CityLine: Health, community and connections

HEALTH CARE CONVERSATIONS ABOUT PREVENTION, DETECTION, AND EDUCATION. THE DOCTORS AND ADVOCATES FIGHTING FOR HEALTHIER COMMUNITIES. THANK YOU SO MUCH FOR JOINING US. I’M JESSICA BROWN. MARCH IS NATIONAL COLORECTAL CANCER AWARENESS MONTH AND DOCTORS SAY IT’S NOW ON THE RISE AMONG YOUNGER ADULTS, EVEN THOSE WHO APPEAR HEALTHY. THAT DIAGNOSIS PLUNGED A LOCAL FATHER INTO A HEALTH BATTLE HE NEVER EXPECTED. NOW HE’S ON A POWERFUL MISSION TO HELP OTHERS STOP THIS DISEASE IN ITS TRACKS. IT’S JUST LIFE IS PRECIOUS. AT JUST 37 YEARS OLD, CHRISTOPHER KOWALSKI NEVER EXPECTED TO BE FIGHTING COLON CANCER. HE’S A FORMER BOSTON COLLEGE BASEBALL PLAYER AND AVID RUNNER WHO WORKS OUT ALMOST EVERY DAY. A HUSBAND DAD TO TWO YOUNG KIDS. BY ALL ACCOUNTS, HEALTHY IN A FLASH, EVERYTHING CHANGED. SO I GOT THE CALL AND HE SAID, CHRIS, ARE YOU ALONE? AND I COULD HEAR IN HIS VOICE AND I KNEW SOMETHING WAS WRONG. AND HE GOES, LISTEN, HE’S LIKE, I, YOU KNOW, WE GOT THE RESULTS BACK OF THE CT AND YOU HAVE COLON CANCER. UNFORTUNATELY, SOME OF IT SPREAD TO THE LIVER, NOT JUST COLON CANCER. STAGE FOUR CHRIS SAYS WHILE LIFE LOOKED NORMAL BEFORE HIS DIAGNOSIS, THERE WERE SMALL SIGNS THAT SOMETHING WAS OFF. I STARTED GETTING A LITTLE BIT OF FATIGUE AND THEN I STARTED GETTING A LITTLE UPPER RIBCAGE PAIN. AFTER THAT DEVASTATING news, HE SAYS. IT WAS HIS WIFE WHO HELPED HIM RESET HIS MINDSET. SHE GOES, WE HAVE 48 HOURS. WE’RE GOING TO LET EVERYTHING OUT. CRYING EMOTIONS, LET EVERYTHING CONSUME YOU AND LET IT OUT. YOU’RE AN INNER CITY KID FROM DORCHESTER. YOU’VE NEVER BEEN AFRAID OF A FIGHT. CHRIS’S STORY IS BECOMING MORE AND MORE COMMON. DOCTORS SAY COLORECTAL CANCER, CANCER OF THE COLON AND RECTUM HAS BEEN RISING AMONG YOUNGER ADULTS. FOR YEARS. WE’VE BEEN SEEING PEOPLE IN THEIR 20S AND 30S, EVEN. THE REASON IS STILL BEING STUDIED. GASTROENTEROLOGISTS AND CLINICAL RESEARCHERS SAY THERE ARE SOME CONTRIBUTING FACTORS, LIKE DIETS LOW IN FRUITS AND VEGETABLES AND HIGH IN PROCESSED FOODS, ESPECIALLY MEATS, AND MANY YOUNGER PATIENTS ARE GETTING DIAGNOSED LATER BECAUSE THE WARNING SIGNS CAN BE SUBTLE. BLOOD IN THE STOOL, CHANGES IN BOWEL HABITS, ABDOMINAL PAIN, LOSS OF WEIGHT THAT’S UNEXPLAINED. PATIENTS SHOULD BE AWARE OF THOSE AND GO TO THEIR PRIMARY CARE DOCTOR OR ANY OTHER MEDICAL PROFESSIONAL THAT THEY THAT THEY KNOW IN ORDER TO LOOK FOR SCREENING. DOCTOR LEON PAPPAS AT MASS GENERAL BRIGHAM CREATED A PERSONALIZED TREATMENT PLAN FOR CHRIS, COMBINING CHEMOTHERAPY AND A CLINICAL TRIAL. SO ONCE I DID BIOPSIES IN MY LIVER, ONCE I DID BIOPSIES IN MY COLON, WE DEVELOPED A TREATMENT PLAN TO TARGET IT. SPECIFICALLY, DOCTORS SAY NEW TREATMENTS LIKE THESE ARE IMPROVING PATIENT’S ODDS WITH NEW TREATMENT PARADIGMS, WITH THE ABILITY TO INCORPORATE SURGERY AND RADIATION THERAPY, WE ARE CURING ALSO MORE AND MORE PEOPLE, EVEN IN THE ADVANCED STAGE FOR SETTING, WHICH IS VERY ENCOURAGING. WHILE TREATMENTS CONTINUE TO IMPROVE, DOCTORS SAY THE BIGGEST LIFESAVER IS CATCHING THE DISEASE EARLY. THAT’S WHY THEY’RE URGING MORE PEOPLE TO GET SCREENED. AND ALTHOUGH COLONOSCOPIES ARE CONSIDERED THE GOLD STANDARD, THERE ARE MORE OPTIONS. THERE’S A STOOL TEST THAT SOME DOCTORS MAIL TO YOUR HOUSE. YOU CAN GET A CT SCAN. YOU STILL DO A BOWEL PREP, BUT IT’S CALLED A VIRTUAL COLONOSCOPY OR CT COLONOGRAPHY COMING OUT WITH BLOOD TESTS NOW. SO YOU CAN JUST GO TO THE LAB AND GET TESTED. AND THE BEST ONE IS THE ONE THAT GETS DONE A MESSAGE CHRIS CONTINUES TO SHARE TO SAVE LIVES. WE HAVE OVER 200 PEOPLE IN MY NETWORK HAVE GOTTEN COLONOSCOPIES NOW. UNFORTUNATELY, EIGHT OF THEM HAVE HAD POLYPS. BUT YOU KNOW, I SAY IT’S ALMOST LIKE A. FORTUNATELY, UNFORTUNATELY, BECAUSE FORTUNATELY WE FOUND THEM. WE DO WANT TO MENTION THAT SINCE CHRIS STARTED THAT TREATMENT, THE CANCER ACTIVITY IN HIS BODY HAS DECREASED DRAMATICALLY. HE’S NOW TRYING TO TURN HIS DIAGNOSIS INTO AWARENESS, INSPIRING OTHERS TO GET SCREENED. JOINING ME NOW WE HAVE MARK KENNEDY, WHO HELPS LEAD CHRONIC DISEASE PREVENTION AT BOSTON’S PUBLIC HEALTH COMMISSION. THANK YOU SO MUCH FOR BEING HERE. IT’S A PLEASURE TO BE HERE. YEAH, ABSOLUTELY. THIS IS SUCH AN IMPORTANT TOPIC. BUT WE JUST HEARD ONE OF THE BIG TAKEAWAYS FROM CHRIS’S STORY DETECTION, DETECTION, DETECTION OF THE CANCER IS KEY HERE. HOW MUCH CAN EARLY DETECTION IMPROVE SOMEONE’S ODDS OF SURVIVAL? I THINK IT’S REALLY THE KEY. IF YOU THINK ABOUT WHAT EARLY DETECTION IS FOR COLORECTAL CANCER, PARTICULARLY IF YOU’RE USING A COLONOSCOPY, THEY’RE LOOKING FOR ABNORMAL ABNORMALITIES IN THE COLON CALLED POLYPS. THOSE ARE TYPICALLY PRECANCEROUS. BUT THEY COULD ALSO BE BENIGN. BUT THE GOAL IS TO CATCH THOSE BEFORE THEY’RE DEVELOPED. TAKE THEM OUT SO THAT IT CAN’T DEVELOP INTO SOMETHING THAT COULD LEAD TO DEATH. AND YOU KNOW WHAT, THOUGH, WHEN YOU HEAR STORIES LIKE CHRIS’S AS WELL, 37 YEARS OLD, SO YOUNG, WE KNOW THAT COLORECTAL CANCER RIGHT NOW IS THE LEADING CAUSE OF CANCER DEATHS IN PEOPLE UNDER THE AGE OF 50. CORRECT. IT’S WILD TO HEAR. IT’S BECOMING MORE AND MORE COMMON IN YOUNGER PEOPLE, RIGHT. SO WHAT ARE YOU SEEING IN BOSTON AT THIS POINT AS FAR AS AGE, RACE, SOCIOECONOMIC FACTORS? YEAH, TYPICALLY IT IS THE CASE, OF COURSE, WITH COLORECTAL CANCER RATES AND IMPACT IN BOSTON TYPICALLY TRACK WITH NATIONAL LEVELS, RIGHT? SO WE’RE PRETTY MUCH IN THE SAME PLACE IN TERMS OF WHAT YOU LOOK AT NATIONALLY IN TERMS OF BURDEN. AND WE LOOK AT IN THE CITY OF BOSTON, WE KNOW RAISING AWARENESS AND OUTREACH ARE KEY PARTS OF YOUR STRATEGY. HOW ARE YOU GETTING INTO COMMUNITIES TO TO MAKE SURE PEOPLE ARE GETTING SCREENED AND GET THE WORD OUT? WELL, WE’VE BEEN DOING THIS FOR A WHILE. WE’RE TAKING SORT OF THE LONG TERM APPROACH. IN 2022, WE ROLLED OUT A COLON CANCER AWARENESS COMMUNICATIONS CAMPAIGN FOR BOSTON RESIDENTS, BUT WITH A PARTICULAR FOCUS ON THOSE THAT HAD THE HIGHEST BURDEN FROM A MORTALITY PERSPECTIVE. SO PEOPLE OF COLOR THAT SPOKE ENGLISH, PEOPLE OF COLOR THAT SPOKE HAITIAN CREOLE, AND OUR LATINO POPULATION, BECAUSE THOSE ARE THE NUMBERS TO YOUR POINT, ABOUT YOUNG ONSET, THAT’S WHERE WE’RE NOTICING THE YEAR OVER YEAR INCREASES IN INCIDENTS. SO WE STARTED THAT IN 2022. WE DID A SECOND ITERATION IN 2024 THAT INCORPORATED SOME LOCAL LEADERS THAT PEOPLE KNOW AND RECOGNIZE IN THOSE COMMUNITIES. AND JUST LAST MONTH, COMING INTO THIS MONTH, WE STARTED A SOCIAL MEDIA CAMPAIGN WITH THE DANA-FARBER CANCER INSTITUTE BECAUSE, AS YOU PROBABLY KNOW, IN 2021, THE SCREENING AGE FOR COLORECTAL CANCER GOT DROPPED FROM 50 TO 45 BECAUSE OF THIS ONSET ISSUE. BUT WHAT WE’RE FINDING IS WHEN YOU LOOK AT WHO SCREENING, THE RATES OF SCREENING FROM 45 TO 49 YEAR OLDS IS LOWER THAN EVERYBODY ELSE. SO WE WANTED TO FOCUS ON THAT. AND THAT’S WHAT THE SOCIAL MEDIA CAMPAIGN IS HELPING US DO. WELL, THAT’S GREAT THAT YOU’RE PUTTING MORE AND MORE INFORMATION OUT THERE FOR FOLKS TO LEARN ABOUT THIS, BECAUSE WHEN YOU HEAR ABOUT 20S AND 30S GETTING DIAGNOSED AND THEN YOU HEAR ABOUT THE SYMPTOMS, THEY’RE SO SUBTLE, RIGHT? OFTENTIMES, AND WE WERE TALKING EARLIER, I MEAN, EARLY STAGE, IT CAN BE EVEN MORE SUBTLE. YOU CAN KIND OF, YOU KNOW, WRITE THEM OFF A LOT OF TIMES, COLORECTAL CANCER DOESN’T EVEN HAVE SYMPTOMS. A LOT OF THE SYMPTOMS THAT PEOPLE TALK ABOUT WITH, YOU KNOW, THE BLOATING BLOOD IN THE STOOL, THAT COULD BE SOMETHING ELSE, HEMORRHOIDS OR SOMETHING LIKE THAT, RIGHT? A LOT OF THESE THINGS CAN HAPPEN FROM CONDITIONS OTHER THAN COLON CANCER. SO IF YOU’RE YOUNGER THAN THE GUIDELINES SCREENING AGE, YOU’RE TYPICALLY NOT PAYING ATTENTION TO THOSE. AND YOU’RE DEFINITELY NOT MAKING A CONNECTION TO POSSIBLE COLON CANCER AT THAT AGE, RIGHT? THAT’S THE THING. SO THERE’S A LOT WE DON’T KNOW ABOUT COLON CANCER. THE DATA IS STILL BEING RESEARCHED ABOUT THIS, BUT WE DO KNOW THAT THERE ARE SOME RISK FACTORS INVOLVED. WE WE TALKED ABOUT IT THERE IN THE STORY WHERE IT’S PROCESSED FOODS BEING A BIG ONE HERE. WHAT ELSE SHOULD WE BE AWARE OF AND WHAT ARE YOU SEEING IN THE DATA? WELL, FROM A RISK FACTOR PERSPECTIVE, FIRST, THINK ABOUT THINGS LIKE SMOKING. THINK ABOUT THINGS LIKE SEDENTARY LIFESTYLES. THINK ABOUT COMORBIDITIES LIKE OBESITY AND DIABETES, WHICH ARE ALSO AT HIGH LEVELS. ALL OF THOSE CONTRIBUTE TO RISK. I WILL SAY THIS BEFORE I FORGET TO SAY IT, THE ONE THING THAT I THINK CONTRIBUTES THE RISK AS MUCH AS ANYTHING ELSE IS NOT GETTING SCREENED. IT’S NOT NOT GETTING SCREENED IS A RISK FACTOR. SO PEOPLE SHOULD BE THINKING ABOUT THIS AGAIN, IF YOU’RE TURNING 45, HAVE THAT CONVERSATION WITH YOUR DOCTOR ABOUT IT SO THAT WHEN THE AGE COMES, YOU’RE READY TO DO IT. THE OTHER THING, AND I DON’T KNOW WHAT WAS THE CASE FOR THE PERSON THAT YOU THAT YOU INTERVIEWED EARLIER, BUT NOW WE HAVE SOME REALLY GOOD NON COLONOSCOPY OPTIONS THAT PEOPLE CAN USE. IF THEY DON’T KNOW THAT THEY’RE HIGH RISK OR IF THEY DON’T KNOW WHAT THEIR RISK LEVEL IS AT ALL. IF YOU’RE AT HIGHER RISK AND YOU KNOW IT, YOU’RE GOING TO GO STRAIGHT TO COLONOSCOPY, RIGHT? BUT IF YOU DON’T KNOW THAT OR IF YOU THINK YOU’RE NOT, YOU CAN USE SOME OF THOSE STOOL BASED TESTS THAT DOCTOR WAS TALKING ABOUT. YEAH, ABSOLUTELY. SO, YOU KNOW, FOR FOLKS WHO ARE WATCHING AND THEY’RE LIKE, OKAY, MAYBE I SHOULD GET SCREENED. HOW SHOULD THEY GO ABOUT DOING SO? AND, YOU KNOW, SHOULD THEY, IF THEY DON’T HAVE A PRIMARY CARE PRIMARY CARE, FOR INSTANCE, WHAT SHOULD THEY DO? RIGHT? IF YOU DON’T HAVE A PRIMARY CARE DOCTOR, YOU NEED TO GET ONE. IF YOU GO TO SHAMELESS PLUG BOSTON.GOV/CANCER, YOU’LL GET RESOURCES TO WHAT WE CALL OUR MAYOR’S HEALTH LINE THAT CAN HELP PEOPLE THAT ARE ELIGIBLE FOR, FOR MEDICAID. SIGN UP FOR THAT, GET ASSIGNED A DOCTOR AND THEN THAT DOCTOR OR STAFF CAN HAVE A CONVERSATION WITH YOU ABOUT THE SCREENING OPTIONS, WHETHER YOU’RE RIGHT FOR A COLONOSCOPY OR A STOOL BASED TEST, IF AVAILABLE, YOU WANT TO WORK WITH SOMEONE THAT’S CALLED A PATIENT NAVIGATOR, THEY’LL HELP YOU SET UP THE APPOINTMENT. THEY’LL MAKE SURE YOU KEEP THE APPOINTMENT. AND THE THING THAT WE ALSO WANT PEOPLE TO DO IS TO ADHERE TO WHATEVER THE FOLLOW UP IS BASED ON THE RESULTS OF THAT FIRST TEST. IF YOU HAVE A STOOL BASED TEST WITH AN ABNORMAL RESULT, THE DIAGNOSTIC PORTION OF THAT IS THE COLONOSCOPY. IF YOU HAVE A COLONOSCOPY AND IT’S CLEAN, THEY’LL TELL YOU THE INTERVALS BASED ON WHATEVER THE RESULTS WERE. SO THERE’S A LOT OF DIFFERENT OPTIONS. ABSOLUTELY. MARK KENNEDY, WE REALLY APPRECIATE YOU BEING HERE AND FOR THE WORK THAT YOU’RE DOING IN THE CITY. THANK YOU SO MUCH. THANK YOU FOR SHINING A LIGHT ON THIS TOPIC. VERY IMPORTANT. ABSOLUTELY. ALL RIGHT. STILL AHEAD, ADDRESSING HEALTH DISPARITIES IN YOUR NEIGHBORHOOD, HOW A COMMUNITY IS COMING TOGETHER TO TRY AND OPEN A HEALTH CENTER.