Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Genetic counseling followed by genetic testing should be considered for
individuals as well as their family members when there are:
Individuals in the family with early onset of colon
cancer, before age 50
Individuals in the family with numerous colon polyps
Families in which multiple members have colon cancer
Families with members with numerous colon polyps
Families with members having colon cancers at young
ages
Families with members having certain non-colon
cancers such as cancers of the uterus, thyroid, ureters, ovaries, small
intestine, etc.
Genetic testing without prior counseling is discouraged
because of the extensive family education that is involved and the complicated
nature of interpreting the test results.
Patients who have hereditary colon cancer syndromes usually
have no symptoms and are unaware that they have colon polyps or early colon
cancers. They usually will develop colon cancers early in life (often before
ages 40-50). Therefore, to prevent colon cancers in patients with hereditary
colon cancer syndromes, colon screening must begin early. For example, patients
with FAP should have annual flexible sigmoidoscopies starting at age 12,
patients with AFAP should have annual colonoscopies starting at age 25, and
patients with HNPCC should have colonoscopies beginning at age 25 (or 10 years
younger than the earliest colon cancer diagnosed in the family, whichever is
earlier). The current screening recommendations for the general population
(fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy beginning at ages 40-50) are
inadequate for most patients with hereditary colon cancer syndromes.
Genetic counseling and testing are important to identify
patients and family members with hereditary colon cancer syndromes so that
screening with flexible sigmoidoscopies and colonoscopies can begin early and,
if necessary, the colon can be removed surgically to prevent colon cancer.
Moreover, depending on which hereditary colon cancer syndrome is present, early
screening for other types of cancer such as ovarian, uterine, stomach, ureter, and thyroid may be
appropriate.
Colon cancer is a malignancy that arises from the inner lining of the colon. Most, if not all, of these cancers develop from colonic polyps. Removal of these precancerous polyps can prevent colon cancer.
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, Ulcerative colitis, or microscopic colitis). Treatment depends on the cause of the colitis.
A colon polyp is a benign tumor of the large intestine. Benign polyps do not invade nearby tissue or spread to other parts of the body. Benign polyps can easily be removed during colonoscopy and are not life threatening. If benign polyps are not removed from the large intestine, they can become malignant over time.
Anal cancer, cancer located at the end of the large intestine, has symptoms that include anal or rectal bleeding, anal pain or pressure, anal discharge or itching, a change in bowel movements, and/or a lump in the anal region. Treatment for anal cancer may involve radiation, chemotherapy, or surgery and depends upon the stage of the cancer, its location, whether cancer is eradicated after the first treatment, and whether the patient has HIV.
Gardners' syndrome, or familial adenomatous polyposis (FAP), is an inherited condition in which cancer of the colon and rectum develop. Colon polyps and growths may develop as early as the teens. If these polyps are not removed, they will become cancerous. There are different inheritance patterns for familial adenomatous polyposis.
The importance of a healthy lifestyle in disease prevention is widely understood and most people know that lifestyle changes and choices can be critical to good health. Yet, few practice healthy behaviors that constitute healthy living.
Disease prevention in men includes routine screening tests that are part of basic prevention medicine. Take an active role in your own health care and discuss screening tests with your doctor early in life. Age of screening and timing of screening depends upon the condition being assessed.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
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