Less Invasive Tests May
July 18th, 2012 by Holly Cornish
Mention the word “colonoscopy” to someone and they’ll probably get a funny look on their face. Although you’re unconscious during the test, it’s not a pleasant thing to think about or go through.
The most unpleasant part is the harsh laxatives you have to take to clear everything out before the test. Is there a better way? There may be now… keep reading…
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Despite the drawbacks, a colonoscopy is worth the bother because it gives you an excellent chance of avoiding colon cancer — one of the most common cancers. As opposed to, say, skin cancers, which are seldom fatal, or other cancers that are extremely rare, colon cancer is one you SHOULD worry about.
And you’re in luck, because colonoscopy is one screening test that IS successful at finding cancer and precancerous growths while they’re still easily treatable.
But if you’d like to avoid some of the bother and discomfort, a large federal study suggests that a simpler, less invasive lower bowel exam may reduce your risk of colon cancer almost as much as a full-scale colonoscopy.
The study, published online by the New England Journal of Medicine, suggests a sigmoidoscopy could be a cheaper, easier way to diagnose colon cancer risk.
The exam can be used to determine whether the lining of your lower sigmoid colon, rectum and anus are normal in color, size and texture. During the exam the doctor can also perform a biopsy on a suspicious growth if one is found.
During the exam, the doctor inserts a flexible tube into your anus and guides it through the rectum deeper into your lower colon, but not through the entire colon as in a colonoscopy. A small camera mounted on the scope sends videos that help the doctor examine the intestinal lining.
And this is BETTER than a colonoscopy because…
According to the National Institutes of Health (NIH), a sigmoidoscopy has quite a few advantages because it:
- Costs far less than the colonoscopy
- Doesn’t require sedation
- Examines only the sigmoid, or descending colon, and is less invasive
- Requires less bowel cleansing, i.e. harsh, nasty laxatives
Although it inspects only the lower part of the colon, this is where most colon cancers occur. And randomized clinical trials suggest that this procedure is effective in helping to reduce colon cancer incidence and deaths.
Current guidelines recommend that people at average risk should have a colonoscopy every 10 years. The sigmoidoscopy is recommended every five years—which increases the opportunity to catch abnormal growths sooner.
As with a colonoscopy, you still might need a laxative or an enema the night before, but it’s not necessary to evacuate the whole colon. And this is true for another screening option doctors use to check colon health…
Talk about ‘virtual reality!’
The American Cancer Society (ACS) has wholeheartedly endorsed the use of virtual colonoscopy as a screening tool for colon cancer.
This procedure uses computerized tomography (CT) scans to detect abnormalities or changes in your colon and rectum. The scan involves a massive dose of cancer-causing X-radiation, and for this reason I don’t recommend it. My first choice would be colonoscopy or sigmoidoscopy.
But so you’re informed about your full range of choices, I’ll describe what a virtual colonoscopy involves.
The exam only takes about 20 minutes and typically is performed in a hospital radiology department.
During the test, the patient lies on her left side on a table connected to a CT scanner or magnetic resonance imaging (MRI) machine.
With the patient’s knees up toward the chest, medical professionals insert a small tube in the rectum and gently pump air into the tube. This helps expand the colon so it’s easier to see.
Finally, with the patient lying on her back, the table slides into the CT or MRI machine to take hundreds of x-ray images of the colon. A computer combines the images to form 3-D pictures of the colon for viewing on a video monitor.
The exam is short and less invasive than a traditional colonoscopy. But remember that the virtual colon exam won’t allow a doctor to remove tissue samples or polyps.
And despite its sweeping endorsements by the medical establishment, many hospitals have been slow to adopt the procedure. They cite a lack of sufficient evidence to support approval for Medicare reimbursement.
With costs averaging between $400 to $800, the virtual scan is significantly less expensive than the average $1800 for a traditional colonoscopy.
But if doctors note a suspicious polyp, they must perform a colonoscopy anyway, in order to excise tissue for a biopsy. This is one reason Medicare won’t reimburse for the virtual scan.
There’s yet another option for checking your colon that won’t require the pesky laxative purge.
Introducing… the world’s first colon cleanser ‘app!’
Researchers at Massachusetts General Hospital (MGH) recently developed computer software that can digitally “cleanse” waste matter from a virtual colonoscopy.
According to study results published in the Annals of Internal Medicine, this procedure produces a pretty accurate picture of the colon wall and any potentially cancerous growths.
NO laxatives and NO probes are required, and this may make it more attractive to people who refuse to go through the more invasive tests.
Lead study author Dr. Michael Zalis, director of CT colonography at MGH, told Time magazine that “the level of performance was very comparable to CT [virtual] colonography as well as optical [scope-based] colonoscopy.”
For this procedure, reseachers asked 605 men and women between ages 50 and 85 to eat a low-fiber diet for two days before the virtual colonoscopy. They also drank small amounts of contrast agent dissolved in their food or drink three times a day.
The contrast agent selectively marked only digested food or drink and feces in the stomach or colon. This allowed all other tissues, including possible polyps, to remain untouched.
Patients underwent a 15 to 20 minute CT scan, without sedation, and were able to go back to their normal activities right after the test.
The investigators then used their software program to digitally remove all elements tagged by the contrast agent. This allowed radiologists to examine a whistle-clean picture of the colon.
Dr. Zalis said this procedure detected a whopping 91% of patients who had one or more of the high-risk lesions that were 10 mm or larger.
This screening tool still won’t allow doctors to remove and test suspicious tissue. But it may help ensure that a great many people don’t get unnecessary treatment for non-cancerous growths.
In any case, these newer, less-invasive tests may encourage more people to schedule colon screenings. And this just might be a step toward cutting colon cancer and death rates down to size.
Lee Euler Publisher