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Wellness & CareFamily Health › Westmed on the Forefront of Colorectal Cancer Diagnosis & Treatment
March 15, 2018

Westmed on the Forefront of Colorectal Cancer Diagnosis & Treatment

Westmed on the Forefront of Colorectal Cancer Diagnosis & Treatment

From Dr. Jonathan Finegold, Westmed gastroenterologist, for March is National Colorectal Cancer Awareness Month:


Cancer of the colon and rectum continues to be the third leading cause of cancer-related deaths for both men and women in the U.S.  Also, “colorectal cancer doesn’t care how old you are,“ according to the Colorectal Cancer Alliance. One in 10 people is diagnosed with colon cancer before age 50.


I cannot emphasize enough the importance for patients to obtain and record a family health history because up to 30 percent of colon cancer and colon polyps are genetically inherited. It’s also important to know the signs and symptoms of colorectal cancer and to see your physician if something is not right. The disease is almost entirely preventable when a gastroenterologist detects precancerous polyps through screening and removes them before they become cancerous.


Key Advances in Colon Cancer Screening Are: 

  1. The discovery that polyps and colon cancers are often different on the right side of the colon than the left side of the colon. (On the right side of the colon, the polyps and early colon cancers are flatter and can be more aggressive and harder to detect.)  This finding resulted in changes to the design and administration of bowel preps.
  2. The improvement in disease detection equipment and technology.
  3. More options available for colon cancer screening than 10 to 20 years ago.

What Are the Current Colon Cancer Screening Options?


Optical Colonoscopy, the test used most often, allows the doctor to see the entire colon, and polyps can be removed during the procedure. It requires the patient to drink a bowel preparation, and is most often performed with sedation.


CT Colonography (“Virtual Colonoscopy”) is a medical imaging procedure which uses X-rays and computers to produce two- and three-dimensional images of the colon. It does not require patient sedation.


Cologuard is a multi-target stool DNA test. If test results are positive, it could mean that a patient has “precancerous” colon polyp adenoma or an early colon cancer. Cologuard is used for patients who are high-risk candidates for optical colonoscopy and sedation due to significant medical comorbidities, complexities (elderly, significant lung disease, cardiac disease, renal disease, etc. It is approved by Medicare and some but not all commercial carriers.


Fecal occult blood testing is a lab test used to check stool samples for hidden (occult) blood, which may indicate colon cancer or polyps. 

Barium enema can be used in clinical practice, but thanks to all the other options, it is now used less frequently.


Bowl Prep Improvements 

Patients preparing for a standard colonoscopy have less prep to drink. Now the doses are in smaller amounts with split dosing. (This means, for example, a six-ounce cup of Suprep taken the night before a procedure and then again 5 hours before the start of the procedure the following day). Patients tolerate the prep better, thus allowing higher quality studies and better detection rates.


Equipment Advances with Higher Definition Digital Video Technology. The colonscopes that Westmed gastroenterologist use—Olympus Colonscopes—are the most advanced and the best available. They have better magnification capability and narrow band imaging and “virtual dye spraying”. Special scope filters simulate different colors of light that hit the intestinal mucosa through light wavelength changes for better detection.


Fast Turnaround Times

The gastroenterologist provides each patient with clear and complete image results of the procedure on the same day! Also, Westmed’s Pathology Lab turnaround times are now the fastest in community practice and even rival some academic tertiary care centers. Lab results are returned to patients by phone or secure email within one to two business days.


Westmed also has Outstanding Tertiary Services for high-risk patients whose cancers have been detected early. Westmed’s dedicated, award-winning colorectal surgeon Dr. Evan Krakovitz performs advanced minimally invasive colon cancer surgical tumor removal.


WMG’s Genetic Counselor Rachel Ratner provides genetic counseling with expertise in colon cancer family syndromes.



What can YOU Do?

 Know the signs and symptoms.

Listen to your body and speak up if something is not right.

Know your family history.


What are the Warning Signs?


–Rectal bleeding, dark or black stool

–Change in bowel habits

–Diarrhea and/or constipation

–Narrowing of stool

–Persistent abdominal discomfort (cramps, gas, pain or feeling bloated)(

–Unexplained weight loss

–Weakness or fatigue

–Nausea or vomiting

–If you have Crohn’s Colitis, or IBS, you are at a higher risk.