Mike Wiegenstein: You're watching Medical News Network, your trusted source for the latest in medical news and information, I'm Mike Wiegenstein. Today we take a look inside the world of computer-assisted colonoscopy, what is it? How does that work, is it safe and reliable? Why its revolutionizing medicine as we know it and how its changing people experiences for the better, so if you're over the age of forty, have a family history of cancer I would just like to be better informed this is for you, stick around its going to get interesting.
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Mike Wiegenstein: Welcome back. We are pleased to have in studio today Dr. William Glenn. Dr. Glenn received his degree from the prestigious Johns Hopkins University; his MD from Washington University and did his Radiological Residency at Harvard Medical School. Dr. Glenn is a recognized leader and international speaking authority on state of the art CT and MRI imaging. Dr. Glenn is the member of the American Society of Neuro Radiology, the radiological society of North America and the American Academy of Orthopedic Surgeons. Dr. Glenn was a pioneer in many of the medical procedures we take for granted today and he is currently at the forefront of the future in colon cancer detection computer assisted or virtual colonoscopy, Dr. Glenn welcome to the show.
Dr. William Glenn: Thank you very much.
Mike Wiegenstein: Okay, I did normally ask you to tell me about your history and your background but you are adamant before you are coming to this interview with me that, I actually go and have this procedure done. I learned a lot about the procedure but how many people here die from colon cancer.
Dr. William Glenn: Mike, well it's between 55,000 and 60,000 a year. So it's the equivalent of one 9/11 event every three weeks?
Mike Wiegenstein: How many of those people have to die from colon cancer?
Dr. William Glenn: The cure rate if you know about the precursor polyps is above 90%. There is a 7% incidence of flat aggressive cancers but the vast majority above 90% if those precursor polyps can be found and removed, those patients are cured.
Mike Wiegenstein: So 50 some thousands of people could be cured if they knew and they had the polyps removed, they just never going to checked?
Dr. William Glenn: They don't get checked, it's not a subject that is comfortable to talk about. Its embarrassing and a lot of their private doctors simply aren't aware of the state of the art of colorectal cancer screening. There are four approved insurance reimbursement methods.
Mike Wiegenstein: Okay, we are going to get into those and I'm going to have you show me because I have we had this decision I've actually had three of the four and now I had four of the four done. And I'll tell you it was probably the most humiliating degrading experience I have ever had so. I would understand why most people don't go and get checked. Before we get into that, there have been some studies out and I want to talk to you about this because I have done research, there have been some studies by multiple organizations, I'm saying that virtual computer assisted colonoscopy is actually better than where they are going with the scope and they put the things to speed up inside and I know brought a scope today, so we could see what that looks like and then there are those who say its not the same and everybody saw on TV nationally and we saw her get a virtual one year and a regular scope to next, why is there is big variance in these reports.
Dr. William Glenn: The first three major reports of 99, 2001 were from single slice CT scan have been showed of a gate and showed the basic equivalency of a Fiberoptic and a virtual coloscopy with the CT scan or above 10 millimeter polyp diameters.
Mike Wiegenstein: Okay, you brought some I know we have a pencil here for you to show me, how big would that polyp be.
Dr. William Glenn: The polyps that we are looking for are as big as the number pencil eraser which is 7 millimeters. That will be the trigger diameter for removing them. We will ignore the ones below 7 millimeters.
Mike Wiegenstein: Why do you ignore the smaller ones?
Dr. William Glenn: Because when you approach 3 millimeters in diameter you have a zero percent chance, nearly zero percent chance of having colon cancer in those polyps, when you get to between 6 millimeters and 9 millimeters there's about a 1% 1 in a 100 chance to that polyp that tiny polyp will have cancer, when you get to 10 millimeters and above especially above 10 millimeters, 12-15 millimeters, the percentage of cancer in those polyps runs between 5 and 10%. So we need to get below 10 millimeters and remove the ones from seven and above.
Mike Wiegenstein: How many of that I know because to target the people, I know that when they going with the scope, a lot of times I will take out 1, or, 2 or 3 millimeter polyps.
Dr. William Glenn: Not necessary.
Mike Wiegenstein: But they how many of those smaller polyps are only cancers?
Dr. William Glenn: Almost zero.
Mike Wiegenstein: So there is really no reason to have them taken out.
Dr. William Glenn: That's right.
Mike Wiegenstein: Okay, back to the studies. The computer-assisted and I will tell you the more I read lately, the more that they're saying it 5 or 6 millimeters and above the computer-assisted the virtual colonoscopy is actually better at seeing the polyps than the scope.
Dr. William Glenn: That the breakthrough study came in December of 03, it was the lead article in The New England Journal and was done by 3 military hospitals and it was an absolutely brilliant study. So for anyone who thinks that sometimes the military doesn't get it right, they got it really right.
Mike Wiegenstein: And what did the study show?
Dr. William Glenn: The study showed that at polyp diameters of 7 millimeters and above that the virtual colonoscopy was better than the fiberoptic colonoscopy. It was safer, it was cheaper and it was more thorough because the -- is if you think that the fiberoptic is seeing a 100% of your colon is a so called gold standard, its really only seeing 80%.
Mike Wiegenstein: Right because it cant see behind the ridges and you are also susceptible there is no real record of it whoever happens to be looking through the tube while they are doing it. If they miss something there is no way to really go back and relook.
Dr. William Glenn: The fiberoptic exams while they are done on video are not video tape. So the operator does not have a chance to recheck himself or herself give you a copy of the video tape or share it with the colleague for a second opinion, so most people don't know that.
Mike Wiegenstein: And the virtual gives you all of that.
Dr. William Glenn: Virtual can see upwards of a 100% of the colon what the radiology people are bending over backwards to do if you are going for a screening exam is to hand you a CD of all of the original data, so that you have everything.
Mike Wiegenstein: How many people in United States every year right now, how many people of age or race that should be checked?
Dr. William Glenn: The number is 60 million and that includes the people with the a family history should start being screened at 40 years old.
Mike Wiegenstein: Does diet have anything to do with it?
Dr. William Glenn: Diet no, but family history does.
Mike Wiegenstein: Environment?
Dr. William Glenn: I don't know the answer to environment, I don't think so family history does, a history of colon cancer alternate colitis, alternative colitis and inflammatory bowel disease predisposes people to have problems with colon cancer.
Mike Wiegenstein: Alright, we're going to take a quick break. When we come back we are going to talk about my procedure what we did, we are going to look at the scopes , we are going to see how it is and I do want to tell you here right here I have never experienced something that was so easy, so painless and so quick. It was less than 30 seconds they had me on the table taking the x-rays, when I did my other scope they tried to knock me out complete and I think it was in there for two hours so, we are going to take a quick break, when we come back we are going to actually look at my personal virtual colonoscopy and we are going to look at some of the scopes and other devices that are normally used in colonscopy. We'll be right back.
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