A report in the October issue of the American Journal of Gastroenterology states that capsule endoscopy can aid in the identification and management of small bowel tumors. Capsule endoscopy lets your doctor examine the lining of the middle part of your gastrointestinal tract. Your doctor will use a pill sized video capsule called an endoscope, which has its own lens and light source and will view the images on a video monitor.

Capsule endoscopy helps your doctor evaluate the small intestine. This part of the bowel cannot be reached by traditional upper endoscopy or by colonoscopy. The most common reason for having this procedure is to search for cause of bleeding from the intestine. It may also be used to detect polyps, inflammatory bowel disease, ulcers and tumors of the small intestine.

Dr. Adam Bailey from the Royal Prince Alfred Hospital in Sydney says "Capsule endoscopy has the potential to achieve earlier diagnosis of small bowel malignancies offering a greater chance of cure. It should be used early in the course of investigation of suspected small bowel disease, avoiding the delay that has let to many patients having advanced disease at diagnoses.

I feel fortunate to have received every cancer drug I needed to fight my breast cancer -- Adriamycin, Cytoxan, Herceptin, and every nausea pill, pain capsule, and anti-anxiety formula on the market. I got exactly what doctors thought I needed -- without worry about availability or funding or politics. I am lucky. Some in the UK are not so lucky.

Two targeted therapies for bowel cancer will not be used in Britain's state-run health system, according to NICE -- the National Institute for Health and Clinical Excellence. NICE, the country's financial watchdog, determined the high cost of the medicines meant their use was not compatible with the best use of resources. Patients are angry because these same two drugs -- Avastin and Erbitux -- are used widely in the United States and in much of Europe. And while neither drug offers a cure for bowel cancer, both treatments have been shown in clinical trials to extend life expectancy by four or five months in some patients.

Based on doses given during the trials, it is estimated that the average cost of treating one patient with Avastin would be around 16,800 pounds and with Erbitux -- about 11,700 pounds. Apparently, this is too much. But according to Hilary Whittaker of the charity Beating Bowel Cancer, the decision to deprive patients of this medication is a scandal. I agree. And for these patients, I am sad.