New Ways to Diagnose Colon Cancer

New advances in colonoscopy promise faster and easier screenings.

If you've been putting off having a colonoscopy out of fear or dread, take heart: New advances are helping make this test faster and much easier to endure.
Durado Brooks, MD, director of Colorectal Cancer for the American Cancer Society, tells WebMD that "most people no longer experience any significant discomfort during the procedure. In fact most report they are pretty comfortable," he says.
Gastroenterologist Jennifer Christie, MD, agrees. "Patients are generally much more comfortable now than in the past. And one reason is because doctors are simply getting better at performing this screening. We're better trained and we're doing more procedures, so patients reap the benefits," says Christie, director of Women's Gastrointestinal Health and Motility at Mt. Sinai Medical Center in New York City.

How a Colonoscopy Works

A colonoscopy is one option recommended for screening of colon cancer in adults at average risk. A colonoscopy is performed by inserting a lighted, flexible tube called an endoscope into the rectum to visualize the inside of the colon. The end of the tube houses a tiny camera that relays the images back to a computer screen.
During the test doctors look for lesions known as "polyps." These are small growths that can sometimes be the precursor to colon cancer. If a polyp is found, the endoscope can also be used to remove them during the same procedure.
"In this sense a colonoscopy is both diagnostic and therapeutic -- it can find a problem and treat it during the same procedure," says Brooks.

Advances in Screening Techniques

If you had a colonoscopy in the past -- and didn't find it quite so easy to endure -- chances are your screening did not include the use of a deeper type of sedation that, until recently, was saved for more complex procedures.
"Traditionally we used just a sedative and a narcotic during colonoscopy. Now we're moving towards using an anesthesiologist so that the patient can be put into a deeper sleep without risking safety. And ultimately that means the procedure can be done more quickly and the patient is really very comfortable," says Christie.
Because, however, not all insurance companies will pay for an anesthesiologist, experts say in the future more gastroenterologists will likely be trained in administering anesthesia, particularly in conjunction with a nurse anesthetist.
In addition to more generous use of anesthesia, advances in the instruments used during the test itself are also increasing the comfort level for patients. One such advance helps reduce the incidence of "looping" -- a complication that can make the exam difficult to complete.
In this instance the flexible tubing used to view the inside of the colon gets caught in the multiple internal curves, causing the scope to push against the colon allowing a "loop" to form. This can make it difficult to complete the test.


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