Podcast Summary: The Interview with Leslie Heaney – Colorectal Cancer: A Conversation feat. Dr. Andrea Surcik and Kelly Bonito
Release Date: January 15, 2025
Introduction
In the episode titled "Colorectal Cancer: A Conversation", host Leslie Heaney engages in a profound discussion with Dr. Andrea Surcik, a board-certified medical oncologist from Memorial Sloan Kettering Cancer Center (MSK), and Kelly Bonito, a survivor of colorectal cancer. The conversation delves deep into the alarming rise of early-onset colorectal cancer, exploring its causes, prevention, and innovative treatment options that offer hope beyond traditional methods.
Rising Trends in Early-Onset Colorectal Cancer
Dr. Surcik sets the stage by highlighting the disturbing increase in colorectal cancer diagnoses among younger populations.
"It's estimated that about 150,000 individuals will be diagnosed with colorectal cancer this year, and that about 52,000 will die of the disease. What's even more striking is that the rates of young individuals under the age of 55 with colorectal cancer are rising. They doubled from 11% in 1995 to 20% in 2019, and this trend continues steadily for unclear reasons." (02:27)
This surge is not confined to the United States but is a global phenomenon affecting countries across Europe, Asia, Africa, and the Americas.
Kelly Bonito’s Personal Journey
Kelly Bonito shares her poignant journey, illustrating the personal impact of this rising trend.
"I was diagnosed at age 28, soon after I gave birth to my son. Initially, my symptoms like blood in my stool and constipation were dismissed by doctors as normal postpartum changes. It wasn't until persistent symptoms led me to a primary doctor who referred me for a colonoscopy that the reality of a tumor set in." (03:26 - 07:32)
Her diagnosis of stage three colorectal cancer was a life-altering moment, compounded by the challenges of being a new mother and navigating healthcare systems.
Innovative Treatment Through Clinical Trials
Kelly’s story takes a hopeful turn when she participates in a groundbreaking clinical trial led by Dr. Surcik.
"By my fourth treatment, my tumor had halfway disappeared. By my ninth treatment, it had completely disappeared. I did not have to undergo chemotherapy, radiation, or surgery." (09:36 - 12:06)
Dr. Surcik explains the significance of this trial:
"Kelly was eligible because her tumor had a mutation called mismatch repair deficiency. This made her tumor particularly sensitive to immunotherapy. The trial aimed to treat the tumor with immunotherapy alone, avoiding the traditional regimen of chemo, radiation, and surgery." (12:30 - 15:24)
This approach not only spares patients from the debilitating side effects of standard treatments but also preserves essential functions and quality of life.
Understanding Risk Factors and Potential Causes
The conversation shifts to exploring why younger generations are increasingly affected by colorectal cancer.
"We believe that this is something environmental, but what it is, no one knows. Areas under investigation include sedentary lifestyles, environmental exposures like microplastics, hormonal changes in diets, antibiotic use affecting the microbiome, and more." (19:15 - 20:09)
Interestingly, traditional risk factors such as obesity, high red meat consumption, smoking, and alcohol don't fully explain the rise in younger, otherwise healthy individuals like Kelly.
"When we look at our young patients, they were never obese, they were active. It just doesn't fit any of those risk factors." (23:15 - 24:04)
Screening and Prevention Strategies
Dr. Surcik emphasizes the importance of early detection through proper screening.
"Colonoscopy is the gold standard because it enables visualization, early diagnosis, and intervention by removing polyps before they turn cancerous." (38:15 - 39:53)
With the American Cancer Society lowering the recommended screening age from 50 to 45, Dr. Surcik advocates for increased awareness and adherence to these guidelines to catch the disease early.
"The first colonoscopy should be at 45 unless there's a genetic predisposition or family history, in which case it may be younger." (40:55)
Support Systems and the Young Onset Center
The Young Onset Center for Colorectal and Gastrointestinal Cancers at MSK plays a pivotal role in supporting patients.
"We provide physical support with fertility, sexual health, integrative medicine, nutrition, and social and psychological support to help patients navigate treatment and survivorship." (28:48 - 33:04)
This center is the first of its kind globally and serves as a model for similar initiatives, offering comprehensive care tailored to the unique needs of younger cancer patients.
Ongoing Research and Future Directions
Dr. Surcik outlines the current and future research efforts aimed at understanding and combating early-onset colorectal cancer.
"We are optimizing biomarker-directed approaches, exploring HER2 mutations in colorectal cancer, and expanding immunotherapy trials to patients without mismatch repair deficiencies. Our goal is to make these innovative treatments widely available and continue to uncover the underlying causes of this rising trend." (50:50 - 55:48)
The collaboration with organizations like The Society is crucial in funding and advancing this research, enabling the development of less invasive and more effective treatments.
Kelly’s Hopeful Future
Kelly concludes the episode with an inspiring account of her recovery and her aspirations to build a family.
"After undergoing treatment, I was told I could have another baby. Those two years were vital for me to process what I had gone through. Now, I have a healthy daughter and am pregnant with my third child." (47:56 - 49:39)
Her story serves as a testament to the effectiveness of the new treatment protocols and the support provided by MSK’s Young Onset Center.
Conclusion
Leslie Heaney wraps up the episode by acknowledging the remarkable work of Dr. Surcik and the resilience of survivors like Kelly Bonito. The discussion underscores the urgent need for increased awareness, early screening, and continued research to address the rising incidence of colorectal cancer among younger populations.
Key Takeaways
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Rising Incidence: Early-onset colorectal cancer is increasing globally, affecting younger generations without traditional risk factors.
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Innovative Treatments: Clinical trials leveraging immunotherapy show promise in treating colorectal cancer without the harsh side effects of standard treatments.
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Importance of Screening: Adhering to updated screening guidelines (starting at age 45) is crucial for early detection and prevention.
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Comprehensive Support: Dedicated centers like MSK’s Young Onset Center provide essential support tailored to the unique needs of younger cancer patients.
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Ongoing Research: Continued research is vital to uncover the causes of this rise and to develop effective, less invasive treatments.
Notable Quotes
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Dr. Andrea Surcik on Rising Rates:
"It's estimated that about 150,000 individuals will be diagnosed with colorectal cancer this year, and that about 52,000 will die of the disease." (02:27)
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Kelly Bonito on Her Treatment Journey:
"By my fourth treatment, my tumor had halfway disappeared. By my ninth treatment, it had completely disappeared." (09:36)
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Dr. Surcik on Environmental Factors:
"We believe that this is something environmental, but what it is, no one knows." (19:15)
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Dr. Surcik on Screening:
"Colonoscopy is the gold standard because it enables visualization, early diagnosis, and intervention by removing polyps before they turn cancerous." (38:15)
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Kelly Bonito on Recovery:
"Those two years were vital for me to process what I had gone through. Now, I have a healthy daughter and am pregnant with my third child." (47:56)
Final Thoughts
This episode of The Interview with Leslie Heaney provides an insightful exploration into the challenges and advancements in combating early-onset colorectal cancer. Through expert insights and personal narratives, listeners gain a comprehensive understanding of the current landscape, hopeful innovations, and the critical importance of early detection and support systems in the fight against this devastating disease.