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DOCTOR IS IN March is National Colorectal Cancer Awareness Month BY DR. RENA DAIZA Colorectal screening saves lives. Part of raising awareness is helping people understand the value and importance of getting regular cancer screenings for early detection. As a primary care doctor, a large part of my role is preventive medicine. The goal of preventive medicine is to ultimately prevent disease, disability, and death. Colorectal cancer screening is one way of implementing this. Despite the benefits of getting screened, only about two-thirds of adults in the United States are on schedule with the recommended tests, according to the CDC. There seems to be a lot of hesitancy among Chaldean patients when it comes to cancer screenings - especially colorectal cancer screens. I spoke to a gastroenterologist, Dr. Jolian Kathawa, to break it down for us. Dr. Kathawa specializes in preventing, diagnosing, and treating conditions of the gastrointestinal (GI) tract, or digestive system. I asked him 5 important questions that every patient needs to know: What is colorectal cancer (CRC) and what are different ways to detect it early? Colorectal cancer is cancer of the colon or rectum. It is the third most common cancer diagnosed among men and women and it is the second most common cause of death among all cancers. It can present in many different ways, a few of which include patients experiencing blood in their stools, weight loss, abdominal pain, changes in their bowel habits — or they could be completely asymptomatic. There are factors which can increase your risk for colon cancer such as smoking, obesity, family history of colon cancer, or certain dietary habits. There are multiple ways to detect colon cancer and to prevent it. There are DR. RENA DAIZA SPECIAL TO THE CHALDEAN NEWS ways where we can directly visualize the colon such as with a colonoscopy, sigmoidoscopy, or CT imaging. Then there are a few stool tests that can be used as well, such as FIT testing and Cologuard. However, the gold standard (best test) is a colonoscopy — this is the most efficient way to detect and prevent colon cancer. During a colonoscopy, you are put to sleep by anesthesia and we use a flexible scope that is inserted through the anus to examine the entire colon. We look for polyps that can be removed in an effort to prevent colon cancer from occurring. This is the only test where we can actually prevent cancer. The other tests are mostly used to detect cancer or advanced polyps. Describe when someone is an appropriate candidate for FIT test or Cologuard versus Colonoscopy. It is important to know that FIT testing and Cologuard testing is only appropriate for patients who are at average risk for colon cancer. Average risk means a patient has no history of colon polyps, no family history of colon cancer, no hereditary conditions that increase their risk for colon cancer and no history of Crohn’s disease or Ulcerative colitis. Also, patients need to be asymptomatic. So if a patient is complaining of rectal bleeding, or changes in their bowel habits, or weight loss, then they should not undergo these stool based tests. If a patient uses these stool tests and the results are positive, the next step would be to undergo a colonoscopy. They say a majority of new cases of CRC occur in people aged 50 years or older. Why do recommendations suggest screening earlier now, for instance, at age 45 years? The guidelines from the American Gastroenterology Association were recently changed to start screening at 45 years of age for all average risk patients. This was done after reviewing multiple studies and looking at the data that showed colon cancer was rising in patients younger than the age of 50. The studies also showed that colon cancer rates were increasing in patients between 50-60 years of age. So by screening earlier, we hope to catch these cancers at earlier stages so that patients can be successfully treated. We also hope to prevent many of these cancers by finding polyps earlier and removing them before they become cancerous. “45 is the new 50” Can or should CRC screening go beyond 75 years of age? When can gastroenterologists make that call? For patients over the age of 75, there are no clear guidelines in terms of colon cancer screening. The American College of Gastroenterology recommends that we have a discussion with the patient and discuss the risks versus benefits of performing colon cancer screening beyond this age. It essentially comes down to the patient’s health, their risk of undergoing a procedure and their values or wishes. For example, if we have a 76-year-old patient who is completely healthy with no significant health issues, then it may be worthwhile to proceed with colorectal cancer screening because we have every reason to believe that this patient will live an additional 7-10 years. However, if we have a 76-yearold patient who is on chronic oxygen, is on dialysis and has significant cardiac disease, then the risks of undergoing colon cancer screening most likely outweigh the benefits. My job, as a gastroenterologist, is to provide them with the facts and the risks and benefits of both approaches. Any other important facts to know about CRC and/or screenings? The main thing I will say is to get screened. Talk to your primary care doctor and get screened - it could potentially save your life. Encourage your loved ones to do it as well. If you have questions or concerns about undergoing a colonoscopy, you can always schedule an appointment with your doctor to discuss it in the office beforehand. Dr. Issam Turk, a gastroenterologist based out of Rochester and Troy said, “The hesitancy within the Chaldean community when it comes to preventative medicine and specifically colon cancer screening is a major issue that needs to be tackled urgently, especially given that colorectal cancer is on the rise. “The classic line that I often hear from patients and sometimes, my own family members is, ‘I feel fine. Why do I need to do this test?’ In the end, although it will be challenging, we must continue to raise awareness regarding this issue and urge our patients, friends, and family members to get screened in a timely fashion.” The outlook for people with the disease has slowly been improving for several decades, largely due to screening. Don’t forget that “45 is the new 50”. If you are age 45 or above, please talk to your doctor now about getting screened. Dr. Rena Daiza is a board-certified primary care physician at the Henry Ford Bloomfield Township Medical Center. She serves as Vice President of the Chaldean American Association for Health Professionals and as Co-Chair of the Chaldean Women’s Committee - a subgroup of the Chaldean Chamber of Commerce. Dr. Jolian Kathawa is a board-certified gastroenterologist. He is credentialed with Beaumont Hospital and the Detroit Medical Center. He practices in both Farmington Hills and Commerce. 40 CHALDEAN NEWS MARCH 2023
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Page 1 and 2: METRO DETROIT CHALDEAN COMMUNITY VO
Page 3 and 4: America’s largest arab and Chalde
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Page 15 and 16: WE ARE HIRING Do you possess a pass
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Page 19 and 20: One of the show’s two judges, Duf
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Page 23 and 24: That changed around 2018 when her d
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Page 27 and 28: 4.375 in. BIG SOUND. UP CLOSE. SOUN
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Page 31 and 32: Clockwise from top right: Hassan Al
Page 33 and 34: From left: Habib Hannona in a 1961
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Page 37 and 38: WASH YOUR VEHICLE AS OFTEN AS YOU W
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Page 43: T:9" CUSTOM-TAILORED SMALL BUSINESS

MARCH 2023

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