Colon test causes fear

It’s a proven lifesaver — the American Cancer Society estimates 65 percent of deaths from colorectal cancer could be avoided if everyone older than 50 had screening tests every 10 years –– yet only about half of Americans have the procedures.

Across the country the reasons for so few getting screened have always been the same: People dread the bowel-cleansing prep, are scared or embarrassed, worry about potential complications or (the uninsured) can’t afford the tests.

Unfortunately, beginning in February 2008, Nevadans had yet another cause for concern when public health officials announced that thousands of Las Vegans were potentially exposed in 2007 to HIV and hepatitis C at two Dr. Dipak Desai-owned clinics, where investigators say doctors and nurse anesthetists reused anesthesia vials and syringes on colonoscopy patients.

Was the quality of medicine in Las Vegas so low that you were in danger of contracting possibly fatal diseases if you went in for a routine screening procedure?

The fear in the community, particularly among seniors, was palpable. One woman, Dr. Joseph Thornton recalls, actually wrote a letter saying she’d rather die of colon cancer than get a colonoscopy.

Even today, five years after the outbreak that saw 50,000 people need tests for hepatitis and HIV, Desai charged with second degree murder and as many as 115 cases of hepatitis linked to the doctor’s clinics, Thornton says people worry about infection-control protocols at other surgical centers.

To counter the fear of colonoscopies –– though there isn’t hard data, Thornton wouldn’t be surprised if fewer Las Vegans get colonoscopies than before the outbreak –– the doctor gives hourlong orientation classes on the procedures twice a month. Health Plan of Nevada, he says, asked that he give them to their clients.

“No other people in America get this, not even at the Mayo Clinic,” he said.

Like many doctors, Thornton, an associate professor at the University of Nevada School of Medicine, is using the fact that March is National Colorectal Cancer Awareness Month to urge people to be screened for the disease that is the second leading cause of cancer-related deaths in the United States –– more than 50,000 yearly.

With an evangelist’s passion, he calls Las Vegas “the safest place in the country to get a colonoscopy” because authorities now inspect local colonoscopy practices twice a year.

Yet as reassuring as that sounds, Thornton understands that what continues to make many Las Vegans uneasy about colonoscopies in Las Vegas is that every gastroenterologist other than Desai who once practiced at endoscopy clinics associated with the hepatitis C outbreak –– nearly a quarter of the city’s specialists –– are still able to practice in Southern Nevada: Eladio Carrera, Clifford Carrol, Vishvinder Sharma, Dipesh Banker, Snehal Desai, Frank Faris, Carmelo Herrero, Albert Mason, Ranadev Mukherjee, Sanjay Nayyar, Shahid Wahid, Nicolae Weisz and David Manuel, who has moved to Illinois.

Not all clinic doctors were implicated in the outbreak.The Nevada State Medical Board filed formal complaints against just three –– Desai, co-owner Carrera and clinic manager Carrol –– but the board’s executive director, Douglas Cooper, admits all doctors weren’t investigated or interviewed because “it wasn’t necessary” to learn who was culpable.

The board backed off serious charges against Carrera –– the complaint cited three patients who contracted hepatitis from a procedure performed by him –– after he testified to a grand jury when prosecutors agreed not to charge him. The board dismissed its complaint against Carrol –– the board said he failed to use reasonable care or skill when a patient under his care transmitted hepatitis to others –– because Desai’s trial has tied up evidence needed for an investigation.

Prosecutors say some of the doctors in Desai’s practice might have known what was going on, and they’ve warned most that they could be called to testify at his trial. Las Vegas gastroenterologist Frank Nemec, who played a key role in formulating the nationwide safe injection campaign promoted by the CDC as a result of the outbreak, said he’s never hired a gastroenterologist who worked for Desai, because of “what they knew or should have known.”

Even if people are disgusted by what’s happened in part of the medical community, Thornton said that is no reason to fear a colonoscopy, which can actually prevent cancer –– more than 143,000 colorectal cancer cases were diagnosed in 2012 –– since it can lead to the detection and removal of polyps, which can progress to cancer. He also points out the five-year survival rate is 90 percent for the cancer when diagnosed and treated early.

Do your homework on physicians, Thornton recommended. Find one with a background you can trust. Ask questions. Pray on it. But don’t let fear paralyze you into the inaction that could kill you.

Or as televangelist Joel Osteen put it the other day, “When fear knocks, let faith answer the door.”

Contact reporter Paul Harasim at pharasim@
reviewjournal.com or 702-387-2908.