Bowel perforation, or a hole in the colon, is one of the complications of colonoscopy.  Different reported rates of perforation have been confusing.

A pooled analysis of published studies of perforation rates was reported during a Digestive Disease Week session on May 31.  Including 17 different studies covering more than a quarter million colonoscopies, the perforation rate for therapeutic colonoscopy was 1 in 1,500 exams.  In purely screening or diagnostic tests, perforations occured in only 1 in 6,000 tests.  Perforation risk is about three times higher when polyps are removed during the colonoscopy.

Analysis showed a trend toward decreasing rates of perforations over time. Read the rest of this entry »

Can a computerized system that monitors patient responsiveness and oxygen levels provide safe sedation using propofol during colonoscopy without a trained anesthetist present?

While not making a recommendation, C3 brought both its positive impressions and its concerns to consideration of a computer-assisted personalized sedation system  for endoscopy procedures to the Food and Drug Administration’s Anesthesiology and Respiratory Therapy Devices Panel (ARTDP) on May 28. Read the rest of this entry »

Adding ginger capsules to standard treatment for chemotherapy nausea reduced nausea and vomiting from chemotherapy.

Patients who got ginger (Zingiber Officinale) in capsules twice a day for three days before chemo and three days after reported significantly less nausea that those who were treated with placebo.  All patients in the study also received standard anti-nausea therapy on the day of chemo.

Almost 650 patients, mostly women, were randomly assigned to ginger supplements or a placebo in a blinded trial that will be reported at the 2009 ASCO annual meeting. Read the rest of this entry »

Trying to predict whether or not chemotherapy was working as soon as possible, Swedish doctors compared FDG-PET scanning before beginning chemo and after two treatments.  Then they looked at CT scans after four and eight treatments to see if early PET scans could predict changes in tumor size.

They found that the scans did show which patients would respond to treatments with tumor shrinkage.  Responders had greater reduction in metabolic readings on PET scans than did patients whose tumors didn’t get smaller. But changes in PET values did not predict benefits in either the time until cancer got worse (progression-free interval) or overall survival. Read the rest of this entry »

American Cancer Society Chief Medical Officer Otis W. Brawley, M.D., says that he is disappointed in the decision by the Centers of Medicare and Medicaid Services not to cover CT colonography screening for elderly Americans on Medicare.

Dr. Brawley points out that randomized clinical trials have shown the CTC option as effective as traditional optical colonoscopy in finding early cancers and precancerous polyps.  He also concerned that there is not a sufficient supply of trained specialists providing colonoscopy to meet the need for screening and that new options are needed.

The American Cancer Society believes, Brawley says, that a full battery of testing for colorectal cancer screening should be available, particularly to the Medicare population who are at higher risk of developing and dying from colorectal cancer. Read the rest of this entry »