Colorectal cancer is the second leading cause of cancer-related deaths in the United States in men and women. It is projected to cause about 50,830 deaths during 2013. The death rate (the number of deaths per 100,000 people per year) from colorectal cancer has been dropping in both men and women for more than 20 years.
The decline is due to the commitment that hospitals and surgeons, including Rajiv Datta, MD, Medical Director of South Nassau Communities Hospital’s Gertrude & Louis Feil Cancer Center, have made to employ the latest advancements in diagnostic technology and surgical and non-surgical approaches to detect and treat colon cancer. It’s also a result of hospitals working with the American Cancer Society to increase public awareness of potential risk factors and the benefit of a regular colonoscopy, the most effective screening technique.
Colon Cancer Screening
The effectiveness of screening is demonstrated by the fact that the risk of dying from colon cancer is reduced approximately 33% among people who are screened regularly. Colonoscopy is the gold standard approach to screening for colon cancer. It’s a visual examination of the colon using a fiberoptic endoscope. With the patient sedated, the endoscope is passed through the bowel, which is examined for polyps, bleeding, ulcerations and other conditions. If a suspicious mass is detected, the physician can perform other minor procedures such as a tissue biopsy or polypectomy to diagnosis the condition.
Oncologists at The Gertrude & Louis Feil Cancer Center say that lifestyle changes can help prevent colon cancer, including increasing the intensity and amount of physical activity; limiting intake of red and processed meats; taking the daily recommended levels of calcium and vitamin D; eating more vegetables and fruits; avoiding weight gain around the midsection and excess consumption of alcohol.
Colon Cancer Symptoms
Colon cancer often starts as a small, non-cancerous tumor (called an adenomatous polyp). Its symptoms may include diarrhea or other changes in bowel habits lasting more than 10 days; regular appearance of blood in the stool; unexplained anemia; constant abdominal pain and tenderness in the lower abdomen; intestinal obstruction; fullness and gaseousness in the abdomen and noticeable weight loss.
Treating Colon Cancer
Colon cancer may be treated with a combination of surgery and chemotherapy. For rectal cancer, chemotherapy and radiation are used before surgery to shrink (or downstage) cancer. They are also used after surgery to destroy cancer cells that may have be left, thereby reducing the probability of local recurrence.
Surgical treatment of colo-rectal cancer involves removal of the affected area of the colon/rectum along with its mesentery (the membrane that attaches the intestines to the wall of the abdomen, maintaining their position in the abdominal cavity – which contains the abdominal organs – and supplying them with blood vessels, nerves, and lymphatics vessels).It has been shown in nationwide research that surgical oncologists have better survival and recurrence outcomes when compared to organ-specific surgeons. Dr. Datta specializes in resections for colorectal cancer, including Total Mesorectal Excision (TME), which is the surgical procedure of choice to treat rectal cancers. A TME involves removing the entire mesorectum, without disturbing nerve or sphincter function, to eliminate the cancer. Compared to other surgical options, post-operative quality of life is better and recurrence rates are significantly lower.
Minimally invasive laparoscopic resection is also offered to suitable patients for treatment of colorectal cancer. When performed using a laparoscope (a tiny video camera that provides detailed images) a colorectal resection requires just a few small incisions through which the laparoscope and surgical instrumentation are inserted to remove the cancer. The patient benefits of laparoscopic minimally-invasive surgery include a quicker recovery time, minimal gastrointestinal complications, minor incisions, reduced blood loss and minmal post-operative pain. In addition, patients who require post-operative chemotherapy can begin immediately because they don’t have to wait for a large incision to heal.
“Follow-up care is essential to the short- and long-term success of the treatment,” said Dr. Datta. “We are vigilant in encouraging our patients to follow through on continuing care.”
South Nassau endorses the National Comprehensive Cancer Network (NCCN) guidelines for follow-up testing. After surgery, patients should have a physical examination every three to six months for the first three years and annually thereafter. Colonoscopies are performed approximately every three to five years.Blood levels for CarcinoEmbryonicAntigen (CEA) of patients treated for colorectal cancer should be measured every two to three months after surgery for two years. CEA is a tumor marker for colorectal cancers and is a protein normally found in the tissues of the intestines, pancreas, and liver. The CEA level is expected to fall to normal following successful surgery to remove the cancer. A rising CEA level indicates progression or recurrence of the cancer.
A recipient of the American College of Surgeons (ACS) Commission on Cancer (CoC) Outstanding Achievement Award, The Gertrude & Louis Feil Cancer Center treats approximately 1,500 patients annually. The Center has evolved into one of the Northeast corridor’s premiere providers of compassionate advanced cancer care. The center is the only one on Long Island that is equipped with three of the most advanced and effective technologies used to treat and eradicate cancer: the Varian Novalis Tx™, da Vinci® Surgical System and Gamma Knife® Perfexion.
In addition to its Cancer Center in Valley Stream, NY, The Gertrude & Louis Feil Cancer Center incorporates the following specialty cancer care services:
• South Nassau’s GYN Oncology Department
• South Nassau’s Long Island Gamma Knife® Center
• South Nassau’s Center for Prostate Health Program
• South Nassau’s Center for Breast Health
• South Nassau’s Center for Lung Health
• South Nassau’s Radiation Oncology Department
• South Nassau’s Surgical Oncology Department
• Complete Women’s Imaging Center
• South Nassau’s PET/CT Service
For more information about colorectal cancer surgery or The Gertrude & Louis Feil Cancer Center, call (516) 632-3350.
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