There is no debate that colonoscopies are vital for the early detection and treatment of cancers of the colon and rectum. Colorectal cancer is the third most deadly cancer among American men and women. The American Cancer Society recommends people begin regular colon screenings at age 50 or earlier if they have a family history of the disease or are presenting bothersome symptoms.

But the procedure is no cakewalk. It involves a one- to two-day prep of cleansing the bowel with a laxative solution that can make patients sick, if not uncomfortable. For the procedure, patients are sedated and a surgeon runs a thin, flexible scope into the colon to look for signs of cancer or polyps, which can be immediately removed.

Because of the uncomfortable nature of the exam, doctors worry that too few people actually have colonoscopies. And those who require follow-up exams may be less inclined to go.

Researchers analyzed data from 3,627 participants in a National Cancer Institute-sponsored trial and found “significant underuse” of surveillance colonoscopy among those considered high-risk for colorectal cancer. Within five years of an initial colonoscopy, only 58.3 percent of patients with advanced precancerous growths had a follow-up colonoscopy, which is typically recommended every three year for such patients.

But even more surprising, researchers also found what they called “substantial overuse” of surveillance colonoscopies among people considered low-risk for colorectal cancer.

“This is a clear example of an intervention not being utilized in relation to the risk,” said Dr. Robert Schoen, senior investigator of the study. The report appears in the latest issue of the journal Gastroenterology.

Source: Reuters

SOURCE: Fleet Attorney › Too many colonoscopies performed on those at low risk for colon cancer

That is one reason why colon cancer has become the second leading cause of cancer-related deaths among U.S. men and women combined. Colon cancer is highly treatable if caught early. But symptoms of colon cancer are often unnoticed or nonexistent until the disease progresses into later stages.

Regular colon screenings with a colonoscopy are recommended for people beginning at age 50 and earlier for people with a family history or who have symptoms such as blood in the stool. But colonoscopies are intimidating.

The process involves sending a probe into the colon while the patient is sedated. To prepare for the procedure, patients must spend at day or two cleansing their bowels, which can be uncomfortable and confining. But enduring such procedures to ensure good health is a small price to pay.

If people would have regular checkups and screenings, and heed the advice of their doctors, Graber says, more diseases could be diagnosed in their earlier, more treatable stages. Graber recommends that everyone adopt a more proactive approach to their health care by having an open dialog with their primary care physician about their general health and their personal and family medical history.

SOURCE: Fleet Attorney › People should be more proactive with their health

Colorectal cancer is the third most common cancer among men and women in the United States, and is among the most deadly of cancers. In an effort to improve those statistics, doctors began recommending that people have regular colon screenings, such as colonoscopies, to look for signs of the disease. Screenings are recommended beginning at age 50 or earlier for people who have a family history of colorectal cancer or are experiencing symptoms such as blood in the stool.

However, colonoscopies are intimidating. The procedure involves sending a tube with a camera on the end through the rectum and into the large intestines. Patients are sedated during the process, but they must prepare at least a day before the procedure by taking large amounts of laxatives to cleanse the bowel before a colonoscopy.

Between the uncomfortable prep required and the thought of the procedure itself, many people opt to go without. Studies show that less than 20 percent of the people who should be screened for colon cancer actually have a colonoscopy.

Which explains why companies like EDP Biotech are working tirelessly to find a more patient-friendly test. (Not to mention that approval of such a test would mean millions, if not billions, for the company that lands a suitable alternative to colonoscopies.)

EDP Biotech’s ColoMarker test involves adding a chemical to a small blood sample. The reading takes about 30 seconds, and the results are revealed on a computer screen. The test detects a certain marker in the blood that indicates if a patient is clear from colon cancer or needs further testing, perhaps by a colonoscopy.

In tests of 2,400 patients, the ColoMarker detected every case of colon cancer during treatable stages. The company is currently seeking FDA approval and hopes to have the ColoMarker available to the public in one to three years.

Source: WBIR.com

SOURCE: Fleet Attorney › Blood test to detect colon cancer seeks FDA approval

The newly released report includes data from the National Cancer Institute (NCI), part of the National Institutes of Health, the Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS), and the North American Association of Central Cancer Registries (NAACCR). The data shows a 3 percent decrease in new colon and rectal cancer cases in men and a 2.2 percent decrease in women. Deaths from colon and rectal cancers dropped 3.9 percent in men and 3.4 percent in women.

Using modeling projections of colorectal cancer rates, authors of the report say that with accelerated cancer control efforts in the United States, such as quitting smoking and having regular colonoscopies, as well as more effective chemotherapy treatments for the disease, overall deaths from colorectal cancers could be reduced by 50 percent by 2020.

“This report shows that we have begun to make progress reducing colorectal cancer. Yet, colorectal cancer still kills more people than any other cancer except lung cancer,” said CDC Director Thomas Frieden, M.D. “Reducing smoking further can bring lung and other cancer rates down, and improved colorectal cancer screening can prevent colorectal cancer.”

SOURCE: Fleet Attorney › NCI report: new cases of colon, rectal cancer deaths declining

The new test can detect more than 50 percent of pre-cancers and 85 percent of cancers, compared to 85 and 90 percent of cancers with a colonoscopy, says Kevin Conroy with Exact Sciences Corp. There is no day-long prep required, as with colonoscopy procedures, and the cost of the test is far less expensive – $300 to $400 compared to $2,500 for a colonoscopy.

The new test is expected to undergo clinical trials in 2011 and be submitted for FDA approval in 2012. While Exact Sciences isn’t the only company working to develop more patient-friendly screenings for colorectal cancers, it is the only one that focuses on stool-based DNA testing for cancers of the colon and rectum.

“We’re taking it through an FDA clinical trial and then we intend to commercialize it broadly throughout the U.S., and then eventually globally,” Conroy said.

Colorectal cancer is the third most common cancer diagnosed in both men and women in the United States, with more than 106,000 new cases of colon cancer and 40,000 new cases of rectal cancer reported in 2009, according to the American Cancer Society. Regular colon screenings are recommended for people beginning at age 50 and earlier for people with a family history of colorectal cancer or who are experiencing symptoms such as blood in the stool.

Source: Milwaukee-Wisconsin Journal Sentinel

SOURCE: Fleet Attorney › Less invasive alternative to colonoscopy set for 2011 clinical trial

Patients were referred to GIA by the InterFaith Health Clinic and The Free Medical Clinic of America, both Knoxville-based organizations that provide health care to the needy. More than half of the people screened had polyps removed. Of the 48 persons screened Saturday, a total of 25 had polyps removed and sent for testing, 16 women and nine men. Twenty-three had no polyps, 15 women and eight men. Polyps, which are typically benign, may contain a small area of cancer or develop into cancer if not removed.

Colon cancer is the second most deadly cancer. “This is a higher percentage than in the population as a whole,” said Dr. Bergein F. (Gene) Overholt of GIA. “This is a big step in the battle against colon cancer. It was a real privilege to serve this group of people.”

Overholt called on other U.S. gastrointestinal practices to replicate “GIA Screening Colonoscopy Day” to help those less fortunate and to make everyone aware of the need for colon screenings. “The national health care debate has focused attention on the role of physicians and other health care professionals,” he said. “I think this can be a great demonstration of the concern medical professionals have for the well-being of their patients.”

Other screening sponsors include Anesthesia Associates of Knoxville, Mercy Health Partners, Premier Surgical Associates, The Endoscopy Center, GI Pathology of Memphis, Boston Scientific, Interactive Optics, the American Cancer Society and Braintree Laboratories Inc.

SOURCE: Fleet Attorney › GI clinic gives free colonoscopies to the needy

During a colonoscopy, a doctor inserts a long tube with a camera on the end through the rectum and the intestines to look for polyps, signs of early colon cancer. The procedure can virtually remove the risk of colon cancer if detected early, making regular colon screenings a must for individuals age 50 and older and earlier for those with a family history or who are showing signs of colon cancer.

The second bowel cleaning some physicians recommend prior to a colonoscopy follows the day-before rigors of drinking a laxative solution or taking a pill that purges the bowels of its contents. Doctors have found that even after the bowel has been prepped the day before and no more food consumed, sometimes a collection of dead cells, bacterial secretions, mucus, bile and other debris collect in the bowels during the night and can interfere with the physician’s view during the procedure. The second cleansing is usually preformed about five hours before the colonoscopy is scheduled, requiring some patients to wake extra early to “get moving.”

But one word of caution about the bowel cleansing process. Take a close look at the laxative your are prescribed or told to purchase over-the-counter by your doctor. A type of laxative often used to cleanse the bowel before colonoscopies, called oral sodium phosphates, or OSPs, have been linked to serious kidney injury. In some cases, the injury has resulted in kidney failure. The finding has resulted in a black box warning on prescription brands of OSPs, such as Visicol and Osmo Prep, and the removal of over-the-counter Fleet OSPs. If you have experienced kidney injury days, weeks or even months after taking OSP products to cleanse the bowel, you may have a claim against the manufacturer.

Source: Boston.com

SOURCE: Fleet Attorney › Second bowel cleansing recommended for colonoscopies

Colorectal cancer has the second highest overall cancer death rate. But it is easily treated if caught early. The best way to screen for colorectal cancer is through regular colonoscopies. U.S. health experts recommend people get regular colonoscopies beginning at age 50, or earlier if they have a family history or are showing signs of colorectal cancer, such as blood in the stool. But only about half of the people who should have the procedure actually have it done. Researchers say it is because the procedure is embarrassing, uncomfortable and may cause injury.

Both the standard and virtual colonoscopy require patients to first thoroughly cleanse their bowel. Doctors usually prescribe a laxative or recommend an over-the-counter product that is taken a day or two before the procedure. One of the most common laxatives used to cleanse the bowel is a product known as oral sodium phosphate, or OSP.

OSP is known by the prescription brand names Visicol and Osmo Prep, and OTC brands made by companies such as C.B. Fleet. Earlier this year, the Food and Drug Administration (FDA) issued a black box warning on the products after studies showed a link between OSPs and a serious kidney injury known as acute phosphate nephropathy. The condition can cause the kidneys to fail and some patients have had to rely on dialysis treatments.

Source: Montreal Gazette

SOURCE: Fleet Attorney › Virtual colonoscopy shows promising results

The New England Journal of Medicine says that a colonoscopy colorectal cancer screening is one of the few preventive services shown to reduce future health care costs.

“We know screening for colorectal cancer is good health policy, and makes good economic sense,” commented ACG President Dr. Eamonn Quigley. “When screening procedures detect colon cancer early, nine of ten patients beat the disease.  In the absence of screening, colon cancer is usually found too late and many patients die.  Those are starkly different outcomes that we have the power to change.”

It is the racial minorities, uninsured Americans and Medicare patients who should be tested but are not being screened appropriately, according to the ACG. ACG is committed to national policy changes to improve access to colorectal screening and increased use of these proven prevention strategies, including reversing Medicare’s massive cuts to reimbursement for these tests since the benefit was first introduced, as well as to payments in the ambulatory surgery centers where many screening tests are performed.

“We can point to impressive milestones indicating a trend moving in the right direction, yet much work remains,” Dr. Quigley said. “We will continue to champion the lifesaving potential of colonoscopy and work to expand access to lifesaving screening tests.”

SOURCE: Fleet Attorney › ACG applauds Obama’s support of colorectal screenings

Sure, the procedure can cause anxiety. Just the thought can make you cringe. And then there’s the process one has to endure to cleanse the bowel even before the procedure begins, a practice that can take a day or more. This involves taking a pill or drinking a solution that forces the intestines to purge their contents.

While an important procedure, it is not without its comics. This week, Sacramento Arts & Entertainment Examiner N.E. Frances, who was preparing for her own colonoscopy, compiled a list of humorous colonoscopy videos. If you’re preparing for a colonoscopy and are feeling a little anxious, check out the colonoscopy humor here.  It’s guaranteed to take at least a little of the stress out of the procedure.

Humor aside, colonoscopies do serve an important purpose. Colorectal cancer is the third leading cause of cancer-related deaths in the United States among men and women combined. Caught early, the disease can be curable, which is why regular colonoscopies are important. Colon screenings are recommended for people beginning at age 50 and younger for those who have a family history or are exhibiting symptoms, such as blood in the stool.

Risks from the procedure are low – about 0.35 percent.

Some patients may also suffer from complications from their bowel-cleansing solution. Recently, the Food and Drug Administration (FDA) issued a black box warning on prescription Oral Sodium Phosphates (OSP) such as Visicol and Osmo Prep because some patients who used the products suffered from a severe kidney injury known as acute phosphate nephropathy. Over-the-counter OSP solutions, such as those made by C.B. Fleet, have been pulled from the market. While the risks with OSPs is higher among older patients, most doctors have turned to other, safer laxatives to prep the bowel before colonoscopy.

Don’t be afraid to talk to your doctor about any concerns you may have about the bowel cleansing process, or the colonoscopy procedure.

SOURCE: Fleet Attorney › Humor takes the anxiety out of colonoscopies

Colorectal cancers often present no symptoms in the early stages, which is why screenings are important. Signs and symptoms of the disease may include

• A change in bowel habits, including diarrhea or constipation or a change in the consistency of your stool for more than a couple weeks;
• Rectal bleeding or blood in your stool;
• Persistent abdominal discomfort, such as cramps, gas or pain;
• Abdominal pain with a bowel movement;
• A feeling that your bowel doesn’t empty completely;
• Weakness or fatigue;
• Unexplained weight loss.

Some symptoms of colorectal cancer, such as blood in your stool, may indicate other conditions, so it is important to discuss your symptoms with your doctor. He may order a colonoscopy to rule out any serious problems. Discuss with your doctor any concerns you have about the procedure.

While generally safe, the elderly are more susceptible to problems from the procedures, most notably, a type of solution used to clean the bowel prior to colonoscopies, oral sodium phosphate (OSP), has been linked to a serious kidney injury. The prescription products, Visicol and Osmo Prep, now fall under an FDA black box warning and Fleet, makers of over-the-counter OSP products, have pulled them from the shelves.

Sources:
American Cancer Society
Mayo Clinic

SOURCE: Fleet Attorney › Understanding the symptoms of colorectal cancer

When researchers looked at data from all patients, rates showed a decrease of 2.8 percent in men and 2.2 percent in women. But when data was narrowed to just patients ages 20 to 49, the rates increased 1.5 percent in men and 1.6 percent in women.

Researchers then broke the data down into 10-year age groups (20-29, 30-39, 40-49) and noticed an annual increase of 5.2 percent in men and 5.6 percent in women who were in their 20s. However, among the group under 50, the actual number of cases of colorectal cancer were higher among those ages 40-49.

People are recommended to begin colorectal screenings beginning at age 50, or earlier for people with a family history or with symptoms of colorectal cancer. Colon screenings are usually performed in an outpatient basis following bowel cleansing with the use of prescription or over-the-counter tablets or solutions.

Be advised that some products for bowel cleansing, namely oral sodium phosphate (OSP) such as Visicol and Osmo Prep, now fall under a black box warning as the use of the products increase one’s risk of a serious kidney injury known as acute phosphate nephropathy. OTC OSP products such as those made by C. B. Fleet also have been linked to the condition.

Source: Cortlandt Forum

SOURCE: Fleet Attorney › Colorectal cancer rates rise among young adults

The colonoscopy has been considered a gold standard in the detection of ulcers, colon polyps, tumors, and areas of inflammation or bleeding. During a colonoscopy, a thin, flexible tube called a colonocsope with a video camera attached at the end is inserted into the rectum and colon, which allows your doctor to look at the lining of the large intestine.

During the colonoscopy, doctors can collect tissue samples, and abnormal growths, like polyps, can be removed. During the screening tests, doctors can check for cancer or precancerous cells in the polyps collected from the colon or rectum.

Before having a colonoscopy, patients must clean out their colons. A clear liquid diet is ordered and prescription or over-the-counter medications are usually taken to help loosen the stool and encourage elimination.

The procedures are extremely beneficial, but patients should be aware of some risks associated with the bowel-clearing products often used to prior to colonoscopies. Two prescription oral sodium phosphate (OSP) products from Salix Pharmaceuticals – Visicol and Osmo Prep – recently fell under a black box warning by the Food and Drug Administration (FDA) after reports of a serious form of kidney injury in patients who had used the products.

The FDA expressed similar concern over over-the-counter OSP solutions, such as Fleet Phospho-soda and Fleet Accu-Prep, that are often used at higher doses to cleanse the bowel before colonoscopies. As a result, maker C.B. Fleet has pulled those products from the shelves, making them only available by prescription.

You should discuss any concerns with your doctor.

Sources:
American Cancer Society
WebMD

SOURCE: Fleet Attorney › Colonoscopies beneficial for finding cancer early