Future Testing Will Be Music to Patients' Ears
June 1, 2000 -- A whole new generation of tests to diagnose disease is on
the horizon. Some laboratory tests and imaging studies may even cost less than
current alternatives, making early cancer detection a reality more often.
In response to consumer demand for cancer screening, imaging centers in
Southern California are offering full-body CT scans (pronounced 'cat' scans and
similar to an X-ray) for healthy people. "Most full-body scans just
identify scar tissue and [noncancerous] growths, but invasive follow-up tests
are often needed to rule out serious disease, says Deborah Baumgarten, MD, an
associate professor of radiology at Emory University School of Medicine in
Full-body CT scans are not covered by managed care health plans, but new
laboratory tests may soon be. As a low cost-screening tool, detection of
genetic mutations holds promise for many cancers and requires just a few drops
of blood, urine, and saliva. "In five years, [these] tests will be routine
for common cancers," says co-developer David Sidransky, MD, professor of
oncology and otolaryngology at Johns Hopkins University School of Medicine in
In diagnosing cancer, Sidransky tells WebMD that these new tests won't
replace traditional testing, but will probably serve as a first step. A urine
test for bladder cancer could be available within the next two years. Soon
after, blood and saliva tests for lung, breast, prostate, and colon cancers
will be available at a cost of about $200.
Until then, new approaches in bowel imaging are less invasive than
traditional exams. Virtual colonoscopy allows doctors to see inside the colon
without a scope inserted into the rectum. "Computer software turns a simple
CT scan into a fantastic voyage of the colon," says Joseph Ferucci, MD,
chairman of radiology at Boston Medical Center and professor of radiology at
Boston University School of Medicine.
Virtual colonoscopy eliminates the risk of penetrating the bowel wall with
the instruments and the need for sedation, but won't replace traditional
colonoscopy for everyone. "If large pre-cancerous polyps are found, they'll
have to be snared with a colonoscope," Ferucci tells WebMD. "But for
most people, the virtual procedure is two thirds the cost of traditional
colonoscopy and will ultimately be the price of a mammogram."
Another approach to imaging of the digestive track is as simple as
swallowing a capsule. Researchers in the U.K. and Israel have developed a
wireless video camera that transmits images, of the stomach and intestines, as
it moves though the digestive tract. "It's a gulpable minicam," says
Sandra Ziv, the marketing manager at Given Imaging in Yogneam in Israel.
"The capsules shoot an eight-hour movie, then computer software turns it
into a 20-minute film clip."
The video capsules are not likely to replace gastroscopy and endoscopy, in
which a long flexible scope is passed through the throat. "Capsules have
fewer risks and don't require sedation, but traditional procedures will still
be needed to treat digestive disorders," adds Ziv. "For diagnosing
problems, the cost will be about the same and patients can continue their daily
activities without interruption." Ziv tells WebMD that the new device could
be available later this year.