Submitted by Mississippi Valley Surgery Center
Though it’s the second leading cancer killer in the United States, there are two things that set colorectal cancer apart from other cancers: it’s preventable and it’s beatable.
That’s what was circling in Evelyn Gullion’s mind when the Davenport resident received reminders from her gastroenterologist, Dr. Sreenivas Chintalapani, to schedule her third colonoscopy. Having a colonoscopy wasn’t something she was looking forward to, but she understood the value of the screening procedure.
“I wasn’t going to do it at first, but they keep after you so I decided to proceed,” said Evelyn. “If you think about it, having this type of screening is the only way you know what’s happening inside your body. Otherwise you just don’t know.
As a gastroenterologist at the Gastrointestinal Clinic of the Quad Cities, Dr. Chintalapani wishes everyone over 50 would be more like Evelyn—especially during Colon Cancer Awareness Month. Dr. Chintalapani frequently performs his colonoscopies at the Mississippi Valley Endoscopy Center, an outpatient facility specializing in the diagnosis and treatment of digestive system disorders.
“The biggest thing people need to realize is that colon cancer is a real threat,” he said. “A colonoscopy is not some passing test your doctor wants you to have. This is a disease that kills people and the important thing to remember is that it can be prevented through early screening.”
What Is Colorectal Cancer?
Colorectal cancer—also called colon cancer—is cancer that occurs in the colon or rectum. The colon is the large intestine or large bowel. The rectum is the passageway that connects the colon to the anus.
Colon cancer is different than most cancers because it’s highly treatable, especially when it’s discovered early. Even if it spreads into nearby lymph nodes, surgical treatment and chemotherapy are highly effective.
The Importance of Screenings
Colorectal cancer usually starts from abnormal growths, called polyps, located in the colon or rectum. Over time, some polyps can turn into cancer. Screening tests can find polyps so they can be removed before they turn into cancer. If everyone aged 50 years or older had regular screening tests, at least 60 percent of deaths from this cancer could be avoided.
“The best weapon is finding it as early as possible,” said Dr. Chintalapani. “Precancerous polyps and early-stage colorectal cancer don’t always cause symptoms. Stage 1 cancer and stage 4 feel exactly the same to the patient. Survival truly depends on when it is found and that’s why screening is so important.
Screening is particularly important for those individuals who have a family history of colorectal cancer. Those individuals should begin regular screening at age 40 (or 10 years before the affected relative’s age at onset of the disease) as opposed to age 50 like those who don’t have a family history.
There are numerous different types of screening choices available, ranging from very inexpensive to very expensive. Some of those include Stool DNA tests, Fecal Immunochemical Test (FIT), Flexible Sigmoidoscopy, Double-Contrast Barium Enema, and CT colonography or virtual colonoscopy among others. One of the most common types of screening is the colonoscopy, a simple and safe procedure in which the doctor uses a high-tech long tube, called a scope, with a light and camera to detect polyps.
“All the other diagnostic screening modalities will need colonoscopy to remove any polyps in up to half the cases,” said Dr. Chintalapani. “It’s the most complete screening method available. It provides visibility to the entire colon and if polyps are found, they can be removed right then, during the procedure.
Having a colonoscopy at a facility like the Mississippi Valley Endoscopy Center is smart. In addition to the highly experienced team, patients are often pleasantly surprised by the relative ease of their experience compared with the hospital setting, from registration to discharge
“Everyone at the Endoscopy Center was very nice,” said Evelyn. “They explained exactly what was going to happen and made me feel at ease. They got me ready and took me back to the room. Then the nurse gave me my sedation and the next thing I knew I was back in the recovery room.”
Colonoscopies—What to Expect
During the procedure, the physician examines the large bowel (colon and rectum) using a colonoscope—a four foot long, flexible tube about the thickness of a finger with a camera and a source of light at its tip. The procedure lasts approximately 20–30 minutes, but most patients spend about two to three hours in the clinic for the entire process. Sedation is used for most cases so the patient feels as though they’re in ” twilight sleep.” Anesthesia is used some cases, to make the patient feel relaxed and drowsy
Before a colonoscopy, patients are asked to clean out (empty) their colon. That’s because any residue in the colon may obscure the view of the colon and rectum during the exam
“The first time I had a colonoscopy—about 20 years ago—it was a three-day process. They put me on a very strict diet of jello and popsicles and I thought I was going to starve,” said Evelyn. “Now things are much easier. You have to drink a special liquid 24-hours before and can’t eat solid foods.”
Dr. Chintalapani emphasized the importance of bowel prep.
“For many people this is the biggest worry surrounding the procedure,” said Dr. Chintalapani. “While it can be a little uncomfortable going through prep, our goal is to make sure the patient goes through the procedure without any complications. If the bowel prep isn’t done properly, it’s harder to spot polyps, the colonoscopy may take longer, or the whole process may need to be repeated or rescheduled, meaning another round of bowel prep.”
What Makes a High Quality Colonoscopy
Not every colonoscopy is a good colonoscopy. Dr. Chintalapani recommends patients pick a Board Certified Gastroenterologist—and an accredited endoscopy ambulatory surgery center (ASC) or an ASC with high endoscopy volume—that have a proven track record of success to ensure you are receiving a high quality colonoscopy.
There are national standards that make it possible for patients to evaluate the experience and quality of work of different colonoscopy providers.
“At my practice, we have more than 50 years of cumulative experience and more than 50,000 colonoscopies under our belts,” said Dr. Chintalapani. “This volume and focus really makes a difference. We are evaluated at every step of the way to make sure we are meeting standards of care, and our completion rates are well above 95 percent, which is well above the national standard.”
When selecting a physician for a colonoscopy, Dr. Chintalapani recommends asking the following questions to ensure high quality colonoscopies.
- How often do colonoscopies result in complications? While complications are not entirely unavoidable, the Endoscopy Center’s rate is very low. Complications are seen in less than one case for every 1,000 cases, which is well above the national benchmark.
- How often do you reach the start of the large intestine? The most skilled doctors, including Dr. Chintalapani, reach the start of the large intestine more than 95 percent of the time.
- How often does your patient’s poor bowel prep lead to incomplete exams? It should be less than 15 percent of the time. In Dr. Chintalapani’s practice, this number is only 5 percent—largely due to the high levels of education that the team provides to all patients.
- How often do you find polyps during routine screenings? It’s common to find them in about 25 percent of screenings. According to Dr. Chintalapani, his practice exceeds that by almost 200 percent compared to the national average.
- Finally, ask when you should return for a follow up exam. Most patients don’t need another exam for another 10 years.
If you are 50 or older or have a family history of colon cancer, please contact Gastrointestinal Clinic of the Quad Cities at 563-359-9696. To learn more about the Mississippi Valley Endoscopy Center, visit www.mvhealth.net and like them on Facebook at facebook.com/MississippiValleySurgeryCenter
Photo Credit: KUO CHUN HUNG/iStock