Leading Medicine Spring/Summer 2026, Houston Methodist West Hospital Edition

LEADING MEDICINE

COLORECTAL CANCER SCREENING: What Young Adults Need to Know

Most people think of colorectal cancer as something that only affects older adults, but recent trends show that young adults are increasingly at risk.

“We’re seeing more and more young adults being diagnosed with colorectal cancer,” said Dr. Saurabh Chandan, a gastroenterologist and advanced endoscopist with Houston Methodist West Hospital. “On the one hand, rates are dropping in people over 65, but on the other, they’re rising among those under 50.”

Colorectal cancer now ranks as the leading cause of cancer death in men under 50, and the second in women, just behind breast cancer. Early detection can significantly change lives.

UNDERSTANDING YOUR RISK

Anyone over 45 is considered at average risk for colorectal cancer, which is why screening guidelines now recommend starting colonoscopies at that age. But younger adults aren’t immune.

Risk factors include being male, being of African American ethnicity, having a family history of colorectal cancer or polyps, having certain medical conditions like IBS or Crohn’s disease, having genetic syndromes and being exposed to radiation in the pelvic area.

“Even if you’re young and healthy, it’s important to understand if you have an increased risk,” Chandan advised. “If you are at higher risk, start building a health history with a gastrointestinal specialist now. Then, in the event you begin to experience concerning symptoms, you have an established doctor.”

SYMPTOMS TO KNOW

Regardless of your age or risk factors, it’s important to recognize colorectal cancer symptoms. The biggest red flags are rectal bleeding, blood in your stool or stool that’s darker than usual.

More subtle symptoms include:

■ Abdominal pain or cramping

■ Changes in bowel habits

■ Fatigue

■ Unexplained weight loss

“No symptom is too general to mention to your doctor,” Chandan said. “He or she knows which are concerning and can perform a workup to decide if more screening is needed.”

SCREENING OPTIONS

Colonoscopies are the gold standard for colorectal cancer screening. They’re typically recommended every 10 years starting at age 45, but if you’re at higher risk, your doctor might advise starting earlier or screening more often.

“A colonoscopy provides a visual of your colon and allows us to intervene right then and there if we see something unusual,” Chandan explained.

There are also less invasive screening options, such as immunochemical fecal tests, high-sensitivity blood tests, stool DNA tests, CT colonography and flexible sigmoidoscopy. Your doctor can help determine which option is best for you.

EARLY DETECTION IS KEY

Catching colorectal cancer early is critical.

“Caught in the later, more advanced stages, colorectal cancer is very hard to cure and treatment is usually palliative,” Chandan noted. “But when we catch colorectal cancer early, treatment is administered with a curative intent.”

If you have symptoms or risk factors, don’t put off talking to your doctor. Early action can save lives — even for young adults. •

to your doctor about colorectal cancer screening options. Visit houstonmethodist.org/ cancer/colorectal-cancer/screening or call 713.790.3333

WOMEN: Get to Know High Blood Pressure and Its Symptoms

You’ve probably heard about high blood pressure enough to know it’s something you should take seriously. But what else do you really understand about it?

“Having high blood pressure causes your heart to work harder and can lead to narrowing and stiffening of your arteries over time,” explained Dr. Irfan Iftikhar, a cardiologist at Houston Methodist West Hospital. “This raises your risk of heart disease, stroke and other health problems.”

Also, high blood pressure is considered a “silent” disease with few or no symptoms, making it frequently underdiagnosed.

SYMPTOMS CAN BE SUBTLE

Early signs of high blood pressure are often easy to miss. Common symptoms include headaches, fatigue and shortness of breath. These can be mistaken for stress or menopause.

“In some cases, a woman with high blood pressure does not have any noticeable symptoms,” Iftikhar said. “The best way to monitor your risk is to check your blood pressure regularly at your doctor’s office or a pharmacy kiosk.”

KNOW YOUR NUMBERS

Checking your blood pressure is only the first step. Understanding what the numbers mean is just as important:

■ Normal: below 120/80 mmHg

■ Elevated: 120-129/<80 mmHg

■ Stage 1 hypertension: 130-139/80-<90 mmHg

■ Stage 2 hypertension: 140/90 mmHg or higher

“If your blood pressure is elevated, we start to worry about progression,” Iftikhar explained. “The higher it gets, the harder it becomes to control and the more likely you are to experience complications.”

PREGNANCY CAN REVEAL HIGH BLOOD PRESSURE

Pregnancy sometimes uncovers high blood pressure that has gone unnoticed.

“Changes during pregnancy can unmask existing high blood pressure,” Iftikhar said. “There is also a specific form called preeclampsia, which is important to manage for both mom and baby.”

Preeclampsia usually resolves after delivery, but women are advised to follow their care team’s guidance closely.

RISK RISES AFTER MENOPAUSE

Hormonal changes and weight gain during menopause increase a woman’s risk of high blood pressure.

“Symptoms of menopause and high blood pressure overlap, such as fatigue and headaches,” Iftikhar added. “Women sometimes delay checkups because they think symptoms are related to menopause, which is another reason regular monitoring is so important.”

PREVENTION IS KEY

The good news: High blood pressure can be prevented. The key is to make healthy lifestyle choices while avoiding harmful habits. For example, try to get 150 minutes of physical activity a week, eat fresh foods, limit your salt intake, moderate your alcohol consumption, don’t smoke and regularly monitor your blood pressure.

“If you have high blood pressure, these steps are even more important for you,” Iftikhar explained. “Getting high blood pressure under control helps prevent it from progressing.”

High blood pressure often goes unnoticed, but it is manageable and preventable. Regular monitoring with a preventive cardiologist and developing healthy habits make all the difference. •

Our cardiovascular experts can help prevent, diagnose, manage and treat various heart conditions. To schedule an appointment, visit houstonmethodist. org/heart-hmw or call 713.332.2539

Steps to DETOX SCREEN TIME From Your Bedtime Routine

Health detox is a popular trend. Most people think of changing their diet, but what about digital detox? Our homes are full of screens — TV, smartphone, tablet, e-book and even some refrigerators. While these devices offer entertainment and convenience, you should think twice before using your smartphone before bedtime.

While it may be important to have a phone in your bedroom for emergencies, you should schedule apps to “sleep mode” during bedtime. The constant DMs (direct messages), “likes” or notifications don’t relax the mind or prepare you for rest. Some people even reach for their device if they wake up in the middle of the night — never a good idea.

“A great bedtime routine is one that helps us relax and wind down, rather than stimulates our brains,” said Dr. Olivia Tomasco, an internal medicine doctor with Houston Methodist Primary Care Group at West Hospital. “Inadequate rest results in daytime fatigue, grogginess and impaired functioning, and can further contribute to stress due to lack of rejuvenation.”

Lack of rest can affect your:

■ Blood-sugar regulation

■ Decision-making process

■ Immune system

■ Mood

■ Physical performance Instead, establish a bedtime routine that allows you to detox from your device.

AVOID DEVICES ONE HOUR BEFORE BED

To help you transition to putting your device away, set an alarm on your phone one hour before bed. This is your reminder to start winding down and get ready for rest.

“Avoid phones, TVs and tablets at least one to two hours before bedtime to prevent disruption of the circadian rhythm and promote better sleep quality,” Tomasco said. “Regular exercise and a nutritious diet also support healthy sleep patterns.”

FOLLOW A SLEEP SCHEDULE

The overstimulation from a device can impact your sleep cycle and trigger a stress defense. In turn, drowsiness the next day from sleep deprivation can lead to memory problems, irritability and difficulty concentrating.

“Going to bed and waking up at the same time each day really helps regulate the body’s circadian rhythm and improves sleep quality,” Tomasco explained.

MEDITATE, PRAY OR READ

Replacing your typical scrolling time with a book can relieve tension and help you relax. When deciding between a physical book or an e-book, choose the physical book. Even an e-book emits some blue light (see sidebar), which blocks the sleep hormone melatonin.

“Blue-light exposure before bed decreases melatonin and increases cortisol, making it harder to fall asleep and promoting alertness,” Tomasco explained.

TAKE A WARM SHOWER

Interacting with and watching a device — any device — activates the mind. Instead, your bedtime routine should include activity that helps your brain wind down and ease any built-up tensions from the day.

“Engage in a relaxing activity such as taking a warm bath or shower and practicing meditation to help calm the body to facilitate sleep initiation,” Tomasco suggested.

Afterward, transition into a cool, dimly-lit room — and don’t check your device.

USE SOOTHING LIGHTING AND SOUNDS

Some people enjoy the flicker and sound of a TV while falling asleep. Unfortunately, the screen does not ease the eyes, and the blue light can exacerbate the problem. Instead, change your room’s lighting. Add a lamp, battery-operated candle or a sound machine that also displays soft waves on the ceiling.

“Create a dim, quiet environment by limiting light, noise and vibrations, such as silencing your phone, to help signal the body and mind that it’s time to rest,” Tomasco said.

FINDING HELP

Sometimes, screen time before bed can act as a substitute for another mental or social issue, such as phone addiction or insomnia. If you can’t turn your mind off at night, your device is likely perpetuating the problem, not helping solve it.

If falling asleep or staying asleep remains difficult despite making changes, it may be time to talk with a primary care provider. Sleep challenges often have multiple contributors, and addressing them early can improve overall health, energy and daily performance. •

What Is Blue Light?

Blue light emitted from screens activates the body by increasing cortisol levels, making you more alert and interfering with the natural sleep-wake cycle, which is regulated by the circadian rhythm. Try turning on your digital device’s night mode or blue-light-blocking setting. There are also glasses and screen protectors with blue-light-blocking capabilities. However, not all products are made the same some may reduce blue-light exposure, but not block it completely, potentially still causing alertness and eye strain.

Same-Day Appointments

Even if you haven’t yet established care with a primary care doctor, get seen the same day for sleep issues and to manage your health and wellness and then you can establish ongoing care. To schedule a same-day or next day appointment, call 713.790.3333.

Find a Primary Care Provider

Houston Methodist Primary Care Group has more than 45 practices across the Greater Houston area. To find a doctor near you, visit houstonmethodist. org/pcg/west or call 713.441.7965

5 SIGNS:

Chronic neck or back pain can signal more than everyday strain. Your doctor may recommend a spine specialist — an expert trained to diagnose and treat spine conditions.

“Your spine must be strong enough to support your body yet flexible enough to move,” explained Dr. Vishal Patel, a neurosurgeon at Houston Methodist West Hospital. “When its components don’t work properly, pain or neurological symptoms like numbness and weakness can occur.”

Spine problems often stem from age-related changes and can cause neck or back pain. Conditions treated by specialists include spinal stenosis, herniated disks, spondylolisthesis, sciatica and more. However, not all pain stems from these issues. Muscle strains from injury, overuse or poor posture are also common.

Here are five signs that indicate it may be time to consult a spine specialist:

1. PAIN THAT WON’T GO AWAY

Neck or back pain lasting weeks or months warrants a thorough evaluation.

“We want to ensure there’s no spine problem,” Patel explained, “so we look for issues like degenerative disk disease or nerve compression.”

2. UNEXPLAINED NUMBNESS OR TINGLING

“Symptoms in the arms or legs may suggest spinal stenosis compressing the spinal cord,” Patel said. “If your symptoms can’t be explained by conditions like carpal tunnel, tennis elbow or neuropathy, it’s recommended to see a spine specialist for evaluation.”

Untreated spinal stenosis can worsen and affect mobility.

3. NECK PAIN WITH ARM PAIN

“When symptoms worsen, and pain extends into arms, hands and fingers, it suggests a spinal problem,” Patel noted.

For instance, neck pain might be caused by a herniated disk that’s putting pressure on nerves in the spine.

4. BACK PAIN WITH LEG PAIN

Pain extending into the lower extremities suggests a spine-related problem.

“At this stage, treatment often needs to go beyond physical therapy and over-the-counter (OTC) pain relievers,” Patel said.

5. OTHER TREATMENTS HAVE FAILED

If physical therapy, activity modifications or OTC medications don’t help, options like prescription drugs, nerve injections or surgery may be considered. Surgery can relieve nerve compression from herniated disks or bone spurs. In cases requiring structural correction, spinal fusion — using screws and rods — may be necessary.

“A spine specialist can guide you through all treatment options and help you choose what’s best for your condition and lifestyle,” Patel added. •

Do You Suffer From Neck or Back Pain?

Make an appointment with a spine specialist to uncover the cause of your pain. Visit houstonmethodist.org/spine/katy-west or call 713.441.0241

Why Your Annual Well-Woman Exam MATTERS

Taking time for your annual well-woman exam is a vital investment in your long-term health. These yearly visits aren’t just about fixing issues — they’re about preventing them.

“A yearly exam is an opportunity to prioritize your health and ensure you’re on the right track for the future,” emphasized Dr. Michael Hold, an obstetrician-gynecologist (OB-GYN) with Houston Methodist West Hospital.

Regular checkups allow you to focus on prevention, identify potential issues early and make informed choices about your well-being.

WHAT TO EXPECT AT YOUR VISIT

During your annual checkup, your doctor will perform a general physical exam, including checks on your heart, lungs and abdomen, as well as pelvic and breast exams.

“These visits are also a time to discuss recommended screenings,” Hold said. “We’ll review your health history and talk through any changes or concerns you may have.”

ESSENTIAL SCREENINGS BY AGE

“Your doctor will suggest screenings tailored to your age, medical history and risk factors,” Hold added. An overview of the screenings and recommended ages to be screened include:

■ Cervical cancer screening

- Ages 21-29: Pap test every three years

- Ages 30-64: Pap/HPV co-test every five years, Pap test alone every three years, or HPV testing alone every five years

- Ages 65+: Screening needs are determined with your doctor

■ Clinical breast exam

- Ages 25-39: Every one to three years

- Ages 40+: Yearly

■ Mammogram

- Ages 40-74: Yearly

- Ages 75+: Screening needs are determined with your doctor

■ Screening colonoscopy

- Ages 45+: Every 10 years

■ Bone density screening

- Ages 65+ or younger if risk factors: Every two to 10 years, based on results

If you have a family history or other risk factors, your doctor may suggest starting screenings earlier or having them more frequently.

OPEN COMMUNICATION IS KEY

Your annual exam is an opportunity to speak openly with your doctor. Expect questions about your health history, recent changes (such as sleep, diet or energy levels), family medical background, medications and mental health. Topics like relationships, safety and substance use might also come up.

“I encourage you to bring your own questions and concerns,” Hold said. “Honest conversations with your doctor help build trust and ensure you get the best care.”

Whether you’re curious about new symptoms, want advice on healthy habits or need guidance on screenings, no question is too small. Your doctor is there to support you, and being proactive helps you take charge of your health. •

Take Control of Your Health

To schedule an appointment with a Houston Methodist OB-GYN near you, visit houstonmethodist.org/ob-hmw or call 713.790.3333.

From highly personalized primary care to

specialty care and emergency care, your Houston Methodist team supports all your health care needs in one manageable system. Throughout Houston, our expert physicians are ready to listen and collaborate with you and each other — providing you with the best coordinated care possible.

That’s the difference between practicing medicine and leading it. For you.