If you hate colonoscopy
Good news for those who dread colonoscopy: Swallowing a pill instead of having a “tele” scope inserted through the anus. The standard procedure for colonoscopy is done with or without sedation, inserting a flexible tube the size of the little finger which has a fiber-optic lens, light, and a hole through which a suction and biopsy forceps could be inserted. This long scope, which is connected to a TV monitor, is inserted through the anus to visualize via a real-time live video the inner wall of the rectum and the entire colon in color. This endoscopy is done to discover any growth (benign polyps or cancerous tumors) or any other abnormalities inside the rectum and colon, two popular sites of cancer.
The pill, which was recently approved by the US FDA, contains a disposable super-miniaturized battery-operated camera, is swallowed, just like any capsule. It takes a color video for ten hours as it travels through the colon and rectum, and transmits high speed images to a receiver-recorder that is worn around the waist of the patient. The video is then reviewed by the physicians. This new diagnostic tool is called PillCam COLON2, a wonder new advances in technology.
What have not changed are the bowel prep and the sage advice for every adult to ask his/her doctor when to have colonoscopy or this new PillCam COLON2, a more comfortable option.
A pinprick instead of a big needle
Blood tests, from blood count to blood chemistries, including blood sugar and cholesterol tests, are conventionally done by drawing blood from a vein in the arm, to fill up a test tube or more, depending on the information needed for diagnosis. Some centers are now casting aside the syringe, tourniquet, test tubes, needle, alcohol swab, and the hunt for the vein, and opting for a new system which needs only a few drops of blood obtained with a simple pinprick, like what diabetic patients do at home to test their own blood sugar level. Thanks to Elizabeth Holmes, a 31-year-old Stanford University dropout, a self-made billionaire (that’s with a “b”) who “invented” a formula patented by her company, Theranos, her new system would allow the performance of more than 200 different blood tests, including DNA analyses, using only a few drops of blood. Unlike our current standard blood testing procedure, which takes about a few days to a week to obtain the results, the Theranos system provides the results within a few hours, and the cost of the tests is a fraction of the charges with the standard system. Theranos Wellness Centers are now available at Walgreens Pharmacies. This will certainly revolutionize blood testing and lead to faster diagnosis.
Angelina Jolie’s test just got cheaper
Sensational film-maker-actress-humanitarian-crusader Angelina Jolie, 39 (born June 4, 1975), had her famous double mastectomies in 2013 following discovery that she had early genetic marker (BRCA1), a faulty mutation which made her more prone (by 80 to 90 percent) to develop breast and ovarian cancers. Early this year, she announced that she had her ovaries removed also. These two procedures have dramatically reduced her risks. Her mother died from ovarian cancer in 2007. Faulty mutation is seen in 5 to 8 percent of all cases. Majority of women with breast cancer do not have BRCA mutation. Only those with strong family history of cancer will benefit from this genetic testing, which cost Jolie thousands of dollars. This faulty gene mutation could also be found in men.
Color Genomics of Burlingame, California, recently announced it is has a new test by analyzing sample saliva test to detect genetic mutations (BRCA1 and BRCA2 and 17 other genetic variants associated with increased risk for cancers) that it offers for only $249, one-tenth of the current cost ($2000+) of the genetic counseling and test. The CG test kit, which could be ordered directly from the company and shipped to the buyer, contains a small plastic tube, where the patient spits into, sealed, and mailed back to the company for analysis of the DNA in the saliva.
The question is how reliable it is for a woman to depend on in making the tough decision of her life to have her normal looking breasts and ovary removed.
More extensive use of this saliva DNA test for genetic mutations is needed to validate its accuracy and consistency before it is accepted as the standard clinical test.
Which prostate cancer to cut out
Men diagnosed to have prostate cancer are faced with the very tough decision of choosing to have surgical resection and the probability of becoming impotent and also have problem with urination, or the non-surgical treatment option, with watchful waiting. The reason for this is the fact that prostate cancer in different individual behaves differently. Some are very aggressive type and others are slower-growing. The pathology or tissue diagnosis is not enough to distinguish the two in all cases and with perfection. A new trail-blazer in diagnosis is the Oncotype DX prostate cancer testing, where genetic evaluation of the biopsied prostate tissue will reveal whether the cancer is a slow (which justifies non-surgical treatment and monitoring) or fast-growing one (which requires aggressive surgery). “For too long we’ve overtreated prostate cancer…this test allows us to avoid aggressive treatment when it is not needed and to save lives when it is,” according to Michael Roizen, MD, chief wellness officer at the Cleveland Clinic.
Predicting heart attack, stroke
Just like in the case of cancer, the earlier physicians make the diagnosis of any disease, or even predict when it will strike, the better it is for the patient, because, as the cliché goes, “an ounce of prevention is better than a pound of cure.”
New studies reveal that there is a correlation between blood level of a substance called TMAO (trimethyl-amine-N-oxide) and cardiovascular events. Persons with the highest levels of TMAO, which is produced when they digest choline (found in eggs, red meat and dairy products) had double the risk of death, heart attack, stroke, compared to individuals with the lowest level. This prediction was found accurate even among those without risk factors like high blood pressure, diabetes, smoking. Since the onset of symptoms of CV illnesses, like heart attack, is gradual, almost everyone have no idea that they have coronary heart disease until a heart attack occurs. This test could help physicians detect the disease earlier, warn the patient ahead of time, and start lifestyle treatment to prevent the progress of the heart disease. This wonderful test will be available this year.
All these and other mind-boggling advances in medical science and technology will help us (if we help ourselves) live a healthier, happier, more productive and longer life.
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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]
