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With age comes wisdom, maturity, and grace. But getting older also slows us down, bringing creaking joints and gray hairs. While many of these changes are obvious, it is essential to monitor the invisible changes happening within our bodies. Brooks D. Cash, MD, is committed to helping people age healthily by detecting invisible changes in the gut that may lead to colorectal cancer.

“Age is the greatest risk factor for developing colorectal cancer, and people should start regular screenings at age 50,” says Cash.

Colorectal cancer usually begins as a polyp, a noncancerous growth on the inner wall of the colon or rectum. A polyp can take as many as 15 years to develop into cancer, and most people do not experience any symptoms until the disease is advanced.

Approximately 145,000 people in the United States are diagnosed with colorectal cancer each year, making it the third most common cancer. It is the second-leading cause of cancer-related deaths, responsible for an estimated 51,000 deaths in 2019.

Colorectal cancer is treatable when found early: The five-year survival rate of people with localized colorectal cancer is 90%. But once the cancer spreads to distant parts of the body, the five-year survival rate plunges below 15%.

“Unfortunately, about one in three Americans who should be tested for colorectal cancer have never been screened,” says Cash. “My goal is to remove the barriers that prevent people from getting screened and offer a variety of effective tests that appeal to the different comfort levels people have.”

Colonoscopy—where physicians insert a colonoscope (a thin, lighted tube) through the rectum into the colon to look for polyps or cancer—has long been the gold standard for colorectal cancer screening. However, many patients avoid the test because they fear discomfort or complications.

Cash is helping to develop an alternative to colonoscopy called colon capsule endoscopy, which may help more people adhere to screening guidelines. The colon capsule is a tiny camera patients swallow. It travels through the gastrointestinal tract to take photos of the colon and detect polyps that are transmitted wirelessly. If physicians find a polyp, they can refer the patient to have a colonoscopy for further examination.

Cash is also developing an x-ray capsule test that works similar to colon capsule endoscopy but without needing to prepare the bowels. After the patient swallows the capsule, it captures x-rays of the colon. A special software recreates the x-rays into detailed images of the colon that can help physicians identify polyps.

“We keep patients at the center of everything we do by opening a dialogue with them and offering choices when it comes to colorectal screening,” says Cash. “At the end of the day, the best test is the one people will take.”

While Cash and his team specialize in making early diagnoses of colorectal cancer, their partnership with UTHealth colleagues at the UT Physicians Colon and Rectal Clinic allows them to help patients who have colorectal cancer plan for surgery. Led by H. Randolph Bailey, MD, the UT Physicians Colon and Rectal Clinic uses advanced techniques such as minimally invasive and robotic surgeries to treat colorectal cancer. UT Physicians is the clinical practice of McGovern Medical School.

“Our surgeons conduct more surgeries for colorectal cancer than any other group in Texas,” says Bailey. “The ability to collaborate with experts such as Cash and his team allows us to offer patients the most effective treatments with the best outcomes.”

“We’re like right hand, left hand,” says Cash. “Put us together, and we can treat anything in the colon.”

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