After turning 50, men and women know they should have a colonoscopy because early detection can prevent death from cancerous polyps, which are slow growing and easily removed.
Unfortunately, an estimated one-third to one-half of people in the 50- to 75-age group haven’t had one. Reasons given are cost, embarrassment, the unpleasant 24-hour preparation process and the procedure itself.
Many people don’t realize there’s an optional approach—a virtual colonoscopy that offers numerous advantages.
“It’s less expensive and less invasive,” said Palisadian Dr. Marvin Portner, an internist and allergist who, along with his wife, recently had a virtual colonoscopy at Lebovic, Schwimer and Goldberg Radiology on 10th Street in Santa Monica.
“In reading the literature, the findings are equivalent in both types of colonoscopy,” said Portner, who has had both procedures. With the virtual, “There is no risk of perforation. It was easy and quick, and I didn’t need a whole day to recover.”
A traditional colonoscopy involves the examination of the colon with a fiber-optic camera on a flexible tube passed through the rectum. After this procedure, some patients complain about cramping and gas. The University of Wisconsin reports there is about a one in 500 chance of perforating the bowel during the colonoscopy, which may then require surgery. Additionally, a regular colonoscopy is less effective in detecting polyps and cancer in the right side of the colon.
By contrast, virtual colonoscopy (CT colonography) has none of those risks. The procedure is less costly (typically less than $1,000 in Santa Monica) and provides a routine screening of other organs such as the kidney, liver, pancreas and gall bladder.
The virtual colonoscopy usually takes 15 minutes or less, and no anesthesia or pain medication is needed. A small soft catheter, about the size of a straw, is introduced in the rectum and carbon dioxide gas is then introduced to distend the bowel.
Radiologists Dr. Joel Bortz and Dr. Ross Goldberg showed this reporter test results on a computer screen, which were more like a movie of the colon. According to Goldberg, the Viatronix program is the only FDA-approved 3D fly-through of the colon currently available in Los Angeles. This was the same program used when President Obama had a virtual colonoscopy in 2009.
“The beauty of this procedure is we can scan the abdomen from the bottom of the chest to the pelvis,” Bortz said. “We can also look at everything around the colon. We frequently see kidney stones, gallstones and aortic aneurysms.”
“Do you see this bulge that looks like a quarter on the left kidney?” Goldberg asked. “A 52-year-old man came in for a routine colonoscopy and this cancerous tumor was discovered. He’s had surgery and its been removed. He’s doing fine.”
If the man had not chosen this procedure, Goldberg said, the tumor might not have been detected for another five years or so.
On another screen, a cancerous pancreas was shown, which would have gone undetected had a virtual colonoscopy not been performed. Bortz said they also spotted an adrenal cancer in a 56-year-old woman.
The virtual colonoscopy allows radiologists to look at the front and back sides of the folds of the colon. A traditional colonoscopy only sees the front side of the colon walls, which means a polyp on the other side might go undetected.
A downside to the virtual colonoscopy occurs when a polyp is detected and is large enough to require removal. The patient must then undergo a typical colonoscopy to have the polyp (or polyps) removed, on the same day.
“Ninety-four percent asymptomatic patients do not require a traditional colonoscopy after a virtual colonoscopy,” Goldberg said.
Goldberg was asked why more people don’t opt for this procedure.
“Most people don’t know about it, but it’s becoming more popular,” Goldberg said. “Some doctors who do [traditional] colonoscopies view this as a threat to their income, and many radiologists don’t know how good it is.
He added, “I don’t like anesthesia, so I had the virtual colonoscopy done seven years ago by Dr. Bortz. Two insignificant polyps were found and left alone.”
Goldberg, who says his office has been doing the procedure since 2009, warns that news stories that offer alternatives to regular colonoscopies will come under fire, but adds, “We know virtual colonoscopy is the right thing to do for our patients. This will be the standard of care in the future.”
Contact: (310) 394-2761.
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