Endoscopy for the Diagnosis and Prognosis of Cancer
Endoscopy is generally defined as an internal examination—to
an object—but it can also be specifically defined as a non-nuclear method of imaging or viewing, in real-time, human anatomical structures. Part of a larger scientific discipline known as Medical Imaging (MI), endoscopy provides cancer doctors with a minimally invasive tool to closely examine specific regions of the body in order to confirm the presence or absence of malignant disease.
Endoscopic examinations are facilitated through the use of an endoscope, a device that can vary slightly in form and function from one manufacturer to another, though, all endoscopes perform essentially the same task, which is to image the interior surfaces of an anatomical structure through the insertion of a rigid or flexible tube into the body.
In addition to using live video and photographic technologies to produce real-time medical images, some endoscopes are designed and equipped to perform the additional function of retrieving small samples of tissue for biopsy, as well as the excision and removal of potentially harmful objects from the body, e.g., the endoscope facilitated removal of benign polyps during a colonoscopy.
Endoscopy Causes Minimal Patient Discomfort
Moderate discomfort may be experienced by patients who undergo a variety of endoscopic examinations, though, such procedures are generally performed using no more than conscious sedation to ensure patient comfort during the course of the examination. Larynx, respiratory tract, and esophageal endoscopic examinations involve the insertion of an endoscope via the mouth or nostrils, and while this point of entry would seem to cause significant patient discomfort, the procedures are generally accomplished using no more than topical applications of local anesthetics such as lignocaine.
Endoscopic examinations are generally performed by physicians who have received special training in the field, and most endoscopy exams can be conducted on an outpatient basis in large hospitals and small neighborhood clinics alike. Endoscopy is one of the most affordable of all the MI procedures, usually costing far less than nuclear or magnetic-based tomographic technologies, many of which employ the use of potentially harmful radiation (X-rays), as well as sometimes requiring a patient to be injected with radioactive materials.
The disadvantages of endoscopy are few, but they do include the potential for the unintended rupture or tearing of the internal organ or anatomical structure being examined. Such an occurrence is rare, but accidental, endoscope-caused injury to tissues will sometimes require invasive surgeries to repair the damage, thus creating an opportunity for the additional complication of infection. Additionally, a small percentage of patients will experience generally mild allergic reactions to contrast dyes that are required for some endoscopic procedures, while a similarly small number of individuals will react poorly to sedation or suffer from over-sedation. When all is said and done, however, the many benefits of endoscopy far outweigh the very minimal risks, and one of the oldest forms of MI will undoubtedly be with us for many years to come.
Endoscopy Claims no Sole Inventor
There have been countless contributors to the field of endoscopy since the first known attempt to use a tube to view the inside of the human body was carried out by the German physician, Phillip Bozzini, in the year 1806. Bozzini’s initiative was halted due to the objections of the Vienna Medical Society—an august body that strongly disapproved of such morbid curiosities.
The first minimally functioning endoscope inserted into a human body was guided by the hand of a U. S. Army surgeon named William Beaumont, who first used his invention in the year 1822. Since that time, myriad advances in technologies and materials have contributed to the state-of-the-art endoscopic devices in use today—devices that are not wholly limited to MI and tissue retrievals.
Endoscopy technologies and techniques have evolved into the realm of cancer surgeries that once required large and highly invasive incisions to allow physician access to anatomical sites affected by malignant disease. Today, laparascopic surgery (LS) is widely used to facilitate exploratory and therapeutic cancer surgeries within abdominal and pelvic cavities—LS allows the use of incisions that average 0.5-1.5 cm in length, as opposed to traditional surgical wounds that are typically many times that length.
Traditional cancer surgeries that require entry into the thoracic or chest cavity are commonly referred to as keyhole surgeries, and these invasive procedures, too, are oftentimes replaced by laparascopic techniques known as thoracoscopic surgeries. Today, the exceptionally advanced, extremely reliable, and extraordinarily miniaturized components of endoscopic and laparascopic surgical devices provide the minimally invasive diagnostic approach cancer doctors prefer for their patients. Laparascopic surgeries of the abdominal, pelvic, and thoracic cavities are done for a fraction of the cost of traditional surgeries, offer far less risk of infection, and can oftentimes allow patients to go home on the same day of the procedure.
Minimally invasive, endoscopy-based, cancer-related examinations of the upper respiratory tract are accomplished through the use of a bronchoscope that is inserted deep into the respiratory tract via the nose or the mouth. Subsequent to the application of a local anesthetic to the nasal mucous membrane, oropharanx, and vocal chords, a device known as a bronchoscope performs a careful examination of all upper respiratory tract structures of those patients who are primarily suspected of having lung cancer. Specially trained MI physicians who monitor the bronchoscopy can view real-time images of tumors or other indications of malignant disease.
When suspicious growths are detected during a bronchoscopy, physicians are able to use the bronchoscope to retrieve tissue samples for further pathological examination. Once again, this endoscopic-based technique results in a low cost, minimally invasive procedure that does not cause great discomfort or prolonged debilitation to the patient.
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