Endoscopy and cancer
Endoscopy is a medical procedure that involves the insertion of a thin tube equipped with a viewing instrument into the body to examine internal structures. This technique is essential in the screening, diagnosis, and treatment of various cancers, including colon, lung, and esophageal cancers. Various types of endoscopes are used depending on the area being examined, such as colonoscopes for the colon and bronchoscopy for the lungs. Endoscopy can provide critical information about suspicious tissues found in imaging scans, allowing for biopsies and enabling doctors to assess the extent of cancer spread for staging purposes.
Additionally, advancements in technology have led to the development of methods like capsule endoscopy, where a small camera is ingested to capture images of the intestines, and virtual endoscopy, which combines endoscopic views with 3D imaging from CT scans. Patient preparation for endoscopy varies but often includes fasting and anesthesia, with many procedures performed on an outpatient basis. While there are risks associated with endoscopy, such as bleeding and infection, its benefits include early cancer detection and the potential for minimally invasive surgical interventions. Overall, endoscopy is a vital tool in modern oncology, contributing to improved cancer management and treatment outcomes.
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Endoscopy and cancer
ALSO KNOWN AS: Brochoscopy, capsule endoscopy, colonoscopy, colposcopy, cystoscopy, cystourethroscopy, endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS), enteroscopy, esophagogastroduodenoscopy (EGD), flexible bronchoscopy, flexible sigmoidoscopy, gastroscopy, hysteroscopy, laparoscopy, laryngoscopy, lower endoscopy, mediastinoscopy, panendoscopy, peritoneal endoscopy, pleuroscopy, proctosigmoidscopy, sigmoidoscopy, thorascopy, upper endoscopy, virtual endoscopy
DEFINITION: Endoscopy is a procedure that involves inserting a thin tube with a viewing instrument inside the body to examine the internal anatomy. There are many types of endoscopes, depending on the purpose of the procedure and the part of the body being examined. Endoscopes may be equipped with lights, fiber optics, ultrasound, lasers, or surgical instruments. Endoscopes may be inserted into the body through small incisions or through natural openings, such as the mouth, vagina, anus, or urethra. Common types of endoscopes include bronchoscopes, colonoscopes, colposcopes, cystoscopes, esophagogastroduodenoscopes, hysteroscopes, laparoscopes, laryngoscopes, mediastinoscopes, sigmoidoscopes, and thoracoscopes.
Cancers diagnosed or treated: Anal cancer, bile duct cancer, bladder cancer, cancer of unknown origin, carcinoid cancer, cervical cancer, colon cancer, colorectal cancer, endometrial cancer, esophageal cancer, gallbladder cancer, laryngeal and hypolaryngeal cancer, liver cancer, lung cancer, cancer of the nasal cavity and parasinuses, metastasized cancer, oral cavity and oropharynngeal cancer, ovarian cancer, pancreatic cancer, prostate cancer, small intestine cancer, stomach cancer, vaginal cancer, uterine cancer
Why performed: Endoscopies are medical procedures used to screen, diagnose, biopsy, stage, treat, and palliatively treat cancer. They screen for certain cancers, allowing early detection and treatment. They provide more detailed information about suspicious tissues seen on imaging scans, which can then be biopsied or removed. Endoscopy is used to determine how far cancer has spread to help in staging. In advanced cancer, surgical endoscopy is used for palliative care.
Endoscopes are used in minimally invasive, or “keyhole,” surgeries. Capsule endoscopy is a newer technology in which a miniature camera and light source are contained in a capsule, which is swallowed. The capsule creates images of the intestine that cannot be reached with standard endoscopy. Virtual endoscopy is another newer technology that uses endoscopy and computed tomography (CT) scans to create three-dimensional images.
Patient preparation: Preparation depends on the type of endoscopy that is being performed. Generally, upper endoscopies use sedation and local or general anesthesia and require fasting. Lower endoscopies use sedation and local or general anesthesia and require fasting, a liquid diet, laxative use, or an enema. Laparoscopic procedures require fasting and general anesthesia. Some endoscopic procedures may use local anesthesia and may not require fasting. Patients receive specific instructions before the procedures. Many endoscopies are performed as outpatient procedures at hospitals or surgical centers. Some procedures may require a short stay in the hospital.
Steps of the procedure: The steps depend on the endoscopy type. An upper endoscopy involves keeping the mouth open with a plastic mouthpiece. The well-lubricated endoscope is placed in the mouth and swallowed by the patient. The doctor gently guides the endoscope through the esophagus, stomach, and small intestine by viewing images on a monitor.
A lower endoscopy involves placing a well-lubricated endoscope through the anus and into the rectum and colon. Visual images guide the procedure on a screen.
Laparoscopic endoscopy involves inserting the endoscope through a small incision. Air may be inserted to expand the body cavity to create a better view.
Surgery may be performed with endoscopy; a biopsy may be taken with surgical instruments, or small cancerous or precancerous growths may be removed with lasers or surgical instruments.
After the procedure: The patient is observed in the recovery area until alert. Patients receiving outpatient procedures may need another person to drive them home. Some procedures may require a short inpatient stay. Depending on the type of endoscopy, patients may experience discomfort and minimal bleeding. They will receive specific care instructions related to their procedures.
Risks: Endoscopy has risks, including pain, bleeding, infection, organ or tissue perforation, and those associated with general anesthesia.
Results: Healthy tissues are free of atypical or abnormal growths. Suspicious tissues may be biopsied during the endoscopy or with a separate procedure. Biopsied tissues or suspicious growths that are removed are tested for the presence of cancerous and precancerous cells.
In the 2020s, new technologies are making endoscopy more effective and less invasive. One such innovation is wireless capsule endoscopy (WCE). This robotic device wirelessly transmits video through a patient's gastrointestinal tract, showing medical staff affected areas. With WCE, sedation is no longer necessary, and risks associated with traditional endoscopic procedures are also reduced.
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