4: is another great screening option. You can do it in

803
00:42:13,960 --> 00:42:16,120
Speaker 4: the comfort of your own home, a little bit of

804
00:42:16,160 --> 00:42:18,120
Speaker 4: a bigger stool sample that you've got a mail in,

805
00:42:18,280 --> 00:42:21,320
Speaker 4: but in their factory they actually test that for signs

806
00:42:21,360 --> 00:42:23,920
Speaker 4: of cancer. It's a little bit better at finding polyps,

807
00:42:23,960 --> 00:42:27,160
Speaker 4: and it also is very good at finding cancers. So,

808
00:42:27,360 --> 00:42:29,680
Speaker 4: whether you want to have the more invasive procedure of

809
00:42:29,719 --> 00:42:32,839
Speaker 4: the colonoscopy or one of these do it yourself at

810
00:42:32,880 --> 00:42:36,879
Speaker 4: home tests, there's many ways to give people access to screening.

811
00:42:36,600 --> 00:42:39,480
Speaker 2: Now, and it weeds out the people who don't necessarily

812
00:42:39,600 --> 00:42:44,759
Speaker 2: need to get a colonoscopy. But if there is a positive, yeah,

813
00:42:44,800 --> 00:42:48,440
Speaker 2: that's true with false positives and false negatives, they have some,

814
00:42:48,800 --> 00:42:50,279
Speaker 2: but they've really reduced that.

815
00:42:50,680 --> 00:42:53,720
Speaker 4: Actually, I just saw someone influencer posts about this today

816
00:42:53,800 --> 00:42:56,440
Speaker 4: on Instagram. She had a positive result and she was

817
00:42:56,520 --> 00:42:59,720
Speaker 4: asking people, what's the likelihood that I have a cancer?

818
00:43:00,040 --> 00:43:01,840
Speaker 4: What we tell people is that when you have a

819
00:43:01,920 --> 00:43:05,360
Speaker 4: positive result, one in ten people with a positive result

820
00:43:05,640 --> 00:43:08,359
Speaker 4: actually have a cancer. I don't say that to scare people,

821
00:43:08,440 --> 00:43:10,719
Speaker 4: but it's really to emphasize that if you have that

822
00:43:10,840 --> 00:43:12,279
Speaker 4: positive result, you need.

823
00:43:12,239 --> 00:43:14,239
Speaker 3: To go in for the second step right, which have

824
00:43:14,440 --> 00:43:16,160
Speaker 3: to follow Flan right.

825
00:43:16,520 --> 00:43:18,719
Speaker 4: And a lot of my research in May Lab at

826
00:43:18,800 --> 00:43:22,040
Speaker 4: UCLA focuses on that getting people in for that second step.

827
00:43:22,840 --> 00:43:25,200
Speaker 3: In that case, the colonoscopy is actually imperative.

828
00:43:26,280 --> 00:43:28,480
Speaker 4: So those people will need to get a colonoscopy and

829
00:43:28,560 --> 00:43:30,960
Speaker 4: that's when we check them for polyps or cancers that

830
00:43:31,120 --> 00:43:31,840
Speaker 4: may have made.

831
00:43:31,640 --> 00:43:32,520
Speaker 3: The test positive.

832
00:43:33,200 --> 00:43:35,440
Speaker 4: So that test, those stool based tests do become a

833
00:43:35,480 --> 00:43:38,759
Speaker 4: bit of a two step process as compared to the colonoscopy,

834
00:43:38,800 --> 00:43:40,120
Speaker 4: which is a one step process.

835
00:43:40,160 --> 00:43:42,160
Speaker 2: But we always say the best test is the one

836
00:43:42,200 --> 00:43:42,680
Speaker 2: that gets out.

837
00:43:44,400 --> 00:43:46,480
Speaker 1: When you hear what Fulla is saying, I'm going to say,

838
00:43:46,800 --> 00:43:49,719
Speaker 1: you know the current effect two point oh what's your plan?

839
00:43:50,080 --> 00:43:56,120
Speaker 2: Like? I mean, I think we need much more research

840
00:43:56,360 --> 00:44:00,960
Speaker 2: in understanding why young people are being affected by this

841
00:44:01,160 --> 00:44:03,480
Speaker 2: disease and how scary it is. When you look at

842
00:44:03,520 --> 00:44:06,200
Speaker 2: the numbers, they're really skyrocketing. We're not talking about a

843
00:44:06,280 --> 00:44:10,919
Speaker 2: slight increase right, Pola, yep, and again then to me yeah,

844
00:44:11,080 --> 00:44:15,160
Speaker 2: and then to me. The plan is doing everything we

845
00:44:15,320 --> 00:44:18,719
Speaker 2: can that's within our power right now, obviously being aware

846
00:44:18,760 --> 00:44:22,920
Speaker 2: of symptoms, talking to doctors, making sure patients are keenly

847
00:44:23,000 --> 00:44:25,880
Speaker 2: aware that if something's off they need to pursue it,

848
00:44:26,520 --> 00:44:31,600
Speaker 2: and with their doctors. But in the meantime or long term,

849
00:44:31,920 --> 00:44:37,960
Speaker 2: I want there to be a test that is more accessible,

850
00:44:38,280 --> 00:44:44,080
Speaker 2: less expensive, and that can be given to people, you know,

851
00:44:44,440 --> 00:44:47,080
Speaker 2: starting at age eighteen. Maybe I'm crazy about this, but

852
00:44:47,200 --> 00:44:52,440
Speaker 2: I had coffee with a really wonderful oncology fellow at

853
00:44:52,520 --> 00:44:57,120
Speaker 2: MONTOFIORI is it a story right? Anyway, she's so nice,

854
00:44:57,280 --> 00:44:59,440
Speaker 2: she's thirty five, she's really pretty, and she'd like a

855
00:44:59,480 --> 00:45:02,279
Speaker 2: boyfriend of if anyone knows anybody in New York. I

856
00:45:02,440 --> 00:45:05,880
Speaker 2: love her. She's so great. But listen, we met for

857
00:45:06,000 --> 00:45:08,239
Speaker 2: coffee because I'm a little bit of a eni. I'm

858
00:45:08,239 --> 00:45:12,240
Speaker 2: a good matchmaker personally, that's one of my many unknown skills.

859
00:45:12,760 --> 00:45:16,920
Speaker 2: But anyway, we met for coffee and she said that

860
00:45:17,520 --> 00:45:21,040
Speaker 2: that past week she had to tell a twenty one

861
00:45:21,160 --> 00:45:28,120
Speaker 2: year old boy no family history, yep, no lynch syndrome,

862
00:45:28,320 --> 00:45:34,080
Speaker 2: no familial polyposis, no, nothing that he had stage four

863
00:45:34,239 --> 00:45:41,560
Speaker 2: calling cancer and until we say, oh, sorry, poor guy.

864
00:45:42,719 --> 00:45:45,920
Speaker 2: I mean, my goal and I have nothing to do

865
00:45:46,040 --> 00:45:48,160
Speaker 2: with it, but I'll support it in any way I

866
00:45:48,280 --> 00:45:52,800
Speaker 2: can is to come up with a better screening tool

867
00:45:53,239 --> 00:45:57,000
Speaker 2: that's accessible to younger people. And that's why I'm excited.

868
00:45:57,120 --> 00:45:58,680
Speaker 2: And I don't know full of how you feel. And

869
00:45:58,719 --> 00:46:02,600
Speaker 2: I'm opening up another can worms here about liquid biopsies

870
00:46:02,880 --> 00:46:05,520
Speaker 2: and blood tests that can you know that are really

871
00:46:05,760 --> 00:46:09,480
Speaker 2: in their nascent period of development, but they're starting. That

872
00:46:09,719 --> 00:46:12,760
Speaker 2: can be done when you just get your yearly physical

873
00:46:13,600 --> 00:46:18,200
Speaker 2: and if they're cancer selves in that blood, you can say, hey,

874
00:46:19,080 --> 00:46:21,680
Speaker 2: we need to look into this. But that's about all

875
00:46:21,760 --> 00:46:24,759
Speaker 2: I know. That's the extent of my expertise. But what

876
00:46:24,960 --> 00:46:28,920
Speaker 2: about better new screening techniques that aren't as costly or

877
00:46:29,000 --> 00:46:33,319
Speaker 2: invasive that can be utilized by the whole population.

878
00:46:33,320 --> 00:46:34,720
Speaker 1: During a physical annual physical.

879
00:46:34,880 --> 00:46:37,320
Speaker 2: Yeah, because I know the risk reward and all that

880
00:46:37,480 --> 00:46:40,320
Speaker 2: stuff that public health advocates think about, like they can't

881
00:46:40,600 --> 00:46:44,400
Speaker 2: screen everyone. But I just am so upset when I

882
00:46:44,480 --> 00:46:47,399
Speaker 2: hear about a thirty two year old man who has

883
00:46:47,480 --> 00:46:51,040
Speaker 2: stage four coling cancer. Another girl I saw on Instagram

884
00:46:51,560 --> 00:46:54,080
Speaker 2: who's like in her twenties, This twenty one year old

885
00:46:54,120 --> 00:46:54,920
Speaker 2: I told you about.

886
00:46:54,960 --> 00:46:58,920
Speaker 1: It's like that is unacceptable to me, that these young

887
00:46:58,960 --> 00:47:01,080
Speaker 1: people are the face of going cancer is just yeah,

888
00:47:01,080 --> 00:47:03,799
Speaker 1: I mean we use you know, we are often being

889
00:47:03,920 --> 00:47:07,680
Speaker 1: contacted now by pediatric offices, you know, trying to seek

890
00:47:07,719 --> 00:47:09,800
Speaker 1: advice on how to treat colorectal cancer.

891
00:47:09,840 --> 00:47:11,839
Speaker 4: And that was something that they never had to reach

892
00:47:11,920 --> 00:47:14,160
Speaker 4: out to us about that before. So this is a

893
00:47:14,200 --> 00:47:18,040
Speaker 4: phenomena that is affecting people very young ages. There's a

894
00:47:18,160 --> 00:47:20,160
Speaker 4: lot that we have to learn. I do think that

895
00:47:20,280 --> 00:47:23,320
Speaker 4: the path forward does involve answering this question as to

896
00:47:23,400 --> 00:47:26,800
Speaker 4: the why. We need research dollars to do that. We

897
00:47:26,960 --> 00:47:30,120
Speaker 4: need to fund the best teams of scientists, not only

898
00:47:30,200 --> 00:47:33,479
Speaker 4: in this country but globally because to answer this question,

899
00:47:33,600 --> 00:47:36,719
Speaker 4: I honestly think you need the science from Australia, from

900
00:47:36,760 --> 00:47:40,440
Speaker 4: the UK, from Asia, from Africa where we're starting to

901
00:47:40,480 --> 00:47:43,400
Speaker 4: see these trends as well, to put these pieces together.

902
00:47:43,800 --> 00:47:46,000
Speaker 4: And then I think the other priority, in addition to

903
00:47:46,160 --> 00:47:49,719
Speaker 4: understanding the why is what do we do in the meantime?

904
00:47:49,800 --> 00:47:52,879
Speaker 4: And I think that's what Katie is getting too. Yes,

905
00:47:53,000 --> 00:47:56,000
Speaker 4: we now have these blood based tests, how can we

906
00:47:56,120 --> 00:48:00,920
Speaker 4: effectively incorporate things like the blood based tests for coorectal

907
00:48:00,960 --> 00:48:04,480
Speaker 4: cancer into normal practice safely in a way that we

908
00:48:04,560 --> 00:48:08,800
Speaker 4: can follow up these patients in a reasonable manner. How

909
00:48:08,840 --> 00:48:11,400
Speaker 4: do we decide which populations need to be tested in

910
00:48:11,440 --> 00:48:14,000
Speaker 4: a with age and those are all areas of research

911
00:48:14,080 --> 00:48:15,640
Speaker 4: that also need to be prioritized.

912
00:48:15,680 --> 00:48:19,960
Speaker 2: And I also know that what prevention, obviously early detection

913
00:48:20,280 --> 00:48:23,440
Speaker 2: is so critical. But I do worry. I mean, I

914
00:48:23,520 --> 00:48:26,359
Speaker 2: think we have to put an emphasis on finding these

915
00:48:26,440 --> 00:48:29,520
Speaker 2: cancers early, and colon cancer certainly when it's when it's

916
00:48:29,600 --> 00:48:32,759
Speaker 2: treatable and curable. And that's one of our goals for

917
00:48:32,880 --> 00:48:35,719
Speaker 2: Stand Up to Cancer, because you can really reduce the

918
00:48:36,160 --> 00:48:36,960
Speaker 2: number of cases.

919
00:48:37,400 --> 00:48:38,560
Speaker 1: But but.

920
00:48:40,480 --> 00:48:44,000
Speaker 2: I think about these people like my husband who are

921
00:48:44,080 --> 00:48:47,520
Speaker 2: diagnosed with stage four coal directal cancer, and I think

922
00:48:47,600 --> 00:48:51,000
Speaker 2: about the fact that the treatment has really not changed

923
00:48:51,440 --> 00:48:54,320
Speaker 2: much since the fifties, where it's five of you and

924
00:48:54,440 --> 00:48:57,760
Speaker 2: Luca born right is the kind of go to treatment.

925
00:48:57,880 --> 00:49:01,359
Speaker 2: And they've come up with some others like I guess, uh,

926
00:49:01,960 --> 00:49:04,560
Speaker 2: campus are I don't even know fort cancer. We've had

927
00:49:04,600 --> 00:49:09,480
Speaker 2: some rectal cancer doctor Diaz at Memorial for a subset

928
00:49:09,520 --> 00:49:13,240
Speaker 2: of people with rectal cancer. I mean just phenomenal results.

929
00:49:13,600 --> 00:49:18,680
Speaker 2: But it pains me and breaks my heart when I

930
00:49:18,880 --> 00:49:23,399
Speaker 2: think that we can't also, at the same time come

931
00:49:23,520 --> 00:49:27,280
Speaker 2: up with better treatments for people who have advanced disease.

932
00:49:28,000 --> 00:49:31,839
Speaker 2: You know, people like James Vanderbeek who had Stage three

933
00:49:32,520 --> 00:49:35,600
Speaker 2: and you would think that that would have been potentially

934
00:49:35,760 --> 00:49:39,920
Speaker 2: curable because he had systemic disease, but it hadn't metastasized, right,

935
00:49:40,120 --> 00:49:43,839
Speaker 2: But he wasn't responsive clearly to the treatment, To people

936
00:49:44,000 --> 00:49:46,600
Speaker 2: like my husband, to people like that twenty one year

937
00:49:46,640 --> 00:49:52,719
Speaker 2: old boy, that I the idea that there is very

938
00:49:52,840 --> 00:49:56,000
Speaker 2: little that can be done for people with advanced col

939
00:49:56,040 --> 00:50:00,239
Speaker 2: of rectal cancer. That is unacceptable to me too. Me know,

940
00:50:00,360 --> 00:50:05,320
Speaker 2: therapeutic approaches haven't borne much fruit in colorectal cancer, but

941
00:50:05,480 --> 00:50:09,319
Speaker 2: we have to keep coming up with better treatments while

942
00:50:09,480 --> 00:50:13,239
Speaker 2: we also encourage early detection because I don't want to

943
00:50:13,320 --> 00:50:16,920
Speaker 2: forget about the people who are dealing with stage four Collings.

944
00:50:17,239 --> 00:50:18,319
Speaker 1: That's right, It's not one or the other.

945
00:50:18,600 --> 00:50:19,200
Speaker 3: Absolutely.

946
00:50:20,760 --> 00:50:22,480
Speaker 1: I guess we do have to wrap up, but I

947
00:50:22,520 --> 00:50:24,719
Speaker 1: would very quick takeaway, if you don't mind. It's really

948
00:50:24,760 --> 00:50:26,680
Speaker 1: hard for me to end this conversation. I would it's

949
00:50:26,719 --> 00:50:28,520
Speaker 1: I can see she's.

950
00:50:28,320 --> 00:50:30,120
Speaker 3: The best, I mean, but for years.

951
00:50:30,120 --> 00:50:33,000
Speaker 1: But I honestly with you, the scream.

952
00:50:37,040 --> 00:50:38,960
Speaker 2: You're doing, I have nothing to talk about it.

953
00:50:39,000 --> 00:50:41,640
Speaker 1: And we're talking about this coupling of again, like you

954
00:50:41,840 --> 00:50:43,560
Speaker 1: two are the dream team, right, I mean, on the

955
00:50:43,640 --> 00:50:46,080
Speaker 1: larger level, it's stand up to cancer, it's the main lab.

956
00:50:46,160 --> 00:50:48,040
Speaker 1: But together you're the dream team. I mean, I just

957
00:50:48,640 --> 00:50:50,680
Speaker 1: I can't thank you enough for coming. I think this

958
00:50:50,840 --> 00:50:54,399
Speaker 1: conversation truly changes lives, you know, the I hope back

959
00:50:54,440 --> 00:50:57,200
Speaker 1: two point zero three point zero. I mean, I can't

960
00:50:57,239 --> 00:51:00,880
Speaker 1: thank you enough. And I do really feel that, you know,

961
00:51:00,920 --> 00:51:03,160
Speaker 1: if anyone is listening, I think if we moved anyone

962
00:51:03,239 --> 00:51:05,480
Speaker 1: even you know, even while we're trying to figure out

963
00:51:05,560 --> 00:51:09,319
Speaker 1: the ideology, the cause, the why, better treatments, I think

964
00:51:09,320 --> 00:51:11,520
Speaker 1: if we got one person to say, I'm moving from

965
00:51:11,600 --> 00:51:13,319
Speaker 1: I should do this too. I did schedule. I think

966
00:51:13,360 --> 00:51:15,480
Speaker 1: that's the impact that we're looking for. And the two

967
00:51:15,520 --> 00:51:19,120
Speaker 1: of you are so brilliant and compassionate and just your

968
00:51:19,120 --> 00:51:21,359
Speaker 1: advocacy is just so inspiring. I can't thank you enough

969
00:51:21,480 --> 00:51:22,200
Speaker 1: for coming on.

970
00:51:23,280 --> 00:51:26,880
Speaker 4: Well, thank you, thank you for championing this topic and

971
00:51:27,000 --> 00:51:29,120
Speaker 4: for talking about it, because again, stigma has been a

972
00:51:29,160 --> 00:51:30,120
Speaker 4: problem for our community.

973
00:51:30,520 --> 00:51:32,560
Speaker 3: So we're just so grateful to be here and to

974
00:51:32,719 --> 00:51:33,440
Speaker 3: share what we can.

975
00:51:33,920 --> 00:51:38,040
Speaker 2: And if you're forty five get screamed, just call your doctor.

976
00:51:38,320 --> 00:51:41,400
Speaker 2: What are you waiting for? Call your doctor. It's not

977
00:51:41,600 --> 00:51:42,319
Speaker 2: that big a deal.

978
00:51:42,360 --> 00:51:45,759
Speaker 4: There are many options, many options, and a lot of

979
00:51:45,800 --> 00:51:49,399
Speaker 4: people complain about the press for colonoscopy.

980
00:51:49,719 --> 00:51:50,040
Speaker 1: The prep.

981
00:51:50,120 --> 00:51:52,840
Speaker 3: Actually the press pretty amazing. It's like a felin.

982
00:51:53,440 --> 00:51:56,760
Speaker 2: It's it's like it's like a colonic But I mean.

983
00:51:56,680 --> 00:51:59,800
Speaker 3: The prep is not a lot of fun free clins.

984
00:52:00,120 --> 00:52:04,719
Speaker 2: But I always say it's so much better than being

985
00:52:04,840 --> 00:52:07,640
Speaker 2: diagnosed with calling cancer.

986
00:52:07,880 --> 00:52:11,640
Speaker 4: And also that freedom you walk out with after the procedure,

987
00:52:11,800 --> 00:52:14,400
Speaker 4: knowing that you don't have cancers or polyps growing in

988
00:52:14,480 --> 00:52:15,800
Speaker 4: your colin that's powerful.

989
00:52:15,840 --> 00:52:18,239
Speaker 2: And also you do it for people you love that's correct.

990
00:52:18,320 --> 00:52:20,600
Speaker 1: And even the reassurance since we both have three polyps

991
00:52:20,640 --> 00:52:26,320
Speaker 1: because we're twins, that that someone's monitoring me right, And

992
00:52:26,400 --> 00:52:27,880
Speaker 1: I feel so lucky. And I think that's why this

993
00:52:28,000 --> 00:52:31,040
Speaker 1: conversation about equating access is so important. I don't think

994
00:52:31,080 --> 00:52:32,600
Speaker 1: that it can be a we can't have it be

995
00:52:32,640 --> 00:52:34,720
Speaker 1: a privilege right to be screened.

996
00:52:35,040 --> 00:52:35,239
Speaker 4: You know.

997
00:52:36,960 --> 00:52:42,960
Speaker 2: That FOLA is doing to educate everyone, people in rural communities,

998
00:52:43,360 --> 00:52:47,360
Speaker 2: you know, people of color, people all over the country.

999
00:52:47,480 --> 00:52:51,399
Speaker 2: It should be a right, not a privilege. And we've

1000
00:52:51,800 --> 00:52:54,520
Speaker 2: that that is such an important message too, right.

1001
00:52:54,640 --> 00:52:57,040
Speaker 1: And clearly and clearly forty five is the new fifty.

1002
00:52:57,239 --> 00:53:02,600
Speaker 3: Absolutely is the new sixty.

1003
00:53:03,640 --> 00:53:04,200
Speaker 2: I don't know.

1004
00:53:06,000 --> 00:53:07,439
Speaker 3: You guys are you guys are the best.

1005
00:53:07,520 --> 00:53:10,080
Speaker 1: I can't thank you enough. Thank you so much, and

1006
00:53:10,160 --> 00:53:11,680
Speaker 1: many more, many more conversations.

1007
00:53:11,800 --> 00:53:13,919
Speaker 2: Yeah, its is so fun, and thank you for doing

1008
00:53:13,960 --> 00:53:17,040
Speaker 2: this podcast because you're doing a real public service bringing

1009
00:53:17,640 --> 00:53:24,480
Speaker 2: I think medical information, valid science backed medical information, which

1010
00:53:24,680 --> 00:53:28,800
Speaker 2: is so critically important right now in our current environment.

1011
00:53:29,000 --> 00:53:31,080
Speaker 2: And so thank you for doing what you're doing.

1012
00:53:31,880 --> 00:53:32,799
Speaker 1: Thank you so much.

1013
00:53:33,040 --> 00:53:33,839
Speaker 2: It's a love fest.

1014
00:53:33,960 --> 00:53:36,360
Speaker 1: It is I guess science. It's so sexy.