From Florida Hospital Apopka
Envision spreading out a 10,000-piece jigsaw puzzle on the table. Pieces upon pieces are scattered. Looking at the complete image on the front of the puzzle box, you know that each piece somehow connects. You start by taking the most obvious ones first — the outer edges. Then, slowly begin filling it in until the bigger picture comes to life.
While not as simple as a jigsaw puzzle, medical science can be thought of in the same way. Our bodies — made up of trillions of cells and complex systems — make up the beautiful masterpiece that we call “health.” But this work of art —and our understanding of it — is constantly evolving to present new challenges. And with time and insight, today’s medical breakthroughs will shape an improved image of your health, tomorrow.
You see, uncovering the relationships between diseases inspires our hope to prevent them. And today, we’re talking about an important one: the connection between heart disease and colon cancer risks.
“We’re finding that cardiovascular disease and colon cancer (among many other types of cancer and diseases) share similar — yet prevalent — risk factors that are linked to metabolic syndrome,” says Dr. Maryam Kashi, board-certified gastroenterologist and internal medicine physician at Florida Hospital.
“A metabolic syndrome is a group of risk factors/conditions that, together, significantly raise the risk of heart disease, stroke, diabetes and even colon and liver cancers,” Dr. Kashi explains.
According to the American Heart Association, metabolic syndrome is generally distinguished by having three of these five metabolic risk factors:
Abdominal obesity or a waist circumference of greater than 40 inches in men and 35 inches in women
Maryam R Kashi, DOGastroenterology Internal Medicine
Triglyceride level of 150 mg/dL or greater
HDL cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women
Systolic blood pressure (top number) of 130 mm Hg or greater, or diastolic blood pressure (bottom number) of 85 mm Hg or greater
Fasting glucose of 100 mg/dL or greater
It is not surprising that the underlying causes of metabolic syndrome are also risk factors for both colon cancer and heart diseases, such as overweight and obesity, physical inactivity, genetic factors and aging.
As reported in 2015 article published in the Journal of the American Medical Association, metabolic syndrome affects nearly 35 percent of U.S. adults. And as the number of people with metabolic syndrome increases, there is concern that the already high incidences of colon cancer and heart disease could climb even higher.
“Metabolic syndrome is associated with both a higher rate of heart disease and colon cancer risk; however, with metabolic syndrome, the most critical risk associated with morbidity (death) is heart disease,” explains Dr. Kashi.
This is concerning because the American Heart Association reports that over 92 million American adults are already living with some form of cardiovascular disease or the after-effects of stroke, with heart disease accounting for one in every three U.S. deaths. Colon cancer, making up eight percent of all cancer deaths, affects over 95,000 Americans annually according to the American Cancer Society, with even higher numbers reported when including the rates of all large bowel cancers.
“When I see a patient with metabolic syndrome, I am concerned about a myriad of things because research supports that their risk factors (like obesity, high blood pressure, high cholesterol and higher fasting glucose) are strongly associated with the development of heart disease, colon cancer, and even a 20 percent increase in the risk of liver cancer and cirrhosis, but the positive thing is that most metabolic risk factors can be reduced or possibly eliminated with a multidisciplinary treatment team and a medically supervised weight loss and exercise program,” explains Dr. Kashi.
“One of the most important risk factors to address with metabolic syndrome is overweight and obesity,” advises Dr. Kashi. She explains that many people experience various challenges to achieving a healthy weight, which can be medical, environmental, psychological and economical.
For this reason, Dr. Kashi recommends a medically supervised weight-loss program that develops a personalized nutrition and exercise plan for your individual needs.
“At Florida Hospital, we have medical, endoscopic and surgical weight loss treatment options to help all patients achieve a healthier BMI,” states Dr. Kashi.
One of the non-surgical medically assisted weight-loss procedures that Dr. Kashi performs is the gastric balloon. Dr. Kashi explains that this procedure is for patients that do not qualify for more invasive surgical weight loss procedures. In fact, the gastric balloon is for patients that have a BMI (body mass index) between 30 and 40 with about 25 to 50 pounds to lose.
Dr. Kashi further describes the gastric balloon procedure, which involves inserting a balloon into the stomach through endoscopy. Once inserted, the balloon helps patients feel full so they don’t eat as much. After six months, the balloon is removed and most patients experience three times the amount of weight loss compared to diet and exercise alone. To be considered for the procedure, Dr. Kashi’s patients must also participate in a weight-loss program that provides a medically-directed nutrition and exercise plan.
“It’s important to provide our patients with all of the tools and education to make them successful in their weight loss for improved health,” she adds.
This education focuses largely on nutrition to reduce metabolic risk factors. “We recommend that patients increase their fiber intake, which has been shown to help decrease cholesterol levels and even colon cancer risk,” says Dr. Kashi.
She also suggests limiting high-calorie meals to support healthy weight, which includes minimizing red meat intake. “Some studies indicate that folate may reduce colon cancer risk as well,” she says.
Since the treatment of metabolic risk factors can involve several medical specialties, it’s important to seek treatment from a connected system of physicians that will coordinate your complete medical care. Dr. Kashi explains that endocrinologists, cardiologists, gastroenterologists and primary care physicians may play an important role in managing metabolic syndrome and your specific risks factors for colon cancer, diabetes and/or heart disease.
Medical specialists can also assess your additional risk factors like family history and recommend appropriate preventive screenings, such as colonoscopies to screen for colon cancer. Dr. Kashi asserts, “Even though research tells us metabolic syndrome is associated with increased colon cancer risk, our recommended colon cancer screening guidelines are currently influenced by age and race.”
Dr. Kashi confirms that current colon cancer screening guidelines advise that both men and women have colon cancer screenings starting at age 50, with African Americans starting at age 45. Colon cancer and its mortality rates are significantly higher among African Americans compared to Caucasians.
“The colonoscopy is still our gold standard and only cancer screening that is also preventive, because if we find polyps (which can be precancerous) during the colonoscopy, we can remove them right away and prevent cancer from developing,” Dr. Kashi says.
Understanding the link between heart disease and colon cancer is important because it’s yet another discovery that connects a few more pieces to the complete picture of your health. But there are more insights to glean.
“Research tells us there is a strong association between metabolic syndrome and many diseases, but the exact mechanisms— from having metabolic risk factors to developing heart disease or colon cancer (as just two examples) — are still unknown,” Dr. Kashi adds.
And while we wait for these details surface, we can act by being aware of metabolic syndrome and taking steps to reduce its risk factors with the hope to also prevent colon cancer, heart disease and other related diseases in the future.
Learn more about Dr. Maryam Kashi, or call 407-303-1812 to make an appointment.
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