A study published in Nature found that “in the past two decades, the incidence of early-onset colorectal cancer, which affects individuals below 50 years of age, has doubled in many countries.”

Similarly, projections from Frontiers in Immunology warn that “with changes in western dietary habits worldwide, the incidence of CRC is expected to increase steadily, resulting in 2.2 million new cases by 2030.”

Emerging science suggests a key piece of the puzzle lies within our gut.

“We think of our microbiome as a separate, living organism within our body. It’s made of billions of bacteria, predominantly growing in our colon. There is a small number of bacteria that does exist in our small bowel, oral pharynx and nasal cavities. Just like we have bacteria on our skin everywhere,” says Daniel Martin, MD, a gastroenterologist with OSF HealthCare.

Colibactin and DNA Damage

Several harmful gut bacteria species, including strains of E. coli, Klebsiella pneumoniae and Citrobacter koseri, produce a toxin called colibactin. Research over the last two decades has linked this toxin to DNA damage that may lead to cancer.

“They have recognized that there’s a much greater incidence of exposure to this particular strain of E. Coli that makes the Colibactin toxin in patients under the age of 50 who are diagnosed with colorectal cancer,” Dr. Martin says. “There’s also a recognition that Colibactin itself has some DNA-damaging properties within the GI tract. This is likely a direct contributor to the development of early, pre-cancerous dysplastic (abnormal growth) changes that ultimately lead to colorectal cancer in those patients.”

Diet, Antibiotics and the Microbiome

Western diets and overuse of antibiotics also play a role, research suggests.

“Also thinking about the infections we can have, both as infants and in adulthood. Over the last handful of decades, there’s the exposure of antibiotics, -- the antimicrobial medications we’re using to try and treat specific, acute illnesses,” Dr. Martin says. “But those can have a meaningful impact on our gut flora and microbiome in general.”

Processed foods, especially ultra-processed products with preservatives and dyes, may be particularly harmful. Dr. Martin recommends eating real food like beans, nuts, legumes, plants and lean meats.

“If you’re purchasing it in the middle of the grocery store, and it’s vacuum-packaged and sealed, looking nothing like its based product, it’s probably an ultra-processed food in every circumstance,” Dr. Martin says.

“When we are consuming a food product of some kind, if it’s going to go bad quickly, it likely has prebiotics and probiotics in it, and those are good for us. If you leave a banana out on the counter for two weeks, no one wants to eat it because it goes bad. If you leave a Twinkie out on the counter for two years, it hasn’t changed,” Dr. Martin adds.

Dr. Martin also warns about hidden culprits like sugary drinks, sports beverages and food dyes.

“Products like sports drinks, juices and sodas can be laden with sugars, whether real or added (which Dr. Martin refers to as ‘fake sugar’). Many of these products also contain food dyes and preservatives which are bad for our gut health.”

The Search for Balance

While probiotic and prebiotic supplements can support gut health, they are not a perfect science.

“Currently, prebiotic and probiotic supplements are created using the ‘95% confidence interval,’” Dr. Martin says. “This means that out of a sample of people, it was determined that 95% of them would benefit from a certain culture, probiotic or prebiotic being included in the product. Because as mentioned earlier, the 100% perfect pie chart of what everyone’s gut microbiome looks like is not currently known.”

For now, the advice remains straightforward: eat whole foods, avoid ultra-processed options and care for the trillions of bacteria that work inside of us every day.

Video Interview Clips

Jason Bill, MD, an interventional gastroenterologist with OSF HealthCare, says the trend is concerning and highlights the urgent need for awareness, earlier detection and preventive screening.

Not only is it being diagnosed more, a JAMA study released in January reveals colorectal cancer is now the leading cause of cancer-related death in adults 50 and younger. The findings suggest colorectal cancer is the only major cancer that has increased in the last two decades, averaging a 1.1% increase every year since 2005. The American Hospital Association (AHA) reports colorectal cancer ranked fifth in cancer deaths from 1990-1994.

A troubling rise in diagnoses among younger adults

“We are seeing much younger people being diagnosed with colon cancer. Unfortunately, these younger people are being diagnosed at later stages of disease, as well," Dr. Bill says. "There is clearly something going on. A lot of research is happening behind the scenes that's trying to sort out what is causing this."

Dr. Bill says researchers are actively investigating the causes behind the increase in cases. While no single explanation has been confirmed, experts believe multiple factors may be contributing.

“There seems to be a birth cohort effect, meaning those born after a certain time, seem to have an increasing incident of colon cancer diagnosis,” Dr. Bill says. “So, what that leads people to believe, is that there must an environmental trigger to the increased incidence. The most likely culprits include ultra-processed foods and the obesity epidemic. Further research is going into other exposures including microplastics.”

Genetics and inherited conditions can increase risk

Genetics can play a significant role in colorectal cancer risk. One inherited condition, known as Lynch syndrome, increases the likelihood of developing colorectal cancer and other cancers.

Lynch syndrome is caused by inherited mutations in genes responsible for repairing damaged DNA – including MLH1, MSH2, MSH6, PMS2 and EPCAM. When these repair systems don’t function properly, damaged DNA can accumulate, increasing the risk of cancer over time.

“In those who have a family history, be a little more aggressive and more sensitive, mindful of your symptoms. With rectal bleeding in a young person, we need to treat that more aggressively and strongly recommend a colonoscopy,” Dr. Bill says.

Doctors may recommend genetic counseling and testing for individuals with strong personal or family histories of colorectal cancer or related cancers. Identifying inherited risk factors can help patients and providers create personalized screening and prevention plans.

 “No one loves the idea of getting a colonoscopy, but it is the right thing to do. If you have any symptoms you’re concerned about, talk to your primary care provider and they can move you forward to get a colonoscopy. But the best advice is to get screened when it’s appropriate and be mindful of the symptoms,” Dr. Bill adds.

Screening guidelines may miss at-risk younger adults

Colorectal cancer screening guidelines have evolved in recent years. The American Cancer Society recommends routine screening beginning at age 45 for people at average risk.

While research is ongoing, Dr. Bill notes that current guidelines may not fully address this younger population; however, the decrease in the screening from 50 to 45 was an important step.

Colonoscopies don’t just detect cancer – they prevent it

A colonoscopy remains the gold standard for colorectal cancer screening, not only detecting cancer but preventing it, Dr. Bill says.

“It’s a test where we’re able to examine the colon and prevent cancer,” Dr. Bill says. “In those patients who have decided to not get a colonoscopy, any screening is better than nothing. That’s where the mailed stool kits come in handy.”

During a colonoscopy, physicians can identify and remove polyps (abnormal growths) that can develop into cancer if left untreated. These samples can then be analyzed to determine cancer risk.

“In general, we can tell you right then and there what your findings are," Dr. Bill points out.

This immediate feedback provides patients with clarity and allows care teams to quickly determine next steps if needed.

Symptoms and risk factors shouldn’t be ignored

Even for adults under age 45, certain symptoms and medical histories may warrant earlier screening. These include:

• Rectal bleeding
• Anemia (low red blood cells)
• A strong family history of colorectal cancer
• Family history of polyposis syndromes
• Personal history of inflammatory bowel disease, including ulcerative colitis or Crohn’s disease
• Sudden abdominal pain
• Unexplained weight loss

If you're concerned your at-risk for colorectal cancer or are experiencing any of the symptoms above, it's time to speak with your primary care provider and request further screening. 

Lifestyle changes can help lower risk

While some risk factors, such as genetics, cannot be controlled, healthy lifestyle choices can help reduce colorectal cancer risk. Experts recommend:

• Avoiding tobacco use
• Limiting or avoiding alcohol
• Reducing consumption of ultra-processed and processed foods
• Exercising regularly
• Maintaining a healthy weight
• Avoiding prolonged sedentary behavior
• Eating a fiber-rich, balanced diet

These steps support overall digestive health and may reduce cancer risk over time.

Screening saves lives

Colorectal cancer is highly treatable when detected early – and often preventable through routine screening.

If you're concerned, OSF HealthCare offers a colorectal cancer risk assessment that can help you figure out when you should start screening.

Video Interview Clips

OSF Cancer Institute B-Roll

September is Prostate Cancer Awareness Month. It's a reminder that the disease is manageable when caught early.

Uwais Zaid, MD, a urologist who provides care at OSF HealthCare, is urging men to get screening appointments on their calendar at the right time. That’s critical, he says, because some people who develop prostate cancer will not show symptoms.

“It is something we certainly do take seriously in urology,” Dr. Zaid says.

What is the prostate?

The prostate is a male gland about the size and shape of a walnut. It surrounds the upper part of the urethra, or the tube that carries urine from the bladder. The prostate makes some of the fluid that’s part of semen.

Risk factors

Dr. Zaid says the risk for prostate cancer increases with age.

Other risks: “African American men are at a higher risk,” Dr. Zaid says. “Certain dietary things like too much red meat and greasy, fatty food. And certain type of exposures such as Agent Orange for some of our veterans.”

And like most other ailments, a family history of prostate cancer should put you on higher alert.

Screening: how and when

Dr. Zaid says prostate cancer screening involves two simple tests. One is a blood test that measures the amount of a hormone produced by your prostate called prostate-specific antigen (PSA). An abnormally high reading might warrant further examination by your health care provider.

The other test is a digital rectal exam, where your provider will feel for lumps on the prostate.

Don’t get that confused with a colonoscopy, the more invasive screening that looks for colon cancer, Dr. Zaid says.

“It doesn’t require any special or horrible bowel prep,” Dr. Zaid says of the prostate exam. “It’s about a 20 second thing we do in the clinic that can save your life.”

You should always see your health care provider anytime something seems off with your body. But the American Urological Association has guidelines for when to get a prostate cancer screening.

“For most men, we want them to start screening with an annual PSA [test] at age 54 to 69,” Dr. Zaid explains. “For certain men, you want to start earlier if you have a risk factor.”

After age 69, Dr. Zaid says you should talk to your primary care provider about what screenings are right for you.

What should you not do?

Don’t think this type of cancer is so common that you should just let it run its course. Dr. Zaid says there are aggressive types of prostate cancer that can be deadly.

Also, Dr. Zaid warns of herbal remedies for cancer in general. He says your best bet is to see a doctor.

Treatment

Dr. Zaid says treatment for prostate cancer depends, in part, on how much the cancer has spread.

If it’s contained to the prostate gland, he says radiation (sending radiation waves to destroy the cancer cells) or surgery to partially or fully remove the gland are options.

“If the prostate cancer has escaped the prostate gland, there are a lot of treatment options,” Dr. Zaid explains. “This is actually a very active area [in medicine] with all sorts of research and new medications.”

Hormone therapy may be an option here, the doctor says.

“It’s very manageable,” Dr. Zaid says on treatment of the disease.

Interview clips

Previous coverage

OSF HealthCare library: Prostate cancer

OSF HealthCare Newsroom: Urinary incontinence and the link to prostate cancer

Remember the chia pet? Well chia seeds are not just for gag gifts anymore. They do have positive health benefits. For example, seeds (two tablespoons) offer an impressive 10 grams of fiber, or roughly one-third of the daily requirement for adults.

There is also a TikTok trend, made popular by celebrity wellness influencer Daryl Gioffre, which makes use of chia seeds and fresh lemon juice to jumpstart a person’s digestion with a goal of alleviating constipation.

Omar Khokhar, MD, a gastroenterologist at OSF HealthCare, says the concoction is also referred to as an internal shower. To make it, combine one to two tablespoons of chia seeds with eight to 16 ounces (one to two cups) of water and lemon juice. Let it stand for at least 15 minutes, so the chia absorbs much of the water.

Dr. Khokhar says it’s one way to get fiber into your diet.

“It’s a very good, natural way to incorporate fiber and protein into your diet. However you want to take it [chia seeds] – a salad, as part of a parfait – there are other ways to ingest it. With this particular phenomenon, you’re mixing it to sort of help it expand ahead of time outside of your body instead of inside your body.” 

The concoction can make you feel full and adds to hydration, which is good for digestion.

Can the drink be dangerous? Dr. Khokhar says if you’re dealing with gastrointestinal (GI) disease or distress, skip the internal shower drink.

“If you have any history of esophageal swallowing issues or any history of intestinal obstruction, this is something you might want to talk to your doctor about ahead of time. Because what you don’t want to do is ingest this gel-like material and cause some kind of blockage.” 

He also warns that if you have constipation that lasts more than just a few days, see a medical provider, particularly if you’re in your 20s. Constipation can be an early sign of colon cancer.

“If you are constipated, for example, don't mask that symptom with a chia seed phenomenon that you saw on TikTok. Go see your doctor. Make sure you get checked out. And if you get checked out, then, by all means, go back to the chia phenomenon.” 

And start slowly. Adding too much fiber too quickly, Dr. Khokhar says, could have the opposite effect. It can cause GI symptoms such as stomach pain, gas, diarrhea, constipation and bloating.

“It can potentially cause bloating or make bloating worse, so I would be careful. If you have any kind of GI or pre-existing issue, it’s something you might want to start maybe a half dose and see how you respond before going with a bigger, normal dose.”

Generally speaking, Dr. Khokhar recommends also trying to get more fiber through your diet. Although, after trying the drink as part of this story, Dr. Khokar declared, “I’m not going to lie, it actually tastes pretty good.”

Dr. Omar Khokhar

B-roll of chia seeds and lemon water-drinking it

The Peoria, Illinois-based hospital system has brought surgical oncologist Tamara Floyd, MD, to the care team at OSF HealthCare Saint Francis Medical Center in Peoria. Dr. Floyd performs cytoreductive and HIPEC (hyperthermic intraperitoneal chemotherapy) surgeries in Peoria, while also seeing patients in Bloomington and Galesburg.

HIPEC procedures are mostly for patients who have tumors or cancer spread in the abdominal cavity. 

Cancerous tumors are removed through cytoreductive surgery where the surgeon initially attempts to remove as much of the cancer as possible. Surgery is then followed by HIPEC, which is when a heated chemotherapy – at just over 106 degrees Fahrenheit – is administered into the abdomen. The heated chemo is then circulated around the area inside the abdomen to treat any remaining microscopic tumor cells.

HIPEC can be beneficial for several types of cancer patients. The one it benefits the most is LAMN, or low-grade appendiceal mucinous neoplasm. HIPEC is considered a standard of care for patients who have seen their cancer spread into the space in the abdomen that contains the abdominal organs.

These can be appendix, colorectal, and now more data indicates stomach cancer patients may benefit from HIPEC, Dr. Floyd says.

"Additionally with more data, pancreatic cancer is being looked at as well. Even patients with breast cancer. Another cancer that benefits from HIPEC is peritoneal mesothelioma." 

HIPEC can be a viable treatment option at any stage, Dr. Floyd says. But as some people are diagnosed with later stage disease, it can feel like no options are possible. HIPEC changes that.

"It's beneficial to have the option of doing HIPEC, or cytoreductive surgeries, for patients who have peritoneal spread of disease, which for most cancers means it is a stage 4 disease," Dr. Floyd says. "In a lot of instances, if you're talking about stage 4 disease, there aren't a lot of other options."

While HIPEC is a viable option for low-grade cancers, it's also a helpful option for later stage, more aggressive cancers. Patients with signet ring or goblet cell features, which are more aggressive subtypes, can also be treated with HIPEC. 

"Signet ring is one of the subtypes of appendiceal, colon or rectal that can be treated. There are even some subtypes of gastric or stomach cancer that are considered a signet ring or have signet ring features," Dr. Floyd says. "Cytoreductive and HIPEC can be considered for those patients."

Throughout a cancer journey, combining traditional chemotherapy that is administered through IV with HIPEC provides a "synergistic effect" Dr. Floyd says. HIPEC allows the chemotherapy to be administered directly to the cancer cells and kill them that way. 

Dr. Floyd has done one HIPEC at OSF Saint Francis so far and has another planned soon. It's anticipated that within the next year, Dr. Floyd and her team will start to do three to four HIPEC surgeries a month as OSF HealthCare Cancer Institute continues to grow as a destination center.

Patient recovery times can be one to two weeks in the hospital after HIPEC surgery, which is why having this option for Central Illinois patients is so important. It allows the patient and their families to stay close to home, instead of having to travel hours away. Dr. Floyd says the longer travel times can turn patients and their families away from pursuing care. 

Heated chemotherapy can also be used in thoracic cavities. This would then be called HITEC or HITOC, Heated IntraThoracic Chemotherapy. This is for patients who have disease spreading in the pulmonary area. 

Types of cancers that can be treated by HIPEC: 

-          LAMN (Low-grade appendiceal mucinous neoplasm)

-          Appendiceal

-          Colon

-          Rectal

-          Gastric

-          Stomach

-          Pancreatic

-          Breast

-          Mesothelioma

-          Ovarian

For more information on cancer treatment options at OSF, visit the OSF HealthCare Cancer Institute website.

Video Interview Clips

A colonoscopy at age 15

But why? Those at an average risk of colorectal cancer are recommended to start getting colonoscopies once every ten years, starting at 45 years of age.

"My dad was diagnosed after just turning 26. Because it was colon cancer, they recommended I be seen ten years before. The doctors said when I turned 15 to get a colonoscopy," Jaxson says. He was just a baby when his father passed away.

Jaxson’s father, Michael, was an avid runner in great shape. Angie Brown, Michael’s wife and Jaxson’s mother, says Michael had no family history of colon cancer, and never drank or smoked. At the age of 26, Michael was diagnosed with stage 3 colon cancer. He underwent six months of chemotherapy and was in remission for almost four years. In 2013, Michael was diagnosed with a rare form of stage 4 colon cancer called signet ring cell adenocarcinoma.

“If he can do it, I can do it!”

Angie says for years, she has helped prepare her sons to know the importance of cancer screening, and that they’d have to undergo a colonoscopy from a young age.

“He figured that if he could go out there and show people that a 15-year-old boy is willing to go through a colonoscopy, without having any symptoms, then anybody can do it,” Angie says. “We had a good amount of people who sent messages and said, ‘if he can do it, I can do it!’”

Jaxson says it helped to know from a young age that the day was coming. Afterwards, he said it “wasn’t that bad.”

"They have you roll over on your side, then they inject the stuff in, and it works like a charm. You're out and don't remember a thing. Best sleep you'll ever get," Jaxson laughs. 

Jaxson’s bravery can inspire others

Daniel Martin, MD, a gastroenterologist with OSF HealthCare, oversaw Jaxson’s treatment. He says Jaxson’s bravery to undergo something uncomfortable, yet potentially lifesaving, should be inspiration for everyone.

"Colon cancer, if caught early (even if not caught at a polyp stage), is a very treatable condition. Where in the early stages of disease, greater than 90% of those patients are going to be disease free at five years," Dr. Martin says. "One of the advantages of colorectal cancer screening is that we can prevent the disease. With colorectal cancer, in a colonoscopy, you can identify the precursor lesions called polyps and remove them during the exam."

Colon cancer is the third-most diagnosed form of cancer in both men and women.

“Lung is first for both, breast cancer is second for women, then colorectal cancer is third. For men, prostate is second, colorectal cancer is third. Colon cancer is the second-leading cause of cancer mortality in this country,” Dr. Martin explains.

The prevalence of colon cancer, along with the rareness of Michael’s signet ring colon cancer, led Angie and Michael to launch the Michael P. Brown Colon Cancer Foundation which lives by the motto “Get Busy Living.”

“A lot of people think you’re guaranteed a long life, especially if they’ve had parents who lived into their 80s and 90s,” Angie says. “You just never know what’s going to happen. If you have a bucket list, start doing those things. Don’t wait until you’re retired.”

The Foundation hosts Michael’s 5K Run for Life each year, raising money for signet ring research

“We try to be an outlet for people to get information about signet ring colon cancer. My husband used to field most of those calls, but now I do. My boys are getting involved too,” Angie says. “If there’s a parent who has cancer, they’re willing to talk to kids about that.”

Signs and symptoms of colon cancer

"The most common concern would be bleeding in your stool. But that would also include abdominal pain that's new or different," Dr. Martin says. "Or changes in the frequency or caliber of your stools."

This was mainly the case with Michael, Angie says.

“Initially, my husband’s symptom was belly pain. He was put on a couple of different medications because it was thought to be a stomach ulcer,” Angie says. “It didn’t work. He started having constipation, diarrhea and vomiting. We went into the emergency department, and he got the diagnosis of colon cancer.”

Traditionally, colon cancer is seen in people in their 60s and 70s. However, more younger people are starting to be diagnosed with colon cancer, Dr. Martin says.

"Specific to colorectal cancer, there are various options available now for screening. We recommend procedural screening with colonoscopy whenever possible. But with the advent of stool studies that are readily available and have been covered by insurance, that has helped increase the pool of patients who are receiving appropriate screening," Dr. Martin says. These readily available options are so important, Dr. Martin says, because most colon cancer patients are getting diagnosed at a later stage in the disease.

In the past, things like smoking, obesity and unhealthy lifestyle choices have been thought to cause colon cancer. Dr. Martin says in addition to that, more recent studies have shown processed foods to be a concern as well, adding that our gut's microbiome may show early indicators of cancer. A study done by Harvard Medical School investigators found that certain types of gut bacteria could lead to the development of precancerous colon polyps. 

Dr. Martin credits the OSF HealthCare cancer tumor boards and medical teams for creating a more organized process over the last five to 10 years that takes care of patients from diagnosis to treatment. 

Jaxson says now that it’s all said and done, the colonoscopy process was not as bad as most people think. This is on par with what most patients say, Dr. Martin adds. His word of caution? Many of his patients undergoing a colon cancer diagnosis wish they would have gotten colonoscopies earlier on.

To schedule a screening, speak with your primary care provider first and get a referral. You can find more information about colonoscopies on the OSF HealthCare website.

Jaxson Brown Video Interview Clips

Angie Brown Video Interview Clips

Dr. Daniel Martin Video Interview Clips

Innovative Technologies at the Forefront

Leading-edge cancer treatments like proton beam therapy, brachytherapy, genetic counseling and dietetics are all offered within the OSF Cancer Institute, providing patients with a one-stop-shop during their cancer journey.  

Proton therapy

Proton therapy was first offered on April 1, 2024.

"Proton therapy lets us offer radiation therapy to patients that maybe wouldn't have been able to tolerate side effects due to tumor location, or factors such as prior radiation treatment to the same area," says Tom Cox, the vice president of operations at OSF Cancer Institute. " This is possible because protons stop after passing through a tumor, eliminating the radiation effects on tissue often treated incidentally to photon (X-ray) therapy. The OSF Cancer Institute is on track to have treated 180 patients by April 1, 2025 – which far exceeded the original first-year target of 130 patients.

Brachytherapy

The brachytherapy suite offers a more patient-friendly way for mostly prostate and gynecological (cervical, endometrial) cancer patients to receive treatment. This option involves placement of applicators or needles directly into tumors so that very controlled, effective radiation can be delivered in discrete volumes. Since the radiation is delivered from within the tumor, there is a dramatic reduction of the dose to normal tissue, even those near the tumor itself. The dose is delivered with high-dose rate techniques so the therapy is delivered in just a few minutes time.

"Being able to bring the introduction of the applicators into the body, the treatment planning CT and the treatment all in one room, has created a much better experience. We're having some really good outcomes there, and we think we can expand what we're able to do there,” Cox says.

Intuitive Ion robot 

The OSF Cancer Institute’s pulmonology team offers state-of-the-art diagnostic tools and treatments, including minimally invasive, robotic surgeries and robotic assistive bronchoscopy. This includes the Intuitive Ion Robot, which allows care teams to get early answers and advance care for lung cancer patients.

"We're going to leverage the ability of an ion robot in the interventional pulmonary lab to really upend how we do the front end of lung cancer care," Cox says. "That robot is going to enable us to biopsy smaller lesions. It has fewer side effects than when you're getting a lung biopsy that's CT-guided. You can also do a staged EBUS (endobronchial ultrasound) exam, so you can diagnosis and stage at the same time."

Rachael Davis, MD, a pulmonologist at OSF Cancer Institute, and her team have been using the ion robot weekly. Dr. Davis and her team are training more providers, and by this summer they’re expecting to quadruple – or more – how often it’s used. 

HIPEC procedures

Hyperthermic intraperitoneal chemotherapy (HIPEC) surgeries are now offered at the OSF Cancer Institute. Tamara Floyd, MD, a surgical oncologist with OSF performs the open surgery and removes tumors from the abdomen. In the HIPEC procedure, heated chemotherapy is circulated through the body for a period of time. The first case went extremely well, and Dr. Floyd is planning her second case for mid-March. 

In addition to treatment options, the OSF Cancer Institute is increasing cancer supportive services in the Peoria region as well.

• Cancer navigation - 13% increase (Specially trained OSF Mission Partners walking you through the process of cancer care) 
• Dietetics - 64% increase
• Palliative medicine - 213% increase (Helps control symptoms, augments treatment from physicians) 
• Genetic counseling - 20% increase

Nutrition journey during cancer

Part of the dietary benefits OSF Cancer Institute offers is in the CEFCU Teaching Kitchen. Oncology dietitians work with patients on recipes to cook and are there with them step-by-step during their cancer journeys. Cox says 50% of people who come in for cancer treatment have dietary risks, while 80% of those people suffer malnutrition during treatment. Having a trained, professional dietary team walking alongside you helps fight those negative complications.

OSF Cancer Institute Culture

Cox credits the Institute’s first-year success to the culture of those who work there. The goal, he says, is to offer cancer support services across the entire spectrum of life. 

"The Mission Partners that work in this building have completely bought in to the idea that we all are advocates for cancer patients. We're always asking patients what they need, to see if we can help them," Cox says. "If we hear there's an issue with travel, or they're having trouble keeping food down, or if their children are not coping very well (with a loved one's cancer diagnosis), we know there are resources in the building, and we try very hard to line up those resources. You can feel it when you walk through the building."

Support services after cancer treatment 

"We can get you with a nurse, an exercise specialist and a dietitian to get back to your best life after cancer. Maybe you like to run a lot and ran half marathons, and you think you'll never be able to do it again. We have rehab and exercise specialists here and nutritionists. Who says you can't do that again? We're going to work with you to see you can get to the life after cancer you want to get to,” Cox says.

Services and medical professionals continue to grow

Building off the first year of OSF Cancer Institute, the administrative team continues to hire world-class medical professionals to offer cancer care in Peoria. A breast surgeon was recently brought onto the team, and a colorectal surgeon will be starting soon.

Additionally, the fourth floor of the building will be built out soon. Cox says this will give much-needed space for the surgical oncology and medical research teams. Research-focused medical oncologists are currently being recruited as well.

Leaving OSF Cancer Institute healthier, and more aware

Patients who leave OSF Cancer Institute don't just leave the building as healthier people; their awareness continues and will benefit other people. Cox admits a cancer diagnosis is not an easy thing to go through, and that the support from the OSF care team doesn’t stop when you walk out the door.

Grateful for community support

Cox says he’s been humbled throughout the years of working in oncology by the incredible commitment of the community and region to the OSF Cancer Institute.

"It is overwhelming to me, the philanthropic spirit of our community and extended community," Cox says. "I take that as, they've made a big commitment to us, and we're making a big commitment back. We're going to bring things to central Illinois that have not been here before. We are going to support you and your family members throughout your life and keep you as healthy, relative to cancer, as we possibly can."

Looking to the future

Cox says the OSF Cancer Institute is looking to bring more pediatric cancer support services to the building, the work collaboratively alongside the adult services.

The team is creating both a lung lesion clinic and a lung multidisciplinary clinic, which aims to reduce the time from finding a cancerous lesion to treatment. The lesion clinic is expected to open in late spring.

The OSF Cancer Institute intake team has been created with oncology nurses who will answer patients’ questions on the very same day, to see if services are right for you.

Cox adds that OSF is planning to put together an early detection hotline as a resource for the community to know if or when they should be screened for cancer.

To learn more about the OSF HealthCare Cancer Institute, visit its website to view the services offered and find contact information to get connected.

Video Interview Clips

Actor James Van Der Beek announced he has colorectal cancer. 

“I have colorectal cancer. I’ve been privately dealing with this diagnosis and have been taking steps to resolve it, with the support of my incredible family,” the 47-year-old said. “There’s reason for optimism, and I’m feeling good."

Colorectal cancer is now the leading cause of cancer deaths for men under 50, and number two for women under 50, according to Fight Colorectal Cancer, a colorectal cancer patient advocacy group.

The American Cancer Society (ACS) estimates that nearly 107,000 new cases of colon cancer will happen in 2024, and just over 46,000 new cases of rectal cancer will occur. The ACS says the rates of people being diagnosed with colon or rectal cancer have dropped since the mid-1980s due to people getting screened and people changing their lifestyles.

But, in people younger than 55, rates have increased 1-2% each year since the mid-1990s. Because of this, newer health guidance from the U.S. Preventive Services Task Force recommends people start getting colonoscopies at 45.

Yvette Blancas, a registered nurse in the gastrointestinal lab at OSF HealthCare, says the procedure is not something to push off.

"A lot of times after patients have had their colonoscopies, they wake up after their procedure and sedation, and they're like 'it wasn't that bad!' We'd like them to spread the word to their family and friends because it really isn't. People just push it off for so long and then they just forget about it,” Blancas says.

To get ready for a colonoscopy, the prep work begins the day before.

"We don't want you to have any solid food the day before. We usually allow a clear liquid diet. You'll start taking your prep medication, that might be in liquid form or pill, depending on your doctor. You will likely use the washroom frequently, but the more you go the better,” Blancas says. "The procedure itself takes 20-30 minutes. You wake up and recovery takes another 20-30 minutes. We just make sure your vitals are stable, you tolerate some snacks, and then if everything is OK, you're good to go!"

Colonoscopies prevent colon cancer by finding polyps and early signs of colorectal cancer when there are more treatment options.

Blancas says to make sure you’re speaking with your primary care team and encourage your family and friends to stay on top of their health.

Aside from colonoscopies, OSF HealthCare offers other options to get screened like CT colonography (virtual colonoscopy), stool DNA test, fecal immunochemical test (FIT) and fecal occult blood test (FOBT). 

Following a successful pilot in Bloomington, OSF HealthCare is planning to expand use across its Ministry of an AI-backed platform, GI Genius, to further enhance detection of pre-cancerous polyps.

Video Interview Clips

The colonoscopy has a special place in comedy, but colorectal cancer is no laughing matter. The reality is that a colonoscopy is the best way to detect the second-deadliest type of cancer.

However, fear prompts many people to avoid a colonoscopy. Now, comes a new, less invasive way to screen for colorectal cancer – a new FDA-approved blood test that can be used for people who have an average risk. Dr. Harishankar (Hari) Gopakumar, MD, a gastroenterologist at OSF Medical Group in Bloomington says the new test is aimed at improving the screening rate for colon cancer which currently stands at 63% of all eligible people.

“This blood test could bridge some of gap; that is where I see its main role. If for whatever different reason somebody is not able to get one of the approved colon cancer screenings, other than this latest blood-based test, this could be a bridge to offer some form of screening to them.”

The American Cancer Society says overall, the lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 25 for women. However, each person’s risk might be higher or lower, depending on their risk factors for colorectal cancer, including but not limited to family history.  In people younger than 55 years of age, rates have been increasing by 1% to 2% a year since the mid-1990s, so it’s recommended screening start at 45 years, beginning with a baseline colonoscopy.

The recently approved blood test is easier than the current stool sample option that’s available for people at average risk, but Dr. Gopakumar suggests it is not good for detecting pre-cancerous cells. He says the sensitivity is enough to detect about 13% of pre-cancerous lesions. The success at detecting actual cancer is about the same with the blood test as the stool-based analysis. However, Dr. Gopakumar stresses testing a stool sample offers a better way to detect those early-forming cancer cells and that’s what’s most important.

Detecting colorectal cancer sooner

“Our goal is to be able to pick up these pre-cancerous lesions way before they even have a chance to become cancer and then treat them because at that stage, it’s relatively easy to treat the polyp – you take the polyp out. Nothing after that except maybe a follow up colonoscopy. That is where the difference comes in.”

Currently, about 60–70% of colorectal cancers are diagnosed at an advanced stage. Research suggests if the healthy population regularly submitted to annual screening, the 5-year survival rate could be increased to 73% (currently 65%). So, does Dr. Gopakumar think this new blood test could become part of annual exam testing?

He thinks it could eventually, but not until the test is improved to increase early cancer cell detection.

“This is probably an early stage and with more effective (technology) where we can match the sensitivity and specificity numbers where they detect what we need to detect – close to the stool-based testing or even better than that – then I see this as the future, but it may be a bit further out.”

Dr. Gopakumar says the blood test should not replace the more intensive colonoscopy procedure which, for people with average risk, should be given every 10 years. The FDA recommends getting the blood test every three years starting at age 45 for people not at high risk.

With the various options now available, Dr. Gopakumar recommends having a conversation with your medical provider.

“Make an informed decision so you get the best test that you can and it’s most appropriate for you so you can feel confident you got what you needed done in an appropriate and efficient way.”

The Affordable Care Act (ACA) requires both private insurers and Medicare cover the costs of colorectal cancer screening tests, because these tests are recommended by the United States Preventive Services Task Force (USPSTF). This includes a blood test, but Dr. Gopakumar says check with your insurer and make sure whether prior authorization is needed and to know whether you will have a co-pay.

Video clips with Dr. Hari Gopakumar

It was nearly 25 years ago that television news anchor Katie Couric, whose husband died of colon cancer, helped raise public awareness of colorectal cancer by undergoing a colonoscopy that was shown on NBC’s “The Today Show.” 

Shelli Dankoff, manager of Media Relations & Multimedia Services for OSF HealthCare, is taking a page from Couric. With a family history of appendiceal and abdominal cancer, Dankoff was excited to learn OSF HealthCare St. Joseph Medical Center in Bloomington, Illinois is piloting use of GI Genius – an FDA-approved Medtronic software platform with integrated AI algorithms. The platform has already shown an increase detection of precancerous polyps since the pilot launched April 1.

The GI Genius platform sits alongside the endoscope used to traverse the folds of the 5 feet of the average person’s colon. Omar Khokhar, MD, a gastroenterologist championed the idea of trying the new technology to reduce his patients’ risk of colorectal cancer, particularly at a time when new cases of colorectal cancer in people under the age 50 have been rising at an alarming rate. 

Dr. Khokhar says the pilot will consider whether to use GI Genius, not only for screening colonoscopies, but for colonoscopies when patients have symptoms indicating possible colorectal cancer. 

“For example, there's a 35-year-old who comes in with diarrhea or constipation or rectal bleeding, and I do that colonoscopy, I'll often tell my staff to turn it (GI Genius) on, to make sure we're not missing anything. So eventually, depending on the data, it could become the standard of care.” 

What exactly does the AI do? Dr. Khokhar says it leverages what it has learned from examining images and results from a large database of polyps from previous colonoscopies. 

“The GI Genius goes through its AI library of images and will highlight any kind of abnormalities of the mucosal surface. And it will call attention to us to go look at that again. Sometimes it might be something, sometimes it might not be anything, but it's a useful additional tool that we can use during colonoscopies to find precancerous lesions.” 

Dankoff is excited that Dr. Khokhar is among physicians willing to test the benefits of AI. She compares it to the use of robotics for certain surgeries. 

“It's kind of like when you hear people talking about robotic surgery or robots operating. No, that's not what it is. The surgeon is still controlling it. This is that same thing; you still have your gastroenterologist on the other end. They still have to know what they're looking at. It is a tool to help and to give better information, which I would think is reassuring to them too.”  

Known for his use of humor and analogies to help patients understand sometimes complex medical terms or conditions, Dr. Khokhar likens GI Genius to the type of technology on today’s new automobiles with sensors around the car to provide lane assist and adaptive braking.

“It’s like you have multiple eyes looking at the surface of the colon. Ultimately the gastroenterologist decides whether to sample, examine and inspect that area with more focus and then determine if that’s something that needs to be removed or not.” 

During Dankoff’s own colonoscopy, Dr. Khokhar reviewed two polyps highlighted by GI Genius and opted to remove them.  He said that’s not unusual, and he was not concerned based on their characteristics. The subsequent tissue biopsy came back benign and Dankoff won’t need to be re-screened for 10 years. 

Knowledge is power

Knowing new technology can support her doctor’s decision gives Dankoff peace of mind.

“I would rather know something up front sooner rather than later. Because we tell people all the time, if you catch it and treat it, it's very treatable. And if I'm not willing to be the person who's going to walk the walk and talk the talk, I have no business doing what I'm doing.” 

Dr. Khokhar will be working with a Performance Improvement (PI) team at OSF Innovation to analyze data from the six-month pilot with GI Genius. The team will evaluate two metrics: The adenoma detection rate (percent of screening colonoscopies where an adenoma is found) and the post-colonoscopy cancer rate.  While not cancerous, adenomas can turn into a cancerous tumor.

The data will be tracked in patients’ electronic medical records. GI Genius does not record patient data. 

PI experts will look at the data to see if the technology is really performing as promised, whether it is an improvement over the previous adenoma detection rate without the AI-backing, and whether it is worth the investment using those metrics. Vice President for Performance Improvement, Kelly George stresses that provider experience is important.

“GI Genius is a non-patient facing tool, so it is imperative to create a feedback loop to understand the experience of the physicians who are using it and monitor the data to identify any iterative changes that need to be made during the pilot.”

OSF consistently explores innovations that don't pose a risk yet could improve patient outcomes in its drive to provide the highest quality care.

Dr. Khokhar applauds the unique approach at OSF HealthCare that includes a willingness to partner with physicians who have ideas to better support clinical care and patients’ experience. 

“They’re the ones who are going to look back and do the math and look at, ‘Was this worthwhile?’ and they have a fantastic team. They're the ones who (are) really nuts and bolts on the ground who took this from, ’Hey, this is a really cool idea that I saw somewhere’ to ‘How do we make this fit a square peg into a square hole?’  

Dankoff thinks having the latest advanced technology could also help recruit new gastroenterologists and she believes it’s something that could attract patients, like her, to have more confidence in results of a colonoscopy – considered the gold standard for cancer detection and prevention.  

“If I could cut down on the number of screenings and have a greater sense of security that they really got to see everything in there. I think it'll be great.”  

Video clips of Dr. Omar Khokhar

Video clips of Shelli Dankoff

B -roll of GI Genius backed colonoscopy

The United States Food and Drug Administration recently approved the first treatment for people with liver scarring due to fatty liver disease. It's welcome news for people battling the disease.

How did we get here?

In some ways, it goes back to the obesity epidemic in the United States. Obesity brings an increased risk of fatty liver disease, an ailment that’s treatable but could mean serious complications. Moreover, health experts say isolation during the pandemic led may to increase alcohol intake, another risk factor for fatty liver.

David Rzepczynski, MD, a gastroenterologist at OSF HealthCare, describes the liver as an “extremely important” factory for the body. It performs many functions, like detoxifying medications, aiding digestion and making cholesterol, proteins and amino acids that help the body function. And have you ever missed a meal? You can thank your liver for releasing glucose and giving you energy.

All those “factory functions” make it critical to be watchful of fatty liver disease. As the name suggests, the disease describes an accumulation of fatty cells in the liver. Dr. Rzepczynski says it takes just 5% of cells with increased fat to make a diagnosis, but some obese people have 100% of cells with fat.

Hepatitis C and excessive alcohol use can cause fatty liver disease or are at least linked to it. But you can still get fatty liver if you’re not a heavy drinker, and that’s where your weight comes into play.

“The big driving force of fatty liver disease is what we call the metabolic syndrome,” Dr. Rzepczynski explains. “There are five factors: obesity, diabetes, hypertension [high blood pressure], high cholesterol and insulin resistance.”

Dr. Rzepczynski adds that fatty liver disease may cause pain in the upper abdomen, but it mostly comes without symptoms. So if any of those five risk factors apply to you or if you’re a heavy drinker, don’t wait. Talk to your health care provider about getting your liver looked at.

A doctor will likely start with a blood test, Dr. Rzepczynski says. An ultrasound or biopsy may also be needed. The next step: lose weight.

“It doesn’t have to be getting back to your ideal body weight,” Dr. Rzepczynski says. “Losing 5% of your weight can reduce fat in the liver. Losing 7% will help reverse some of the inflammation associated with fatty liver. And some studies have even shown that losing 10% or more might reverse some of the scarring.”

While it may be a bit alarming, left unchecked, fatty liver disease can lead to a serious condition called cirrhosis, or scarring, of the liver.

“You have normal liver tissue replaced by scar tissue,” Dr. Rzepczynski says. “When that occurs, you have a loss of liver function. You have less liver cells performing their duties.”

Cirrhosis of the liver can cause the organ to fail, making a transplant necessary. Liver issues can also mean an increased risk of heart disease, stroke and cancer, particularly breast and colon cancer.

Learn more about fatty liver disease and other gastroenterology care on the OSF HealthCare website.

Interview clips

Cancer can impact anyone, and the numbers show cases skewing younger.

Recently, the American Cancer Society reported that for the first time colon and rectal cancers have become leading causes of cancer deaths in younger adults. 

Overall, lung cancer remains the leading cause of cancer death among men and women of all ages. Prostate cancer is second for men, and breast cancer is second for women. Colorectal cancer is third for both men and women. 

Another study suggests that certain cancers are being diagnosed more often in younger adults in the U.S., and the spike is due, in part, to adults and especially women in their 30s.

The study published in the journal JAMA Network Open, looked at 17 National Cancer Institute registries with more than 500,000 cases of early-onset cancer, or cancers diagnosed in patients under age 50, between 2010 and 2019. The study showed early-onset cancers increased during that time by an average of just over a quarter of a percent (.28).  

In 2019, breast cancer had the highest number of incidences of early-onset cases. Gastrointestinal cancers and cancers of the urinary system and the female reproductive system are right up there as well.  

Peggy Rogers is a nurse practitioner in genetics and medical oncology for OSF HealthCare. She sees similar trends among her patients.

“For women, they are the caregivers in the family, and they tend to worry about everyone else besides themselves, and maybe put off seeking care sooner," says Rogers. "But women also encourage their husbands to seek and visit with their provider. So that’s a positive. But in general, I would say we have to keep talking.”

 Among gastrointestinal cancers, the most common early-onset cancers were found in the colon, rectum, stomach and pancreas. The fastest-growing incidence rates were found in the appendix, bile duct and pancreas.

“I think the nuance that we found is it's more common to find gastric cancers, which I don't think people realize, and I don't think people are aware of, the signs for gastric cancer can be as simple as abdominal pain and nausea or feeling full quickly, and they may need medical attention sooner," says Rogers. 

Some of the reasons for increased cancer rates in adults under age 50 include:

·         Drinking alcohol in excess

·         Smoking tobacco

·         Eating a Western diet (prepackaged foods, fried foods, processed meats, high-sugar drinks)

·         Being obese or overweight

·         Being exposed to environmental toxins

“We are concerned that obesity is an epidemic, and it's not just overconsumption of food and inactivity," says Rogers. "It’s the types of foods that people are eating, which is processed, it's quick, it's easy, but it's not the most beneficial.”

To lower your overall cancer risk, Rogers recommends maintaining a healthy weight, increasing your exercise, trying to eat five to nine servings of fruits and vegetables each day, limiting processed foods, not smoking and drinking in moderation.

Colonoscopy screening is usually recommended starting at age 45. People with family history may have to start earlier.  And pay attention to potential symptoms such as blood in the stool, abdominal pain, changes in bowel habits and unexplained weight loss. 

Rogers also recommends having conversations with your physician about your health. And for younger people who don’t have a provider, it’s important to find one. 

“I think working towards having a visit at least once a year to establish with a provider – establish goals for their health care – is very important and sometimes family history is contributory and why people get cancers," she says. "So those are discussions that you can have with your primary care provider. Maybe they need a referral or their family member that's been affected with cancer should consider a genetic risk assessment to further look at what may be contributing to some of the cancers in the family, even at early onset.”

For more information about cancer, visit OSF HealthCare. 
 

Interview Clips 

B-roll

It’s important for women to keep track of health screening recommendations. Early detection of issues like breast cancer can mean a better outcome.

Since everyone’s situation is different, you should talk to your health care provider about what screenings are right for you and when to get them. But Deena Brown, a board-certified family nurse practitioner at OSF HealthCare, says there are a few screenings every woman should know.

• Breast cancer: Brown says women aged 40 and up should talk to their provider about a yearly mammogram that looks for breast cancer.

For adult women of any age, mammograms should be combined with monthly breast self-checks. Brown suggests doing a self-exam a week after your menstrual cycle. If you’re no longer menstruating, you can choose the same day each month (the first of the month, for example) to help you remember. You should feel for changes or other abnormalities like lumps, bumps, one breast being larger than the other, any nipple discharge and swelling or soreness under the armpit. Make an appointment with your provider if you notice any of those changes.

• Cervical cancer: Brown says cervical cancer screenings typically begin at age 21 and occur every three to five years.

“Those screenings involve a pap smear, which takes a cell sample from the cervix and looks for any abnormal cells that need to be addressed,” Brown says.

• Osteoporosis: The National Institutes of Health (NIH) says osteoporosis is a bone disease that develops when bone mineral density and bone mass decrease or when the structure and strength of bones change. This can lead to a decrease in bone strength and an increased risk of bone fractures.

Brown says women over age 65 should be checked for osteoporosis. The NIH says the screening is typically a simple X-ray, and it should be done every two years.

“If the bone density is low, we can initiate treatment with medication to help increase the strength of the bones,” Brown says. “This helps prevent future fractures and debility for women.”

• Colon cancer: Screenings starting at age 45 can help detect colon cancer and other serious issues. A once-a-decade colonoscopy involves a doctor using a tube and camera to check for polyps or cancer in your colon and rectum. Another option is to take a stool sample at home, send it to a provider and they will look for abnormalities. Talk to your provider about which option is best for you.

How things can change

Brown says some women may need these screenings more frequently or earlier in life based on a family history of a disease or your own history.

“It’s all individualized,” she says.

“There are these screening recommendations, but we like to take a personalized approach to care and help address issues as soon as we can.”

In other words, seeing a doctor isn’t just about treating chronic conditions. It’s about preventing them too. And screenings are the best way to do that.

For more on women’s health services, visit the OSF HealthCare website.

Interview clips

Related stories

A breast cancer survivor's toolkit
Say yes ma'am to the mammogram
FDA dense breast rule promotes earlier cancer detection
Don't relax when it comes to annual cancer screenings
HPV vaccine: Taking a shot at cervical cancer
Osteoporosis: Be proactive rather than reactive
Colon cancer and young people: Trust your gut
Staying the course for a colonoscopy