The American Cancer Society recommends screening for colorectal cancer
beginning at age 50. If you have a family history of colon cancer or
polyps, or if you are African-American, screening should begin at age 40.
Virtual Colonoscopy is also particularly useful for patients in the following
categories:
A. Patients on Coumadin therapy. There is no need to discontinue
anticoagulation for a Virtual Colonoscopy.
B. Patients who require antibiotic prophylaxis for invasive procedures.
Virtual Colonoscopy does NOT require antibiotic prophylaxis
C. Incomplete/Failed Optical Colonoscopy or Occlusive Disease of the
colon. Published studies have reported that Optical Colonoscopy can
not be completed in 10-20% of cases. Virtual Colonoscopy will frequently be
able to image the remainder of the colon when spasm, poor prep or obstructive
tumors prevent passage of a colonoscope throughout the length of the colon.
D. Patients too frail to tolerate anesthesia or invasive procedures. Virtual Colonoscopy does not require any anesthesia. Therefore, it is
ideal for patients who are unable or unwilling to tolerate an invasive
procedure or are concerned about effects of anesthesia.
E. Patients who are resistant to Optical Colonoscopy.
Virtual Colonoscopy offers a comfortable alternative that is non-invasive,
does not require sedation and does not require the patient to miss a day of
work.
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2.
What kind of prep is required?
Patients are advised to follow a liquid diet for 24 hours prior to their
scans. A well-cleansed colon is required to achieve high sensitivity and
specificity. The night prior to the scan, the patient you take 3 oz
of Fleet Phosphasoda (divided into 3 doses). Patients generally report
little or no difficulty with the prep. For those patients who are unable or
unwilling to follow a liquid diet, a low-residue, tasty and highly nutritious
meal package is available from EZEM.
In the near future it may be possible to perform Virtual Colonoscopy without a
laxative prep. The use of barium tagging of each meal for 24-48 hours prior
to the scan allows for the digital subtraction of the colon contents. However, the sensitivity and specificity of Virtual Colonoscopy using this
methodology has not yet been as well established.
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3.
What should I expect during a Virtual
Colonoscopy?
The Virtual Colonoscopy is a quick and easy procedure. A very small rubber
catheter tip is inserted into the rectum and the colon is gradually
insufflated. The Princeton Longevity Center uses CO2 insufflated under
controlled pressure. Inflation with CO2 causes less cramping than room
air. In addition, it is quickly absorbed from the colon after the procedure
so there is no concern about having to expel air from the
colon during the hours following the procedure. The ability to carefully
control the insufflation pressure also enhances patient comfort. Because
the CO2 is quickly absorbed, you can expect to feel entirely back to normal by
the time you leave the scanner room.
Adequate insufflation is generally achieved in less than 5 minutes. Then two scans
are done, one laying on your back and one laying on your stomach. Each
scan is a single breath-hold scan that takes approximately 10 seconds. The change in position allows
for movement of any retained stool or fluid, improving the sensitivity of the
procedure. .
Before your scan, our we will review your medical history and fully
explain the procedure. Following the test, you are welcome to spend a few minutes in
our lounge area where a breakfast or light snack is provided. The
final report from our radiologist is usually completed within 24 hours and a
copy will be sent to both to you and the referring physician.
The scanner is non-magnetic and non-claustrophobic.
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4.
How much X-Ray exposure is involved?
Virtual Colonoscopy requires very little X-ray exposure. The usual dose is a fraction of the natural radiation exposure we all receive each year from the sky and other environmental sources. When done every 3-5 years, a Virtual Colonoscopy provides an average
X-Ray dose that is less than the additional radiation a person would receive from living at the same altitude as Denver during that same time period
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5.
Why do a Virtual Colonoscopy
if I may need a regular Colonoscopy if an abnormality is found?
The vast majority of patients will be found to
have a normal colon on Virtual Colonoscopy. Depending upon the size criteria
used for referring a patient with a colon polyp for regular Colonoscopy, only
2-5% of patients will require a regular Colonoscopy or Flexible Sigmoidoscopy
after Virtual Colonoscopy.
The successful completion rate for a Virtual Colonoscopy is better than 98%.
However, numerous studies have shown the successful completion rate for
regular
Colonoscopy to be only 80-90%. That means 10-20% of patients undergoing
regular Colonoscopy have to have the procedure redone. Therefore, you are more likely to need a repeat Colonoscopy after your regular
Colonoscopy than after a Virtual Colonoscopy.
Virtual Colonoscopy is only a fraction of the cost of regular
Colonoscopy and, without the risks of perforation or anesthesia complication,
it is safer. Now that Virtual Colonoscopy has been shown to be equal or
superior to regular Colonoscopy, it is more cost-effective and safer to have
your colorectal cancer screening done by Virtual Colonoscopy
and then proceed with regular Colonoscopy only for those who have documented
polyps or tumors.
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6.
Who is not a candidate for
Virtual Colonoscopy?
Patients with the following condition should be sent for Optical
Colonoscopy:
A.
Patients with a previous history of polyps or familial polyposis where there is
a high likelihood of finding new polyps requiring excision.
B.
Patients with a history of colon cancer.
C.
Patients with Ulcerative Colitis where a biopsy should be done to
evaluate dysplasia.
D.
Patients over 300 lbs.
E.
Patients who are pregnant
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7. Who will read my Virtual Colonoscopy?
Proper
interpretation of a Virtual Colonoscopy requires great skill. Our radiologists are extensively trained and experienced in the interpretation of Virtual Colonoscopy. If a questionable abnormality is found, your scan is also reviewed by The Boston Diagnostics Center for Virtual Colonoscopy (www.BostonDiagnostics.com), nationally renowned academic experts in the field of Virtual Colonoscopy.
They have published much of the medical research on Virtual Colonoscopy and
lecture around the world. When you combine Princeton Longevity Center's
highly skilled staff with our radiologists' unsurpassed expertise in the
interpretation of 3-D Virtual Colonoscopy you can feel secure that your
Virtual Colonoscopy is among the best available anywhere.
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8.
What about those ads I hear from other centers
offering discount prices for Virtual Colonoscopy?
You may hear radio advertisements from other centers that offer
discounted rates for Virtual Colonoscopy. These centers typically use
less
expensive room air insufflation which is more uncomfortable, and have their
scans read by in-house radiologists whose expertise and experience can not
compare to the radiologists reading your 3-D Virtual Colonoscopy
scan at the Princeton Longevity Center.
We strongly believe you should have a scan that is of the highest technical
quality, read by radiologists with the most expertise and is as safe and
comfortable as possible. If you agree that the choice
of where to have your Virtual Colonoscopy done should be based on experience
and quality, not price,
your
choice is clearly Princeton Longevity Center.
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9.
Will insurance reimburse the patients for
Virtual Colonoscopy?
In our experience, many patients are covered.
Iinsurance carriers have very diverse coverage policies. As with
other procedures, the reasons for the referral can also play a role in
reimbursement decisions. Our staff will be happy to call your
insurance carrier to verify your coverage prior to making your
appointment.
At this time, Medicare does not yet cover Virtual Colonoscopy. The Princeton Longevity Center is not a Medicare Provider and Virtual Colonoscopy can not be submitted to Medicare for consideration for reimbursement.
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10. How do I make an appointment for a Virtual Colonoscopy?
Simply call us and our Patient Service
Coordinators will take it from there. Our staff is here to make it as easy
as possible for you. They can answer any questions
you may have. They will ensure that you are completely
cared for from explaining the procedure and prep to ensuring that you receive
your final report. They will also be happy to assist you with verifying
your insurance coverage and providing you with the materials to file a claim
with your insurance carrier.
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