Preventative Care: Colonoscopies
Sometimes, people get a little bit shy when it comes to talking about colonoscopies. Dr. Nancy Panko discusses the importance of getting a colonoscopy, what the process entails, how frequently you should get one, and more.
Featuring:
Nancy Panko, MD
Nancy Panko, MD has been providing exceptional care on the Palouse since 2019. As the Medical Director for Pullman Surgical Associates, Dr. Panko seeks to provide a seamless, simplified experience for patients and referring providers. She attended medical school at the University of Washington through the WWAMI program, completed her surgical residency at St Joseph Hospital in Chicago, and a fellowship in advanced GI and minimally invasive surgery at the University of Texas, Houston. Transcription:
Deborah Howell: People sometimes get a little bit shy when it comes to talking about colonoscopies. Well, to learn a little bit more about why we should be talking more about them, as well as getting these screenings regularly, we'll talk to someone who knows all about it. Today we'd like to welcome Dr. Nancy Panko, a board certified general surgeon and medical director of Pullman Surgical Associates. Hello, Dr. Panko, and welcome.
Dr. Nancy Panko: Hi. Thanks for having me.
Deborah Howell: You are so welcome to be here. Now, as part of being a general surgeon, you perform endoscopies. Could you please briefly describe the colonoscopy process?
Dr. Nancy Panko: Sure. So the colonoscopy process is where I use a specialized camera that allows me to take a look at the lining of the entirety of the large intestine or the colon. So that is something that we do under anesthesia. We do it in our same day surgery department. And typically patients are able to come in, have their procedure and are out within about an hour.
Deborah Howell: Fantastic. Now, I know there's some prep required prior to the procedure, what can a patient expect before and during a colonoscopy?
Dr. Nancy Panko: Yes. So I always tell my patients the prep is the least fun part of the colonoscopy. That being said, it's very important because in order for your physician to take a very good look at the lining of the colon and detect any polyps or any abnormalities in the lining of the colon, we need that colon to be very, very clean. And so what we do is we have our patients take a medication the day before that essentially cleans out the entire colon. We also have patients stay on a clear liquid diet. So anything that see through to help decrease the amount of food that could potentially stay in the colon and then make the physician unable to get an adequate exam.
Deborah Howell: Sure. Sometimes the dread is worse than the actual prep itself. I found.
Dr. Nancy Panko: I think that's absolutely true. And I see so many patients the morning of the procedure who tell me, that really wasn't as bad as I anticipated.
Deborah Howell: Exactly. Now, what does a colonoscopy examination look for?
Dr. Nancy Panko: So with a colonoscopy, we are looking for any abnormalities in the lining of the colon, and so the most common type of colonoscopy that we do is a screening colonoscopy, and we're using that exam to screen for colorectal cancer. We know that colonoscopies are the best way for us to both diagnose and screen for colon cancer. And so when we're looking at the colon, I'm essentially looking for any polyps or any kind of bumps or bunched up tissue in the lining of the colon. And then when I see these, I can remove them and send them off to pathology for them to be examined under the microscope.
These polyps have the potential to transform into colon cancer over time. So by removing them, we're potentially preventing cancer from forming. That's the primary thing I'm looking for during a colonoscopy. We're also looking for, as I mentioned, any abnormalities in the lining of the colon, any inflammation or any other things that could be potentially causing dysfunction with bowel habit.
Deborah Howell: Okay, and who should be getting a colonoscopy and how frequently should they get one?
Dr. Nancy Panko: Yes, so the national guidelines suggests that patients should start colorectal cancer screening with colonoscopy at the age of 45. In a patient with a normal colonoscopy, the recommended interval is every 10 years. So it's not an exam that you have to do all that frequently, but it is important. There are some patient groups that need to have colonoscopies more frequently or at an earlier age. So for example, if you have a first degree relative, meaning mom, dad, brother, sister, children who have colon cancer, the recommended time to start screening is either at age 40 or five years earlier than the the age of that family member was diagnosed with colon. And similarly, if you've had polyps or if you've had personal history of colon cancer, we do more frequent screening.
Deborah Howell: Sure. But 45, not 50. Correct?
Dr. Nancy Panko: Yes. 45. That's an important point. And that's changed, it actually changed in the national guidelines probably about 10 years ago. And really just within the past five years, have insurance companies begun to recognize that. And so now we are seeing a backlog of patients who are, getting their colonoscopies starting at age 45.
Deborah Howell: Correct. Okay. Now, well, not the most comfortable way to spend the day. Why is it so important to stay on top of your screenings like colonoscopies?
Dr. Nancy Panko: So as I mentioned, colonoscopy is both diagnostic and therapeutic, meaning it allows us to find polyps and remove them and potentially prevent a colon cancer from forming. And that's why I think this is such an important exam. I really encourage my patients that while it's not the most fun way to spend your day, that it's an important and vital part of your routine health maintenance.
Deborah Howell: And, you actually kind of feel better after the prep you feel a little bit more energy, I think.
Dr. Nancy Panko: I've had so many patients tell me that actually.
Deborah Howell: Yeah. Now, you've addressed this earlier, but it's such an important point. I'm gonna hit you up with it again. Sometimes polyps can be removed during a colonoscopy, and sometimes they require a separate procedure to remove. If someone has polyps, does that mean that they have an increased risk of colon cancer?
Dr. Nancy Panko: So there are certain types of polyps. The primary different types of polyps that we see are what we call adenomatous polyps. Those are the polyps that we know have an increased risk of transforming to a colon cancer. And so if you've been diagnosed with adenomatous polyps, that does mean that you need to have an increased frequency of screening colonoscopy, generally between three and five years as opposed to 10. There are other benign polyps that we see and we can't tell the difference between them just looking at them during the exam. It's really something that has to be determined when they look at these specimens under the microscope, but those benign polyps do not increase the risk of colon cancer and don't increase the frequency with which you need a colonoscopy.
Deborah Howell: That's fascinating. Anything else you'd like to add or underline Dr. Panko?
Dr. Nancy Panko: So I really encourage all of my patients to stay on top of their colonoscopies, and it's something that your primary care physicians should be helping address with you. It's your yearly visits. It's something that I ask my patients about, even if I'm not seeing them for a colonoscopy, I always make sure that people are on top of this because. It's a preventable illness potentially. And so by doing colonoscopies we can prevent really devastating health issues down the road. And so I really express to all my patients and my family this is a vital part of taking care of yourself as we get older.
Deborah Howell: If you're gonna be a wife and you're gonna nag your husband about one thing, this is it, right?
Dr. Nancy Panko: Absolutely.
Deborah Howell: Well, Dr. Panko, we so appreciate your time and everything you do to help our wonderful patients. Thanks so much for being with us today.
Dr. Nancy Panko: Yes. Thank you so much for having me.
Deborah Howell: And you can learn more about this subject, providers and services at Pullman Regional Hospital online at pullmanregional.org/surgery. This has been The Health Podcast from Pullman Regional. I'm your host, Debra Howell. Thanks for listening and have yourself a terrific day.
Deborah Howell: People sometimes get a little bit shy when it comes to talking about colonoscopies. Well, to learn a little bit more about why we should be talking more about them, as well as getting these screenings regularly, we'll talk to someone who knows all about it. Today we'd like to welcome Dr. Nancy Panko, a board certified general surgeon and medical director of Pullman Surgical Associates. Hello, Dr. Panko, and welcome.
Dr. Nancy Panko: Hi. Thanks for having me.
Deborah Howell: You are so welcome to be here. Now, as part of being a general surgeon, you perform endoscopies. Could you please briefly describe the colonoscopy process?
Dr. Nancy Panko: Sure. So the colonoscopy process is where I use a specialized camera that allows me to take a look at the lining of the entirety of the large intestine or the colon. So that is something that we do under anesthesia. We do it in our same day surgery department. And typically patients are able to come in, have their procedure and are out within about an hour.
Deborah Howell: Fantastic. Now, I know there's some prep required prior to the procedure, what can a patient expect before and during a colonoscopy?
Dr. Nancy Panko: Yes. So I always tell my patients the prep is the least fun part of the colonoscopy. That being said, it's very important because in order for your physician to take a very good look at the lining of the colon and detect any polyps or any abnormalities in the lining of the colon, we need that colon to be very, very clean. And so what we do is we have our patients take a medication the day before that essentially cleans out the entire colon. We also have patients stay on a clear liquid diet. So anything that see through to help decrease the amount of food that could potentially stay in the colon and then make the physician unable to get an adequate exam.
Deborah Howell: Sure. Sometimes the dread is worse than the actual prep itself. I found.
Dr. Nancy Panko: I think that's absolutely true. And I see so many patients the morning of the procedure who tell me, that really wasn't as bad as I anticipated.
Deborah Howell: Exactly. Now, what does a colonoscopy examination look for?
Dr. Nancy Panko: So with a colonoscopy, we are looking for any abnormalities in the lining of the colon, and so the most common type of colonoscopy that we do is a screening colonoscopy, and we're using that exam to screen for colorectal cancer. We know that colonoscopies are the best way for us to both diagnose and screen for colon cancer. And so when we're looking at the colon, I'm essentially looking for any polyps or any kind of bumps or bunched up tissue in the lining of the colon. And then when I see these, I can remove them and send them off to pathology for them to be examined under the microscope.
These polyps have the potential to transform into colon cancer over time. So by removing them, we're potentially preventing cancer from forming. That's the primary thing I'm looking for during a colonoscopy. We're also looking for, as I mentioned, any abnormalities in the lining of the colon, any inflammation or any other things that could be potentially causing dysfunction with bowel habit.
Deborah Howell: Okay, and who should be getting a colonoscopy and how frequently should they get one?
Dr. Nancy Panko: Yes, so the national guidelines suggests that patients should start colorectal cancer screening with colonoscopy at the age of 45. In a patient with a normal colonoscopy, the recommended interval is every 10 years. So it's not an exam that you have to do all that frequently, but it is important. There are some patient groups that need to have colonoscopies more frequently or at an earlier age. So for example, if you have a first degree relative, meaning mom, dad, brother, sister, children who have colon cancer, the recommended time to start screening is either at age 40 or five years earlier than the the age of that family member was diagnosed with colon. And similarly, if you've had polyps or if you've had personal history of colon cancer, we do more frequent screening.
Deborah Howell: Sure. But 45, not 50. Correct?
Dr. Nancy Panko: Yes. 45. That's an important point. And that's changed, it actually changed in the national guidelines probably about 10 years ago. And really just within the past five years, have insurance companies begun to recognize that. And so now we are seeing a backlog of patients who are, getting their colonoscopies starting at age 45.
Deborah Howell: Correct. Okay. Now, well, not the most comfortable way to spend the day. Why is it so important to stay on top of your screenings like colonoscopies?
Dr. Nancy Panko: So as I mentioned, colonoscopy is both diagnostic and therapeutic, meaning it allows us to find polyps and remove them and potentially prevent a colon cancer from forming. And that's why I think this is such an important exam. I really encourage my patients that while it's not the most fun way to spend your day, that it's an important and vital part of your routine health maintenance.
Deborah Howell: And, you actually kind of feel better after the prep you feel a little bit more energy, I think.
Dr. Nancy Panko: I've had so many patients tell me that actually.
Deborah Howell: Yeah. Now, you've addressed this earlier, but it's such an important point. I'm gonna hit you up with it again. Sometimes polyps can be removed during a colonoscopy, and sometimes they require a separate procedure to remove. If someone has polyps, does that mean that they have an increased risk of colon cancer?
Dr. Nancy Panko: So there are certain types of polyps. The primary different types of polyps that we see are what we call adenomatous polyps. Those are the polyps that we know have an increased risk of transforming to a colon cancer. And so if you've been diagnosed with adenomatous polyps, that does mean that you need to have an increased frequency of screening colonoscopy, generally between three and five years as opposed to 10. There are other benign polyps that we see and we can't tell the difference between them just looking at them during the exam. It's really something that has to be determined when they look at these specimens under the microscope, but those benign polyps do not increase the risk of colon cancer and don't increase the frequency with which you need a colonoscopy.
Deborah Howell: That's fascinating. Anything else you'd like to add or underline Dr. Panko?
Dr. Nancy Panko: So I really encourage all of my patients to stay on top of their colonoscopies, and it's something that your primary care physicians should be helping address with you. It's your yearly visits. It's something that I ask my patients about, even if I'm not seeing them for a colonoscopy, I always make sure that people are on top of this because. It's a preventable illness potentially. And so by doing colonoscopies we can prevent really devastating health issues down the road. And so I really express to all my patients and my family this is a vital part of taking care of yourself as we get older.
Deborah Howell: If you're gonna be a wife and you're gonna nag your husband about one thing, this is it, right?
Dr. Nancy Panko: Absolutely.
Deborah Howell: Well, Dr. Panko, we so appreciate your time and everything you do to help our wonderful patients. Thanks so much for being with us today.
Dr. Nancy Panko: Yes. Thank you so much for having me.
Deborah Howell: And you can learn more about this subject, providers and services at Pullman Regional Hospital online at pullmanregional.org/surgery. This has been The Health Podcast from Pullman Regional. I'm your host, Debra Howell. Thanks for listening and have yourself a terrific day.