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New technology eases colonoscopies
SALEM
With technology available at Salem Community Hospital, the dreaded colonoscopy can be a breeze.
No more drinking seemingly unending colon-cleansing fluids in preparation for the main event.
No more sedation medications and taking a day off work.
No potentially dangerous anesthetics and probing of the colon with a 20-foot-long tube with a flashlight and camera on the end used to search for cancer-causing polyps.
Instead, enter the virtual Dual-128 CT (computed tomography, sometimes called a CAT scan), offered at Salem Community for about one-third the cost of a traditional colonoscopy.
“There is no need to travel to big medical centers. The service is available locally,” said Dr. Peter Apicella, chairman of the Department of Medical Imaging at Salem Community Hospital.
Preparation also is reduced.
It involves a one-day clear-liquid diet of water, tea, coffee, and other beverages, imbibing small amounts of barium and gastrofin, and a night-before colonic cleansing with magnesium citrate, he said.
Other comfort, convenience and safety advantages for the patient include less time involved. The CT scan, which includes the pelvis in addition to the abdomen, takes just a few seconds and the whole procedure takes between 10 and 20 minutes. Patients usually can return to work immediately after the examination.
Also, rather than inserting a 20-foot-long tube into the colon, a small soft tube about the size of a straw is inserted a few inches into the colon through which a machine, which controls the flow of gas to prevent cramping, pumps CO2 gas to expand the colon. The patient will feel bloated for a few minutes, but the new scanner is so fast, it takes just a couple of seconds to scan the abdomen. The technologist will have the patient roll and repeat the scan. The gas is released and the patient feels normal, said Dr. Apicella.
There also are medical advantages to the virtual CT colonoscopy.
The new technology uses a very low dose of radiation and produces three-dimensional images, much like those of a 3-D movie, which give sharper, more accurate pictures for the physician/radiologist to view on their remote computer monitor.
When polyps are found, in about one in 10 cases, a traditional colonoscopy is done to remove the polyps before they become cancerous, and routinely are sent to the laboratory to test for cancer.
Early detection is the key to preventing colon cancer, the third leading cause of cancer in the United States, but only 30 percent of eligible individuals are screened by current methods, said Dr. Apicella.
Colon cancer is a leading cause of cancer death because most people will not take the time to be screened. This is unfortunate since colon cancer grows slowly and can be easily detected and cured. The most common symptoms of colon cancer are change in bowel habits, bleeding and dark stools. Recommended screening for colon cancer begins at age 50 before symptoms appear and continues at five or 10 year intervals, he said.
As an added bonus, the same virtual CT scan that views the interior of the colon also picks up conditions such as kidney stones, gallstones, aneurysms and tumors at an early stage before they cause symptoms.
The new CT has a special mode with images that are so detailed they can even show whether the kidney stone is calcified or not, which dictates the type of treatment, he said.
“We think this is the future. Most private insurance covers the new procedure, and the Department of Veterans Affairs is using it in all its hospitals. Medicare only covers the procedure for special circumstances,” Dr. Apicella said.
The next application for the hospital’s advanced Dual-128 CT scan system, which cost about $3 million, is a $99 lung-cancer screening for long-term smokers at risk for lung cancer, which is the leading cause of cancer deaths in the U.S. Early detection of lung cancer can save lives, he said.
The new lung-cancer screening, which began in September, is not covered by Medicare and most insurance companies, he said.
A 1982 graduate of Salem High School, Dr. Apicella graduated summa cum laude from John Carroll University, where he studied biochemistry and computer science, and did his radiology residency at Washington University in St. Louis.
He joined Salem Community in 1994 following in the footsteps of his father, Dr. Frank Apicella, who retired as a radiologist after 41 years.