March is National Colorectal Cancer Awareness Month, and in the United States, colorectal cancer is the third most common cause of cancer death in both men and women. In Columbiana County, about 30 people die each year from this type of cancer. "Colon cancer refers to cancers of the large intestine, which is located in the lower part of a person's digestive system or in the rectum which is the last few inches of colon," explained board certified radiologist Peter Apicella, M.D. "Even though traditional colonoscopy is a very effecting screening method, colorectal cancer is still a leading cause of death because many people choose not to get screened for the disease, due to the perceived discomfort of the exam or its preparation. This is unfortunate, since colon cancer usually grows slowly and can be cured if found at an early stage."
Screening for Colon Cancer:
The American Cancer Society recommends screening for colorectal cancer beginning at age 50 and continuing every 5 or 10 years. Dr. Apicella explains, "Most cases of colorectal cancer begin as small growths or polyps which look like tiny strawberries growing on the wall of the colon. Over time, these polyps can grow larger and become cancerous. Screening studies are designed to detect colon polyps while small in size before symptoms occur. This screening process is difficult because the colon is like a long tunnel with lots of twists and turns and must be very clean to see well with traditional colonoscopy."
Screening: Traditional Colonoscopy
Dr. Apicella said, "For a traditional colonoscopy, the colon must be very clean, so the patient's physician will recommend a special diet and prescription medications to clean the colon a day or more before the procedure. During the traditional colonoscopy, a sedative medication will be given to put the person nearly to sleep. A flexible tube with a tiny video camera at the tip is then inserted into the colon, so that the physician can view inside. If necessary, polyps or other types of abnormal tissue can be removed through the tube during a colonoscopy. Following the exam, the patient recovers for a few hours afterwards, and can resume activities usually by the next day."
New Screening Technology: Virtual CT Colonoscopy
Symptoms of colon cancer include:
- A change in bowel habits, including diarrhea, constipation or stool consistency
- Rectal bleeding or blood in stool
- Persistent abdominal discomfort, such as cramps, gas or pain
- A feeling that your bowel
doesn't empty completely
- Weakness or fatigue
- Unexplained weight loss
Virtual CT Colonoscopy relies on the newest 3-D CT technology which is available locally only at the Salem Community Hospital. The goal of this fast, less-invasive colorectal screening test is to use a less vigorous bowel preparation, no sedation, and allow convenient scheduling so more people will be screened for colorectal cancer without even missing work. Dr. Apicella said, "We are fortunate at Salem Community Hospital to have a Dual-128 CT, the newest and fastest scanner between Cleveland and Pittsburgh, with the highest imaging quality and using the least radiation."
Virtual CT Colonoscopy - Patient Benefits
- Less vigorous bowel preparation
-3-D images of the entire colon and complete CT abdomen and pelvis
-Lowest radiation dose
"The preparation for the Virtual CT Colonoscopy procedure begins the day before with a clear liquid diet and the patient drinking small amounts of medication with breakfast, lunch, and dinner. The patient is able to work throughout the day and may drink liquids as needed to stay hydrated until after the exam. In the early evening, a glass of fizzing medication cleans the colon well enough for the exam the next day. Patients will want to spend some time in the bathroom that evening," Dr. Apicella added. "Because the test does not require sedation, convenient scheduling is available in the morning or on weekends. People may even drink their morning cup of coffee before the exam.
"The Virtual CT Colonoscopy examination takes only about 10-20 minutes and involves the person changing into a gown and lying on the CT scanner table. A short, straw-like tube is then placed into the colon and gas instilled. The gas machine is designed to avoid cramping but the patient will feel bloated for a few minutes. The CT scanner is so fast that it takes just a few seconds to image the abdomen, the patient then rolls on their belly and then their side, and the final images are obtained. When the gas is released, the patient will feel as good as normal. They can go eat breakfast and even go to work for the day." Dr Apicella added, "President Obama chose Virtual CT Colonoscopy a few years ago for his colon cancer screening, so that he didn't have to miss a day of work. One of the other major benefit of this exam is that unlike traditional colonoscopy, which just looks inside the colon, Virtual CT Colonoscopy obtains complete CT images of the abdomen and pelvis and can help detect other conditions like kidney stones, gallstones, aneurysms, or tumors at an earlier stage before they may cause symptoms."
"The challenging part of developing new medical technology is winning approval of the government and insurance companies," Dr. Apicella concluded. "Fortunately, many insurance carriers in our area have recognized that this test costs one-third as much as a traditional colonoscopy and is more likely to be requested by patients because it is less invasive, requires less vigorous bowel preparation, is faster, and more convenient. We even have a self-pay method which is lower than many insurance deductibles. We hope to win approval for screening from Medicare soon so that our seniors can also benefit from the examination."
Those interested in having a virtual CT colonoscopy can ask their doctors to refer them to Salem Community Hospital. Colon preparation is provided for free and the exam can be scheduled any day of the week and on weekends for convenience.
Peter Apicella, M.D., is a board certified radiologist and chairman of the Medical Imaging Department at Salem Community Hospital. For more information about virtual colonoscopy, please contact Salem Community Hospital's Medical Imaging Department at (330) 332-7413, or visit Dr. Apicella's website at www.salemrad.com.