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CTCA Oncologist Talks About Colorectal Cancer

Colorectal Cancer (CRC) is still the second leading cause of cancer deaths in the U.S. today. Despite this fact, many Americans are still putting off getting colonoscopy screenings because of the perceived invasive nature of the test.

That is why according to, there is new research that suggests less invasive at-home screening tests could potentially redefine how Americans screen for CRC in the future. Dr. Kundranda, a colorectal cancer expert and medical oncologist at Cancer Treatment Centers of America (CTCA) talked to Brandi Walker about these less invasive tests, the benefits of these tests for people who don't have the condition, and what questions a newly diagnosed patient should ask their doctor(s).

1. How effective are these less invasive at-home colonoscopy screening tests?

A screening test has to be very sensitive in order to be successful. Sensitivities for the detection of colorectal cancer, using these less invasive at-home colonoscopy screening test, are around 92 percent. This percentage has greatly improved from previous studies and also ranks much higher than the one-time use of a fecal immunochemical test (FIT) for hemoglobin which was 73.8 percent for colon cancer. (Note: Sensitivity of a test indicates the percent of time that patients who have the disease – in this case it’s colon cancer – are positive)

2. How beneficial are these new tests for people who don't have colorectal cancer?

In patients who do not have colon cancer but have advanced adenomas (that will almost always progress to colon cancer), the sensitivity is about 43 percent and in patients that have benign (non-cancerous) lesions, the sensitivity is 86.6 percent. Overall, this appears to be one of the most useful non-invasive tests that is currently available and things will continue to improve as technology advances.

3. What questions should every newly diagnosed patient ask their doctor(s)?

There are five questions that I recommend patients ask their physicians after initial diagnosis:
• What stage is my colon cancer in and is it curable?
• What chemotherapies are used to treat my colon cancer? What are the side effects?
• Are there any appropriate clinical trials that may be appropriate for me?
• Is there a nutritionist available who can be incorporated into my cancer treatment team?
• Will you be taking a multidisciplinary approach to my treatment?

4. What are the prevention factors of CRC?

Prevention strategies focus on modifying environmental and lifestyle risk factors that promote cancer.

Specific modifiable risk factors may include:
• Smoking
• Weight gain – Men who gained ≥21 kg after age 20 had a 60 percent higher risk of colorectal cancer than men who gained only 1 to 5 kg
• Diet
• High intake of red meat including beef, pork, veal and lamb is associated with an elevated risk of colorectal cancer in both men and women
• Epidemiologic studies suggest a weak association between the intake of a diet high in fruits and vegetables and protection from colorectal cancer
• Epidemiologic studies suggest a significant inverse association between fiber intake and colorectal cancer risk
• Calcium – Multiple studies have demonstrated that higher calcium intake (either dietary or supplemental) is associated with a reduced risk of colorectal cancer
• Vitamin D for prevention of colorectal cancer is not recommended
• Aspirin – This is still controversial. The use of aspirin can reduce the risk of adenomatous polyps and colorectal cancer, however, the risk of cancer versus the risks associated with bleeding still needs to be weighed. Current expert opinions, including that of myself and my colleagues at Cancer Treatment Centers of America, recommend aspirin only if indicated for cardiac causes.

For more information on Dr. Kundranda and CRC, visit

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