loaded civil war cannon
with gunpowder mixed with purple anger
schredded medical bills printed in cold red blood
lab reports cold facts on rye
cat scans with dark shadows of the past
crushed confetti compressed into a cannon mixed with chocolate buckshot
i aimed the cannon
out the window and fired into times square below
a hot branding iron stamped "CURED"
hiding the cancer tatoo branded into my hide
I fired the cannon with the sound of sulfure mixed with whispers
explosion of rage into the street
white snow falling on a parade of cancer patients
returning home
after another chemo treatment
Wednesday, August 3, 2011
Tuesday, July 12, 2011
My Friend in the Muumuu
My chemo treatments had become routine. Xeloda twice a day at home, Oxyplain once a week in the doctor’s office. Today was Wednesday. Time for Oxyplatin.
Nurse Betty smiled and called my name. We walked to treatment room B. The door was left open. Nurse Betty took my vitals. Tried to get comfortable. Patients passed my open door. A bald woman dressed in a brilliantly colored Hawaiian muumuu dropped a large canvas bag to rest and peeked into my room.
“Good morning. How are you ?”
“Ok I guess…”
“What type of cancer do you have?”
“Stage three colon cancer. And you?”
“Ovarian.”
“What do you have in your bag there?”
She recited a list of items from memory. Magazines, a thick mystery novel, water bottles, snacks, walkman cassette player and new age relaxation tapes in a ziplock bag.
“How long is your chemo treatment?”
“Eight hours. And yours?”
“One hour.”
“I don’t know what your treatment is like. Did you bring a book?”
“Angels and Demons by Dan Brown.”
“Do you have a bookmark?”
“No. I use scrap paper”
“Here is a stainless steel bookmark. I got a bunch from my sister. I think you will like it.”
I smiled and thanked her for the gift. She picked up her bag and disappeared.
I was shocked. The lady in the muumuu had to endure eight hours of chemo!
Oh. My God.
I was lucky!
I will be out of here in one hour.
Nurse Betty entered my room with two clear bags, closed the door, hung a bag of saline solution and a bag of Oxyplatin over my head, put a needle in my left hand, adjusted the drip, checked her watch, made a note on my chart and asked how am I doing.
“Fine thanks.”
She disappeared. I read my book. The cold chemo creped up my arm. I tried to read with bookmark in place. Oxyplain knocked me out cold. I opened my eyes Rick was standing in the doorway to drive me home. In four hours I recovered. My friend in the muumuu was still sitting in a chemo chair for three more hours as I sat in a lounge chair watching Seabisket on a large screen TV and nibbled on mac and cheese.
I never saw my friend in the muumuu again. I don’t know her name. Don’t know if she is still alive. Still have the ACCO Stainless steel bookmark (made in Taiwan). Now holding my place in a Kurt Wallender mystery The Pyramid by Henning Mankell.
Nurse Betty smiled and called my name. We walked to treatment room B. The door was left open. Nurse Betty took my vitals. Tried to get comfortable. Patients passed my open door. A bald woman dressed in a brilliantly colored Hawaiian muumuu dropped a large canvas bag to rest and peeked into my room.
“Good morning. How are you ?”
“Ok I guess…”
“What type of cancer do you have?”
“Stage three colon cancer. And you?”
“Ovarian.”
“What do you have in your bag there?”
She recited a list of items from memory. Magazines, a thick mystery novel, water bottles, snacks, walkman cassette player and new age relaxation tapes in a ziplock bag.
“How long is your chemo treatment?”
“Eight hours. And yours?”
“One hour.”
“I don’t know what your treatment is like. Did you bring a book?”
“Angels and Demons by Dan Brown.”
“Do you have a bookmark?”
“No. I use scrap paper”
“Here is a stainless steel bookmark. I got a bunch from my sister. I think you will like it.”
I smiled and thanked her for the gift. She picked up her bag and disappeared.
I was shocked. The lady in the muumuu had to endure eight hours of chemo!
Oh. My God.
I was lucky!
I will be out of here in one hour.
Nurse Betty entered my room with two clear bags, closed the door, hung a bag of saline solution and a bag of Oxyplatin over my head, put a needle in my left hand, adjusted the drip, checked her watch, made a note on my chart and asked how am I doing.
“Fine thanks.”
She disappeared. I read my book. The cold chemo creped up my arm. I tried to read with bookmark in place. Oxyplain knocked me out cold. I opened my eyes Rick was standing in the doorway to drive me home. In four hours I recovered. My friend in the muumuu was still sitting in a chemo chair for three more hours as I sat in a lounge chair watching Seabisket on a large screen TV and nibbled on mac and cheese.
I never saw my friend in the muumuu again. I don’t know her name. Don’t know if she is still alive. Still have the ACCO Stainless steel bookmark (made in Taiwan). Now holding my place in a Kurt Wallender mystery The Pyramid by Henning Mankell.
Wednesday, May 18, 2011
Colon Cancer: Prevention, Early Detection and Treatment
Steps you can take NOW to prevent or defeat this highly treatable cancer
Colon (or colorectal) cancer is the second leading cause of cancer-related deaths among both men and women in the United States...
...Yet when diagnosed and treated in the early stages, it is among the most curable of all cancers.
Consider this: The five-year survival rate for people whose colon or rectal cancer is discovered and treated in its earliest stage is 93 percent.
In many cases, regular screening reveals precancerous growths that can be removed, thereby preventing cancer from developing in the first place. In fact, it is estimated that 80 to 90 percent of all colorectal cancers could be prevented if everyone were screened and polyps identified and removed!
The challenge: What can you do right now to protect yourself against colorectal cancer, or, if you've already been diagnosed, to ensure a positive outcome?
To answer this question, we turned to Ross. C. Donehower, M.D., Director of the Division of Medical Oncology at the Johns Hopkins University School of Medicine. Dr. Donehower is at the forefront of research in gastrointestinal malignancies and new anticancer therapies. Dr. Donehower shares his expertise and extensive hands-on experience treating patients with colorectal cancer and those at high risk for it in our new guide: Colon Cancer: Prevention, Early Detection and Treatment .
If you have been diagnosed with colon or rectal cancer - or you think you may be at risk - it's critically important to learn everything you can now, so you can partner with your doctor effectively, ask the right questions and understand the answers. That's why we have made Colon Cancer: Prevention, Early Detection and Treatment available to you instantly as a digital PDF download.
Just click the order button below and in a few moments your guide will be delivered to your email address. It's that simple.
Knowledge is Key
When It Comes To Preventing and Defeating Colon Cancer
What will you learn in this comprehensive resource? Colon Cancer: Prevention, Early Detection and Treatment explains the way colorectal cancer develops, how it can be detected early and how you can reduce your risk. It describes new developments in colon cancer screening, diagnosis, treatment and research. And it explains the ways in which people who have already been treated for colon cancer can lower their risk of having a recurrence.
In the early chapters, we explain the risk factors for colorectal cancer and look in-depth at the importance of family history. If you have a familial history of colon cancer, you may want to consider genetic testing to determine your risk. Is it a good idea? What about privacy concerns? What about the cost?
In Colon Cancer, we discuss the risks and benefits of genetic testing and counseling as well as the roles of diet, lifestyle and ethnicity on colon cancer risk.
You'll read about hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome) and familial adenomatous polyposis (FAP), the most common genetic causes of colon or rectal cancer. Other genetic conditions that increase your risk are also explained, including MUTYH-associated polyposis (MAP), Peutz-Jeghers syndrome (PJS) and juvenile polyposis syndrome (JPS).
The "Ick" Factor: Colon Cancer Screening
Fewer than HALF of Americans over the age of 50 have ever had any kind of colon-cancer screening test. If you've been putting off screening because of the "ick" factor, you'll want to read our chapter on Screening and Prevention, which explains your many screening choices:
Take-home fecal occult blood test (FOBT)
FIT - an alternative to the standard FOBT
Stool DNA test - the latest option
Flexible sigmoidoscopy - the five-year test
Colonoscopy - the gold standard
Double-contrast barium enema
Virtual colonoscopy - the new noninvasive option
Computed tomography - spiral CT scans, PET, MRI and ultrasound
What else can you do to prevent colon cancer? While the only known way to prevent it is to have regular colonoscopies to detect and remove precancerous polyps, researchers are looking at various medications, minerals and nutrients that may be protective.
We discuss the progress - and pitfalls - of many of the more promising options and offer bottom-line advice:
Asprin
HRT
Omega 3s
Statins
Vitamin B6
Vitamin D
For Patients Diagnosed with Colorectal Cancer:
Your Options for Treatment
If your polyp biopsy results come back positive for colon cancer, it's time to make treatment decisions, and these decisions often involve surgery. Dr. Donehower addresses many of the questions that may be on your mind as you weigh your treatment options:
What type of cancer do I have - colon or rectal?
Where is it located? Is it in more than one place?
Are the lymph glands involved? Has the cancer spread outside the colon?
What stage is the cancer?
Am I a candidate for minimally invasive therapy or do I need abdominal surgery for my colon cancer?
What's transanal edoscopic microsurgery (TEM)? What's fulguration?
What will happen during abdominal surgery for colorectal cancer?
What about recovery - how long will I be in the hospital and what complications can I expect?
Will I need adjuvant therapy after surgery - radiation, chemotherapy or both?
What drugs are used for chemotherapy?
How serious are the side effects from chemotherapy drugs?
New treatments for advanced colon cancer are emerging all the time, and can often offer hope of a longer life and better quality of life. In Colon Cancer you'll learn about:
State-of-the-art chemotherapy for treating advanced, recurrent, and metastatic colorectal cancer: "targeted" antibody therapies like Avastin, Erbitux and vertibix... transarterial chemoembolization (TACE)... hepatic artery infusion (HAI).
Radiation therapy is used most often for inoperable tumors or for tumors that have not responded to chemotherapy. Choices include: brachytherapy, intensity-modulated radiationt therapy (IMRT), intraoperative radiation therapy (IORT), TheraSphere and cyberknife.
Weighing the benefits of participating in a clinical trial. A clinical trial may give you access to promising new or experimental therapies that are not available otherwise.
Palliative and hospice care
Emotional issues surrounding colon cancer and its treatments
Direct to You From Johns Hopkins - America's #1 Hospital
Colon Cancer: Prevention, Early Detection and Treatment is designed to give you unprecedented access to the expertise of the hospital consistently ranked #1 of America's Best Hospitals by U.S. News & World Report -in annual rankings for more than 4,800 American hospitals.
Johns Hopkins Health Alerts
500 Fifth Avenue
19th Floor
New York, NY 10110
Attn: Web Team
Colon (or colorectal) cancer is the second leading cause of cancer-related deaths among both men and women in the United States...
...Yet when diagnosed and treated in the early stages, it is among the most curable of all cancers.
Consider this: The five-year survival rate for people whose colon or rectal cancer is discovered and treated in its earliest stage is 93 percent.
In many cases, regular screening reveals precancerous growths that can be removed, thereby preventing cancer from developing in the first place. In fact, it is estimated that 80 to 90 percent of all colorectal cancers could be prevented if everyone were screened and polyps identified and removed!
The challenge: What can you do right now to protect yourself against colorectal cancer, or, if you've already been diagnosed, to ensure a positive outcome?
To answer this question, we turned to Ross. C. Donehower, M.D., Director of the Division of Medical Oncology at the Johns Hopkins University School of Medicine. Dr. Donehower is at the forefront of research in gastrointestinal malignancies and new anticancer therapies. Dr. Donehower shares his expertise and extensive hands-on experience treating patients with colorectal cancer and those at high risk for it in our new guide: Colon Cancer: Prevention, Early Detection and Treatment .
If you have been diagnosed with colon or rectal cancer - or you think you may be at risk - it's critically important to learn everything you can now, so you can partner with your doctor effectively, ask the right questions and understand the answers. That's why we have made Colon Cancer: Prevention, Early Detection and Treatment available to you instantly as a digital PDF download.
Just click the order button below and in a few moments your guide will be delivered to your email address. It's that simple.
Knowledge is Key
When It Comes To Preventing and Defeating Colon Cancer
What will you learn in this comprehensive resource? Colon Cancer: Prevention, Early Detection and Treatment explains the way colorectal cancer develops, how it can be detected early and how you can reduce your risk. It describes new developments in colon cancer screening, diagnosis, treatment and research. And it explains the ways in which people who have already been treated for colon cancer can lower their risk of having a recurrence.
In the early chapters, we explain the risk factors for colorectal cancer and look in-depth at the importance of family history. If you have a familial history of colon cancer, you may want to consider genetic testing to determine your risk. Is it a good idea? What about privacy concerns? What about the cost?
In Colon Cancer, we discuss the risks and benefits of genetic testing and counseling as well as the roles of diet, lifestyle and ethnicity on colon cancer risk.
You'll read about hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome) and familial adenomatous polyposis (FAP), the most common genetic causes of colon or rectal cancer. Other genetic conditions that increase your risk are also explained, including MUTYH-associated polyposis (MAP), Peutz-Jeghers syndrome (PJS) and juvenile polyposis syndrome (JPS).
The "Ick" Factor: Colon Cancer Screening
Fewer than HALF of Americans over the age of 50 have ever had any kind of colon-cancer screening test. If you've been putting off screening because of the "ick" factor, you'll want to read our chapter on Screening and Prevention, which explains your many screening choices:
Take-home fecal occult blood test (FOBT)
FIT - an alternative to the standard FOBT
Stool DNA test - the latest option
Flexible sigmoidoscopy - the five-year test
Colonoscopy - the gold standard
Double-contrast barium enema
Virtual colonoscopy - the new noninvasive option
Computed tomography - spiral CT scans, PET, MRI and ultrasound
What else can you do to prevent colon cancer? While the only known way to prevent it is to have regular colonoscopies to detect and remove precancerous polyps, researchers are looking at various medications, minerals and nutrients that may be protective.
We discuss the progress - and pitfalls - of many of the more promising options and offer bottom-line advice:
Asprin
HRT
Omega 3s
Statins
Vitamin B6
Vitamin D
For Patients Diagnosed with Colorectal Cancer:
Your Options for Treatment
If your polyp biopsy results come back positive for colon cancer, it's time to make treatment decisions, and these decisions often involve surgery. Dr. Donehower addresses many of the questions that may be on your mind as you weigh your treatment options:
What type of cancer do I have - colon or rectal?
Where is it located? Is it in more than one place?
Are the lymph glands involved? Has the cancer spread outside the colon?
What stage is the cancer?
Am I a candidate for minimally invasive therapy or do I need abdominal surgery for my colon cancer?
What's transanal edoscopic microsurgery (TEM)? What's fulguration?
What will happen during abdominal surgery for colorectal cancer?
What about recovery - how long will I be in the hospital and what complications can I expect?
Will I need adjuvant therapy after surgery - radiation, chemotherapy or both?
What drugs are used for chemotherapy?
How serious are the side effects from chemotherapy drugs?
New treatments for advanced colon cancer are emerging all the time, and can often offer hope of a longer life and better quality of life. In Colon Cancer you'll learn about:
State-of-the-art chemotherapy for treating advanced, recurrent, and metastatic colorectal cancer: "targeted" antibody therapies like Avastin, Erbitux and vertibix... transarterial chemoembolization (TACE)... hepatic artery infusion (HAI).
Radiation therapy is used most often for inoperable tumors or for tumors that have not responded to chemotherapy. Choices include: brachytherapy, intensity-modulated radiationt therapy (IMRT), intraoperative radiation therapy (IORT), TheraSphere and cyberknife.
Weighing the benefits of participating in a clinical trial. A clinical trial may give you access to promising new or experimental therapies that are not available otherwise.
Palliative and hospice care
Emotional issues surrounding colon cancer and its treatments
Direct to You From Johns Hopkins - America's #1 Hospital
Colon Cancer: Prevention, Early Detection and Treatment is designed to give you unprecedented access to the expertise of the hospital consistently ranked #1 of America's Best Hospitals by U.S. News & World Report -in annual rankings for more than 4,800 American hospitals.
Johns Hopkins Health Alerts
500 Fifth Avenue
19th Floor
New York, NY 10110
Attn: Web Team
Wednesday, March 30, 2011
Signs and Symptoms of Colon Cancer
When something goes wrong with the digestive system, it usually makes itself known pretty quickly, through pain or discomfort. Common problems are upset stomach, constipation, and diarrhea, which are usually not serious and don’t last long.
Unfortunately, colon or rectal cancer may generate few or no symptoms in the early stages. Colon cancer grows slowly, does not usually interfere with function in early stages, and can remain undetected for some time. This is bad news; by the time symptoms are noticeable, colon cancer may be advanced.
Many symptoms of colon cancer that do show up could be related to other digestive issues. If they are related to colon cancer, the disease could be advanced beyond early stages. Therefore, signs or symptoms of digestive problems that last more than a few weeks should be discussed with your doctor.
Possible symptoms of colon cancer include:
* a change from usual bowel habits and appearance, such as constipation, diarrhea, or extremely narrow stools, that lasts for 10 days or more
* bright red blood in the stools or black, tarry stools, which can be a sign of rectal or intestinal bleeding
* pain or tenderness in the lower abdomen that doesn’t go away
* bloating, cramps, or gas pains
* a feeling that the rectum isn’t completely empty after bowel movements
* loss of appetite and weight
* anemia, which can be a sign of blood loss from intestinal bleeding
* vomiting
* persistent fatigue, paleness, and heart palpitations, which can be signs of anemia
* inability to pass stools at all for more than a week. This can signal an intestinal blockage, which is an emergency situation.
Posted from John's Hopkins University
Unfortunately, colon or rectal cancer may generate few or no symptoms in the early stages. Colon cancer grows slowly, does not usually interfere with function in early stages, and can remain undetected for some time. This is bad news; by the time symptoms are noticeable, colon cancer may be advanced.
Many symptoms of colon cancer that do show up could be related to other digestive issues. If they are related to colon cancer, the disease could be advanced beyond early stages. Therefore, signs or symptoms of digestive problems that last more than a few weeks should be discussed with your doctor.
Possible symptoms of colon cancer include:
* a change from usual bowel habits and appearance, such as constipation, diarrhea, or extremely narrow stools, that lasts for 10 days or more
* bright red blood in the stools or black, tarry stools, which can be a sign of rectal or intestinal bleeding
* pain or tenderness in the lower abdomen that doesn’t go away
* bloating, cramps, or gas pains
* a feeling that the rectum isn’t completely empty after bowel movements
* loss of appetite and weight
* anemia, which can be a sign of blood loss from intestinal bleeding
* vomiting
* persistent fatigue, paleness, and heart palpitations, which can be signs of anemia
* inability to pass stools at all for more than a week. This can signal an intestinal blockage, which is an emergency situation.
Posted from John's Hopkins University
Wednesday, March 9, 2011
Can dietary fiber help prevent colorectal cancer ?
The issue of whether dietary fiber can help prevent colorectal cancer has always been unclear, as studies have reached inconsistent results. Now a study from the Journal of the National Cancer Institute (Volume 102, page 614) suggests that the type of dietary assessment tools used in these studies might be to blame.
Researchers in the United Kingdom compared data from 579 people who developed colorectal cancer and 1,996 people who did not develop colorectal cancer. Some of the participants kept four-or seven-day food diaries in which they recorded what they ate, and others filled out a food frequency questionnaire detailing their usual diet.
In the food diary group, people who consumed 24 g of dietary fiber per day had a 30% lower risk of colorectal cancer than those who ate 10 g per day. This association remained even after the researchers adjusted for other risk factors such as age, physical activity, alcohol intake, and red meat consumption. However, the same analysis performed on the food frequency questionnaires did not find the same association.
Take-away message. Since food diaries are thought to be more accurate than food frequency questionnaires, this study supports the idea that higher dietary fiber intake can reduce colorectal cancer risk. Other studies using different parameters and assessment tools, such as food frequency questionnaires, may have reached inaccurate or inconclusive results.
Researchers in the United Kingdom compared data from 579 people who developed colorectal cancer and 1,996 people who did not develop colorectal cancer. Some of the participants kept four-or seven-day food diaries in which they recorded what they ate, and others filled out a food frequency questionnaire detailing their usual diet.
In the food diary group, people who consumed 24 g of dietary fiber per day had a 30% lower risk of colorectal cancer than those who ate 10 g per day. This association remained even after the researchers adjusted for other risk factors such as age, physical activity, alcohol intake, and red meat consumption. However, the same analysis performed on the food frequency questionnaires did not find the same association.
Take-away message. Since food diaries are thought to be more accurate than food frequency questionnaires, this study supports the idea that higher dietary fiber intake can reduce colorectal cancer risk. Other studies using different parameters and assessment tools, such as food frequency questionnaires, may have reached inaccurate or inconclusive results.
Friday, January 28, 2011
FICE -- A New Imaging Tool
FICE -- A New Imaging Tool
Colonoscopy is considered the gold standard for finding and removing – and possibly preventing – colorectal cancer. It can detect up to 95% of colon cancers and can be used to remove precancerous polyps before they develop into cancer. Today researchers are working to make colonoscopy an even better screening tool. One new imaging system in development is the Fuji Intelligent Chromo Endoscopy (FICE).
As with narrow-band imaging, FICE also narrows the bandwidth of conventional white-light colonoscopy to improve visualization, but it creates this effect electronically. Using special software, FICE takes the image transmitted from the white-light colonoscope and creates a "virtual" image at predetermined wavelengths.
The virtual image shows minute details in the polyp and the colon lining that can't be seen using standard colonoscopy. As with narrow-band imaging, the doctor can, with the push of a button, alternate between the white-light-generated image and the virtual one.
FICE is beneficial in the same way as narrow-band imaging. Research shows that it likely doesn't improve polyp detection, compared with white-light colonoscopy, but it does help differentiate cancerous and precancerous polyps from benign polyps. What's more, it may do it even better than narrow-band imaging. In a 2009 study in Gastrointestinal Endoscopy, the overall accuracy of FICE in identifying cancerous and noncancerous polyps during colonoscopy was 98%.
While the FICE device is commercially available, it is a newer technology than narrow-band imaging and its benefits in accurately identifying benign versus cancerous polyps require confirmation in larger studies.
From John Hopkins University
Colonoscopy is considered the gold standard for finding and removing – and possibly preventing – colorectal cancer. It can detect up to 95% of colon cancers and can be used to remove precancerous polyps before they develop into cancer. Today researchers are working to make colonoscopy an even better screening tool. One new imaging system in development is the Fuji Intelligent Chromo Endoscopy (FICE).
As with narrow-band imaging, FICE also narrows the bandwidth of conventional white-light colonoscopy to improve visualization, but it creates this effect electronically. Using special software, FICE takes the image transmitted from the white-light colonoscope and creates a "virtual" image at predetermined wavelengths.
The virtual image shows minute details in the polyp and the colon lining that can't be seen using standard colonoscopy. As with narrow-band imaging, the doctor can, with the push of a button, alternate between the white-light-generated image and the virtual one.
FICE is beneficial in the same way as narrow-band imaging. Research shows that it likely doesn't improve polyp detection, compared with white-light colonoscopy, but it does help differentiate cancerous and precancerous polyps from benign polyps. What's more, it may do it even better than narrow-band imaging. In a 2009 study in Gastrointestinal Endoscopy, the overall accuracy of FICE in identifying cancerous and noncancerous polyps during colonoscopy was 98%.
While the FICE device is commercially available, it is a newer technology than narrow-band imaging and its benefits in accurately identifying benign versus cancerous polyps require confirmation in larger studies.
From John Hopkins University
Wednesday, January 5, 2011
Narrow Band Colonoscopy
Mixed Results on Narrow-Band Imaging
A standard colonoscope uses a regular white light to illuminate the colon. Narrow-band imaging uses an optical filter to produce blue light, which provides more contrast between the polyp and the colon lining. At the push of a button, a colonoscope with narrow-band imaging capabilities can switch between white light and blue light. Blue light has a narrower wavelength, which is why the device is called "narrow-band" imaging.
Researchers hypothesized that narrow-band imaging would improve a doctor's ability to find polyps. But clinical trials have shown mixed results, with one randomized study reporting improved polyp detection and three others showing it was no better than standard white-light colonoscopy. Based on these results, narrow-band imaging will likely not be used to improve detection of polyps.
Where narrow-band imaging appears most promising, however, is in differentiating benign polyps from those that are cancerous or precancerous. Today, the standard of practice is to remove all polyps and send them to the pathology lab for analysis. But about a third of these polyps end up being benign and thus were removed unnecessarily, putting the patient at risk -- albeit a small risk -- for bleeding complications.
Narrow-band imaging can visualize differences in surface and blood vessel patterns that can help determine whether or not a polyp is cancerous. So far, six well-designed studies have investigated whether narrow-band imaging can be used accurately to differentiate polyp types during colonoscopy. These studies found that using narrow-band imaging, doctors could accurately identify suspicious and benign polyps about 80 to 90% of the time.
Although a narrow-band imaging colonoscope called Exera is commercially available, more research and refinement of this technology are necessary to bring the accuracy rate closer to 100%. If this level of accuracy is reached, doctors could begin diagnosing polyps during colonoscopy, removing only those that are life-threatening and leaving benign ones in place.
A standard colonoscope uses a regular white light to illuminate the colon. Narrow-band imaging uses an optical filter to produce blue light, which provides more contrast between the polyp and the colon lining. At the push of a button, a colonoscope with narrow-band imaging capabilities can switch between white light and blue light. Blue light has a narrower wavelength, which is why the device is called "narrow-band" imaging.
Researchers hypothesized that narrow-band imaging would improve a doctor's ability to find polyps. But clinical trials have shown mixed results, with one randomized study reporting improved polyp detection and three others showing it was no better than standard white-light colonoscopy. Based on these results, narrow-band imaging will likely not be used to improve detection of polyps.
Where narrow-band imaging appears most promising, however, is in differentiating benign polyps from those that are cancerous or precancerous. Today, the standard of practice is to remove all polyps and send them to the pathology lab for analysis. But about a third of these polyps end up being benign and thus were removed unnecessarily, putting the patient at risk -- albeit a small risk -- for bleeding complications.
Narrow-band imaging can visualize differences in surface and blood vessel patterns that can help determine whether or not a polyp is cancerous. So far, six well-designed studies have investigated whether narrow-band imaging can be used accurately to differentiate polyp types during colonoscopy. These studies found that using narrow-band imaging, doctors could accurately identify suspicious and benign polyps about 80 to 90% of the time.
Although a narrow-band imaging colonoscope called Exera is commercially available, more research and refinement of this technology are necessary to bring the accuracy rate closer to 100%. If this level of accuracy is reached, doctors could begin diagnosing polyps during colonoscopy, removing only those that are life-threatening and leaving benign ones in place.
Subscribe to:
Posts (Atom)