Colon Cancer Screening: Know Your Options

Colon cancer is the second-leading cause of cancer death in the United States, even though it is one of the most treatable forms of the disease… if found early. Sadly, most Americans who should receive screenings, avoid it. This may be out of a mistaken belief that colon cancer can’t happen to them. Or fear of getting bad news. Or squeamishness. Or even embarrassment.

Whatever the reason, thousands of people die annually from a cancer that could easily have been cured, or even prevented. There is an answer; another option: Virtual Colonoscopy, offered by Lexington Diagnostic Center and Open MRI.

Unlike the traditional “optical” procedure, in which a fiber-optic tube is threaded through the bowel allowing the doctor to see and capture images along the way, virtual colonoscopy is performed outside the body, using CT scanning technology.

CT scan technology has been used for years to examine internal organs and structures – the liver, pancreas, brain, spine and joints, said George Privett, M.D., Medical Director at Lexington Diagnostic Center.  “Several years ago, doctors started to think about using CT technology to look at the colon.”

“The quality of the virtual colonoscopy is very good,” he said, adding, “Studies have shown it to be as accurate as an optical colonoscopy for identifying any significant sized polyp.” Lexington Diagnostic has been performing these procedures since 2009.

For patients, the benefits of virtual colonoscopy are many, Dr. Privett said. “First, because virtual colonoscopy is non-invasive, it doesn’t require sedation,” he said. “This allows patients to return to their normal daily activities immediately after the procedure, with no down time, no recovery period, no problem.”

Second, because virtual colonoscopy does not require snaking an instrument through the bowel, there is no risk of bowel perforation. And for patients on anti-coagulant therapy, virtual colonoscopy allows them to have the screening without stopping their medication regimen, reducing their risk of stroke.

What to Expect
As with a standard optical colonoscopy, patients must first complete a bowel prep over a period of 24 to 36 hours prior to the procedure. On the day of the exam, the patient comes to the center, completes some paperwork and then is positioned on the scanner table on their back. The bowel is inflated using air inserted with an enema tip. The first series of images is captured. The patient then lies face down on the table and the second set of images is completed.

The computer melds the images together to form a virtual view of the bowel, from the inside, across the descending, transverse and ascending colons. Even the hard-to-image appendix can be viewed. Results are read and interpreted by one of Lexington Diagnostic’s board-certified radiologists. If there’s a problem, the patient is informed immediately.

Should a polyp or tumor be found, Lexington Diagnostic Center has made arrangements with a local colorectal surgery group for its patients to be seen that same day for biopsy and to address the problem, allowing quick resolution and peace of mind for the patient.

Colon Cancer Screening Recommendations
The American Cancer Society recommends that men and women begin colon cancer screening at age 50 and continue the screening at regular intervals (every five to 10 years) until age 75.

People at high risk for colon cancer – those with a family history of the disease or a personal history of bowel problems – may begin screenings sooner. Talk to your primary care physician about what’s right for you.

Although virtual colonoscopy offers significant benefits for a large number of people, it’s not for everyone, including pregnant women; those with ulcerative colitis (especially an active case); people who have hip implants; or anyone with a previous rupture of the colon.

Insurance Coverage  
“Kentucky law requires that commercial insurance plans cover virtual colonoscopy in the same way that optical colonoscopy is covered”, Dr. Privett said. “The procedure is not covered by Medicare/Medicaid unless the patient tried and was unable to successfully complete an optical colonoscopy.”

For those with no insurance, Lexington Diagnostic offers special pricing for the procedure; a coupon is available on the center’s website.

Colonoscopy is not something people look forward to. But virtual colonoscopy can make the procedure easier and less intimidating for patients from all walks of life. “Somewhere between 5 and 10 percent of people who should have a screening colonoscopy in a year actually have it done,” Dr. Privett said. “If the availability of the virtual exam causes another 5 to 10 percent to have the screening, that’s a great thing,” he added.

Know the Warning Signs, Reduce your Risk
1.    Change in bowel habits
2.    Blood in the stool
3.    Cramps, abdominal pain
4.    Other bowel disorders

Unfortunately, by the time these warning signs become evident, it may be too late. For this reason, screening programs are vitally important.

When it comes to colon cancer, there are risk factors you can control, and those you cannot (such as your age or family history). Here are some things you can do to reduce your risk:
• Maintain a healthy weight.
• Eat a diet rich in fruits and vegetables.
• Get enough fiber in your diet.
• Follow a low-fat diet.
• Get regular exercise.
• Avoid tobacco use.

“If you use tobacco products in any form, stop,” Dr. Privett advises. “The risk of cancer increases considerably in patients who are smokers or who are exposed to second-hand smoke,” he said.  “There is no safe tobacco product.”

Lexington Diagnostic Center and Open MRI is located at 1725 Harrodsburg Road, Suite 100, Lexington. To find out more about our services and how we can save you money on your medical care, please check us out at www.lexingtondiagnostic.com or give us a call at (859) 278-7226.

Lung Cancer Screening

Low Dose CT Lung Cancer Screening
Dr. George W. Privett, Jr.

In honor of Lung Cancer Awareness Month, we should be reminded that Kentuckians have the highest rate of death from lung cancer in the United States. Most lung cancers cause no symptoms until they are too large to be successfully treated.

Lung Cancer is a dreaded diagnosis, particularly when it is discovered after it has already spread throughout the body. What can you do to lower your risk of early death from Lung Cancer? There are two things: 1. STOP SMOKING! and 2. Get a screening test for early detection.

Discovering a screening test that would effectively diagnose this disease before it spreads and would make a cure possible has not been easy. Chest X-rays and sputum analysis for malignant cell have been tried in the past without success.

Fortunately, the CT Scan became available. The CT (or Computed Tomography) scanner takes images of the lungs by spinning an X-ray tube around a patient lying on a bed. By using a powerful computer program, detailed images of the lung are obtained that can detect lung tumors as small as 2 mm. No injections or dyes are needed and the test takes less than 10 minutes. In addition and at no extra charge, other structures in the chest such as the aorta, spine, lymph nodes, heart and ribs are imaged.

We have been providing Low Dose Screening Lung CT for 10 years. However, it was only recently that a large study confirmed what we had suspected – a CT Screening is very effective at reducing deaths in high risk patients by detecting lung cancers early when they are still curable. (As an aside, Screening Lung CT is much more effective than Screening Mammograms and Screening PSA for prostate cancer.)

What is High Risk? High Risk is defined in patients are those who are 55 to 74 years of age who have smoked at least one pack of cigarettes per day for 30 years (or two packs per day for 15 years, etc.). If a tumor is found, then the patient will need additional tests and possibly a biopsy to determine if it is a cancer or something benign.

Because a spiral CT scan is so detailed, it is possible that something will show up on the exam that is not cancer (false positive) and additional necessary testing may be costly and lead to side-effects. There is also slight risk due to radiation exposure; however, modern screening is performed with low dose techniques to minimize the exposure.

Currently Anthem covers this Screening Lung CT, and because of the Affordable Care Act (Obama Care) all other commercial carriers must cover it by January 1, 2015. Medicare will decide if it is going to cover the Screening in November 2014. Low Dose CT may cost as much as $500 in some hospital based centers. For patients without insurance, the current cash price at Lexington Diagnostic Center is $169, and this includes the radiologist charge.

Remember, most lung cancer can be successfully treated if it is found early. If you are at high risk for lung cancer you should consider Low Dose CT Lung Screening, especially if you meet the following criteria:
• Age 55 to 74
• Current or past smoker
• 30 pack-year history of smoking
And no matter what your risk is…..If you are a smoker, stop!