Colonoscopies save lives through cancer screening

By Paula J. McGarvey for The Montana Standard - 09/12/2006

Nurse Teal LaVelle checks a patient’s chart during a colonoscopy procedure at Summit Surgery Center in Butte, recently. Lisa Kunkle photos / The Montana Standard

While attending a colonoscopy recently in Butte, I couldn’t help but be reminded of that 1966 sci-fi flick, “Fantastic Voyage” where a shrunken submarine and crew are injected into an ailing man, giving us an inside look at the human body.

They say life imitates art, and although we still haven’t found a way to shrink a medical team, science has come up with a great way to look inside an unpopular, albeit necessary part of our anatomy.

Dr. Brian Landsverk of the Bozeman Gastro Clinic, routinely performs colonoscopies at Summit Surgery Center in Butte. Landsverk said the procedure is used primarily to screen for colon cancer and has the technology to allow physicians to remove small growths called polyps found during the procedure.

“Most polyps are precancerous, so it’s good that we take them out. If we remove them, they won’t turn into colon cancer,” he said. Landsverk said the procedure is also used to diagnose diseases such as ulcerative colitis, Crohn’s disease, diverticulitis and to find and treat internal hemorrhoids.

Landsverk explained that during a colonoscopy, a physician inserts a tiny camera at the end of a long scope into the rectum.

“It’s basically a long telephoto lens,” said Landsverk, who added that the scope was approximately the width of an adult’s little finger. The physician directs the scope through the tube-like colon, which averages about 5 feet in length. As it progresses, the camera transmits images to a video screen, giving the physician the opportunity to spot cancer in the early stages.

Linda Foote, age 50, recently had a colonoscopy to screen for cancer at Summit Surgery Center. A nurse by profession, Foote was already aware of the benefits of colorectal screening.

“I have a history of colon cancer in the family. If there’s something I can do about it, I will,” she said. Foote said that she experienced no discomfort during or after the procedure.

“I think the only part I didn’t like, was the prep,” she said.

Landsverk said dislike of the prep is a common patient complaint. Typically, patients must consume a clear liquid diet on the day before the procedure, followed by taking a pharmaceutical prep designed to empty the colon. The prep prompts frequent trips to the bathroom, but ultimately allows the physician to see clearly during the procedure.

On the day of the colonscopy, Landsverk said patients have an IV inserted and are given a sedative which creates a “conscious sedation”.

“They just feel very sleepy, relaxed and comfortable. Most people are unaware that we’ve even started (the procedure),” he said.

Landsverk said that air is introduced into the colon during the procedure and that some people experience cramping, pressure and bloating. Risks associated with the procedure are rare, but include bleeding, perforation of the colon and infection. Landsverk said most people just go home feeling groggy.

“Afterwards, the sedation can linger, so we don’t like people to drive or go to work,” he said.

The colonoscopy has become a valued tool in the early diagnosis of colorectal cancer. The American Cancer Society estimates that colorectal cancer will claim an estimated 55,000 lives in 2006.

“Colon cancer is the second leading cause of cancer deaths in the country and it’s preventable,” said Landsverk. Statistics show that finding the disease in its early stages can increase a patient’s five-year survival rate from less 10 percent to 90 percent.

Currently, the American Cancer Society reports that only 39 percent of colorectal cancers are being found in the early stages.

The good news is that statistics show that over the past 15 years, deaths from colorectal cancer have been dropping. The American Cancer Society credits better treatments, earlier diagnosis and increased screening as the likely reasons.

Although genetics have been found to play a role in the disease, lifestyle and diet can also be a factor and regular colorectal screening has been recommended by the American College of Gastroenterology, The American Academy of Family Physicians, The U.S. Agency for Health Care Policy and the American Cancer Society.

“It’s recommended by the American College of Gastroenterology for anyone over 50, even if you don’t have a family history,” said Landsverk. For those with a first degree relative such as a sibling or parent with colorectal cancer, Landsverk said screening should start 15 years before the age of onset of the disease in that relative.

Although procedures such as testing for blood in stool, barium enemas, flexible sigmoidoscopies and virtual colonoscopies can also be used to screen for colon cancer, Landsverk said that he prefers the colonoscopy. Landsverk said the procedure is more thorough and provides a 95 to 98 percent rate of accuracy. The procedure has the added plus of allowing the doctor to remove polyps during the procedure.

In what Landsverk calls “the Katie Couric effect,” the numbers of colonoscopies rise when people see celebrities like the former Today show host undergoing the procedure on TV or talking about it in the media. The same is true when they hear about it from friends and families.

“I think that most people have worries and concerns about it, but after they’ve had it, they feel a lot more comfortable about it. More people are having it done and telling others ‘it’s not that bad,’” he said.

t On the Web For more information about colorectal cancer visit www.cancer.org. For more information about colonoscopy, visit www.digestive.niddk.nih.gov.