We first meet Peter and Tom when their car pulls up to Prince of Wales Private Hospital in Sydney. Already, it is evident that the two men, who have been going for regular colonoscopies for years, are upbeat and relaxed about the day ahead.
Before the procedure, the men chat individually with the hospital nurse, who records and updates their medical history.
“Are you allergic to anything?” asks the nurse. “Pain,” Peter chuckles.
Once in their robes, the men chat to Professor Newstead about the procedure and what to expect if polyps — which are tiny growths that can become cancerous — are found.
“We’ll go around the bowel to make sure you haven’t got any polyps. If you’ve got no polyps it’s an easy day, and if you’ve got any polyps we’ll burn them away at that time, any of size are retrieved for pathology,” Professor Newstead tells Peter and Tom.
While not all polyps become cancerous, removing them during colonoscopy reduces a person’s risk of developing bowel cancer, resulting in fewer unnecessary deaths, he explains.
“The most common [cancer] in men is prostate, and the most common in women is breast, and neither of those are preventable... Whereas with bowel [cancer] we actually have these little polyps, which are terribly common. The vast majority do not turn to cancer, but nearly all the cancers come from the polyps; so, the logic is that if you find the polyps and you remove them, you prevent the cancer.
“Get yourself a colonoscopy and then you should be able to prevent the large majority of bowel cancers,” Professor Newstead says.
Back in the prep area, the men are still in good spirits. With the important pre-consultation out of the way, the men suggest a friendly coin toss to determine who’s going first. Tails. It’s Tom.
In the examination room, hospital staff prepare the patient for the procedure.
For TV audiences, it’s a chance to go behind the scenes with the health team and better understand their role in assisting the surgeon with the colonoscopy. We see at least four health professionals working together in the examination room – making for a quick and seamless procedure.
To begin the procedure, Professor Newstead inserts a colonoscope — which is a tube-like instrument with a light and camera lens — into the rectum to identify any polyps or cancerous cells.
A colonoscopy takes around 30 minutes and patients are given sedation, which means they are not awake during the procedure and even if they are they do not experience any pain.
How does a surgeon prepare for colonoscopy? Watch this bonus footage with Professor Graham Newstead to find out.
Things move quickly from then on and it’s not long before Professor Newstead, who is closely examining the images on the live video monitor, locates some very tiny polyps inside the anal canal. Given their small size, the polyps can be burnt away towards the end of the colonoscopy, Professor Newstead explains. This ability to burn away problematic polyps on the spot is just one advantage of the colonoscopy procedure.
Moving through the colon there’s no cause for concern, so our surgeon navigates all the way up into the cecum, which is the pouch forming the beginning of the large bowel, or intestine. Here, he identifies some mild inflammation, which is slightly unusual so he uses a small instrument to take a biopsy, which will be sent to pathology for further testing and monitoring. Another advantage of colonoscopy.
According to Professor Newstead, colonoscopy is an effective procedure but he’s optimistic that in 20-50 years’ technology will have advanced even further.
“In the longer term... I question whether we’ll need to be removing polyps. We might know more about what causes them and therefore be preventing polyps [in the future]. And the other thing is, when we find a cancer will we actually be operating on those cancers in the years to come? Or will patients be given an injection of something to immunise them against the cancer and so get rid of it?” he says.
How social media reacted to the episode
@CelebrateAwe - I now feel less nervous about possibly getting a colonoscopy in the future after seeing it done on #KeepingAustraliaAlive @ABCTV
@Tailgator1 - #keepingaustraliaalive #abc I want a film crew along for my next colonoscopy. Better feedback than I've ever got.
@stevenst - Loving the Bowel Brothers! #keepingaustraliaalive
@Jewelangel - @BowelCancerAust It's too late for my Dad but I tell everyone I know to get screened. It's so easy to do and early detection saves lives.
@frankarr - Colonoscopy video on #KeepingAustraliaAlive Thx @ABCTV for that #fantasticjourney
@ChristineSarraf - It's a silent killer but it shouldn't be a topic of discussion we shy away from. Early diagnosis is vital.
@msjuju8 - Beautifully optimistic surgeon #KeepingAustraliaAlive
@Samara_McCann - I am 100% about the adventures of these bowel bros. #keepingaustraliaalive
@NSunners - It is sad that there are 10 times more deaths from bowel cancer than road fatalities but there's little publicity #keepingaustraliaalive
For now, Tom’s colonoscopy is all finished up and it’s time for him to have that highly anticipated tea and sandwich (his first real meal in 24 hours), then to see Professor Newstead for his follow up consultation.
The follow up consultation with the surgeon is a very important part of the entire procedure. This is an opportunity for the patient to not only learn about his or her examination results, but a chance to ask any questions about treatment options, preventative measures and medication concerns, if relevant.
In Tom’s case, his consultation is complete with diagrams, photos from the colonoscopy and step-by-step explanation of how the screening panned out.
Professor Newstead explains to Tom that he identified some inflammation and little ulcers in the cecum, and that he has sent a biopsy away for further investigation. At this time, the doctor also reassures Tom that there is no cause for concern but it is simply a precautionary measure.
With every question, Tom becomes more engaged and informed. “Could it be caused by some of the medications?” asks Tom, referring to the inflammation. “Possibly,” replies Professor Newstead. And before he has time to elaborate, Tom interjects with his informed observation: “Because that [the medications] sometimes mucks around with your tummy.” Professor Newstead agrees. And they continue like so.
Outside the examination room, Peter is waking up from his colonoscopy and it’s not long before he’s back to feeling upbeat and relaxed as well.
“We like boring in my business, it’s good. And you’re almost boring,” says Professor Newstead during Peter’s follow up consultation. For Peter, the colonoscopy procedure has picked up a 3mm polyp in his colon, which has been removed and sent to pathology for routine checking.
Before the segment ends, we hear from Professor Newstead, who nicely sums up the screening process: “The two guys were a good example of being reasonably relaxed about getting yourself screened. But it does give the message I hope that, a, you should be aware and, b, it’s not too big a deal,” he said.
To find out more about colonoscopy and other screening tests, visit https://www.bowelcanceraustralia.org/tests-investigations
Keeping Australia Alive is a landmark 7-part documentary capturing the Australian health system in one 24 hour snapshot. The program airs on ABC, Tuesday 8.30pm.
Missed this episode? Watch it again on ABC iView here (episode 3).