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Endoscopies in cancer diagnosis

 

What is an endoscopy?

 

An endoscopy is a procedure where the surgeon uses specialized instruments to examine and operate on the body’s internal organs and vessels. It helps doctors to see issues inside the body without making large incisions. A surgeon inserts an endoscope through a small cut or a natural opening in the body. An endoscope is a flexible tube with a camera attached to it that lets your doctor see. Your doctor can control forceps and scissors at the end of the endoscope, to perform biopsy operations.

 

Why do I need an endoscopy?

 

To screen for cancer, and prevent it. For example, doctors use a type of endoscopy to test colorectal cancer, called a colonoscopy. Your doctor may remove growths, called polyps, during a colonoscopy. Without removal, polyps may lead to cancer.

 

To treat determine the cause of the symptoms. The type of endoscopy recommended by your doctor is dependent on the part of the body being examined.

 

To give treatment. Doctors use endoscopes for certain treatments.


Treatments possibly involving an endoscope include:

 

  • Laparoscopic surgery: Done through small incisions in the skin
  • Laser therapy: Uses a powerful beam of light to destroy cancer cells
  • Microwave ablation: Uses heat to destroy cancerous tissue
  • Endoscopic mucosal resection: Surgery using an endoscope inserted into the gastrointestinal tract
  • Photodynamic therapy: To destroy a tumor with a laser after injecting it with a light-sensitive substance
  • Medication delivery: To administer any medication directly at the site of the disease. 

 

The doctor will confirm the symptoms, do a physical exam, and probably order blood tests before endoscopy. Such assessments will help your physician gain a greater understanding of the potential cause of your symptoms. These tests may also help them determine whether they can treat the problems without endoscopy or surgery.

 

How is an endoscopy performed?

 

The doctor then puts the endoscope into your mouth. He or she can ask you to swallow, as the scope passes through your throat. You may feel some pressure in your throat but you do not necessarily experience pain. Once the endoscope passes your throat you cannot speak, but you can make noises. The endoscope should not mess with the respiration.

 

  • A small camera at the tip transmits pictures to the video display. Your doctor will watch the monitor look into your digestive tract for abnormalities. If there are abnormalities in your digestive tract, your doctor can record pictures for subsequent tests.
  • Gentle air pressure can be injected into the esophagus to inflate the digestive tract. This allows free movement of the endoscope. It helps the doctor to inspect the folds of the digestive tract more easily. 
  • Your doctor can pass special surgical equipment through the endoscope to retrieve a tissue sample or remove a polyp, if necessary. Your doctor will use the video display to direct and control the devices.

 

The endoscope is slowly retracted through your mouth after your doctor has finished the exam. Depending on the case, an endoscopy usually requires about 15 to 30 minutes.

 

What are the types of endoscopy?

 

Endoscopies are categorized based on the area of the body that they investigate. The American Cancer Society (ACS) has categorized the following types of endoscopies:

Name of procedure Name of Scope Area or organ examined Route of Insertion
Anoscopy Anoscope Anus and/or rectum Through the anus
Arthroscopy Arthroscope Joints Through a small incision over the joint
Bronchoscopy Bronchoscope Trachea, or windpipe, and the lungs Through the mouth
Colonoscopy Colonoscope Entire length of the colon and large intestine Through the anus
Colposcopy Colposcope Vagina and cervix Not inserted. Placed at the vaginal opening
Cystoscopy Cystoscope Inside of the bladder Through the urethra
Esophagoscopy Esophagoscope Esophagus Through the mouth
Gastroscopy Gastroscope Stomach and duodenum, which is the beginning of the small intestine Through the mouth
Laparoscopy Laparoscope Stomach, liver, or other abdominal organs, female reproductive organs, including the uterus, ovaries, and fallopian tubes Through a small, surgical opening in the abdomen
Laryngoscopy Laryngoscope Larynx, or voice box Through the mouth
Neuroendoscopy Neuroendoscope Areas of the brain Through a small incision in the skull
Proctoscopy Proctoscope Rectum and sigmoid colon, which is the bottom part of the colon Through the anus
Sigmoidoscopy Sigmoidoscope Sigmoid colon Through the anus
Thoracoscopy Thoracoscope Pleura, which are the 2 membranes covering the lungs and lining the chest cavity, and structures covering the heart Through a small surgical opening in the chest

What are the side effects of an endoscopy?

 

Endoscopy poses a much lower risk of bleeding and infection compared with open surgery.  However, it is a medical procedure, so there is some risk of bleeding, infection, and other rare complications like:

 

  • Pain in the chest
  • Probable perforation of organs
  • Fever
  • Pain in the endoscopic area
  • Redness and swelling at the site of incision