Early detection means optimal chance of successful treatment

A message from Dr. Kelsey Louie, FNHA Medical Officer, Primary Care

March is National Colorectal Cancer Awareness Month -- and National Kidney Health Awareness Month -- and National Liver Health Awareness Month -- so it's an opportune time to talk about the importance of regular checkups with your physician about these things. The main message I'd like to share is that with some adjustments to your lifestyle, including regular screening, these and many other health problems are preventable -- or at least detectable, treatable and beatable!

Following are some fast facts about each, including who should get screened, what screening entails, and how to lessen your risks.

Colorectal Cancer

Finding cancer early, when it's small and hasn't spread, often allows for more treatment options. Remember that while some early cancers may have noticeable signs and symptoms, some do not. That's why screening is so important!

Who should get screened:

Everyone between ages 50-74, and people under the age of 50 with risk factors such as a family history of colorectal cancer, inflammatory bowel disease, personal history of cancerous growths or polyps, or hereditary syndromes such as familial adenomatous polyposis.

What screening entails:

Several options for screening are available. Talk to your healthcare provider about which test to use, and how often testing is needed. The most often used, and simplest to do, is a stool (poo) test, often called a FIT test. It looks for blood in your stool that you can't see with the naked eye. It is often recommended every two years between the ages of 50-74. Another option is colonoscopy, the gold standard. Although more invasive, this 30- to 90-minute procedure allows visualization of the entire colon for polyps, along with removing them and reducing their potential to turn cancerous. Based on the specialist's assessment, it may only need to be done every 10 years. Other screening tests offered may include a special type of X-ray that uses barium sulfate and air to outline the lining of the colon, or a sigmoidoscopy, which is a flexible camera that visualizes the tail end of the colon.

How to lessen the risk of developing colorectal cancer:

• Eat plenty of vegetables, fruits, and whole grains; eat less sugar and red meat (beef, pork, or lamb) and limit processed meats (hot dogs and some luncheon meats).

• Get regular exercise and maintain a healthy weight.

• Don't smoke.

• Limit alcohol consumption.

For more information, see the Colorectal Cancer Canada website at https://www.colorectalcancercanada.com/ or

https://www.uptodate.com/contents/colon-and-rectal-cancer-screening-the-basics?csi=08dbaed9-70c6-40ec-9166-29b760ea6001&source=contentShare.

Kidney Disease

As the symptoms of kidney disease are often silent in the early stages, it is challenging to know the health status of your kidneys. However, early detection of altered kidney function can result in a better chance of preventing further kidney damage or long-term kidney problems such as kidney failure, dialysis or a kidney transplant.

Who should get screened:

Everyone, but especially those diagnosed with diabetes, heart disease, high blood pressure or a family history of kidney disease.

What screening entails:

Three routine kidney function tests may be performed, including: 1) a blood test for creatinine and eGFR levels (these may become elevated or low if the kidneys aren't working properly); 2) a urine test to see if you have too much protein, glucose (sugar) or blood in your urine; and 3) a measurement of blood pressure (hypertension, or elevated blood pressure, is a risk factor for chronic kidney disease). These tests can be done or organized during routine office visits.

How to lessen the risk of developing kidney disease:

•Eat a healthy diet with lots of vegetables and real foods, not processed foods.

•Don't smoke.

•Limit alcohol and sugar consumption.

•Keep active. 

For more information, see the Kidney Foundation of Canada's website at https://www.kidney.ca/.

Liver Disease

There are over 100 forms of liver disease that affect men, women and children. Only one is directly caused by alcohol -- most are caused by various factors including viruses, toxins and genetics. Non-alcoholic fatty liver disease is the most common liver disease in Canada, affecting over seven million people, and liver cancer is now one of the fastest-rising forms of cancer in Canada.

Who should get screened:

People with viruses like viral hepatitis, autoimmune disorders and cancer; people who are obese (especially those who carry extra weight in the belly); people who have relatives with liver disease; and people who consume alcohol on a regular basis or overuse alcohol or drugs, including over-the-counter medications like Tylenol.

What screening entails:

Most liver function tests are blood tests that measure the amount of enzyme levels present from liver cells. A liver that is inflamed or damaged often has abnormal amount of enzymes in the bloodstream. Your doctor may also arrange a non-invasive, non-painful test called a Fibro Scan. Essentially a modified ultrasound, it is able to transmit pulses through the liver to try and detect liver stiffness, which may indicate fibrosis or scarring. Your healthcare provider can work with you to determine the best screening option for you.

How to lessen the risk of developing liver disease:

• Maintain a healthy weight, avoid a high-fat, high-sugar diet, exercise regularly, and, if you are diabetic, control your blood glucose levels within the normal range.

• If consuming alcohol, it is important to do so in moderation and to avoid binge drinking, which is very harmful to the liver.

• Get vaccinated for Hepatitis A and B, and, to avoid risk of contracting Hepatitis C, do not share razors, toothbrushes or anything that could be contaminated with blood.

• Use acetaminophen (Tylenol) only as directed; excessive use can cause life threatening liver failure especially in combination with alcohol and other drugs.

For more information, see the Canadian Liver Foundation's website at https://www.liver.ca/ or https://www.uptodate.com/contents/nonalcoholic-fatty-liver-disease-including-nonalcoholic-steatohepatitis-nash-the-basics?csi=8247cff0-1bbf-48e8-a1f3-aa5ba8901320&source=contentShare or https://www.uptodate.com/contents/cirrhosis-the-basics?csi=358edc02-dccf-4714-b2bf-7581a25dcbf1&source=contentShare or https://www.uptodate.com/contents/toxic-hepatitis-the-basics?csi=7fc428cd-abc7-4272-ad6c-d484887bf879&source=contentShare.

I encourage everyone to consider screening an important component of their health and wellness routines. Please speak to your healthcare provider for more information about the importance of screening to your health.