Katie Couric is well aware that March is Colorectal Cancer Awareness Month. In fact, I’ll bet if the Emmy-winning journalist had her way, every month would be dedicated to educating the public about the 2nd-leading cause of cancer-related mortality in the United States. Couric’s relentless activism began after her husband, Jay, died in 1998 from metastatic colon cancer, leaving the TODAY Show host behind to raise two daughters under the age of five. He was only 42. During my recent interview with the television news icon, she discussed the ongoing need for colorectal cancer screening, her own breast cancer journey and her partnership with Medtronic including a panel discussion at this year’s SXSW Festival.
From Cancer Caregiver To Patient
As a physician who has seen far too many patients die from gastrointestinal cancers including both of my maternal grandparents who died of colon cancer, I wanted to know what surprised Couric about the commonalities and contrasts between being a caregiver of a loved one with cancer and experiencing cancer herself. She felt there were “major differences” in the two experiences.
“Jay was diagnosed at 41 with Stage 4 colorectal cancer—a very bleak prognosis,” reflected the former CBS evening news anchor. At the time, therapeutic options were limited to 5-fluorouracil and leucovorin, medications that were around since the 1950s. “Very few options for extending his life or managing this cancer that was galloping through his body,” said Couric. “So that was devastating. Our girls were 1 and 5 when he was diagnosed. My world came crashing down, and of course Jay’s, needless to say.”
Couric’s own breast cancer journey was quite different. The malignancy was diagnosed during a routine mammogram, and later confirmed with a breast ultrasound. The Peabody Award winner “felt very grateful” because the disease was caught early. “Fast-forward to my [experience with] breast cancer which was diagnosed at Stage 1A. I had no lymph node involvement,” recalled Couric. Her late husband’s cancer ordeal and hers “represented one end of the spectrum versus the other. Jay was diagnosed very late, clearly.”
Early Detection Saves Lives
Couric’s cancer advocacy initially began with colorectal cancer but has now extended to breast cancer. Through her personal journey, she has shared the importance of additional screening beyond mammography, particularly for the near 50% of women with dense breasts which increase the risk for breast cancer. While some women benefit from extra imaging such as ultrasound or MRI, these tools can also show many benign findings which can lead to unnecessary tests. Current recommendations are to discuss potential screening tests with your doctor and specialists.
The author of Going There could not emphasize early screening enough: “My experience reinforced this idea that early detection saves lives.” Couric knows that the earlier a cancer is diagnosed, the better the chance for treatment and cure. After breast cancer was detected, she underwent surgery followed by radiation therapy. She is here today to tell her story – an opportunity deprived from her late husband. “It was a world of difference … I just wish Jay had the same experience I had.”
Health Inequities And Cancer
Couric acknowledged that when Jay was first diagnosed, she was less aware of the significant health inequities that exist in the U.S. healthcare system. “When I learned that Black women or women of color have a 40% higher mortality rate, I felt both grateful that I had access to care but also enraged that so many women don’t.” Black women are more likely to have an aggressive form of breast cancer which is now the leading cause of cancer death among Black women, in large part because they are diagnosed at a later stage when it’s harder to treat. Couric isn’t alone in her high-profile advocacy. Nine-time grammy winner Mary J. Blige has actively encouraged women of color to be screened earlier.
Health inequities apply to other cancers. Black, Hispanic and Native American women have the highest incidence of cervical cancer, with the former facing the highest mortality. Black men in the U.S. are twice as likely to die of prostate cancer as their white counterparts. As a former primary care doctor, I will underscore Couric’s point that early detection saves lives. I have performed countless Pap smears which can detect pre-cancerous abnormalities in the cervix. No woman, in my opinion, should be dying of cervical cancer.
Medtronic Survey Reveals Many Myths
When Couric teamed up with Medtronic, she was surprised by the healthcare technology company’s survey results which revealed pervasive myths. For instance, one in three women still believe that colorectal cancer affects men more than women. In reality, men and women are at nearly equal risk: 1 in 25 women versus 1 in 23 men. This misperception is impacting screening rates as less than half (44%) of Gen X women who are eligible for screening have undergone colonoscopies. Twice as many women (80%), interestingly, have had a mammogram. While Couric is happy that women are embracing breast cancer screening, she pointed out that many young women still believe the myth that colon cancer is an “old man’s disease.” Hearing this, the classic Katie Couric spirit shone through.
“We need to remind [women] that their colons are as important as their breasts!”
More Younger People Are Getting Colon Cancer
Studies also reveal that colon cancer incidence is rising among younger adults, specifically those under age 50. This data led to the U.S. Preventive Services Task Force lowering its colon cancer screening recommendations to 45 from 50. Couric wants more doctors to be aware of this alarming cancer trend and screen patients accordingly. She also wants young adults to be mindful of unusual symptoms. A change in stool, rectal bleeding, blood in the stool, change in bowel habits, unintentional weight loss and fatigue should warrant a call to the doctor.
While the reasons for rising rates in younger people are unclear, specialists like Supriya Rao, MD, Dipl ABOM Dipl ABLM, Director of Medical Weight Loss at Lowell General Hospital, believe it’s multifactorial. “I recommend a healthy and active lifestyle including increased plants and fiber in your diet, 30 minutes of exercise a day, restful sleep and avoiding alcohol and tobacco,” advises Dr. Rao.
Can AI Transform Colon Cancer Screening?
Couric is very optimistic about the role of artificial intelligence in the field of colorectal cancer screening. The newly-minted grandmother discussed Medtronic’s GI Genius system which demonstrates AI’s ability to improve diagnostic accuracy and to serve as the endoscopist’s second set of eyes in detecting polyps. “I’m excited that AI is going to allow doctors to identify abnormalities [such as] polyps and get rid of them before they become cancerous.”
But even before AI can work its magic, people need to get themselves to the doctor. As Dr. Rao, Clinical Assistant Professor at Tufts University School of Medicine reminds us: “Don’t be afraid to discuss new symptoms of rectal bleeding, abdominal pain or changes in bowel habits with your physician. It could save your life.”
My Take
I have always respected Katie Couric for her intelligence, curiosity and journalistic integrity. But I underestimated how deeply she cares about health and how medically-savvy she is (when I said she deserved an honorary medical degree, she reminded me, “I actually have several honorary degrees!”) Couric is also one of the bravest people I’ve ever met. I couldn’t imagine losing the love of my life in my early 40s then raising two little kids while having such a public-facing career. As a physician who’s cared for many patients with cancer, I stand by Couric in reminding all of you to know your body, recognize unusual symptoms and advocate for colorectal cancer screening. Early detection can truly save your life. [The full interview will air on my YouTube channel on Friday 3pm EST, 3/29/24].
