COLONOSCOPY - NOT JUST FOR COLON CANCER
Virtual colonoscopy is being hailed as a life-saving diagnostic tool. In fact, a new study shows it's invaluable for spotting colon cancer. But now it may also help diagnose other diseases and one man may owe his life to it.
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Sculptor Stephen Hollingsworth thought he was the picture of health. That was, until he went in for a routine colonoscopy.
Stephen Hollingsworth
Had virtual colonoscopy
"They called me a few days later and they said, 'Your colon's fine, but we found this lump on your kidney.'"
Stephen had a virtual colonoscopy. It's a CT scan that looks inside the entire torso.
Judy Yee, MD
"We are sitting inside the colon and looking around at the wall of the colon from the inside."
But the scan also allows doctors to see more. Computer software enables them to zoom in on 3D images and examine anything suspicious. In Stephen's case, Doctor Judy Yee saw something disturbing.
Judy Yee, MD
Radiologist
San Francisco Veterans Administration Hospital
San Francisco, CA
"What we found was a mass on his left kidney that did not look benign."
In a recent study, 500 patients were given a virtual colonoscopy. 45 of them were diagnosed with serious diseases outside the colon -- problems like kidney cancer, lung lesions and even aneurysms. Doctors say it's not just what the test found, but when.
Judy Yee, MD
"When we do find diseases outside the colon, often it's at an earlier stage of the disease when it's more easily resected, more easily cured."
That was the case for Stephen. Usually, patients with kidney cancer don't have symptoms until it's too late. But the virtual colonoscopy found his before it spread.
Stephen Hollingsworth
"I feel lucky. If I hadn't had this thing, it would have progressed and probably would have killed me."
Now, Stephen's looking forward to many happy and healthy years.
Surgeons removed Stephen's cancerous tumor and say he's doing fine. Doctors recommend everyone over age 50 should have a colon screening, but only 40 percent of people actually do. They're hoping with this new minimally invasivie colonscopy, more people will be encouraged to have the screening done. The new scan is just as accurate as a standard colonoscopy when performed correctly.
BACKGROUND: Virtual colonoscopy uses X-rays and computers to produce two- and three-dimensional images of the colon (large intestine) from the lowest part, the rectum, all the way to the lower end of the small intestine and display them on a screen. The procedure is used to diagnose colon and bowel disease, polyps and cancer. Virtual colonoscopy can be performed with computed tomography (CT) or with magnetic resonance imaging (MRI).
THE PROCEDURE: While preparations for a virtual colonoscopy may vary, patients are usually asked to take laxatives or other oral agents at home the day before the procedure to clear stool from the colon. They may also be asked to use a suppository. The procedure will take place in the radiology department of a hospital or medical center. The exam takes about 10 minutes and does not require sedatives. During the procedure, the doctor asks the patient to lie on his/her back and inserts a thin tube into his/her rectum. Air is then pumped through the tube to inflate the colon for better viewing. The table moves through the scanner to produce a series of two-dimensional cross-sections along the length of the colon. A computer program puts these images together to create a three-dimensional picture that can be viewed on the video screen. The scanning procedure is then repeated as the patient lies on his/her stomach. After the exam, the information from the scanner must be processed to create the computer picture or image of the colon. A radiologist evaluates the results to identify any abnormalities. Patients may resume normal activity after the procedure. If abnormalities are found, some patients may need to have a conventional colonoscopy, which can be performed the same day.
ADVANTAGES AND DISADVANTAGES: Virtual colonoscopy is more comfortable than a conventional colonoscopy for some people because it does not use a colonoscope. As a result, no sedation is needed. Virtual colonoscopy provides clearer, more detailed images than a conventional X-ray. It also takes less time than a conventional colonoscopy. However, doctors cannot take tissue samples or remove polyps during a virtual colonoscopy, so a conventional colonoscopy must be performed if abnormalities are found. Also, virtual colonoscopy does not show as much detail as a conventional colonoscopy, so polyps smaller than 10 millimeters in diameter may not show up on the image.
VIRTUAL COLONOSCOPY FOR OTHER DISEASES: In a recent study, doctors found virtual colonoscopy not only detects colon cancer, but it may detect other diseases as well. Researchers studied 500 patients who were given a virtual colonoscopy. Forty-five of the patients were diagnosed with serious diseases outside the colon. Problems like kidney cancer, lung lesions and even aneurysms were detected. Doctors were also able to spot the diseases sooner with the virtual colonoscopy. Judy Yee, M.D., from San Francisco Veterans Administration Hospital, says, "When we do find diseases outside the colon [with a virtual colonoscopy], often it's at an earlier stage of the disease when it's more easily resected and more easily cured."
Steve Tokar
Manager of Communications
San Francisco VA Medical Center
4150 Clement Street, 151 NC
San Francisco, CA 94121-1545
(415) 221-4810 x5202
steve.tokar@ncire.org
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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