Word: colon
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Dates: during 1990-1999
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...almost anyone what's wrong with HMOs these days, and the answer is often the same: precertification. Before ordering tests for colon cancer or even scheduling surgery, many doctors must submit their therapies and plans to company reviewers. Examples of denied care have produced the worst horror stories associated with managed care. The process has left doctors frustrated and patients anxious. It also fueled a revolt in Congress last month in which a band of rebel Republicans rolled over the House leadership to pass a bill giving patients the right to sue their insurance companies for the medical decisions they...
INSIDE INFORMATION Colonoscopy is probably the world's most unpopular procedure, but the notoriously uncomfortable test, in which a probe is snaked through the anus and into the bowel, is still considered the gold standard for detecting colon cancer in its earliest, most treatable stage. Now there may be a less traumatic alternative. A study shows that a "virtual colonoscopy"--basically, a fancy CAT scan--is nearly as accurate (82%) as the real thing in detecting tiny precancerous polyps. The procedure zaps patients with radiation equivalent to about five chest X rays, but it's noninvasive, requires no sedation...
Within five years, early detection will be available for many other types of cancer as well. A stool sample will be all that is needed to search for colon-cancer cells on their way to becoming tumors, and drugs like the new COX-2 inhibitors, which are improved versions of pain killers, can prevent those precancerous cells from progressing. By the end of the next decade, a simple blood test could alert doctors to a wide variety of cancer precursors...
Still, Nichols wanted to know how FGN-1 worked. Until then, colon cancer was thought to be a disease of uncontrolled growth. Nichols' scientists suspected instead that the problem was uncontrolled death. Cells lining the intestines usually live only 72 hours. But while cells are born at the usual rate in FAP patients, some fail to self-destruct, producing an excess. Johns Hopkins' Giardiello eventually showed that drugs like sulindac work by restoring the natural process of cell death in the colon. Precisely how it does that, however, remains unknown...
Last year Cell Pathways began tests on children. The first child to be enrolled in the study was Eric Nichols, 11, who had been found to have his father's disease. Other studies are showing that related drugs may be effective against a broad range of cancers, including colon cancer, the No. 2 cause of cancer deaths...