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Fecal DNA Testing: Is This The Future Of Colon Cancer Screening?

It’s Saturday morning, and I’m in an undisclosed location drinking a fabulous cup of coffee while turning the pages of The New York Times, knowing that ink and newsprint will be vanishing too soon. Yes, I do have an iPad now, but I haven’t figured out how to blog on it. Any suggestions?

Buried in the first section of the paper is an article on stool, which in my view as a gastro specialist, should have merited front page placement. Yes, we all know the adage, ‘one’s man’s trash is another man’s treasure’, but stool – as in excrement – should be prized by everyone. Perhaps, as a gastroenterologist, I have a jaundiced view on this issue, which explains my dyspeptic reaction.

All Whistleblower posts have an accompanying image, and I wonder what visual would be appropriate here.  I opted against my first choice, and choose instead a photo of our beloved Labrador Retriever, Shoshie, of blessed memory.

The Times reported a new program to Read more »

*This blog post was originally published at MD Whistleblower*

Colon Cancer Screening: Guideline Truths And Myths

Colon cancer screening has a particular personal interest for me — one of my colleagues in residency training had her father die of colon cancer when she was a teenager.

No one should lose a loved one to a disease that, when caught early, is often treatable. But for both men and women, colon cancer is the third most common cancer behind lung cancer and prostate cancer in men, and behind lung cancer and breast cancer in women, it’s the second most lethal.

The problem is that patients are often confused about which test is the right one. Is it simply a stool test? Flexible sigmoidoscopy? Colonoscopy? Virtual colonoscopy? Isn’t there just a blood test that can be done? (No.)

In simple terms, this is what you need to know:

All men and women age 50 and older should be screened for colon cancer. Even if you feel healthy and well and have no family history, it must be done. Note that Oprah’s doctor, Dr. Oz, arguably a very health-conscious individual learned that he had a colon polyp at age 50 after a screening test. Left undetected, it could have cut his life short. This wake-up call caused him to abort his original second season premier on weight loss and instead show the country why colon cancer screening matters. He admitted that if it wasn’t for the show and the need to demonstrate the importance of screening to America, he would have delayed having any test done.

The least invasive test is a stool test. If it is to screen for colon cancer, then the test is done at home and NOT in the doctor’s office. Either the fecal occult blood test (FOBT) or the fecal immunochemical test (FIT) are available to screen for unseen microscopic blood that could be a sign of a colon polyp or cancer. Research shows that when a stool test is done annually, the risk of dying from colon cancer can fall by 15 to 33 percent. If you don’t want any fiber optic cameras in your rectum and lower colon, this is the test for you. You must do it annually.

The next two tests are similar but often confused: The flexible sigmoidoscopy and the colonoscopy. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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