Endoscopy
Thomas E. and Alice M. Hales Endoscopy Unit
The Facts
Colorectal cancer (cancer of the colon or rectum)is the second leading cause of cancer-related deaths in the United States for both men and women combined. A study published in the September issue of The Journal of Family, in 2002, predicted that approximately 150,000 Americans would be diagnosed with colorectal cancer and nearly 56,000 would die from the disease.
The Good News
Screenings for colorectal cancer play an essential role in its detection and treatment. Colonoscopy is the preferred procedure to detect colon cancer in its early stages, when treatment is most successful. Between 1973 and 1995, mortality from colorectal cancer declined by 20.8% and incidence declined by 7.4% in the United States. Most experts agree that this significant reduction in colorectal cancer mortality is due to increased use of endoscopic screening as a preventive measure and to aid physicians in utilizing early intervention techniques.
Phelps Memorial Hospital Center opened the Thomas E. and Alice M. Hales Endoscopy Unit in November 2002. The state-of-the-art Endoscopy Unit features three procedure rooms and nine private patient rooms equipped with televisions and telephones. Unit at Phelps has the capacity to serve more than 500 patients per month.
Designed to serve community members as well as hospital patients, the unit provides a full range of endoscopic procedures, including colonoscopy, gastroscopy/upper endoscopy and ERCP, a procedure that integrates endoscopic and x-ray techniques to visualize the patient's bile and pancreatic ducts. Endoscopic ultrasound (EUS), a valuable diagnostic procedure that Phelps introduced to Westchester, is also offered in the new unit. EUS combines the use of the endoscope with ultrasound in order to enhance visualization of the digestive (GI) tract.
All procedures are performed by Board-certified Gastroenterologists, with the assistance of specially trained Registered Nurses and Endoscopy Technicians. Patients are monitored by an R.N. throughout the procedure and recovery process - an added benefit of having such a procedure performed in a hospital-based setting.
Briarcliff Manor residents Thomas E. and Alice M. Hales are longstanding supporters of Phelps Memorial Hospital Center. Mr. Hales, President and CEO of Union State Bank, said Phelps "holds a special place in our hearts," particularly since the Hales' six children and several of their grandchildren were born here.
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| Two patient rooms. All rooms have sliding glass doors and curtains for privacy and are equipped with telephone and tv. | One of three procedure rooms, fully equipped with state-of-the-art technology. |
Endoscopic Ultrasound
Phelps Memorial Hospital Center was one of the first community hospitals in Westchester to offer endoscopic ultrasound, the newest, most rapidly expanding GI procedure, which enables physicians to get a better and closer look at the body from the inside. Although Endoscopic Ultrasound (EUS) was first developed in the mid-1980's, it is available in fewer than 15% of hospitals nationwide, primarily because there is a shortage of physicians trained to do the procedure.
Gastroenterologist Floyd Byfield, MD, who brought this expertise to Westchester when he joined Phelps' staff this year, was trained at Columbia Presbyterian by Charles Lightdale, MD, one of the founding fathers of endoscopic ultrasound. Dr. Lightdale is not only a pioneer, but also an international leader in endoscopic ultrasound. Dr. Byfield was a fellow at Columbia Presbyterian for three years. During that time, he performed more than 350 endoscopic ultrasounds.
EUS is a non-invasive procedure that involves insertion of an endoscope (thin tube) through the mouth into the esophagus, stomach, and duodenum. The patient is sedated, pain-free, and comfortable during the entire procedure. Attached to the endoscope is a small sonographic probe. Once the probe is in place, it is turned on, thus yielding sonographic pictures from inside the body.
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Extremely small lesions less than 3 millimeters (smaller than the size of a dime) in diameter can be detected with endoscopic ultrasound. This allows the earliest possible diagnosis of esophageal, rectal, and pancreatic cancers, enabling treatment at a stage when the patient's prognosis will be much better.
If cancer of the pancreas is found, EUS can help assess the feasibility of surgery without the patient having to undergo a separate radiologic procedure.
EUS is considered the best test, or "gold standard," for the staging of esophageal or rectal cancer prior to surgery or chemotherapy. It is also helpful in evaluating and managing patients who have previously been treated for these cancers.
Endoscopic ultrasound is also used to evaluate the gallbladder and bile duct. Its superior resolution results in an ability to detect stones in the bile duce in 95% of patients. Abdominal sonography, on the other hand, which is traditionally used for this purpose, detects stones in the bile duct only 50-60% of the time. Undetected stones in the bile duct can cause persistent abdominal pain and/or fever.
When a routine endoscopy reveals suspicious "lumps and bumps" in the gastrointestinal tract, an endoscopic ultrasound can determine whether or not the patient's "lump" is cancerous.
The state-of-the art sonography equipment, which is manufactured by Olympus, will be installed in the hospital's Ambulatory Surgery Unit. Dr. Byfield expects to begin offering the procedure to Phelps patients by January 2000.
Dr. Byfield is an associate of Westchester Gastroenterology Associates, PC, and is located in the Medical Office Building on the Phelps Campus in Sleepy Hollow.
Endoscopic Ultrasound Fact Sheet
Who should have an endoscopic ultrasound?
- Patients with newly diagnosed or previously treated esophageal and rectal cancer.
- Patients who may have pancreatic cancer.
- Patients who may have stones in the bile duct not seen on abdominal sonography.
- Patients who have suspicious " lumps and bumps" in the gastrointestinal tract.
How long does endoscopic ultrasound take?
Most procedures are completed in less than 30 minutes. More complex cases may require up to an hour. The patient usually goes home about half an hour after the procedure is finished.
Is Endoscopic ultrasound safe?
Endoscopic ultrasound is as safe as a routine endoscopy that would usually be performed by gastroenterologists to evaluate symptoms such as heartburn, ulcers or rectal bleeding.
Will insurance pay for endoscopic ultrasound?
Endoscopic ultrasound is recognized as a useful procedure and is generally covered by Medicaid, Medicare and most forms of commercial insurance.