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Fight Against Colon Cancer Goes Virtual (March 2002)

“Conventional colonoscopy has failed to lower colon cancer rates for one primary reason - it is not widely accepted by the public.”Traditional colonoscopy does not meet the standard for a workable screening procedure”

- Dr. James Ehrlich, Colorado Heart & Body Imaging, Denver

Did You Know: about 130,000 new cases of colorectal cancer will be diagnosed in 2002 and 56,000 people will die, more than 300,000 who should be screened, won’t be.

DENVER - The Traditional colonoscopy is unpleasant and embarrassing. Each year, hundreds of thousands avoid the colon cancer screening test - this year, about 50,000 people will succumb to a disease that has more than a 90 percent cure ratethis year, about 50,000 people will pay for that decision with lives. if detected early.

It’s a tragic avoidance that has Two of the nation’s top trend setters experts in preventive imaging - , Dr. Michael Wright of San Diego, Calif., and Dr. James Ehrlich of Denver, Colo. - and Michael Wright, are touting the use of FDA-approved “ultrafast,” low radiation electron beam tomography (EBT) combined with advanced workstations to visualize the large intestine simply, safely and noninvasively.

technology, which could pave the way for more effectively dealing with one of the nation’s deadliest, yet most preventable, forms of cancer.

“People are risking their lives just to avoid the traditional procedure,” says Wright, president and chief medical officer of LifeScore San Diego. “We’re providing a proven, accurate and more palatable alternative to standard colon exams.”

“Traditional colonoscopy has been a failure of acceptance,” says Ehrlich, medical director and founder of Colorado Heart & Body Imaging in Denver. “It is an important preventive procedure that, tragically, attracts too few people nationwide.”

Experts at imaging centers that perform virtual colonoscopies say the new procedure promises to bring in more people for screening, leading to earlier detection

“Traditional colonoscopy has been a failure,” says Dr. James Ehrlich of Denver, Colo. “When you look at how few people who should get screened actually do, it’s tragic.”

Fight Against Colon Cancer Goes Virtual

“You can talk all you want about how important screening is, but if people find the procedure too distasteful, they won’t do it.”

Both doctors operate imaging centers that offer the new technology, which they say will pave the way for more effectively dealing with one of the nation’s deadliest, yet most preventable, forms of cancer.

LifeScore of San Diego recently started offering the virtual colonoscopy procedure. Wright is president and chief medical officer of the facility, associate professor in the Preventive Medicine Department at San Diego State University and clinical instructor in the Department of Family and Preventive Medicine at the University of California, San Diego. He believes strongly in the value of this virtual alternative and predicts that insurance companies will eventually cover the procedure under the same guidelines it covers traditional colonoscopy, which is actually more expensive.

“Virtual colonoscopy sees 100 percent of the colon surface because of its ability to navigate in both directions and can always reach the cecum,” says Wright. “The patient undergoes a much milder bowel preparation, receives no sedation and can return to normal activities immediately.”

In addition to Colorado Heart & Body Imaging in Denver, Ehrlich and serves asis medical co-director of similar facilities in Houston and Washington D.C., and performs consulting at imaging centers nationally and in Europe. He says he is working closely with ggastroenterologists to get more people screened.

“It gives patients another option and gets more people in for screenings, and I think better insurance coverage is on the horizon.”

Another imaging center, LifeScore of San Diego, has just started offering virtual colonoscopies. CEO and Medical director Dr. Michael Wright also believes in the value of virtual colonoscopies.

“A lot of time and effort has been pored into awareness and public service campaigns with the best of intentions,” says Wright. “But you can change the fact that the traditional procedure is unpleasant, uncomfortable and people can’t immediately return to normal activities.

Both doctors readily admit that there are circumstances when it is preferable for individuals to undergo traditional colonoscopy - a history of repeated polyps that need to be excised is a prime example. Patients need to be aware that conventional optical colonoscopy offers the capability of immediate excision of discovered polyps, an advantage its virtual “cousin” cannot claim.

Yet, the fact remains that hundreds of thousands of people still avoid screening altogether. Wright and Ehrlich believe that offering patients the option of a far more agreeable examination represents a tremendous advance and should save lives.

Lack of general public awareness of the disease has limited funding for research, kept colon cancer patients unaware of their treatment options, and, tragically, prevented early detection and treatment in far too many cases.

Conclusions of New England Journal of Medicine study 1999: In patients at high risk for colorectal neoplasia, virtual and conventional colonoscopy have similar efficacy for the detection of polyps 6 mm or more in diameter. http://content.nejm.org/cgi/content/abstract/341/20/1496

Resources Listing

LifeScore San Diego: www.lifescore.com

Colorado Heart & Body Imaging www.coloradoheart.com

Colon Cancer Alliance www.ccalliance.org

New England Journal of Medicine 1999 study: comparison of virtual and conventional colonoscopy in patients at high risk for colorectal neoplasia.

http://content.nejm.org/cgi/content/abstract/341/20/1496

Colon Cancer Screening with Virtual Colonoscopy: Promise, Polyps, Politics. Dr. Joseph T. Ferrucci AJR 2001;177:975-988. http://www.ajronline.org/

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