March 9, 2007

Colorectal cancer care moves sharpen focus on patients’ needs

Featured Image

From left, Roberta Muldoon, M.D., Duveen Sturgeon, R.N., Paul Wise, M.D., and Alan Herline, M.D., in the new inpatient colorectal surgery space in Medical Center North’s round wing. (photo by Susan Urmy)

Colorectal cancer care moves sharpen focus on patients’ needs

Colorectal cancer care at Vanderbilt-Ingram Cancer Center has taken on new space for both inpatient care and outpatient visits.

Previously, colorectal surgery patients went to the ninth floor of the main hospital after surgery, where their care team also dealt with general surgery patients and other cases. Now, inpatient colorectal surgery has a new space of their own on the fourth floor of the round wing in Medical Center North, where the burn unit was located.

“Having this dedicated space for colorectal surgery allows us to provide more focused care to our patients,” said Alan Herline, M.D., colon and rectal surgeon.

In addition, the department is currently renovating space on the second floor of The Vanderbilt Clinic for office visits and outpatient procedures. The new space will bring the total number of rooms for visits and procedures to five, which will allow Herline and his colleagues to perform more minimally invasive procedures and send patients home in the same day.

Surgeons at Vanderbilt-Ingram are performing laparoscopic surgeries for colorectal cancer and benign disease, and Herline said his team probably performs more than anyone else in the Southeast.

“Vanderbilt is a leader in this area,” said Herline. “Laparoscopic surgery allows the patient to have smaller incisions, less scarring and pain, shorter hospital stays and to get back to what they do quicker.”

But Herline said laparoscopic colorectal cancer surgery is still considered new and remains somewhat controversial. Fewer than 15 percent of colon resections are performed this way in the United States, but Herline said with a skilled colorectal surgeon performing the operation, laparoscopic surgery has been proven to be just as effective as conventional surgery.

“Survival rates of colon cancer patients are comparable for both laparoscopic and open surgery, 86 percent versus 85 percent, respectively.”

Another new procedure on the way for rectal cancer patients at Vanderbilt-Ingram is something called transanal endoscopic microsurgery or TEM. This procedure is also a less invasive option. TEM allows surgeons to use a small scope to remove tumors from the rectum, preventing the need for what would otherwise be an abdominal operation with a larger incision area.

Herline said TEM is so new, it's not yet offered by any other medical center in Tennessee and only a handful of hospitals across the country. It will be available to Vanderbilt patients beginning this summer and can be used to remove small tumors caught very early and benign, non-cancerous tumors.

March is Colorectal Cancer Awareness Month. This year, more than 153,000 people in the United States will be diagnosed with colon or rectal cancer, with most cases striking after age 50. For that reason, screening is recommended for men and women beginning at age 50. If you have a family history of the disease you may need testing even sooner.

“If you compare prostate or breast cancer to screening for colon cancer we're still behind,” said Herline. “And death rates are 15 percent higher for African-American men.”

Herline said he thinks the numbers are still lagging because many people think the screening tests for colorectal cancer will be more difficult than other cancer screenings. “What's important to remember is that we can prevent it. We have a seven- to 10-year lag time from a normal colon to a cancer developing.”

Herline said patients should remember these three important words when it comes to colorectal cancer: preventable, treatable, beatable.