Top-Rated Doctors 2010

Part Two

Internal Affairs

By Eileen Metheny Carlton

Dr. Sanjeev Wasan, Gastrointestinal Specialist, Inova Loudoun Hospital (Photography by Jonathan Timmes)

Dr. Sanjeev Wasan, Gastrointestinal Specialist, Inova Loudoun Hospital (Photography by Jonathan Timmes)

Dr. Sanjeev M. Wasan practices gastroenterology and internal medicine at Inova Loudoun Hospital, working with those 18 and older who have liver and gastrointestinal problems, most commonly esophageal reflux and heartburn.

Wasan explains he performs endoscopic procedures that can be beneficial to people in discovering medical pathologies. The symptoms of esophageal reflux can include ongoing heartburn, chest pain, hoarseness, cough and upper abdominal pain, with the condition affecting children, teenagers and adults.

“[But] I cannot have a conversation about this medical field without bringing up colon cancer. Colon cancer is the second most common cause of cancer deaths in the United States. Number one is lung cancer. It affects men and women nearly equally, almost 50-50,” Wasan says, emphasizing that colon cancer typically affects people above the age of 50 but can affect those younger (of all ages).

“I call it an equal-opportunity cancer, as it affects both genders, and a simple procedure can prevent it. And that is the tricky part of it,” he says.

“Colon cancer originates from a growth in the colon called a polyp,” Wasan explains. “There can be little or no warning until the tumor is advanced. It is preventable by having a full colonoscopy performed to identify these polyps and subsequently have them removed before they grow into a more advanced lesion. This is an outpatient procedure that establishes what the risk is, and it can be therapeutic in terms of removing polyps that may be pre-cancerous.”

One of Wasan’s patients, William Washington, 72, of Purcellville, was surprisingly struck with the news one day in April 2008 that he had colon cancer.

A man who is in relatively good shape for his age—“he doesn’t smoke or drink,” says his wife, Shirley—Washington and his family were shocked to hear the diagnosis for his fatigue.

“I went in for a regular checkup,” Washington recalls. But with the results, even more than a year later, the emotions associated with the cliche, “it couldn’t be me,” still surface. Having done a partial colonoscopy in the past, results were negative, and the thought of colon cancer never entered Washington’s mind.

“I was in great shape, and I had no symptoms, whatsoever,” he recalls.

During his regular checkup Washington mentioned he was experiencing some tiredness. Blood work was taken and Washington was “found to be rather anemic, suggesting that he was losing blood somewhere in his body but most importantly, he had no symptoms,” recalls Wasan.

Washington underwent a full colonoscopy with Wasan, and a large mass was found in the beginning of his colon.

“He underwent a surgical bowel resection and required chemotherapy,” explains Wasan. Now, having received six treatments of chemo—three days a week every four months—Washington is “cancer-free and in remission,” Wasan says.

“Given that this condition can have a strong genetic preponderance, I advised the patient to have his children screened for colon cancer,” Wasan says.

Heeding the advice, the Washingtons urged their 44-year-old son to be tested.

“There is cancer on my side of the family too, so I kept on him,” Shirley says, adding that she has herself checked every three to five years, and she has had all of her nephews undergo colonoscopies.

Their son finally agreed and went to Wasan for the procedure.

“Interestingly, his son, with no symptoms as well and not anemic, had a colonoscopy with me and was found to have a very large precancerous polyp that was near-cancer, that was also in the beginning of his colon and required surgical resection,” says Wasan.

This case illustrates the following, says Wasan: “That colon cancer can present without symptoms such as pain, diarrhea or obvious visible bleeding. [There is a] strong familial component. [And there is a] need and utmost importance for screening.”

(February 2010)