Early detection, newer options make the difference for colorectal cancer

Credit: Family handout

Credit: Family handout

The family touched down all over the world: China, South Korea, Japan, Italy, Ireland, Croatia, Hungary, Romania, Bosnia. The travel brought them the new knowledge and memories they sought until Kris received a shocking Stage 4 colorectal cancer (CRC) diagnosis in the spring of 2021.

Types of testing

Before that point, Kris had been experiencing gurgling in his stomach. The acid reflux medication his doctor recommended didn’t improve things, and an ensuing CT scan revealed a mass in his colon and cancer on his liver.

This is the type of situation Dr. Sam Asgarian, vice president of clinical development at Guardant Health, has spent years trying help people avoid. By detecting colorectal cancer early, survival rates drastically increase.

In Georgia, CRC is the second leading cause of cancer morbidity and mortality. According to the American Cancer Society, with the exclusion of skin cancers, colorectal cancer is the third-most diagnosed cancer in the United States in men and women with nearly 60,000 deaths expected for 2025. The United States Preventative Services Task Force moved its guidelines for screening for asymptomatic individuals down to age 45 from 50 in 2021.

Those who find themselves in the window for screening have several options, including Shield - a new FDA-approved blood test. Shield can detect colorectal cancer markers in the blood, improving screening rates and allowing detection at earlier stages when they are treatable.

“Our goal is to kind of show that folks aren’t getting screened, and there are more options available now,” Asgarian said. “We know that a lot of people are ordering the test. We’ve seen a lot of great results for physicians — not just for primary care doctors, but for specialists.”

Partial sample stool-based tests like the fecal immunochemical test measure blood in stool; negative tests generally mean no testing again for a year, Asgarian said. Stool DNA tests like Cologuard require a full stool sample, and a negative result usually means no screening for three years.

Colonoscopy is usually the next step after positive results from blood and DNA-based screenings. Colonoscopy, in which providers visualize the colon with a camera, also allows for biopsies and a negative result generally means asymptomatic patients can go 10 years before another screening.

Invasiveness or inconvenience often keep people from following through on screening, but it’s worth doing says Asgarian.

The impact of a story

Kris, in his trademark positivity, kept his head up, even when he learned his mutation wasn’t curable. Elizabeth remembers him trying to lift other patients’ spirits during chemo treatments, and he worked through media outlets and social media to spread awareness about early detection.

He fought for 20 months, finally succumbing to cancer on Feb. 20, 2023, after going home on hospice care. He was 48 at the time of his diagnosis, which occurred just after the recommended age for screening dropped to 45.

Elizabeth feels his outcome would have been different if the cancer had been detected earlier. Today, she continues her late husband’s efforts in spreading awareness about screening.

“I think that we’re very fortunate that we have multiple options,” she said, adding that people have told her hearing Kris’ narrative made the difference in their decision to be screened. “I’ve had a lot of people come up to me like, ‘If I didn’t hear Chris’s story, I wouldn’t have. It just really impacted me.’”