STANFORD, CA (Ivanhoe Newswire) - In the next twelve months, 150,000 people will be told they have colorectal cancer and 50,000 will die from it. The worst part is most of these deaths could have been prevented if the cancer would have been detected sooner. Now, a new camera is giving doctors a better view to detect cancer before it becomes a killer.
Time on the driving range is time well spent for john reed and his son Zach. They're learning the game together.
"Whenever we start off, he always hits in the woods, unless there's a lake, then I hit it in the lake, not the woods," Zachery Reed, John Reed's son, told Ivanhoe.
He may not be a straight shooter on the golf course, but when it comes to his health, john doesn't fool around.
"It has to start somewhere in your family, and I didn't want that to be me," John Reed said.
John's talking about colon cancer, and that's why the 51 year old recently had his first colonoscopy.
John is one of the first patients to use a new FDA approved device that gives doctors another view to the traditional colonoscopy, It's called third eye retroscope. A camera is snaked through five feet of your colon to detect polyps that could be an early sign of cancer.
"It's almost like a mushroom that grows inside the colon," George Triadafilopoulos, M.D., a gastroenterologist at Stanford University School of Medicine, explained. "The issue of the colonoscopy, is that's it's not perfect all the time. Sometimes these small polyps grow behind the fold, and they're not visualized at the time of the examination."
The third eye fits through the traditional colonoscopy catheter. Instead of just a forward facing camera, another tip comes through the catheter revealing a backward facing camera with an LED light.
"It's almost like having a rearview mirror in your car. As you drive forward, you can look through the mirror and see what's behind you, so you don't miss any spots," Dr. Triadafilopoulos said.
If a polyp is found, it can be removed immediately during the procedure. A new study shows the device detects 41 percent more precancerous polyps for people who are at high risk and 23 percent more in people not at risk.
As for John, he was polyp free and can now concentrate on his game.
"Having a bad day doesn't stress me out. It's better than having to do other things, like have a colonoscopy," John said.
It's recommended that everyone start getting a colonoscopy at the age of 50. How often after that depends on your family history and cancer risk.
RESEARCH SUMMARY
BACKGROUND: Colon cancer is cancer of the large intestine, colon, and the lower part of the digestive system. Rectal cancer is cancer of the last several inches of the colon. Together they are often referred to as colorectal cancer. Most cases of colon cancer begin as small, noncancerous, clumps of cells called adenomatous polyps. Overtime some of these polyps become colon cancers. Polyps can be small, and produce, if any, symptoms. For this reason, doctors recommend regular screening tests to help prevent colon cancer by identifying polyps before they become colon cancer. (www.mayoclinic.com)
CAUSES: In most cases, it is not clear what causes colon cancer. Doctors know that colon cancer occurs when healthy cells in the colon become altered. Healthy cells grow and divide in an orderly way to keep your body functioning normally. However, sometimes this growth gets out of control. Cells continue dividing even when new cells are not needed. In the colon and rectum, this exaggerated growth may cause precancerous cells to form in the lining of your intestine. Over a long period of time, spanning up to several years, some of these areas of abnormal cells may become cancerous. (www.mayoclinic.com)
SYMPTOMS: Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they will likely vary depending on the cancer's size and location in the large intestine. Symptoms can include: a change in bowel habits, diarrhea or constipation or a change in the consistency of the stool; rectal bleeding or blood in the stool; persistent abdominal discomfort such as cramps, gas or pain; a feeling that the bowel does not empty completely; weakness or fatigue; and unexplained weight loss. (www.mayoclinic.com)
SCREENING: The Third Eye Retroscope is an imaging device that illuminates and delivers a continuous retrograde view of the colon. When used in conjunction with a colonoscope, it allows the physician to look behind the folds to find hidden lesions and potentially increases diagnostic yield without significantly impacting procedural time. (www.thirdeyeretroscope.com)
APPLICATION: The Third Eye Retroscope is passed through the working channel of the standard colonoscope until it extends beyond its distal tip. As it emerges, the device automatically turns around 180 degrees to aim back toward the tip of the colonscope and the endoscopist locks it into place. Then, as the colonoscope is withdrawn from the colon, the Third Eye comes along with it, providing a continuous retrograde view to complement the forward view of the colonoscope. When a lesion has been detected in the retrograde view, quick and easy removal of the Third Eye Retroscope frees up the working channel for polypectomy snare or biopsy forcep. (www.thirdeyeretroscope.com)
INTERVIEW
Dr. George Triadafilopoulos, Gastroenterologist, Clinical Professor of Medicine at Stanford University talks about a new procedure for colonoscopy called Third Eye, which can look forwards and backwards to find polyps
Fifty thousand people die of colon cancer a year and they don't have to?
Dr. Triadafilopoulos: Correct and a hundred and fifty thousand are being diagnosed with colon cancer per year so that's a large number of the American population that suffer from this.
But it's one of the most treatable if detected early?
Dr. Triadafilopoulos: It is one of the most treatable or to say curable cancer and more importantly it's a preventable cancer. And that I think is very much of significance here in this discussion.
And the key is colonoscopy?
Dr. Triadafilopoulos: The key is colonoscopy, the key is to find out if you have the predisposition to colon cancer. That predisposition is called a colon polyp which is a little growth almost like a small mushroom that grows inside the intestine. If we look for those growths at an earlier stage before they become cancerous we can remove them during the exact same procedure, the colonoscopy. Eliminate them and therefore eliminate the risk of cancer.
Do all polyps become cancer if they're not eliminated?
Dr. Triadafilopoulos: Not necessarily so not all polyps become cancerous but if they stay there long enough they eventually deteriorate. So the earlier you pick them up and you remove them the better you are in terms of preventing colon cancer.
So after fifty you're supposed to be getting colonoscopies?
Dr. Triadafilopoulos: All the societies in the field of gastroenterology as well as cancer medicine recommend the colonoscopy at the age of fifty for everybody. Men and women of any ethnicity and race should have that.
But colonscopies there's some downfalls?
Dr. Triadafilopoulos: Actually if it's done by a professional who is well qualified to do the procedure it is a very safe intervention. Thousands and thousands of them are done every day in the United States and the world over so it's a very safe procedure, the risk of less than one to two per thousand of something to go wrong so it's a very safe procedure.
Safe but sometimes there's a higher missed rate?
Dr. Triadafilopoulos: The issue of the colonoscopy is that it's not perfect all the time and there are certain imperfections in the issue of colonoscopy. The imperfection that we face most commonly is a poor preparation. So if the patient is supposed to have a colonoscopy they are supposed to drink something the night before that will make them go to the bathroom and empty their bowels so when we look inside the bowel the bowel is clean. If that preparation is not adequate then the quality of the examination is inferior to what it should be and therefore inadequate. Another limitation of colonoscopy is that sometimes the small polyps grow behind a fold in the intestine and they are not visualized at the time of the examination. The examination is like looking through a tunnel and as you look through the tunnel you only look forward and as you remove the colonoscope and you go backwards and you may miss the things that are hiding behind folds. And therefore we have this new technology called third eye that allows us to look backwards as well as forward as we come out doing the examination. Therefore increasing the yield of detecting these polyps.
How long is the intestine that you have to go through?
Dr. Triadafilopoulos: About three and a half feet.
And that's a lot of folds in there?
Dr. Triadafilopoulos: That's a lot of folds because almost every inch or two inches there is a fold that you basically face in a normal colon.
What makes third eye different?
Dr. Triadafilopoulos: third eye is a special device that allows us to examine the bowel by looking backwards almost like having a rearview mirror on your bike or on your car. So as you drive forward or as you drive the colonoscope you can actually look through the mirror and you can actually see what happens behind you and you don't really miss any spots behind the car for example.
How many colonoscopies do you do a day?
Dr. Triadafilopoulos: Approximately ten.
How long have you been doing colonoscopies?
Dr. Triadafilopoulos: For thirty years.
When you first used this third eye what was that like for you?
Dr. Triadafilopoulos: It was very exciting of course because I was the first to use it ever so it was a very exciting time. But we realized over the course of the years, over the past ten years at least we recognized that colonoscopy has its inadequacies and we can miss polyps. When we came up with the third eye and we started using it in several studies we found out how much we thought we were missing is now picked up by the third eye which is a very significant innovation here.
What's the difference?
Dr. Triadafilopoulos: The difference is depending on the study and depending on the particular patient population it can go anywhere between five and forty percent so that's a significant difference. Of polyp detection that is better with the third eye than without the third eye. So as we're looking for polyps we think that we've gotten a good look and yet if we were to use the third eye we realized that we have missed on the average about twenty percent of polyps. So if we are going to do a colonoscopy it's best to do it with the help of a third eye thereby increasing to a max, hopefully max level, the quality of the examination so we do it only once instead of bringing the patient back more frequently to make sure that everything is okay.
Would the patient know any difference between the third eye and the normal colonoscopy?
Dr. Triadafilopoulos: Not at all it does not matter to the patient they don't feel any different. It's just a matter of using this additional tool that attaches to the colonoscope that allows us to look backward. Again it's the same thing as driving the car, you add the mirror or you drive the car without the mirror.
Did you develop this?
Dr. Triadafilopoulos: Not personally but a lot of smart engineers did. We did the help the development and the clinical implementation.
Did you see a need?
Dr. Triadafilopoulos: We saw a need for that very early on.
This is all covered by Medicare then?
Dr. Triadafilopoulos: It is covered by Medicare and it is covered by some insurers I think.
Do you have to ask for this or is this something that doctors will just go ahead and use?
Dr. Triadafilopoulos: If the doctor is using it in their practice then it is almost guaranteed that they will use it. Not all the physicians are using it as yet.
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