00;00;00;18 - 00;00;07;15 Speaker 1 I'm Doctor Rob Winn and you're listening to Real cancer Talk from VCU Massey Comprehensive Cancer Center. 00;00;07;17 - 00;00;34;01 Community Clovia This is community conversations. The Black Health Wins podcast. I am this community. Yeah. And during this month of March, we're celebrating women in history for all of the great work you do locally and globally. And we also celebrate March Madness. But most importantly, we are bringing awareness not only to Virginia, but around the nation about colorectal cancer. And we're going to start that dialog. 00;00;34;01 - 00;00;45;29 Community Clovia And I always go to the source for you. He is too sweet to be sour. Your man of the hour. He is director of the VCU Massey Comprehensive Cancer Center. Doctor Robert Winn, how you doing? 00;00;46;02 - 00;00;56;11 Dr. Robert Winn Let's say hello anytime. I'm with you. I'm good. And it's March Madness season. They're both, you know, UVA and VCU actually did a solid job. They represented well. So it's all good. 00;00;56;14 - 00;01;14;08 Community Clovia It's all good. And we are saluting women as well. And I want to salute this wonderful women in history that's joining us today. She is Julianne Duvall, executive director of Cancer Linc, a colorectal cancer survivor. And we're going to start this dialog. Julianne, how are you? 00;01;14;11 - 00;01;19;20 Julianne Duvall I'm doing so well. Thank you for having me. I'm just delighted to be part of the conversation. This morning. 00;01;19;20 - 00;01;40;09 Community Clovia And I am delighted to have you. I have been talking about this for weeks, and the science is how we're going to get to Doctor Robert Winn. But share your story with us as a colorectal cancer survivor. Now, Julianne, before you start sharing this story, did you have any symptoms or... 00;01;40;11 - 00;02;12;08 Julianne Duvall No symptoms, no family history. No reason to think that anything was off kilter at all. I had, scheduled my initial screening. I was it was a little later than I was supposed to be because of Covid and not being able to get in for that. But I was 53 at my first screening, and I have to tell you, I walked into the screening a little cocky, like, piece of cake. 00;02;12;15 - 00;02;26;09 Julianne Duvall No worries. And they found a tumor, in my screening and my very first colonoscopy. No symptoms. So then the journey began from there. 00;02;26;15 - 00;02;49;29 Community Clovia Julianne, I want to jump in here really quick because I joke about this a lot, but it's truth. A lot of truth told in jokes, too. I always say it's cool to check your stool. And I've always said live filming. I've always done live filming from from my colonoscopies when I come out and I'm high on the gas and everything, and I always do a thumbs up and say, it's cool to check your stool. 00;02;50;02 - 00;02;52;20 Community Clovia Did you check your stool prior to that? 00;02;52;22 - 00;03;22;20 Julianne Duvall No. Okay. You didn't have any, you know, didn't really have any reason, didn't have any, you know, gi distress in any kind of regular way. Obviously everybody goes through periods of time where things are moving and things are not moving. But I didn't really have any anything that I was worried about. I knew I was past 50 and I was supposed to get the screening and my, gynecologist had put it on my to do list. 00;03;22;24 - 00;03;50;00 Julianne Duvall And like I said, with with Covid. So this was, February 2022 was when my cancer journey started. And I had, I think I took six months to be able to get in for that screening appointment. You know, like I said, lots of things were backed up after Covid and trying to get back to, you know, kind of regular routine things. 00;03;50;03 - 00;04;10;00 Julianne Duvall I was just trying to do due diligence, if you will. Yeah. I found a point of due due diligence, that I was trying to. Yeah. So show was trying to do what I was supposed to do for my health. And I knew I was a little bit later than I ought to have been, but without any symptoms. 00;04;10;03 - 00;04;37;15 Julianne Duvall You know, I had no worries going in. Well, that's why, you know, obviously, doctor, when we'll talk about the screening ages, you know, moving younger. I mean, I immediately started telling everybody I knew who was in their 40s, you know, hey, look, you know, it's time to start thinking about this. And I know a lot of people got screened because I, you know, because of my journey. 00;04;37;17 - 00;04;44;08 Julianne Duvall And they thought, oh, gosh, you know, maybe that's something I need to be paying attention to. 00;04;44;10 - 00;05;11;01 Dr. Robert Winn That's a great point that you just made. I mean, because, you know, here's the here's our reality. Colorectal as we stand today is still the second leading cause of cancer deaths in the United States. Now, the interesting part about that is that we had seen for a while a decline in the rates of just cancer overall, but certainly even colorectal cancer. 00;05;11;03 - 00;05;36;23 Dr. Robert Winn But I think people got lulled into sort of things were good. And what we found is that we are now worried that younger people are starting to get colorectal cancers, that whole young people sort of, you know, mystery. We don't know that. But what we do know is that the old days of thinking, yeah, 55 to 60 has now gone down to if you're 45 and over and you have not gotten screened. 00;05;36;26 - 00;05;58;07 Dr. Robert Winn Yeah, only, by the way, only a third of adults, one third, not two thirds. Only one third of adults in the United States actually, at this point have gotten colorectal screening. And it's easy in fact, I think, is too cool. What do you say? Don’t be too cool to check your stool. I love that, because. 00;05;58;09 - 00;06;02;18 Community Clovia I need to trade my dad Doctor Winn. Don’t y’all try to take it over at VCU Massey. 00;06;02;20 - 00;06;23;09 Dr. Robert Winn There's about that. But you know, research. Exactly. But when you think 30 years ago, 40 years ago, all they had really was, you know, the fecal colo- stuff which we were or you had to get, you know, the, the scope. And most people were like, what? And so we now have, you know, so many more ways. 00;06;23;09 - 00;06;44;15 Dr. Robert Winn Yes, of just simply screening even at home. So there's a lesser excuse now than it was 30 years ago to get screened. But I love your story because you exactly did the right thing. You're like, yeah, I'm 50. I ain't got no, you know, symptoms. That was what we used to think back in the day. But thank goodness what we recognize is that things, we need to move the goalposts a little bit. 00;06;44;15 - 00;06;48;10 Dr. Robert Winn So if you're 45 and over, you should get strength. 00;06;48;12 - 00;07;20;13 Julianne Duvall You know, kind of add to that Doctor Winn because I think that's that's you know, obviously the most important message today. But on the surface I didn't really even have any huge risk factors. I, you know, I'm not significantly overweight, which I know can be a risk factor. I'm not even a meat eater, which I know can be, you know, when you start to look at diet and things, relatively healthy, no other major health issues, no cancer in my family at all. 00;07;20;15 - 00;07;40;26 Julianne Duvall I'm talking any kind. I mean, I have to tell you, when the when the doctor, when I came to out of my little foggy fog and they gave me my ginger ale and the doctor came in to talk with me, I thought he was kidding. It's like, wait, we found what? You know, it just didn't make it just didn't add up. 00;07;40;26 - 00;08;02;20 Julianne Duvall And so, you know, that's why I think that the screening process and, you know, I obviously I launched in with a full colonoscopy, but as Doctor Winn said, you don't even have to do that for screening. I know a lot of people get worked up about a colonoscopy. I I've had so many of them now. And for the last four years its been a piece of cake. 00;08;02;22 - 00;08;06;14 Julianne Duvall But, you don't even have to do that for screening. 00;08;06;17 - 00;08;23;09 Community Clovia And Julianne, again, thank you so much for being here. I call you a colorectal cancer Thriver. You get that diagnosis and then the doctor offers treatment to you. And what was their treatment like and what treatment did you choose for your recovery? 00;08;23;10 - 00;08;46;08 Julianne Duvall Well the first yeah. So you know, the first thing is obviously they have to stage the cancer. So I was referred from the gastroenterologist to a colorectal surgeon. I have to tell you, as a, as somebody who leads an organization and I was not leading Cancer Linc at the time. I was the head of a school, and I was used to running my own schedule. 00;08;46;08 - 00;09;08;07 Julianne Duvall And I walked in and I said, here's when I can do surgery and here's spring break and here's. And he looked at me. He said, you're not in charge of this. And I thought, oh, now I really have to give over a lot of control over the, you know, decisions and things. So they went through the staging process. 00;09;08;08 - 00;09;55;15 Julianne Duvall I was stage three. Yeah. So then I, you know, I lived out in the Northern Neck, so I was in a rural area, but I also had, you know, some, some friends in, in Richmond that where I could stay if I needed to be in the city. And so I immediately got a consultation with Doctor Matin at, Massey and figured out, you know, what a path forward would be with, colorectal surgeon and, and, I was so fortunate to have a team of folks who were all talking to each other, because I lived out in the Northern Neck, the the recommendation. 00;09;55;19 - 00;10;30;16 Julianne Duvall Well, not because I lived there, but the recommendation was that I, go through chemo first and then radiation, and then surgery. So that was kind of the way that the year was going to be lined up. And, because I lived in the Northern Neck and, chemo was chemo pump. So every two weeks chemo where the bag had to get a stylish bag to hold the chemo pump where the chemo pumped for 48 hours. 00;10;30;19 - 00;10;59;22 Julianne Duvall I had chemo administered at the little local hospital out in Kilmarnock. And then about halfway through chemo, as I say, I failed chemo, but that's just my joke. My body wasn't responding to chemo particularly well, which seemed like a surprise. I was going to work. And I had an amazing support system. This is so important for for anybody going through treatment. 00;10;59;22 - 00;11;03;23 Julianne Duvall I had a community of folks around me who were helping. 00;11;03;26 - 00;11;10;16 Community Clovia And it takes all of that a support system. We have more. Stay close. This is community conversations. 00;11;10;24 - 00;11;37;05 Community Clovia For folks who are just joining us. Welcome to Community Conversations the Black Health Wins podcast. And our topic today is Colorectal Cancer Awareness Month. And it's all about screenings and most importantly, communication and a strong support effort. We're back on the show with my special guest, Julianne Duvall, executive director of Cancer Linc, and Doctor Robert Winn, director of the VCU Massey Comprehensive Cancer Center. 00;11;37;05 - 00;11;42;08 Community Clovia When it comes to science communications, family support means what? Doctor Winn? 00;11;42;15 - 00;12;04;24 Dr. Robert Winn Yeah, you know what that means everything to me and I, and I know people are thinking about colorectal cancer, and we're thinking about screening absolutely key prevention behaviors, eating well, sleeping low stress, all important. And actually when we think about the stages, I usually just sort of say you have the early stage, right? So if you find a polyp and they're doing the colonoscopy, they can take it out and boom, you're done. 00;12;04;25 - 00;12;26;03 Dr. Robert Winn It goes all the way from that to having chemo or radiation, as you just heard from Julianne. And or also surgery. But remember there are new therapies that are out. But actually that's not what I really will tell you is the game changer. That is a part of the foundation of how you change it. The game changer is the stuff that Julianne does incredibly well. 00;12;26;03 - 00;12;53;10 Dr. Robert Winn And she mentioned in the last segment communication and support. Because once you've done with the cancer, the truth of the matter is it's not about just surviving, it's about thriving. And how does one do that. And so to me, I think the 34% reduction in, cancer across the United States, in part, is certainly because of the screening, in part because better prevention, although, you know, you know, we're out there and we could be better on this yet. 00;12;53;13 - 00;13;04;19 Dr. Robert Winn But when it comes to that statement, but what I actually think is an unsung hero, and that is the thing that Julianne does with Cancer Linc and other things, which is support, because that's what people need. 00;13;04;21 - 00;13;29;29 Julianne Duvall You know, I mean, just to tie in part of the reason why I'm at Cancer Linc is because I was I was so fortunate in my treatment. I had amazing folks at Massey who helped see me through. I'm so fortunate. I avoided surgery, I had my tumor, was taken care of by chemo and radiation only, and I've been what they call a watch and wait. 00;13;30;02 - 00;13;59;04 Julianne Duvall So I have frequent screenings just to make sure that the tumor isn't growing back and it's been four years, knock on wood. And I have been completely healthy, but I was so fortunate to have a community around me to have some resources available to me. And that was because, you know, I had a security in my job, I had security in my housing, and not everybody has those things. 00;13;59;04 - 00;14;37;04 Julianne Duvall And so it was so important to me to become part of an organization that can help other cancer patients navigate all of the other things connected with a cancer diagnosis. We have amazing medical professionals in Richmond and at Massey and and they've got it. They've got the medical expertise. But there's so many other components that a cancer patient right at diagnosis starts facing things like, hey, how am I going to afford this is obviously the first question. 00;14;37;05 - 00;15;06;00 Julianne Duvall Yeah. And then the other, like, how am I going to work through treatment? What if I get evicted because I'm not able to keep up with my bills? What if I get denied for Social Security disabilities? All of those things, where you do need some handholding and an expert on your side, whether it's an attorney or financial advisor or another social worker who can help navigate all of that. 00;15;06;02 - 00;15;33;17 Julianne Duvall And that's what Cancer Linc does very well. We they I like to say we we walk the journey with a cancer patient, to be part of the comprehensive team, to make sure that that patient is able to stay on their medication, to stay on their treatment protocol, to focus on that process. So we are we are at no cost to cancer patients. 00;15;33;17 - 00;15;39;26 Julianne Duvall And, we're really here to make sure that cancer patients move from surviving to thriving. 00;15;39;29 - 00;16;02;14 Community Clovia Thank you so much for sharing that. And Julianne, thank you for sharing your story. And that's Cancer Linc I know I have listeners that are listening locally and globally trying to get that website. Just Google it at Cancer Linc and that's Cancer. L-I-N-C all one word Julianne. Again thank you Doctor Robert Winn we want to get back to the science. 00;16;02;14 - 00;16;08;20 Community Clovia Now what is the latest on colorectal cancer in the US and within Massey's catchment area. 00;16;08;22 - 00;16;37;05 Dr. Robert Winn Yeah. So you know so here's the good news. The good news is that we've done better over the last decade. We actually have seen almost, over the last decade, a 1%, almost a 1% decline in cancer deaths. The issue is, though, that as we are seeing a reduction in cancer deaths, we over the last several years have noticed the trend, particularly with younger people, where we're seeing increased rates of people getting new cancers. 00;16;37;07 - 00;16;59;28 Dr. Robert Winn And so it's a so all this says to us is that the screening and prevention matters now when it comes to the science. What I love about it is that, you know, we have new therapies, immunotherapies and a whole bunch of other things that are actually coming off the market to be able to sort of help fight other therapies that are actually even on the horizon that, you know, we haven't even called yet. 00;16;59;28 - 00;17;19;18 Dr. Robert Winn So the big picture is the treatment is going to be important. But what I love about what you and Julianna and what we're talking about today is the science of outreach and engagement and the science of thriving. Yeah. And in fact, we know that some of the therapies that you use, right, also can actually hurt things like your heart and your nerves. 00;17;19;22 - 00;17;50;02 Dr. Robert Winn We have a new emerging field. This is why I really love Cancer Linc, because it's a it's a social it's about the law and it's about making sure you can get things that you need, but it's also making sure that, you know, people like Susan Hong, who is the head of my survivorship program at Massey, also has the most wonderful opportunity to work with Cancer Linc to make sure that you're also getting things like you know, if you're having issues with hearing or if you're having issues GI that may be related to the drugs we get you in. 00;17;50;07 - 00;18;06;21 Dr. Robert Winn So when I think about the science and how far we've moved from colorectal cancer to what, 30 or 40 years ago, we used to do it. You know, we cut it out. We were like, good luck. I'll see you to all of that. All of a sudden. Know that you have issues around the treatment. And so they're checking you now. 00;18;06;22 - 00;18;27;18 Dr. Robert Winn They're looking at your mucosal health. And I mean it is just such a different world, for the same cancer. But that's because what do they say as you, as you know better, you do better. I think we're not we're starting to learn about colorectal cancer better not only in how to prevent it and how to treat it, but that once you've been treated, how to make sure you're whole. 00;18;27;18 - 00;18;29;12 Dr. Robert Winn That's why I love Cancer Linc. 00;18;29;15 - 00;18;37;05 Community Clovia And early detection is key. And I know it sounds like a cliche, but it's so true. And I know you agree with that. Julianne. 00;18;37;11 - 00;19;06;29 Julianne Duvall Well, it absolutely is, because obviously the earlier you find something, the easier treatment can be in your obviously, as Doctor Winn has talked about, your survival. Is is rate is so much higher. And we, you know, the cancer community I will call it in the greater Richmond area. And that's the hospital systems. And the community based organizations are all amazing. 00;19;06;29 - 00;19;32;16 Julianne Duvall We have a really amazing network. And one thing that Cancer Linc does, sort of sitting at the center of that, is point people in the right direction and walk them where they need to go and anticipate what they might be needing. But you know, that community piece, your own. You know your family, your friends, your church. You know, that's so vitally important. 00;19;32;16 - 00;19;47;09 Julianne Duvall But then also having another layer of experts and guidance through all of those things that you're navigating, it's really important. And we're we're so proud to be part of the cancer community in that way. 00;19;47;13 - 00;20;16;08 Dr. Robert Winn Julianne, you know what I love? What you know what I love what you just said. It's just trying to direct people because I don't know. But I know we've met people that when they've gotten the cancer word, sometimes people shut down. Yeah. And they don't hear. So being able to have someone that's able to guide you to other places, I think is one of the most important things that we've learned in this journey of cancer, that it's not just about the drug therapy, it's about what happens next. 00;20;16;11 - 00;20;37;27 Dr. Robert Winn How do you get appointment? Because, you know, you get foggy head when people say, hey, in fact I was going to ask you again and you know, out go back and ask you a question like, you know, you mentioned it. But what, you know, when you got the big C word to you, it sounds like initially was a joke, but how were you able to then get into action to sort of get every everything lined up? 00;20;37;27 - 00;20;41;20 Dr. Robert Winn Because sometimes those therapies, you know, the chemotherapy alone can make you tired. 00;20;41;26 - 00;21;02;18 Julianne Duvall Well, I again, I was such a fortunate circumstance in so many ways. If there's such a way to talk about that. I was the head of a school and I lived on campus at my school, I could walk home in the middle of the day and take a nap if I needed to. And, you know, very few other people have that. 00;21;02;18 - 00;21;30;05 Julianne Duvall And I recognized right away I am in a unique circumstance. And if there is anything that I can do to help ease the journey for others, that's my next purpose. And, so my life circumstances were very different than most than most people. And, I had security and, you know, a team around me that not everybody has. 00;21;30;05 - 00;21;42;07 Julianne Duvall And, you know, like I said, cancer Linc can help create that for for others who are going through it, who might not have it organically or in their job or family situation. 00;21;42;14 - 00;21;58;25 Community Clovia Cancer Linc sounds like it's the only way we're going to take another break and come on back, and we're going to talk about when is the best time for screening for colorectal cancer. Stay close. This is Community Conversations the Black Health Wins podcast. 00;21;58;28 - 00;22;23;27 Community Clovia Welcome back to Community Conversations, the Black Health Wins Podcast. We are highlighting Colorectal Cancer Awareness Month and colon cancer is preventable. Yes it is. My special guest joining me on the show. She is a colorectal cancer thriver Julianne Duvall. Thank you so much for being here. She is executive director of Cancer Linc. You can Google it and get all of that information. 00;22;23;29 - 00;22;35;09 Community Clovia And Doctor Winn is director of the VCU Massey Comprehensive Cancer Center. Doctor Winn how is it important and to get that early colorectal cancer screening? 00;22;35;12 - 00;22;55;15 Dr. Robert Winn No, he is what I would say, you know, in the in the Commonwealth of Virginia, we know that, it is still one of the top four cancers that kills people in Virginia. In fact, I think it's the number two, number 2 or 3 in the state. But here's the reality. G.I. Cancer is preventable because you have screening. 00;22;55;19 - 00;23;15;19 Dr. Robert Winn The same thing is true with breast cancer and many others. But here's the real fact. This is where science works now. Oftentimes people say, oh, that's fine. Some doctors don't know what they were doing. Well, here's the truth. You know, what I loved about your story is that you were absolutely in compliance with what the science taught us at that moment. 00;23;15;25 - 00;23;47;28 Dr. Robert Winn They said 50, and you're just like, you know, other people said, okay, I'll get screened at 50. But we found out because of the trend and other things like that is that actually we probably should have moved the needle earlier. And that's at 45. So what I love about your story is your story is one of not only triumphs for me, but it's also one to let people know that when they're hearing things and science and we're moving ages, it's not because we missed the first time, it's because we got more data that said, hey, the trends are saying that we can move it sooner. 00;23;47;28 - 00;24;09;04 Dr. Robert Winn And we imagine had you actually had been at 45, what we're recommending now. They may have picked that up even earlier. And so what I love about your story, it's also three part one and lets us know that the side continues to move and continues to benefit people. It also says that when you're in trouble, are the way we treat people now much better and much easier therapy. 00;24;09;05 - 00;24;27;27 Dr. Robert Winn And by the way, that when you actually post treatment, we got a whole team just like Cancer Linc and other things for you. So I if I had one thing to say today, if you 45, I'm just like, like what Biggie said, you know, if you didn't know before, now, you know, get yourself screening. You got a whole bunch of ways to do it. 00;24;27;27 - 00;24;29;12 Dr. Robert Winn So. So stop the whining. 00;24;29;15 - 00;24;47;02 Community Clovia Wow. You said a whole mouthful at that age for folks who are listening and our folks that are over 50 and under 50. If something doesn't look right or feel right, and as I said before, it's cool to check your stool. What should folks be looking for at the possibility of a problem or symptom? 00;24;47;04 - 00;25;05;11 Dr. Robert Winn Absolutely. Well, let's go to the first one, which I find pretty amazing, but sometimes happens if you're losing weight and you can't explain it because, yo, you ain't actually been on a diet, get yourself checked out. If you're having blood coming from your food, that people will say to me, well, I don't look at my stool, well you probably better start. 00;25;05;18 - 00;25;28;08 Dr. Robert Winn It should be a habit. Ain't nobody trying to tell you to stare at it, to take no pictures of it. But the reality is, that's an important part of your body every single day. And so if you have blood in your stools or if your stools look like it's greasy, or if all of a sudden it went from being a dark color to pair light, all of those are signs that you need to get yourself checked out. 00;25;28;10 - 00;25;43;12 Dr. Robert Winn But the reality is people can't check you out. Part of the doctor is that as a team, that we are a team that works with you, but we also need you to participate. Meaning that check your stool. You should be doing that on the daily. 00;25;43;14 - 00;26;07;28 Community Clovia Very good. Thank you so much for joining us on the show. We have moved that age from 50. So if family members are listening and they have family members under the age of 50, that number is now 45. 45 to start your colonoscopy screenings. Okay. All of this information is at MasseyCancerCenter.org. That's MasseyCancerCenter.org. 00;26;07;28 - 00;26;27;00 Community Clovia And Julianne Duvall, thank you so much for being on the show. Executive director of Cancer Linc. Please Google it. Get that information if you need support for your family and your village. If you get that C word, but also stay connected to VCU Massey Comprehensive Cancer Center and Doctor Winn, just help that all the way up for us. 00;26;27;00 - 00;26;30;02 Community Clovia I know you got a word before we go. 00;26;30;04 - 00;26;44;26 Dr. Robert Winn Listen, you know what I will do? I'm going to go. I'm old school. I'm going 70s now. I'll go back to Bill Withers. Julianne, thank you for having us. Have a lovely day. And that's how they go out. That's the way. Check your stool. 00;26;44;26 - 00;26;51;22 Community Clovia Y'all is cool, right? This has been Community Conversations, the Black Health Wins podcast.