Detecting Cancer

Richard (Rick) Mills
Ahead of the Herd

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As a general rule, the most successful man in life is the man who has the best information

 

Endoscopy is often used in the prevention, early detection, diagnosis, staging, and treatment of cancer.

 

X-rays and CT scans can show physical changes within the body and give information about the size, shape, and location of the changes. Endoscopes show details like color and surface texture allowing doctors to see exactly what’s going on.

 

If you go to a doctor exhibiting certain symptoms, endoscopy could be used to find the cause:

  • Long-term hoarseness - Laryngoscopy to look at the vocal cords
  • Trouble swallowing - Upper endoscopy
  • Anemia (low red blood cell counts) with an unknown cause - Colonoscopy
  • Blood in stool - Colonoscopy

Colonoscopy and sigmoidoscopy are used to look for cancer in people who have no symptoms by screening for colon and rectal cancer. They also help prevent cancer by finding polyps (growths in the bowels) that could become cancer. Thoracoscopy and laparoscopy can be used to find out if cancer has spread into a patients thorax or abdomen.

 

Most endoscopes can, with an attached tool, take small tissue samples – called a biopsy. Instruments passed through an endoscope can also be used to cut out growths, a cautery or laser can be used to burn or vaporize them.

 

Minimally invasive surgery

 

Many types of endoscopic tools have been developed to let doctors perform minimally invasive surgery.

 

When endoscopy is used for the abdomen it is called laparoscopic surgery. Instead of one long incision several small cuts are made - usually in the chest or abdomen. A video endoscope – a thoracoscope or laparoscope – is put through one of the holes so that the surgeon can see inside during the operation.

 

This type of surgery, called video-assisted thoracoscopic surgery or VATS, can also be used to treat small lung cancers. It can also be used for the colon  (laparoscopic colectomy), prostate (laparoscopic radical prostatectomy), and some other organs.

 

Patients, physicians, providers, and payers have wholeheartedly embraced minimally invasive therapy for many reasons:

  • Minimally invasive therapy obviates the need for major open-surgery procedures.
  • Minimally invasive therapy produces much less of the sequelae (a condition that is the consequence of a previous disease or injury) of open surgery procedures.
  • Minimally invasive therapy leaves minute scars versus open-surgery procedures.
  • Minimally invasive therapy results in shorter hospital stays and reduced outpatient treatments.
  • Minimally invasive therapy results in a much more rapid return to normal activity.
  • Reductions in length of hospitalization and the ability to return to work much sooner are economically attractive.

The demand for endoscopy as a tool in cancer detection has been increasing significantly because of the growing preference for minimally invasive surgeries, which reduce patients’ pain, speed recovery and reduce the overall costs to the healthcare system.

 

The endoscope is the most important weapon in the minimally invasive therapy arsenal.

 

Other factors driving the growth of global endoscopy include:

  • Aging population
  • Increasing prevalence of diseases that require endoscopy procedures

Bladder cancer

 

Fact; Advances in bladder cancer treatments, let alone a breakthrough, have been slow like in coming - no new products have been developed and Urologists have been using the same diagnosis and treatment methods for decades.

 

According to the National Cancer Institute (NCI) bladder cancer is the sixth most common cancer in the United States and the third most common cancer in men, with over 72,000 new cases diagnosed annually (380,000 worldwide). It is estimated that approximately 577,400 people are currently living with bladder cancer in the United States, generating over 1,500,000 physician consultations per year, and that approximately 16,000 individuals will died from the disease in 2015.

 

Bladder cancer facts:

  • Low grade non-muscle bladder cancer has a reoccurrence rate of 40%. High grade non-muscle bladder cancer has a reoccurrence rate of 70%. The average reoccurrence rate for this type of cancer is nearly 50%, which is one of the highest reoccurrence rates of all cancers.
  • Bladder cancer is the most expensive cancer to treat in the US.
  • Bladder cancer represents 4.6% of all new cancer cases in the U.S.
  • In 2016, it is estimated that there will be 76,960 new cases of bladder cancer and an estimated 16,390 people will die of this disease.
  • Age: Seniors are at the highest risk of developing bladder cancer.
  • Sex: Men are three times more likely than women to have bladder cancer.
  • Race: Whites have a much higher risk of developing bladder cancer than other races.

 

Bladder cancer is generally identified in the clinic by a procedure called cystoscopy, an endoscopy in the bladder.

 

When detected early, bladder cancer can be treated successfully. Initial treatment of bladder cancer is based on a tumor’s clinical stage, determined by how deep the tumor is thought to have grown into the bladder wall, and whether or not it has spread beyond the bladder.  Other factors, such as the size and grade of the tumor, may also affect treatment options. 

 

Unfortunately, bladder cancer has a very high rate of recurrence, one of the highest among the cancers. Because of the high risk of recurrence, patients who have been treated for bladder cancer undergo follow-up endoscopy every 3-6 months. For the rest of the patient’s life, a cystoscopy on a quarterly, semi-annual or annual basis is essential.

 

It is estimated that over 4 million cystoscopies are performed each year and approximately US$4B is spent on bladder cancer surveillance annually.

 

Bladder cancer is the most expensive cancer to treat over the lifetime of a patient.

 

The majority (about 70%) of bladder cancers are superficial meaning they are only in the lining of the bladder. However, if left undiagnosed and untreated, these cells can invade the muscle wall which could require complete removal of the bladder - a radical cystectomy.

 

It is important that cystoscopy imaging be both:

  • Highly sensitive by being able to detect subtle cancer
  • Specific meaning able to distinguish between benign and cancerous tumors

These two attributes enable surgeons to remove cancerous tissue at an early stage.

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