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Photo courtesy of Barco ------ 5 columns color (or bw if it's only bw) for healthy living |
BY TESS HAMILTON
A relatively new procedure called virtual colonoscopy will soon bring colon cancer screening to area residents too squeamish, too busy or too sensitive to anesthesia to undergo a traditional colonoscopy.
Virtual colonoscopy offers a less invasive alternative to conventional methods, which require a tube to be threaded through the large intestine to look for precancerous growths called polyps.
Already available at major research institutions like the University of Virginia, virtual colonoscopy is now making its way to Fredericksburg.
Fredericksburg Radiology Associates has obtained the necessary equipment and hopes to offer virtual screenings to the public within the next six months.
The group recently began trials to build familiarity with virtual colonoscopy technology, which requires extensive hands-on training.
Dr. Christopher Meyer, a radiologist with the group, sees the group's investment in virtual colonoscopy as a logical response to its growing popularity.
"I have a feeling that this will be mainstream screening within a few years," Meyer said.
In virtual colonoscopy, also known as CT colonography, the doctor makes a digital three-dimensional model of the colon, which is scanned for unwanted growths.
The procedure gives people uncomfortable with sedation, or squeamish about having a tool put inside them, a more relaxing option. Studies show that most patients consider it a more convenient option.
And a more relaxing environment may make for more screening--and more early detection of colon cancer.
Though colon cancer is highly treatable when caught early, screening opportunities are consistently underused. In Virginia, as of 2002, only 40 percent of those over 50 had received colon cancer screenings at the recommended intervals.
Colon cancer screening is particularly important because of the effectiveness of treatment. When their cancer is found early, the five-year survival rate for colon cancer patients is 90 percent. Due largely to inconsistent screening, however, only 40 percent of colon cancers are found early.
The CDC estimates that proper screening of those over 50 could prevent 60 percent of colon cancer deaths.
Fredericksburg Radiology Group hopes to contribute to prevention efforts.
"The more options, the more people will actually be screened," Meyer said.
optimism and drawbacksThough candid about the procedure's disadvantages-particularly its out-of-pocket costs-Meyer considers virtual colonoscopy a valuable tool.
Virtual colonoscopy was first performed in 1994, but it has taken over a decade to move beyond major medical markets and research facilities. The delay is due to largely to uncertainty surrounding its effectiveness.
National groups are still trying to strike a balance between encouraging screening and treading cautiously with what they see as a developing technology.
The main concern of national research groups and cancer societies is effectiveness. Virtual colonoscopy has been shown to miss very small polyps in the colon that have a small but real chance of turning into cancer.
The American Cancer society, for example, supports virtual colonoscopy research and clinical trials, but is not ready to recommend the technology in place of conventional colonoscopy due to unresolved questions about precision.
Similar concerns have led the American College of Gastroenterology to endorse conventional colonoscopy over virtual methods.
Dr. David Johnson, president of the ACG, explained that the organization is not opposed to the procedure, but cannot recommend it when "there are a lot of unanswered questions" about its sensitivity and exaggerated claims about its comfort and safety. A particular concern is radiation exposure, as well as the possibility of discomfort and even injury from the air used to inflate the colon for screening.
The American College of Radiology recommends the procedure when patients are unable to undergo conventional colonoscopy, and as a backup procedure for normal-risk patients. The ACR has recently finished the largest study done to compare the two methods. Results will be available later this year.
Despite the controversy, Meyer is confident that virtual colonoscopy will soon be established as a recommended option for colon cancer screening.
"This is not us taking a leap of faith," Meyer said.
Dr. Waring Trible, a gastroenterologist at Rappahannock Gastroenterology Associates in Fredericksburg, is also excited about the innovative technology, despite its shortcomings.
"Anything that lowers the hurdle of getting your colon examined is a good thing," Trible said.
Tess Hamilton: 540/374-5000| Those over 50 should be screened. Options include:
Colonoscopy once every 10 years Fecal occult blood test--which checks for blood in the stool--every year Sigmoidoscopy (every 5 years) and double contrast barium enema (every 5 years). Those with a family or personal history of colon cancer or colon diseases should start earlier and may need more frequent screenings. Source: Centers for Disease Control and Prevention |
