An international study described in the Oct. 17 Journal of the American Medical Association (JAMA) found that universal tumor testing in all newly diagnosed colorectal patients produced a “modest increase” in finding people with Lynch syndrome.

One in every 35 people with colorectal cancer has Lynch syndrome – an inherited genetic mutation which greatly increases the person’s chance of developing colorectal cancer more than once, plus other cancers (stomach, pancreas, urinary system, brain or skin cancers). Women with Lynch syndrome also face a 40-60 percent chance of developing endometrial (uterine) cancer in their lifetime and an increased risk for ovarian cancer.

Until genetic tests of tumors became available in recent years, Lynch syndrome could only be  diagnosed based on a family history of cancers. But even with genetic testing, Lynch syndrome is still significantly under-diagnosed.

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Occasionally people having CT scans or other imaging exams will have an allergic-type reaction to the iodine contrast, but research has found that they can be treated safely without long term effects. In fact, almost all reactions are mild and more han 99 percent patients with them will get better within a day.

Radiologists at the University of Michigan hospitals in Ann Arbor studied nearly 85,000 intravenous injections of nonionic iodinated contrast media looking for allergic-type reactions.  They analyzed both how the reactions were treated and whether there were any long term problems after a reaction. Read the rest of this entry »

Simple whole milk may be as effective in barium drinks to distend and outline the intestinal tract so it can be clearly seen during a CT scan.

Radiologists at Columbia University randomly gave patients who were having CT scans of their abdomen and pelvis either whole milk or a drink containing barium (VoLumen).  In addition, intravenous contrast was used to enhance images. Read the rest of this entry »

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“Symptoms and Risks” fact sheet (PDF)
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People come to an initial medical work-up for colon or rectal cancer from different places. They may have had a suspicious polyp or cancer found during a routine screening. They may be experienced symptoms that might be caused by colorectal cancer. Getting an accurate diagnosis is critical because treatment for colorectal cancer depends on the diagnosis. For example, treatment for colon cancer is different than treatment for rectal cancer, and treatment for cancer which has spread outside of the colon is different than treatment for cancer which is limited to the colon. Getting an accurate diagnosis can take time and many different tests. It may require surgery, and examination of surgically-removed tissue to determine whether the cancer has spread. This process can involve several health professionals including:

• The gastroenterologist who will perform a colonoscopy if it has not been already done and remove tissue for biopsy. The gastroenterologist may remove suspicious polyps for pathology or, if they are large, leave them in place for later surgical removal.
• Pathologists who will examine biopsies under the microscope to identify precancerous cells or cancer (malignancy.)
• Radiologists who will perform CT-scans or other x-ray tests to see if the cancer has spread to other parts of your body.
• A general surgeon or colorectal surgeon who will give you a physical examination and ask about your medical history, order blood tests, review reports from gastroenterologist, radiologist, and pathology, and help decide on an initial treatment plan.
• If necessary, a medical oncologist who deals with chemotherapy treatment or a radiation oncologist may be involved at this point or they may join the treatment team after surgery. Specialized surgeons may also be called in to examine you if there is a possibility that the cancer has spread beyond your colon.

Choosing a medical team is an important initial step in getting an accurate diagnosis, especially if rectal surgery is involved. Work with your medical team to make sure that your evaluation, diagnosis, and staging are done carefully and thoroughly.. Get a second opinion if there is uncertainty about issues such as what tests are necessary, if surgery is the right first step, and whether staging is accurate. A second opinion at a large cancer center, particularly a National Cancer Institute designated cancer cancer or a member of the National Comprehensive Cancer Network can be valuable even early in the diagnostic process.

• Locate an NCI Cancer Center in your state.
• Locate an NCCN Comprehensive Cancer Center

Where Can You Go for More Information?

American Cancer Society How is Colorectal Cancer Diagnosed? Cancer.Net When the Doctor Says Cancer along with a podcast can help you learn questions to ask about your cancer and its diagnosis and how to understand and manage the information you get from your doctor.

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