Once or twice a month, we like to feature a Q&A with someone working on the front lines of colorectal healthcare: a gastroenterologist, researcher or other physician who specializes in colon cancer and colon cancer screening.
Meet the second physician we'd like to bring into the spotlight: Dr. Jeff Bullock.
Dr. Bullock has spent over a decade practicing gastroenterology with a specialty in colon cancer screening, diagnosis, and treatment. He was kind enough to take time out of his busy schedule to answer a few of our questions, which you can find below.
Be Seen, Get Screened: Tell us about your professional experience with colorectal cancer screening?
Dr. Bullock: I have been a private practice Gastroenterologist for 11 years in the San Antonio area. My primary focus in my practice is endoscopic procedures, primarily colonoscopy.
Over the years, I have diagnosed untold numbers of colon cancer. In each instance I spent the next several months and years riding the emotional and physical roller coaster associated with the treatment of their cancers.
In just about every instance, we had to live with the knowledge that this could have all been avoided by earlier screening and detection of pre-cancerous polyps.
BSGS: What do you say to patients who are hesitant to get screened for colorectal cancer?
Dr. Bullock: I try to address their specific reservations first. Often they have heard of a bad outcome from another patient or have specific concerns about the prep for the procedure, etc.
More often than not, the answers to these questions alleviate their fears. For instance, I had a patient recently tell me they heard that "a lot of people get perforations" from having a colonoscopy.
When I explained that the national average for severe complications is less than 1 in 10,000, and that I personally have never had a patient suffer that specific complication, they were reassured enough to schedule and complete their exam.
If they just have doubts in general, I try to emphasize two things:
- Colon cancer is one of the major causes of death from cancer in this country, and it is the only cancer that is totally preventable. Depending on the patient's specific risk factors, they often have upwards of a 50% chance of having a pre-cancerous polyp that needs to be removed.
- I do these procedures all day, every day. Everyone wakes up in my recovery room relieved that it is over, and astonished at how easy it was. I reassure them that their experience will be the same.
BSGS: What are some common objections to colorectal cancer screening? How do you address them?
Dr. Bullock: Probably the most common thing I hear is complaints about what they think the prep will be like. We try to address this by re-assuring people that we are constantly looking for the easiest and safest preps out there.
I am frank and tell them that no doubt the prep is the worst part, but most people don't have any problem with it. Usually they have heard some horror story from someone else.
One funny anecdote was last week, I saw a husband and wife in follow up of their colonoscopies. He had gone first, the week prior to hers. She told me that he had her "a little freaked out," listening to him tell her how bad it was. Then she did it and it was easy.
She laughed that as usual she should have expected him to be a little "whimpy" when it comes to that kind of stuff.
BSGS: Besides screening, what do you recommend to patients to improve colorectal health?
Dr. Bullock: There are about a million things out there that are being studied, most of them unfortunately haven't panned out. The big three that I try to focus on are:
- Weight loss: Studies show that weight loss, especially if the patient is morbidly obese has been proven to reduce the risk of not only colon cancer, but just about all common forms of cancer. Not to mention the beneficial effects on other common killers such as diabetes, heart disease and stroke just to name a few.
- Smoking: A lot of people don't think of this as a big risk for colon cancer, but it is. Again, this might be the most unhealthy thing anyone can do. Stopping smoking reduces your risk of all forms of cancer, as well as heart disease, chronic obstructive pulmonary disease (COPD) and stroke.
- High fiber diet and fiber supplements: Almost no one gets enough fiber, once they get on a regimen, most of my patients feel much better.
BSGS: What one thing should everyone know about colorectal cancer screening?
Dr. Bullock: It saves lives! I mean this not in some nebulous doctor talk, quoting statistics way. I mean if you go in and have a pre-cancerous polyp removed, you have just prevented colon cancer! That is something you know the moment you wake up from anesthesia!
This happens all the time, and is probably more common than you think. If you want some statistics, last year alone I performed over 1,000 colonoscopies and found pre-cancerous polyps in roughly 39% of patients having the exam for colon cancer screening. That is quite a few of the people you know and talk to every day.
Don't fool yourself into thinking that you probably don't need it. Colon cancer often has no symptoms. Colon polyps almost never have symptoms.
BSGS: Is there anything else you'd like to share with us?
Dr. Bullock: I once wrote in a newspaper column that as a doctor it is tough to lose patients for reasons that modern medicine can not control, but that it is truly unbearable to lose people we care about from something that can be prevented. Since I wrote those words, every day they ring more and more true to me.
Ask your doctor if you need screening. Implore your loved ones to get screened. If you have, spread the word about how easy it was.
To contact Dr. Bullock, you may find his information here via San Antonio Gastroenterology Associates, P.A.