Total Access Medical - Direct Primary Care Blog

An Interview With Dr. Teresa Saris About Colorectal Cancer

Posted by Total Access Medical on Jul 23, 2019

Screen Shot 2017-06-13 at 10.02.47 AMDr. Teresa Saris of Total Access Medical answers questions regarding colorectal cancer. A graduate of the University of Pennsylvania and Hahnemann University Medical School, Dr. Saris has been in practice and board certified in Internal Medicine since 1991. 

Are there specific risk factors for colorectal cancer? 

Your risk of getting colorectal cancer increases as you get older. More than 90% of cases occur in people who are 50 years old or older.

Other risk factors include: inflammatory bowel disease such as Crohn’s disease or ulcerative colitis, a personal or family history of colorectal cancer or colorectal polyps, and a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).

Lifestyle factors that may contribute to an increased risk of colorectal cancer include: lack of regular physical activity, a diet low in fruit and vegetables, a low-fiber and high-fat diet, or a diet high in processed meats, overweight and obesity, alcohol consumption, and tobacco use.

What are the typical symptoms?

If you have symptoms, they may include: 

  • Blood in or on your stool (bowel movement).
  • Stomach pain, aches, or cramps that don’t go away.
  • Losing weight and you don’t know why.
  • A persistent change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool
  • Rectal bleeding or blood in your stool
  • Persistent abdominal discomfort, such as cramps, gas or pain
  • A feeling that your bowel doesn't empty completely
  • Weakness or fatigue
  • Unexplained weight loss
  • Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they'll likely vary, depending on the cancer's size and location in your large intestine.

In your experience, have you noticed any unusual symptoms?

No, only noticing that there are more younger patients getting diagnosed with colon cancer. We should not only think that people over 50 years of age can get colon cancer.

If someone has a high risk of colorectal cancer, what are some preventative steps to take to lower the risk?

You cannot change your age, your family history or your genetic make-up, so the best steps you can take is to modify your lifestyle habits and follow the screening recommendations.

  • Doctors generally recommend that people with an average risk of colon cancer begin screening around age 50. But people with an increased risk, such as those with a family history of colon cancer or African-American heritage, should consider screening sooner.
  • Several screening options exist — each with its own benefits and drawbacks. Talk about your options with your doctor, and together you can decide which tests are appropriate for you. If a colonoscopy is used for screening, polyps can be removed during the procedure before they turn into cancer.

Unfortunately, there are people who might get colon cancer before they are screened. 

Other than surgically removing the cancer, are there other treatments and what are the side effects? 

Typically, surgical removal is the first step to treat colon cancer when we catch it early.  Sometimes it requires chemotherapy and/or radiation first to shrink the cancer.  All treatment depends on the location of the tumor, how aggressive it is and the patient’s medical health concerns. 

Using a multidisciplinary approach with specialists allows us to find the best approach with the least side effects. If we can do minimal surgery to remove the cancer and avoid additional treatments, that is the goal. If chemotherapy and/or radiation is required, we try and find the best medications/doses that destroy the cancer cells without leaving injury to the healthy tissues. The surgeon, oncologist, and radiation specialist need to review the benefits and risks of the options available in your situation.

There are newer targeted drug therapies, immunotherapy, proton beam therapy and palliative care therapies available in the treatment of colon cancer to hopefully minimize the classic side effects.

Have there been recent technological advancements in the detection of colorectal cancer?

Since screening is the most effective way to reduce your risk, there have been several advancements in the detection of colorectal cancer. Most commonly, we use testing for blood in the stool and colonoscopy to screen for colon cancer. 

Virtual colonoscopies with cat scan imaging is an option for those who might not tolerate sedation for the direct visualization with the colonoscope. 

There are newer techniques that do not require an invasive procedure or radiation that simply use stool specimens to detect DNA (FIT) or special markers (Cologard) to calculate your risk of colon cancer. 

There is also a capsule that you can swallow that will take a video of your digestive tract looking for disease, but this is not standard of care for colon cancer screening.

Is there any additional information, especially recent research or clinical trials, that you would like to introduce? 

There are plenty of healthcare professionals working on prevention, detection, treatments, and providing the best care to people diagnosed with this disease.  Resources and information are readily available on-line and through discussion with your personal physicians. 

Consider, National Cancer Institute, American Cancer Society,, Fight Colorectal Cancer and Colorectal Cancer Alliance.

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