Frequently Asked Questions
What is colonoscopy?
Food passes through the stomach and is digested in the small intestine. Here, nutrients are absorbed, then waste enters the colon, also known as the large intestine. The colon absorbs excess fluid and the final result is a formed bowel movement, which leaves through the anus.
Colonoscopy is an examination of the lining of the colon to look for abnormal growths called polyps, inflammation, bleeding sites or ulcers. It is used to understand why patients have symptoms such as abdominal pain, blood in the stool, weight loss or a change in bowel habits. The procedure is also performed to detect polyps and cancer in patients without symptoms. Most often, colon polyps do not cause symptoms, and this is why screening is recommended.
Colonoscopy is diagnostic and can be therapeutic. That is, if a polyp is found, it can be removed during the exam and sent to the lab to see if it contains cancer cells. Most polyps are benign (do not contain cancer), but virtually all colon cancer begins as a polyp. Therefore, removing polyps at an early stage is an effective way to prevent colon cancer.
When polyps are found at an early stage they are usually removed easily and completely. Polyps can grow and eventually contain cancer. When colon cancer is found at later stages it is often fatal.
What does colonoscopy prep involve?
Prior to the test, the patient undergoes a colon preparation to empty the colon. This can take one or two days, depending on each patient. The typical prep at Jefferson involves staying on clear liquids the day before colonoscopy. At noon on the same day, two laxative pills are taken. At 5 p.m., the patient consumes 1 liter of Gatorade, which includes a laxative powder. At 4 a.m. on test day, a second 1 liter dose of Gatorade mixed with laxative is taken. This liter must be completely finished so that the patient takes nothing by mouth for at least 3 hours before the procedure. This is to avoid the risk of aspiration (or inhaling any stomach contents that might be refluxed) of any fluid into the lungs.
It is also important that the patient consumes several liters of fluid throughout the day before the exam to stay well-hydrated, because the prep leads to frequent stools and even diarrhea.
In addition, talk to your doctor to get explicit instructions regarding any medication you are taking on a regular basis before preparing for colonoscopy. If you are taking a blood thinner such as Coumadin, adjustments have to be made to decrease the risk of bleeding. Other over-the-counter medications that can also thin your blood and should be discussed include aspirin and pain relievers, such as Advil®, Motrin®, Aleve® or any form of ibuprofen.
How is colonoscopy performed & how long does it take?
Colonoscopy is an outpatient procedure. Sedation is administered by a certified nurse anesthetist. This "conscious sedation" makes a patient very sleepy and relaxed, but it does not involve general anesthesia. While lying on the left side on a comfortable stretcher, the thin flexible tube is inserted through the anus and the entire colon is examined. There is a small video camera inside the scope that gives the physician a clear view, and pictures can be taken of any abnormal findings. Most often, the exam takes less than 30 minutes, but sometimes longer if multiple polyps are found.
Is there any pain or discomfort after the procedure?
Following the procedure, the patient remains in the recovery area for about one hour to ensure that the vital signs are stable and that he/she can tolerate juice and crackers without getting sick. The colon is insufflated with air during the exam, so some retained gas is common. The patient may experience cramping or bloating, and may pass gas for several hours. The average patient is fully recovered and back to a normal routine on the following day.
The doctor will talk to the patient and review the findings of the exam. The nurse will again read and review written discharge instructions from the doctor before the patient leaves the Endoscopy Unit. In rare instances a patient may develop side effects and should call the doctor immediately if experiencing any of the following:
- Severe abdominal pain
- Rectal bleeding
Because sedation is administered, each patient must be accompanied by a relative or friend at discharge. The restrictions following sedation include no driving for 24 hours and no drinking of alcohol for 24 hours.
At what age should colonoscopy begin & how often should it be repeated?
Studies suggest that age 50 is the time to begin routine screening to look for early signs of colon cancer. However, there are certain risk factors that lead some patients to begin colonoscopy at a younger age.
- A patient is at increased risk if a first-degree (parent, sibling, child) relative has had colon polyps or colon cancer. The formula determining the first screening exam considers the age when the affected relative was diagnosed. For example, if a parent is diagnosed at age 50, then screening should begin when the patient is 10 years younger. Here, the new patient would begin routine screening at age 40.
- A personal history of colon polyps or colon cancer
- A personal history of inflammatory bowel disease including Crohn's disease or ulcerative colitis
- A personal history of uterine or ovarian cancer before the age of 50
When the colonoscopy is repeated will be determined by the findings at the initial examination. If a patient has no polyps and no family history or other risk factors listed above, they are often instructed to return in 10 years. The important point to remember is that a patient should call his/her doctor and return immediately if he/she develops new symptoms or signs such as rectal bleeding, change in bowel habits or abdominal pain. A patient might also need repeat colonoscopy sooner if a new diagnosis of colon polyps or colon cancer is made in a family member.
If a patient has no polyps or cancer, but they have a family history of colon polyps or cancer, they will likely be asked to return for colonoscopy every five years.
For patients who do have colon polyps found during the exam, they will be asked to return at a time interval depending on how many polyps are found, how large they are and the pathology report. Each case will be discussed in great detail with the doctor who performed the colonoscopy exam. If multiple polyps are found, the exam may have to be repeated in three years. If a very large polyp is found, colonoscopy may even be repeated within one year to ensure that all the polyp tissue was removed.
Can you tell me a little about the Infusion Center?
The Center features spacious, light-filled treatment bays, individual flat-screen TVs and relaxing décor. There are 20 reclining chairs in the unit along with chairs for anyone who may have accompanied you. There are curtains around each unit that can be used for privacy.
The Infusion Center tends to be cold. We can provide blankets if you are feeling chilly or feel free to bring a blanket from home if it will make you feel more comfortable.
Laptops and cell phones are permitted and can provide instructions on how to connect to the Internet through our Hospital Wi-Fi system, Jeff Guest.
Can I bring a family member with me?
On the day of treatment, we encourage you to bring one family member or friend with you. Depending on the length of treatment and medication administered, you may be too tired to drive home. Please understand that many of our patients are at an increased risk for infection from viruses due to compromised immune systems. It is for this reason that a strict policy has been implemented that no children under the age of 16 may be permitted in the Infusion Center unless they are receiving treatment themselves.
Am I allowed to eat before treatment?
There are no restrictions on what you can eat on the day of treatment and you can eat anything during the treatment process. You can bring in your own food or eat what is provided by the Infusion Center. We have snacks, juices, coffee, tea and sodas available at all times and sandwiches are available at lunchtime.
There are also many places outside of the Infusion Center where you may purchase food.
Am I allowed to take my medications on the day of treatment?
If you are taking any prescription medications for any conditions, you are permitted to take those on the day of treatment unless your oncologist has instructed otherwise. If you are unsure, contact your doctor.
Where can I park?
Valet parking is available on 10th street between Market and Chestnut Streets in the Rothman Building. The cost of parking is dependent upon the length of stay. Your parking ticket will be validated at the end of your stay and costs can range anywhere from $2.00 to $4.00. You may also self-park in the Laz Parking Garage on 10th and Chestnut Streets.
What is the check-in process at the Infusion Center?
Upon arrival you will check in on the 2nd floor. At the reception desk, you will see a computer monitor and you need to enter your name in the computer and take a seat in the waiting room. If you have any questions on how to do this, one of the receptionists can help you.
Within a short time, someone will call your name and you will be asked to verify your identity and contact information some questions and asked to provide copies of insurance cards, referrals if needed and any co-pays to complete your registration. Once you have completed the registration process, you take a seat in the waiting room until your name is called to have your lab work done. If you do not have a port, you will be brought back to have a phlebotomist or nurse draw your blood.
If you do have a port, you will be taken into the Infusion Center to have your labs done via your port by an assigned registered nurse.
If you are seeing your physician on the same day of your treatment, you will do that after your labs have been drawn. The physician offices are located on the 3rd or 4th floors.
Once you have completed your physician visit, you will come back to the Infusion Center where you will be seated and treatment will begin.
What lab work will I need done?
Your physician will order blood work to be drawn prior to each treatment to ensure that your lab values are within range to proceed with treatment. Labs will either be drawn from our highly skilled phlebotomists or by a registered nurse if you have an infusaport.
Once the labs are drawn and sent to the lab, it will take approximately 60 to 90 minutes for your physician to get the results. We encourage: You can ask your doctor to have your lab work done several days prior to treatment to avoid the wait time and to speed up your treatment process.
How long can I expect my treatment to take?
The length of your treatment is dependent on the type of chemotherapy your physician has ordered based on your type of cancer.
On your first visit, your chemotherapy is mixed specifically for you and your type of cancer at our onsite pharmacy. The pharmacist does not start mixing the chemotherapy until they receive a checklist from your assigned nurse.
This checklist contains your lab results and weight, which needs to be a certain range for you to receive treatment. If the lab values and weight are acceptable, the pharmacist will mix the therapy. This process can take approximately 30-60 minutes depending upon the type of chemotherapy you are receiving.
Overall you can expect to be there anywhere from an hour to several hours.
Will I need an IV to receive treatment?
When you come in for your treatment a registered nurse will be assigned to you. They will determine whether you require an IV or if you have a port that needs to be accessed.
What happens if I miss my appointment?
If you miss your appointment, please be sure to notify your physician so you can be rescheduled for another time. Please contact your physician’s office directly to reschedule.
What if I am running late for my appointment?
If you are running late, please notify the front desk. The telephone number is 215-955-8874. You will not be cancelled but you may be delayed in being seated.
How many times will I need to receive chemotherapy treatments?
Your physician will discuss your treatment and determine how often you will need to receive treatment. Depending upon your type of cancer, a chemo cycle could be every week, every two weeks or every three weeks.
What is a Complete Blood Count (CBC)?
This is a lab value that helps your physician determine if you are able to receive treatment. It looks at your white blood count, hemoglobin (the protein molecule in red blood cells that carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues to the lungs.) and platelets (important for blood clotting). If any of these values are extremely low, treatment may be delayed and you will be rescheduled in a week or so to give your counts time to recover.
If your white blood count is too low, you may receive an injection that will boost your count to prevent you from developing an infection or your physician may put you on antibiotics. If your hemoglobin level or platelet count are too low, you may require a blood transfusion.
Where do I go for blood transfusions if I need one?
If you need a blood transfusion because of a low hemoglobin level or platelet count, a blood specimen is drawn and sent to the Blood Bank so that they can match your blood type.
Once your blood type is matched, a bag is prepared and we are notified that it’s ready. Your physician may order pre-medication (Tylenol or Benadryl) prior to the infusion to avoid a possible blood transfusion reaction. Typically the doctor will order 2 units.
This entire process can take up to 4 hours.
What if I have a problem after I get home?
If you have any issues after you receive your treatment please call 215-955-8874 and you will be directed on what to do.
If it is an emergency, please call 911 immediately or go to the nearest hospital.
What are the side effects of chemotherapy?
You may experience some side effects after receiving your treatment. The most commonly reported symptoms are nausea, vomiting, diarrhea, hair loss, peripheral neuropathies, and fatigue. Before your treatment begins, you will be given anti-nausea medications, which will help you during your stay.
It’s important to remember that everyone is different and you may experience none of these effects, some or all. It’s important to share the side effects with your physician who may be able to help you manage the side effects with medications. If your symptoms are severe, please contact your physician immediately.
Also, the Jefferson-Myrna Brind Center of Integrative Medicine offers an Integrative Cancer Care Program that provides complementary therapies such as vitamins, special diets, herbs and acupuncture that may help with some of your symptoms.
You also have access to oncology social workers who are trained in individual and family therapy and are available to meet with you to assist with the psychosocial impact of cancer treatment, and can provide a valuable link to available community resources.
I understand I may lose my hair after treatment. Where can I purchase a wig?
Jefferson's Wig Program for Cancer Patients was created to help ease the stress and/or embarrassment of sudden hair loss experienced by our patients. If you are being treated for cancer, either as an inpatient or an outpatient at Jefferson, and you have hair loss, we are happy to provide you with a free synthetic wig, turban or hat.
To make an appointment, place call Patient Services at 215-955-7777 or 5-7777 (from inside the Hospital).
Here at Jefferson, we want our patients to be as educated and informed as possible when it comes to their cancer care. We suggest you bring a list of questions and a notepad to ensure you get the most information possible during your visit with us. Some frequent questions asked of our radiation oncologists about cancer include:
- What type and stage of cancer do I have?
- How will radiation therapy help me?
- How does radiation therapy work? Is it internal or external?
- How many and how long will I receive radiation treatments?
- What are the chances that radiation therapy will work?
- What is the chance that the cancer will spread or come back if I do not have radiation therapy?
- Will I need chemotherapy, surgery or other treatments?
- How can I expect to feel during treatment and in the weeks following radiation therapy?
- Can I drive myself to and from the treatment facility?
- Will I be able to continue my normal activities?
- What side effects may occur from the radiation?
- Will radiation therapy affect my ability to have children?
- What are some of the support groups I can turn to during treatment?