Early Diagnosis of Multiple Sclerosis | Colorectal Cancer

Early Diagnosis and Treatment of Multiple Sclerosis
Can Make a Difference

By Barbara Dappert, M.D.

Multiple Sclerosis (MS) is a neurologic disorder which usually strikes during early and middle life—ages 20 to 45. It is the most common neurologic disorder of young adults, with women of northern temperate zones being most susceptible. (Vitamin D deficiency and various infectious exposures are thought to predispose one for the disorder.)

Genetics may alter risk, but it is not a hereditary disorder. The symptoms of MS can be as nonspecific as severe fatigue and dizziness and as blatant as weakness of a limb or side, mimicking a stroke. Double vision, memory difficulties, incoordination and aberrant sensations are other recognized symptoms.

As technologies have advanced in confirming the diagnosis, so have the available disease modifying treatments. The success of treatment of this disorder, like so many others, is dependent upon your timely communication of new and unusual symptoms to your physician. Early treatment can impact ultimate prognosis.

Dr. Dappert is a Neurologist from UPMC Passavant.

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Colorectal Cancer: The “Silent” Disease

an interview with Ved Kaushik, MD

What is colorectal cancer and what are the risks?

March is National Colorectal Cancer Awareness Month. Colorectal cancer, the second most common cancer in the United States, is a form of cancer that forms in the tissues of the colon and/or the tissues of the rectum.

Colorectal cancer is known as a “silent” disease because many people do not develop symptoms, such as bleeding or abdominal pain, until the cancer becomes difficult to cure. The average person’s lifetime risk of developing it is about one chance in 20. The risk is increased if there is a family history of colorectal polyps or cancer, and it is still higher if there is a personal history of breast, uterine, or ovarian cancer. Risk is also higher for people with a history of extensive inflammatory bowel disease, such as ulcerative or Crohn’s colitis.

Why should testing be done and what kinds of tests are performed?

Most colon cancers start as non-cancerous growths called polyps; if the polyps are removed, then the cancer may be prevented. In fact, if colorectal cancer is found and treated at an early stage before symptoms develop, the opportunity to cure is 80 percent or better.

The simplest screening test for colon and rectal cancer is testing of the stool to detect tiny amounts of invisible blood; this is called fecal occult blood testing. Unfortunately, this test only detects cancer or polyps which are bleeding at the time of the test. Therefore, further screening is necessary for accurate detection of cancers and polyps.

Flexible sigmoidoscopy is a test which allows the physician to look directly at the lining of the lower colon and rectum. During this test, which is performed in the physician’s office, the lining of the lower one-third of the colon and rectum can usually be seen. This is the portion of the lower intestine which accounts for most polyps and cancers.

When a polyp or cancer is detected by sigmoidoscopy, or if a person is at high risk to develop colon and rectal cancer, colonoscopy provides a safe, effective means of visually examining the full lining of the colon and rectum. Colonoscopy is used to diagnose colon and rectal problems and to perform biopsies and remove colon polyps. Most colonoscopies are done on an outpatient basis with minimal inconvenience and discomfort.

How often should be screening tests done?

People with high risk factors should be screened at an earlier and more frequent rate. The American Society of Colon and Rectal Surgeons recommends getting screened beginning at age 50 with a colonoscopy. For low-risk people with no symptoms or immediate family with colorectal cancer, it is recommended that you get a yearly rectal exam, a sigmoidoscopy or fecal occult blood test every three years, or a colonoscopy every 5 to 10 years.

Can one lower their risk of colorectal cancer?

Yes they can. In addition to getting screened regularly for colorectal cancer, people should avoid foods that are high in fat, eat plenty of vegetables, fruits, and other highfiber foods, exercise regularly and maintain a normal body weight, quit smoking, and drink alcohol only in moderation.

Ved Kaushik, MD, is a colorectal surgeon at UPMC Passavant and may be reached at his office at 412-366-2979.

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