COLON AND RECTAL POLYPS AND CANCER
Colon cancer is the second leading cause of cancer death in the U.S. for men and women combined. Although it can occur at almost any age, the incidence of colon cancer increases with age and average risk people over 50 should be considered for screening. It is believed that 90% of colon cancers begin as benign polyps in the colon. Therefore detection of polyps and their removal with screening colonoscopy is an effective way to prevent colon cancer.
COLONOSCOPY FOR SCREENING
The most thorough and effective means of screening the colon for polyps and cancer is with colonoscopy. A colonoscope is a flexible fiber optic scope which can be used to comfortably exam the length of the colon and many procedures such as biopsies and polypectomies can be performed through the colonoscope. This is usually performed as an outpatient procedure with sedation and is painless and safe for most people. Patients at average risk for colon cancer should begin screening exams at age fifty and if normal every ten years after that.
COLONOSCOPY WITH POLYPECTOMY
Removal of a polyp or polypectomy can usually be performed safely during colonoscopy. This is important to prevent progression of the polyp to colon cancer. The physicians of Colon and Rectal Associates are experienced in all techniques for polyp removal and perform hundreds of these procedures a year.
ENDORECTAL ULTRASOUND FOR STAGING
Ultrasound imaging of rectal cancer has become standard for determining the depth of tumor invasion which is important for treatment planning. This procedure can be done quickly as an outpatient with only mild discomfort. Colon and Rectal Associates have the expertise and specialized equipment needed to perform this staging exam.
The cornerstone of therapy for most colon and rectal cancer is surgical removal. Colon and Rectal surgeons have specialized training in the latest techniques to provide patients the best chances at a good long-term outcome.
The lymph nodes associated with the colon or rectum can be an early site of regional spread of malignancy. The adequate removal of the lymph nodes is critically important to the treatment and accurate staging of colon and rectal cancers. This information is important for prognosis and guiding further therapy.
Complete and careful removal of the mesentary (fat, blood vessels, and lymphatics) associated with rectal cancer has been recognized as important for the prevention of local recurrence. Colon and rectal surgeons through specialty training are experienced in the technique of total mesorectal excision which has been shown to reduce this type of cancer recurrence.
Sphincter Sparing Resection of Rectal Cancer
Although some patients with very low rectal cancers may still require permanent colostomies, newer techniques allow for preservation of the anus and sphincters allowing patients to maintain nearly normal bowel function. These procedures require careful patient selection and training and are best performed by a colorectal surgeon.
Transanal Techniques of Resection
Many rectal polyps and even some early cancers can be resected by a transanal technique avoiding an abdominal incision. Specialized training and equipment is required for these procedures. The physicians of Colon and Rectal Associates have the expertise needed to offer transanal endoscopic microsurgery to appropriate patients.
When cancers present at a late stage they can cause near obstructions of the colonic or rectal lumen. Endoscopically placed stents can be used as a bridge to surgery to avoid multistage procedures or temporary colostomies. It is also a useful technique for palliation of obstruction in advanced cancers.
Mostly used for palliation in advanced or recurrent cancer, laser ablation is a technique to reduce symptoms from cancers such as bleeding.