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Wednesday, February 26, 2014 - Defeating colorectal cancer using minimally invasive surgery


Defeating colorectal cancer using minimally invasive surgery

By Thomas J. Kayal, M.D.

Colorectal cancer is the second leading cancer killer in the United States, effecting more than 130,000 Americans each year. About 75 percent of cases occur in the colon and about 25 percent are diagnosed in the rectum. Surgery, in conjunction with chemotherapy and radiation, is generally the most successful treatment option; by removing the tumor and surrounding tissue, we can prevent the cancer from spreading to other parts of the body.

As a colorectal surgeon, it has been especially rewarding to help cancer patients using less invasive laparoscopic surgery that allows faster recovery, less post-operative pain, smaller scars and less risk of infection. In most cases, patients can go home about three days after surgery.

Simple screening saves lives

The colorectal cancer death rate remains high because this kind of cancer is often asymptomatic. As a result, the cancer is often diagnosed in later stages or after it has spread to other parts of the body. But when discovered early, colorectal cancer is highly curable. Therefore, screening is essential, particularly for people over age 50 or those with a family history of this cancer. I recommend three key screenings: high-sensitivity fecal occult blood testing (FOBT); sigmoidoscopy; or colonoscopy, which still offers the most detailed and precise look in and around the colon.

What do these tests reveal? Colorectal cancer generally begins as a polyp which can become cancerous if left untreated. Eventually, more advanced cases may present physical symptoms such as rectal bleeding, blood or changes in the stool; cramping in the lower stomach; a feeling of discomfort or an urge to have a bowel movement.

Robotic surgery technology available locally

For early stage colon cancer, a colectomy, or segmental resections, is often performed where the cancer, a piece of normal colon on either side of the cancer and  nearby lymph nodes are removed. Cutting-edge robotics plays a key supporting role in performing many colorectal surgeries; I performed the first robotic colorectal cancer surgery in Monmouth County at CentraState Medical Center in 2011. A four-armed robot assists me by enhancing my ability to observe intricate areas of the colon and rectum to discover and remove both benign polyps and cancerous tumors. This operation is performed through the use of miniaturized surgical instruments that fit through a few tiny incisions about the width of a dime. Robotics can also be useful in the treatment of diverticulitis and inflammatory bowel disease (ulcerative colitis and Crohn’s disease).

The most up-to-date colon and rectal cancer care

Today’s minimally invasive surgical advancements for cancer treatment and other conditions can provide successful outcomes with significantly less physical stress on the patient. But patients can’t be helped if their cancer is not diagnosed through prompt medical attention or a screening, as recommended by your personal physician. Talk with your doctor about your risk factors for colon and rectal cancer, particularly if you are over age 50. Keep in mind, once your colorectal screening comes back clear, you may not need to undergo another exam for several years.

The Colon and Rectal Cancer Program at CentraState Medical Center offers a full range of the latest preventative, diagnostic and treatment services. The program team is led by doctors and clinicians who specialize in colon and rectal cancer. The hospital also offers the da Vinci® Fluorescence Imaging Vision System (Firefly™), an advanced robotic surgical technology that supports surgeons in treating cancerous tumors using this minimally invasive technology. CentraState’s surgical program includes doctors and nurses who have undergone specialized surgical training with the collective goal of getting patients back on their feet as quickly and safely as possible. For more information, contact the Cancer Center at CentraState at (855) 411-CANCER or visit centrastate.com/cancer-center.

Dr. Thomas Kayal is a board-certified and fellowship-trained colorectal surgeon specializing in robotic surgical procedures. He is on staff at CentraState Medical Center in Freehold and can be reached at Advanced Surgical Health Associates by calling 732-308-4202.