Why are We Seeing So Much Colorectal Cancer?!? Discussion with Dr Erin King-Mullins

Transcript

0:00

Bozeman as King T'Challa transformed Hollywood for many black Americans offering representation long overdue accomplishing so much in just a few short years, all while waging a personal and private battle. A statement on Instagram revealing the star just 43 had undergone treatment for colon cancer since 2016, making movies during and between countless surgeries and chemotherapy. News of Boseman's untimely death stunning the world. Denzel Washington, who helped pay for Boseman to study acting at the British Academy of Dramatic Acting in Oxford, saying he was a gentle soul and a brilliant artist. to be young, gifted and black. We all know what it's like To be told that there is not a place for you to be featured, we could create a world that exemplified a world that we wanted to see

Chris: 0:54

Welcome to pulse check, Wisconsin.

1:36

Good morning. Good evening. Good afternoon. This is Dr. Ford Pulse Check, Wisconsin. And I wanted to thank you for joining us We have a good episode here for you today. As you heard from the intro today, we're going to be discussing a topic that is on the minds of a lot of folks right now, which is colorectal cancer. As we've seen, at least in recent years, we've seen an increase in the rates of colorectal cancer. We've seen it more readily in the media. We've seen celebrities, James Van Der Beek, Chadwick Boseman, who have been either diagnosed or have died secondary to colorectal cancer. And so it's something that we need to take a look at and something that I continue to get fan questions about, uh, what is their risk, who should get screened, things of that nature. And so, um, um, I thought it would be good to go directly to the source and have one of our experts on the topic really speak out and to give us some pointers and give us some tips about it. So today we have with us Dr. Erin King Mullins, who is a board certified colorectal surgeon in Georgia. Dr. King Mullins has a couple of different resources that are available. She's an author. She has her own website. She has her own organization, which is focused on increasing awareness about colorectal cancer and about colorectal cancer screening as well. So with that being said, we are very fortunate to have her with us and hope you enjoy this interview.

Chris: 3:27

right. All right. We're going to get started again. Uh, Dr King Mullins I appreciate you coming out and speaking with us on this topic. Again, we've got a lot of, Uh, fan questions about it and we just more so wanted to dig a little bit more into it and I gave an intro for you at the beginning of this episode, but if you could, could you share a little bit, about yourself and who you are and then about your journey into medicine?

Erin: 3:48

Sure. Thanks for having me. Um, always a pleasure to enlighten anyone on colorectal cancer and the risks and just, colon health in general, because there's so many myths out there and so many things that we understand stood about it has changed over time. So we just gotta, you know, keep our ear to the ground. So I'm a colorectal surgeon. I've been in practice for almost 10 years now. I, you know, when I first went into medicine. So I knew since I was about 12 that I wanted to be a doctor. I didn't have some big, like, aha moment or some, like, crazy, scary medical situation with myself or my family member. It was just kind of I knew it. And so I was privileged to have my older sister, who's about 11, 12 years older than me, she actually pursued medicine. And so I kind of was able to see that trajectory. So people were like, you know, did she inspire you? And I'm like, yeah, it was weird though. Cause I kind of knew before she went to medical school that I wanted to be a physician, but I was able to actually, you know, kind of mirror her footsteps. Once she was there. And then kind of after all of that, just going through the process and you know, really not fraying from that, just going straight through high school, you know, college, mid school, residency and all of that stuff. My solidification on what I wanted to specialize in really just didn't, Come until time and experience to figure out what I liked and I didn't like. Yeah.

Chris: 5:10

Yeah. And, and, you know, you bring up a good point there too, especially being able to see it and, and kind of walk those steps that your sister did too. We, we had another discussion on with actually a few other physicians that came on too, and it's the, the idea comes up over and over again of, you know, you can't be what you can't see and what you can't perceive yourself in those, in those roles. And so it's really good that. You had that experience and that you had, someone who also is in that, in that Avenue and you're able to see the educational steps as well as the training so we, we brought it up at the very beginning. I believe it was season one that we talked about one of the potential topics that we were going to discuss. And the reason being is, We're seeing a lot of social and health disparities associated around colorectal health, especially in the, in the common area right now, we're seeing, you know, these rates of colorectal cancer being diagnosed, you know, unfortunately, in some cases in late stages, what. What unique challenges do you think, you know, African American patients face when it comes to colorectal health and just colorectal health in general for all demographics?

Erin: 6:10

So I think a lot of just kind of what we understand about disparities in general with underrepresented populations in this country a lot of the disparities in colorectal health can just mirror that. Those who are from lower socioeconomic classes, uh, may have decreased access to certain screening and care. Um, but it's interesting, you know, the studies have actually shown that if you Mitigate all of the disparities and just look at person to person. There's no real disparity in the overall outcomes of colorectal cancer, the ability to get screened, the willingness to get screened. So there's something that's going on along the way that that's causing this to happen. And time will tell as we're able to perform more research. What is the key factor? We just talked about if you can't see it, you can't be it. And again, the studies show that when you have a concordance of the gender, race, ethnicity of patient and provider, there's a better relationship there. And the patient is much more likely to have better outcomes and to adhere to recommendations. And then also outside of that, you know, when they did some research, they found out the number one. Reason that people don't get screened is actually not being told they have to be screened And so again, so there's so many levels and layers to all of this. Um that that that plays a role

Chris: 7:41

Yeah, and you know, you brought up a good point because you know, it's not just in african american communities, too, right? We're seeing in the hispanic communities as well You know, there was a study that came out, I think it was about like 2020, I'm sorry, 2013 or so, where they saw that, you know, minority populations had a rate anywhere from like 15 percent to 26 percent higher, being diagnosed with colorectal cancer. But like you said, some of that is, how much exposure that you have to primary care physicians, how close that, that, that treatment is and even being aware that you're at risk for it is a whole different perspective, right? Like knowing that you should be screened and what those risk factors are. Yeah. And so in 2020, so this is the one, this is the question that I get the most. So in 2020, we were all devastated by the loss of Chadwick Boseman. You know, we all know him from his roles, various roles, right? So, um, yeah, the most notable one for most is, you know, King T'Challa and Black Panther that put colorectal cancer, back on the map for a lot of us because he was so young when he, when he died of it, he was still in his forties. Um, and at that point in time, you know, the, the cancer had progressed to the point where, it was, it was, it was unfortunately terminal. Why are we seeing in your estimation, why are we seeing such a higher rate of colorectal cancers and being more severe in these cases now on young, younger demographics than we've seen before?

Erin: 9:00

So I'm actually going to start out with, um, uh, a stat that is, that's current by the year 2030. Now that sounds like some futuristic date, right? Five years from now, by 2030, colorectal cancer is going to be the number one cancer killer in patients or persons under the age of 50. Okay. Um, and Again, this is something that it's complex. You know, when I refer to Chadwick Boseman, I tend to tell people. So he was actually diagnosed when he was 38. Okay. He underwent a surgery, had treatment and all of those things. And, um, I'm not sure if he, you know, had, um, if he went into remission and it came back or whatever kind of progressed to him to get to that point, but he was originally diagnosed at 38. 38. Now, what we don't know is was he having symptoms for a period of time that either he ignored or that he reported to a provider that that got ignored? Don't know. Or was he at increased risk for some other reason? Was there a family history of Uh, of a hereditary, um, factor or colorectal cancer that either he didn't know about or, or, you know, you know, didn't pursue screening early. So there's so many things to potentially consider that we don't know. But what we do know is he was 38. He was young. And so across the board, you know, um, we're learning about all of the environmental challenges, um, the microplastics, the, the GMO and processed foods and steroids and food and pesticides and food, um, you know, the relative, uh, when you look at the overall level of activity of most, persons these days, I'm so used to train to say patients, but the, the activity levels that we all have right now are much lower than, our ancestors, our BMIs, right? The baseline body mass and all of those things that the ideal body weight is shifted. So there's so many of those things. It's hard to trigger what the exact, um, and there is probably not going to be one exact, like smoking gun that we're going to find, but all of those Things play a role. And what that does is feed into how we have to then screen your family and, and, and talk and family children, you know, earlier and more frequently once this age and your family keeps getting lower and lower. And then the one key thing that I really want to hit on as well is everybody talks about whether or not they had a family history of colorectal cancer. But you also have to talk about if there's a family history of. Polyps because polyps are a pre cancer, right? That's what eventually grows and turns into cancer. So when you get a colonoscopy, yeah, you may have a polyp. Your family member may have had a polyp that was removed that was benign, but they need to know about it because again, that's a pre cancer. So that also increases risk.

Chris: 12:00

And that's, you know, that brings up a good point too. Just how important that history is. We're taught in medical education. We're taught in medical school as well. that the history is the most important thing that you can obtain. Not labs, not tests, not, you know, whatever. Right. Um, but actually having that context, especially in the cases of things like cancers, right. Colon cancer, breast cancer, you know, you name it. having that family history and knowing your quote unquote genetic history as well, things that you're predisposed to, um, you know, what effect that will have on you and what effect that'll have on your, your workup and the way that your doctor is looking at your case or even your symptoms is, is paramount. And a lot of that too is loss, right? So if you think about it, especially as we are nearing in more and more states that we're seeing now, we're trying to expand the access of care, especially in primary care. You know, I can tell you for a fact. that my grandmother, you know, Oh, my father said, I didn't go to the doctor all the time. Right. And, and, you know, I can tell you many people, you know, probably you have family members like that too. And so, a lot of the things could be risk factors that we don't know about. Uh, and even if we had that information that we couldn't tell, our physicians about too. And so those are all the things that, you know, we need to consider when we're looking at all these parameters that could be extraneous, factors playing into why these colorectal cancer rates are going up so high.

Erin: 13:20

Yeah. And it's key to, you know, as you said, as one of those primary providers, right, that sees a more longitudinal, um, developmental pattern with your patients and just kind of all the baseline. When you go, I tell patients, like, when you go and have your annual visits or you go see a specialist and this and that, like, You need to be updating your primary care physician on new findings, not only for yourself, but also in the family, right? Because that impact of you all of a sudden you're fine, you're trucking along. And then all of a sudden, Hey, yeah, last year my mom did go and have some, um, have a colonoscopy and she had several polyps removed. So now that's going to change my index of suspicion on certain things. If you come to me next year or the year after with certain complaints or symptoms, my ears might be in tuned or peaked or may think you need more aggressive evaluation of those symptoms because now you are in a higher risk category than if you would have been at steady state, no family history, no nothing, you know? So again, it's also important to update your family history with your different doctors.

Chris: 14:26

Right. Absolutely. One of the questions that came in specifically was having to do about biological, uh, the biology of the patient or genetic factors. Are there any, intrinsic biological or genetic factors that disproportionately affect minority communities, African American, Hispanic communities with colon cancer that, that you're aware of?

Erin: 14:46

So not that we're immediately aware of, um, and one of the things is just because as we know, um, African Americans are less likely to be represented in scientific studies. And so a lot of the different, data banks, you know, when you hear about the Lynch syndrome or the HMPCC and all of those types of things, you know, typically, underrepresented populations. And so African American, Native American, you know, um, Latin American, um, Patients will be underrepresented in those studies and those data banks. So it's hard to, at this point, distinguish a true genetic or hereditary link, or is it more of what we call is epigenetic and environmental, you know, type due to diabetes tends to run in families, not because. Mostly genetics, but because they tend to have the same dietary habits and, and, and physical, um, uh, activity or lack thereof. And so right now those are gonna be the most, contributing factors that we know of for sure. And hopefully over time as we get increase the numbers and of the biogenetics of cancers and tumors and polyps, we can then truly look back and see, you know, is there truly a genetic leak or is it just mostly, um, epigenetic or environmental?

Chris: 15:57

Absolutely. And I'll link, you know, for our listeners, cause some of our listeners are medical, some are not. And I'll link some of that information just kind of getting into, you know, polyps versus primary cancers and things like that too, in case you guys want to do a deep dive on all of that but a couple of things that you brought up there leads us to our next point. You know, like you said, a lot of the studies that we have right now do not unfortunately include some of those populations that are most affected, right? And we had Dr. Jane Morgan come on who was a cardiologist in Atlanta as well. And she spoke to that, right, because she does a lot of these, uh, a lot of these studies and, you know, she, she, she's begging folks in some cases to, to be a part of those cardiac studies, just because a lot of the data that we have is not based on our epigenetics and it's not based on, you know, the things, the, the demographics that we commonly see represented in our populations and in our families. And so with that being said, colon cancer is often preventable and, you know, we see the things like Cologuard and things like that are covered by insurance. at age 45, right? What are some of the most effective strategies for prevention and you know, how can those be better communicated or made better available, uh, to those communities most affected

Erin: 17:03

so the number one, um, single piece of power that you have is the power of conversation. Okay, so to talk to your providers, um, talk to your family members, your kids, like everybody, just understand, you know, who had what and when. And sometimes it's not as simple as who had colon cancer or who had polyps, but if you start seeing a pattern of different cancers, so, you know, a smattering of people had breast cancer and then somebody had pancreatic cancer and then somebody had prostate cancer, that's another potential genetic link that might increase your risk of colon cancer. of colorectal cancer. So number one, just having those conversations before you even worry about involving doctors and procedures and doing all of that. Um, also there's a difference between, we have to understand the difference between screening and diagnostic. So screening means that, you know, you've reached a certain level of risk where we need to start looking. You're not having any symptoms, there's no problems. So the average risk individual, the recommended age for screening is now 45. The age decreases with certain, um, family history or personal history. If someone has inflammatory bowel disease or Crohn's disease, ulcerative colitis, again, family history of different cancers of colorectal cancer or polyps, um, screening may need to occur earlier. Now, that's different than diagnostic, meaning if someone presents with symptoms, so a change in their bowels, abdominal pain, uh, bleeding, um, from the rectum or blood mixed in the bowel movements, that's a diagnostic examination. And so that's a different reason to go look. So a colonoscopy is considered to be both a screening and diagnostic tool and a therapeutic tool. If you see something, sometimes you can do something about it right then and there. You see the polyp, you remove it and preventing it from growing and turning into cancer. So you've diagnosed a pre cancer, you've screened for colorectal cancer, but you've provided a therapy all in one fell swoop. Some of the other what we call our non invasive testing, like the, um, the, the stool based exam. So people may see the brand name Cologuard quite a bit. Um, there's different testing for microscopic blood and the bowel movements. Again, those are all screening examinations and not everybody is a candidate. for those. So anybody with any increased risk. So family history, they're automatically not a candidate for those things because it's not quite as sensitive or specific to really pick that up. Um, and then also if they have symptoms, it's not advised to do it because there can be a false positive or a false negative. It's not going to diagnose the changes in your bowels, right? Um, and then the last thing, uh, and I hope this doesn't just get me booed off the stage, but The non invasive tests that are frequently advertised, um, or discussed or preferred sometimes by patients, you have to understand the risks of using that examination and testing. Knowing if it's the most accurate examination for you. So we talked about African Americans not being as represented in research studies. And so some of the studies for some of these stool based examinations did not have. Fully adequate numbers of African Americans in them to say that the sensitivity, specificity, accuracy, all of those different statistical words you want to talk about, is as good in the African American population as in the general population. So it's better than nothing. Yeah, if, if number one, you can't get anybody to do anything else or doing a colonoscopy is an investment. So not only do you have to take off work for that day, someone else may have to take off work that day. You need a driver, you know, there's so many things that go into it. So if you cannot get the gold standard examination, the colonoscopy, I'd rather you get something, but understand what you're getting out of that test and what it means.

Chris: 21:08

And that's key too, especially, you know, I, I won't go on my tangent about some of the, you know, the, the financial aspect of medicine and the financial aspect of some of these kits and medications and et cetera, et cetera, we can go on for days and days. But as you start to see more of the commercialization of these tools, like you said, it's, it's really, You know, it's hidden in there, like who that actually applies to, right? And you know, what those studies are based of. And even when they're talking about even those bullet points, 90 percent specific, the sensitive, I should say, uh, specificity X, Y, and Z, what demographics that actually includes and what demographics that does not include. Right. Um, and so those are things that you and I read those studies. Studies knowing, because we went through the training and we know how to do it now, but that, that's key. I feel like that's a key point for everyone to know. Who's listening to this too? You know, what, what those numbers actually mean and you know, all the things that you see, uh, coming up with a Super Bowl or a national championship on those commercials that may not be, you know, what you expect'em to be.

Erin: 22:07

Yep. Yep. Yep. Yep.

Chris: 22:09

So screening is key to prevention, like you said, and you know, whatever folks are willing to, to, to do. I can tell you, I've had many a discussion and many of, uh, you know, uh, of a fight with folks and trying to get them to get the colonoscopies, both patients, friends, you know, family members at the barbershop, et cetera, et cetera. Right. So what advice do you have for individuals who may feel hesitant or fearful about the colonoscopy? How would you approach them?

Erin: 22:35

Well, oftentimes, you know, the stories that people always want to tell bad stories. Okay. How many people come to you and say, Oh, I had my colonoscopy and it was the best experience ever. like reading those restaurant reviews online, right? Y'all always got to add one or two points more because if people just had a normal, traditional regular, I showed up at the restaurant, they ordered their food, they enjoyed it and they went home. They're probably not going to necessarily a writer review if they didn't have a glowing experience and the overwhelming majority of people who had a bad experience are going to go. On and talk about that. So you have to understand that. So that's what I advise folks too. And then sometimes you just have to meet people where they are, like, understand what is their fear? What is their understanding? What is their hesitancy? Because there's a lot of myths that we as providers sometimes, um, have to, you know, debunk. And then especially in the folks, um, When you think about now, again, the younger and younger age, um, of diagnosis, a lot of these folks have younger and younger children, okay? We're talking about babies, toddlers, like people that they are still responsible for. It's not like the 70, 80 year old grandma who have their children who can actually help them in the process. We're talking about this sandwich generation, and some of these folks may have to care for their parents, and now they're also caring for littles too. And so What I usually say that really gets them. I'm like, okay, do you have kids or, you know, you have a loved one, a spouse or anything? They're like, yeah, I'm like, okay. Um, you love them. Yeah, of course you do anything for them. You know, you, you jump in front of a train, a bullet. Oh yeah, yeah, yeah. So why don't you live for them? If you're willing to die for them, let's make sure you live for them. Don't put them through a tragedy that they don't have to experience. But also again, what impacts you impacts them. If you have something bad going on inside, like. Wouldn't you want to be able to protect your kids so that they don't have to live through the same battle that you go through? Um, you know, and a lot of times, and then people are like, Oh, you know, you got to die or something. Colorectal cancer is not a fun way out.

Chris: 24:38

That's the one you want to do the way you want to go.

Erin: 24:41

It's, it's, it's, it's not like, Oh, I had a heart attack or a stroke and I'm just out and it didn't feel anything. Okay. And so those, those are the, so you got to come up with your tactics to figure out like who, how you're going to hit that person that just. for whatever reason.

Chris: 24:57

And that's the thing you're, like you said, you, you, you have to live for your family members, right? This is something that not only physically is going to affect you down the way for, in some cases, long periods of time. I'm sure Dr. King Mullins and I both have seen patients for a number of years who have had complications associated with colorectal cancer complications associated with some of the surgeries when, you know, some of those things could have been prevented early on. And. You know, not only that physical effect, but also the financial burden on patients too, as we're starting to see in the media more and more, some of these insurance issues that folks are having, you know, it's going to affect you in every aspect of your life. And so, that, that's the thing you got to consider when you're thinking about some of the, any aspect of your health, not even colorectal cancer, but any aspect of your health. So we're trying to get people, to, to, to get access to primary care doctors, to get access to their medications, because you know, this, the old ounce of prevention, right? This is, these are things that we're trying to prevent to prevent you from having, you know, that, that morbidity and mortality down the road too.

Erin: 25:55

And again, just like kind of hitting back on when you think about the concept of the younger and younger generation being affected, you know, a lot of these are primary breadwinners for their family. So it's not like folks that are older in that near retirement age and they had a. And or a 401k that they building on forever. So if they need to kind of slow roll into retirement now, um, and you need another caregiver, a lot of times to help you with that process. So if you're 45 and being diagnosed with stage three colorectal cancer, now you can't go to work and your spouse or some other loved one can't go to work either. So it's a double. triple hit on the pocket of, you know, the losing earning potentially from more than one person. And the financial impact of now you have to pay to cover all of, you know, these medicines and insurance. So it's, it's so, it's so much different to just go in and get your covered free screening, colonoscopy, screening examination. To ward off all of those evil spirits. Absolutely.

Chris: 26:53

Absolutely. So here's a question from, from, from one of my good friends on our text thread here. So one of the things that he asked was, so we all are below the age of 45 right now. We are not in the cohort that would qualify for any of these home testings or things like that. Even the colonoscopy based on our risk factors. What recommendations would you have for someone who is in the minority community as we're seeing these incidences of colon cancer, colon cancer. Is this something that they should consider paying out of pocket for for colon screening should just watch out for symptoms. What are some of the things with some of the recommendations you would give as a colorectal surgeon?

Erin: 27:29

So the first thing is make sure you're actually in that low risk category, right? So go back and have them. So go back and have that conversation. Ask your, your mama, everybody, whoever it's like, don't just say specifically like whoever, just like, what did people die of? How old were they when they died of it? You know? So all of those things. So, and be explicit like, mama, did you have your colonoscopy? You said it was fine. What does that mean? Did you have a. Polyp that was removed. They again, may have told you that polyp was quote unquote fine. That doesn't mean that it wasn't a pre cancer. So we're

Chris: 28:01

good at doing that. Oh, everything was fine.

Erin: 28:04

Exactly. Exactly. So get all in the business. That's the number one. So number one, make sure you are in that low risk category. And then if you are, um, you know, I can't advise you one way or the other, you know, outside of that, you know, really, um, there, you may have access in your area if you're really, really concerned. Um, you know, if you, you may be in an area that has some kind of pretty low cost access to some, examination, colonoscopy or whatnot. Um, and so I'm just going to leave that to you and your family to make that decision on how concerned you are. But yeah, but also don't. ignore symptoms. And the thing is, symptoms for colorectal cancer are very, what we call, are non specific. So there's not going to be a smoking gun. Um, so changes in your bowels that are persistent, naive. If you ate the nachos last night, like most of us are lactose intolerant. Most of

Chris: 29:00

us need to take that lactate.

Erin: 29:02

So, you know, within, within reason, like a persistent change in the bowels that can't be explained by a recent illness or change in medicine or change in diet, you know, rectal pain, bleeding, you know, any other just kind of prolonged constellation of. Things outside of your norm, not saying you have colorectal cancer, not saying you have pancreatic cancer or anything else, but go talk to your physician and number in the, and that again brings back the importance of a primary care physician. I, and I, I get on my soapbox in my office, you know, I understand I'm a colorectal surgeon, but I ask people all the time, who's your primary care doctor? Cause you showing up to me saying you saw rectal bleeding and I'm like, who's your primary? I'm like, I don't have one. I'm just like, I'm your first line of defense. I'm like, no, I should not be your first line of defense. Because, you know, so if you're seeing your primary care doctor, they know your labs every year, um, your general disposition, your general complaints. So if you show up outside the norm, they're like, wait, wait, wait, no, no, no, they're more of an advocate. They're not, you know, they're not going to, Brush you off. They know you, they know your body. Or, you know, you've been getting labs all this long and all of a sudden you're saying you see bleeding and I check your labs and your labs have been hemoglobin 15 this whole time. And now it's nine. Wait a minute. I have a track record. I know this is abnormal for you, but if you only showing up when you have symptoms, nobody knows.

Chris: 30:29

Absolutely. Thank you for that. And so this is, this is a, the last question here because this isn't just came in not too long ago. Okay. What role, and this is from someone who is on the nutritionist end too, what role does diet and lifestyle play in reducing colon cancer risk? And are there any specific recommendations that you have for the communities most affected by?

Erin: 30:51

Yep. So, uh, my easiest punchline is what's good for the heart is good for the good. It's good for the butt. Right. So, you know, I'm going to steal

Chris: 31:00

that.

Erin: 31:02

But it's true, right? Um, so, you know, the same thing that I would tell anybody who's trying to get right from a cardiovascular standpoint, from obesity, from a diabetes standpoint, it's all of those things that are leading to, you know, toxicity, inflammation, you know, dis ease within your body. So you got to eat a diet, you eat all the colors of the rainbow. Okay. Um, you need to eat off of the periphery of the grocery store, going up and down the aisles will predispose you to packages with. All these extra sugars and ingredients and preservatives and all that stuff. So eating whole foods, high in grains, um, you know, and then exercise. So obesity is linked to increased rates of colorectal cancer, but even separately, just lack of exercise, right? There's. The blood has to flow to the gut for you to digest and be healthy. And so the less you move, the less blood flow, the less oxygen and nutrients are delivered to the gut as well, to the colon as well. So no smoking, you know, alcohol in, you know, minimal to none. Um, I'm not even going to say moderation. I'm going to say minimal to none. You know, avoiding red meat again, not saying never, ever, but that shouldn't be your consistent diet. And so you're going to stick with the fruits, the veggies, the whole grains. Um, and then everything else that's pleasurable, you're just going to have as needed and not as the core of, your diet.

Chris: 32:27

And, you know, like you said, moderation is, is the key, right? And so a lot of the things that taste really, really good. moderation, right? That's the thing. And unfortunately, especially as we see in a lot of our communities as well, you got a lot of these fast food places that taste really good. You got a Popeye's on every corner, right? Especially here in Milwaukee. And you know, those things over time. Are, are not going to be good for your cholesterol. It's not going to be good for your heart, your gut, or your butt. As Dr. King Mullins said, right? So this is what we, this is the reality situation and you know, it is what it is. Right. So,

Erin: 33:00

yeah.

Chris: 33:01

All right. Well, Dr. Erin King Mullins, I appreciate you coming out and speaking with us. Any closing thoughts that you have for our audience or anything you want to impart and how can they get more information, you know, on you or your specialty, et cetera.

Erin: 33:13

Sure. So, um, so my website is colo wellness.com. Um, and, you know, parting words is, can have as, have as many words as you can with your family, with your kids, and all of those types of things so people truly understand their risk. And I am gonna plug, um, I did, I, I started a book series, so two book books down. A couple more to go. Um, can find them on Amazon. So mommy, I made a boo boo, uh, talks, uh, helps with again, that younger generation who has young kids who got to start talking about this stuff with. So natural digestion, um, you know, kind of the parts of the body. You can even learn the different digestive organs. Um, book two is also available on, on Amazon. Mommy gets a colonoscopy. So walking through that process of getting that screening and then books three and four are available. So, um, mommy's brave journey, she's going to talk about her experience with colorectal cancer. Um, and it's going to be a family friendly book. So you can talk with younger kids about it. And then ultimately, um, we're going to have, um, mommy's new best friend or something. I actually haven't officially created the title, but mommy has an ostomy bag, right? So what are some of the long standing ramifications of going through these process? So appreciate the time. Um, and just letting me share with your audience.

Chris: 34:30

Absolutely. And you know, kudos to you for doing all the books. I just purchased mommy. I made a boo boo So you all go out and get that but but shout out to you and and make Making it more palatable for our communities and making it more palatable for our younger generations, too And as you said as we're starting to see this more and more, you know, more awareness is going to be the key Uh more, you know avenues for research, etc, etc So I appreciate all that you're doing and I appreciate you spending the time here with us. Dr. Aaron King Mullins I appreciate you.

Erin: 34:56

Thanks. Chris. Have a good one.

Chris: 34:58

Have a good one Alright,

Erin: 34:59

bye.

35:01

Recent information that we have from the NIH's National Cancer Institute Surveillance Epidemiology and End Results Program demonstrates that approximately 4% of men and women will be diagnosed with colorectal cancer. at some point in their lifetime. And that's based on the data from 2018 to 2021. And with that being said, 2020, the information is a bit off due to COVID 19. As of 2021, over 1. 3 million people living with colorectal cancer in the United States. So this is something that is going to affect a lot of folks in our generation, a lot of folks to, in generations to come as well. And so as Dr. King Mullins had spoken to in our interview, there's a lot of things that you need to have in the back of your mind when you are considering what is your risk for colorectal cancer. As we discussed having adequate and accurate family history is going to be key. And with that being said, a lot of that's going to call back to some of the things that we've talked about on this show before and other episodes, having access to that family history, having access to primary care doctors, making sure that your family members do too, because your history is tightly tied to your family's history as well. Your mother's risk factors associated, your father's, your maternal, paternal grandmother, All your family members history is tied to your own. So make sure that you're having these discussions with your family members as after King, well, I spoke to make sure that you have that accurate information talking about if you go to the emergency department, if you go to your primary care doctor, Make sure your family members understand what they're being told. Make sure that they understand what the results of those test are. And if they need help, definitely give them the help. Definitely reach out to your primary doctor if you have any further questions. Or you can always reach out to us here at Pulse Check Wisconsin. We try not to give any medical advice, but we can direct you in the right direction to make sure that You're able to interpret that information and take that forward and helping to promote a healthier lifestyle. I want to thank Dr. Aaron King Mullins for joining us here today. Hopefully we'll have her on again. We're looking forward to, uh, helping her continue to build her brand, helping her continue to get the word out about colorectal cancer, about what she does as a colorectal surgeon. Um, and just enjoyed speaking with her today with that being said, I want to let you guys know, I appreciate you coming out. I appreciate you listening to us here and giving us more information, giving us questions, a lot of what you're saying, questions that you send translate into how we're going to tailor the show. I want to make sure that we're making the show as interactive as possible. Want to make sure that you all know that we are listening to you. We try to get back to everybody, uh, as soon as we get those questions. So keep them coming and, uh, you never know, your idea may end up as a show. So that being said, I want to make sure that you guys stay tuned. We got good episodes coming up here, uh, in season two, as we round out season two. So definitely keep those comments, stay tuned. And with that being said,