How common is colorectal cancer?

COLORECTAL CANCER is the second most common cause of cancer deaths and third most common cancer overall, representing 11 % of all newly diagnosed cancer cases. There are over 130,000 new cases of COLORECTAL CANCER each year and over 56,000 people die from this disease each year.

What are some of the risk factors? 

The following have been identified as RISK FACTORS for colorectal cancer.

• Age greater than 50 years

• Inflammatory bowel disease  for 10 years or greater

• Ashkenazi Jewish ancestry (APC gene)

• Colon polyp syndromes (e.g. Gardner's syndrome)

• Family history of colorectal cancer

• History of ovarian, endometrial or breast cancer

• Low fiber, high fat diet

• Inactivity, obesity

• Smoking, alcohol

Why are colon polyps important and how frequent are they?

Most colon cancers arise from benign (adenomatous) polyps. If you can detect and remove these polyps you can prevent colon cancer from developing. Polyps increase in frequency with age; for example, 50% of people over the age of 50 have polyps.

Do cancers occur in all polyps and how long does it take for a cancer to develop?

Cancers are rare in small polyps (less than 1 cm. or 1/4 inch). 50% of polyps greater than 2 cm. in size are cancerous. Fortunately, 70% of polyps discovered on a routine colonoscopy are less than 1 cm. in size- It takes about 10 years for a cancer to develop into a benign polyp.

What are the current recommendations for screening for colorectal cancer?

Regular screening is recommended for people over 40 with a family history of colon cancer, and for all people over 50.

What is Virtual Colonoscopy or Colonography?

VIRTUAL COLONOGRAPHY is a new, fast and reliable CT scan test, which can examine the colon for polyps or cancer.  This test is painless, does not require IV sedation and is safer and less expensive than conventional colonoscopy. This test is comparable to conventional colonoscopy and has been shown to be sensitive for polyps 1 cm. or larger, 80% for polyps 0.5-1cm. and 59% for polyps less than 1/2 cm.

Who should have a Virtual Colonoscopy or Colonography?

• Anyone who has had a failed or incomplete conventional colonoscopy

• Symptomatic patients (rectal bleeding, for example)

• High-risk patients (see above)

• People over age 50

So what's the bottom line?

If you are over age 50 or at high risk for colon cancer, A CT colonography could save your life

How common is lung cancer?

Lung cancer is the leading cause of cancer deaths, killing more people than colorectal, breast and prostate cancer combined and accounting for 150,000 deaths per year in the U.S.

How serious is this disease?

The five-year survival (the amount of people alive five years after detection of the disease) is 14% and, until now, has NOT changed significantly in the past 25 years.

Why is survival from lung cancer so poor?

Typically 8 out of 10 cases of lung cancer have spread by the time they are diagnosed, with no effective treatment available in this late stage.

What are some of the risk factors for lung cancer?

• Active smokers

• Positive family history

• Past smokers 

• Known other cancer

• Patients with emphysema 

• Chronic exposure to secondary smoke from cigarettes

What radiology screening tests are currently available for lung cancer?

Chest X-rays have been used for decades to screen for lung cancer. More recently, many physicians have advocated high-resolution chest CT scans as a far better test; chest CT screening for lung cancer has also received a great deal of attention by the news media.

How accurate is chest CT screening in comparison to chest X-rays? 

CT scans have the capability of detecting lung cancers when they are as small as a grain of rice. CT screening in smokers and former smokers can detect very early lung cancers. Most of these early cancers are in the early stages of the disease and therefore may be potentially curable by surgery.

Does this test involve more radiation than a regular chest X-ray? 

Yes, but the benefits of early cancer diagnosis far outweigh any miniscule increased risk associated with slightly higher radiation exposure.

So what's the bottom line?

CT screening for lung cancer is quick, painless, inexpensive and the best test available to detect this disease. IF YOU ARE A HIGH RISK PATIENT FOR LUNG CANCER, A CT SCREENING EXAMINATION COULD SAVE YOUR LIFE.

How common is cardiovascular and coronary artery disease in the United States?

Cardiovascular disease remains the leading cause of death in this country, almost double that of the combined death rate from all cancers. Over one million people in the U.S. will have a heart attack this year. Sudden death is the first sign of any cardiovascular disease in 150,000 people each year. 

What are some of the risk factors for this disease?

• Age greater than 45 years (male) and 55 years (female)

• Pro-inflammatory factors

• Active cigarette smoking

• Homocysteine blood levels

• High blood pressure (greater than or equal to 190/140)

• Lipoprotein levels

• Diabetes Mellitus

• Prothrombin (clotting) levels

• Low HDL-c ('highly desirable lipoprotein') blood profile

• Elevated cholesterol levels

Are there other tests available to screen for this disease? 

Yes. CT screening of the coronary arteries for calcification in the wall of the vessels has emerged as a new way to determine if this disease is present.

Does the amount of calcium detected in the wall of the coronary artery matter?

Yes. Several studies have shown that patients with coronary calcification are 4.2 times as likely, on average, to have a significant coronary event such as an acute heart attack. The amount of calcium in the wall of the vessel roughly correlated with the severity of the disease. Recent studies suggest that very high levels may actually indicate a relatively stable form of the disease and that medium levels may be more significant.

What if no calcium is detected in the vessel wall?

This indicates the absence of coronary artery disease with 98% certainty.

How is the amount of calcium in my coronary arteries determined?

This involves a simple CT scan of your heart connected to an EKG device. No injection is needed and the examination takes minutes. After the study is complete, the data is transferred to a sophisticated computer workstation, there the location and amount of calcium in your coronary vessels is determined. Finally, you are assigned a score which reflects the amount of calcification present; the higher the score the more calcium detected.

What is the significance of calcium scoring? 

As discussed above, the presence of calcification indicates the presence of coronary artery disease. The score given to you simply parallels the amount of calcification present. The ability of calcium scoring to predict the likelihood of future coronary events remains under study, especially with respect to an acute heart attack and sudden death. Treatment is based on all risk factors as well as your calcium score.

So what's the bottom line?

CT screening for coronary artery disease is quick, painless and inexpensive. IF YOU ARE A HIGH RISK PATIENT, A CT SCREENING EXAMINATION COULD SAVE YOUR LIFE.