More Than A Screening

In most cases, physicians performing a colonoscopy can immediately remove pre-cancerous lesions

Colorectal cancer is the third leading cause of cancer-related deaths in the United States when men and women are considered separately, according to the American Cancer Society. It is the second leading cause when men and women are combined.

With facts like that, it may be hard to believe that things are actually getting better. But the death rate of colorectal cancer has been dropping for both men and women. One of the most important factors in this encouraging trend is colonoscopy screening. This is why regular screenings are recommended for men and women beginning at age 50, or younger for those who have a family history of colorectal cancer.

Why are these screenings so effective? Part of the reason is that physicians can do more than just look.

First, The Search

“In a colonoscopy, we are looking for pre-cancerous growths or lesions that have a potential to become cancer in the future,” explains Gregory D. Borak, MD, a gastroenterologist at Gastroenterology Consultants of Savannah, P.C.

Growths in the colon are called polyps. Before coming in for their colonoscopy, patients undergo bowel preparation. Typically patients drink a medicated liquid that will clear out their bowels as much as possible. This allows the physician to clearly see any polyps on the lining of the colon.

Gregory Borak, MD
Gregory D. Borak, MD


Between the unpleasant taste of the liquid and the numerous bowel movements it induces, bowel preparation is considered the most difficult part of a colonoscopy by most people. But it is absolutely essential.

“Of course you need an experienced physician who knows what to look for and who uses the most advanced tools, but you also have to have a clean colon,” says Telciane Vesa, MD, a gastroenterologist at The Center for Digestive & Liver Health. “That’s the bottom line.”

Most polyps protrude from the lining of the colon, but not always.

“Sometimes they are more like a carpet instead of bumps,” Vesa says. “That is the kind of thing that could be missed if you don’t have a clean colon.”

Telciane Vesa, MD


The physician uses a colonoscope, a thin, flexible tube with a tiny camera that takes video images. The colonoscope is gently guided through the colon to the cecum, a pouch at the beginning of the large intestine.

“The withdrawal of the scope is when we really get our information,” Borak says. “We can get a 360 degree view of the colon.”

Then, The Removal

If the gastroenterologist finds a polyp, in most cases he or she can remove it immediately with a polypectomy snare.

“People will sometimes ask me what happens if I find a polyp, and they are a little taken aback when I tell them I can remove it at the same time,” Borak says.

Though some polyps may be too large or in a position where they can’t be removed immediately, Dr. Borak says those cases are few and far between. He adds that, because the inside lining of the colon doesn’t have pain fibers, polyp removal is not painful.

“That’s the beauty of a colonoscopy,” Vesa says. “We’re going to remove these polyps, in many cases before they even have a chance to be pre-cancerous.”

Don’t Wait To Stop Cancer

“The idea of a colonoscopy seems intrusive to a fair amount of people, and they may take the approach that if they feel fine, there’s nothing to look for,” Borak says. “I think that goes against the whole idea of any kind of screening.”

Dr. Vesa agrees. She says that if a person waits until they are experiencing abdominal pain, unexplained weight loss, or blood in the stool, the cancer may have already advanced.

“It’s very difficult to see cancer in patients, knowing sometimes that if they had just come in a couple of years earlier, we would have caught it and taken it out before it had the opportunity to become cancer,” she says.

Both Dr. Borak and Dr. Vesa have one simple message for men and women who have turned 50: don’t wait.

“This is not about finding cancer early,” Vesa says. “By removing polyps, you stop cancer from happening. That’s how important it is.”

Learn more about what to expect from a colonoscopy screening in our Ask A Magnet Nurse feature in this issue. 

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