A New Level of Diagnostic Accuracy Pankaj A. Patel, MD
Michiana Gastroenterology, Inc. On staff at SJRMC
The American Cancer Society estimates that more than 277,000 people will be diagnosed with cancers of the digestive system this year, and nearly 139,000 will die. Up to 60 percent of those deaths could be prevented through early screening. “Once cancer is diagnosed, the key to treatment is exact staging of the primary tumor’s size and whether the disease has spread to other areas of the body,” explains Pankaj A. Patel, MD. In the past, hard-to-reach tumors could not be clearly staged without major surgery. But with the introduction of a new technology called endoscopic ultrasound (EUS), physicians at SJRMC are now able to diagnose and stage such tumors without surgery. “An endoscopic ultrasound allows precise staging and can even detect tumors when other tests are inconclusive or conflicting,” says Dr. Patel. “It can also scan nearby structures, giving us a more comprehensive view. This is critical for effective treatment planning.”
An Advanced Approach EUS combines endoscopy and ultrasound to create more detailed images of the digestive tract and the surrounding tissue and organs. During the procedure, a thin, flexible tube called an endoscope that has a built-in ultrasound probe is guided to the area of concern. The physician uses sound waves to create images of the digestive tract. Because the EUS can get so close to the organs, the images are clearer, more accurate, and more detailed than those provided by other techniques. EUS allows doctors at SJRMC to see organs and structures not typically visible during GI endoscopy. This detailed imagery is used to diagnose and stage abnormalities in the esophagus, liver, pancreas, stomach, lymph nodes, and bile ducts. “Endoscopic ultrasound can find tumors less than one-quarter inch in size, which may not be visible on a CT scan,” says Dr. Patel.
Pinpointing the Source of the Problem
In some patients, EUS can be used for a needle biopsy of a cyst or lesion to help determine whether it’s benign or malignant. This technique is known as a fine-needle aspiration (FNA). “EUS with FNA has revolutionized our ability to diagnose and stage cancers of the digestive tract and assess the pancreas,” says Dr. Patel. “It’s a much less invasive way of imaging and doing biopsies that avoids damage to other organs, while giving us the information we need to determine the most effective line of therapy.”
SJRMC is one of the few medical centers in Michiana that offers EUS, and its GI doctors are some of the most experienced in performing it. The procedure is available at the Mishawaka Campus. For more information or a referral to a trained EUS gastroenterologist on staff at SJRMC, please talk with your doctor. Need a primary care physician or specialist? Call our Physician Referral Line at 866-757-6248 or go to sjmed.com and click on Find a Physician.
14 Michiana Medical Update I Winter 2013