The Facets of Preventing and Curing Colorectal Cancers

Intestinal tract

The incidence of colorectal cancer goes up with age and risk never goes away. Yet as more people have colonoscopy screenings, mortality from the disease has decreased.

“When patients undergo colonoscopy, physicians are looking for a lesion or polyp before it develops into cancer,” said Larry Miller, MD, chief of gastroenterology at North Shore University Hospital.

Genetic mutations cause polyps in the colorectal tract to form. A patient at average risk may take 10 years from having no colorectal abnormalities to forming a polyp that can advance to cancer. That gives a physician plenty of time to detect and remove the polyp (or polyps) before further, more dangerous mutations form.

Still, colorectal cancer is a significant problem. Lung cancer is the deadliest cancer in the US, followed by colorectal cancer. This is so because colorectal cancer goes undetected until it has been developing for years.

Colorectal cancer patients benefit from a continuum of individualized, personalized care at the Cancer Institute. A patient’s first team encounter is with a gastroenterologist, who typically makes a diagnosis based on colonoscopy results. Next is a review of treatment options with colorectal surgeons to determine how to proceed.

“Deciding on a surgical approach is a multifactorial process,” said David Rivadeneira, the North Shore-LIJ Health System vice chair of surgical strategic initiatives and Huntington Hospital’s director of surgical services colon and rectal surgery. “It depends upon the size of the tumor and the location.”

The Center for Colon and Rectal Diseases boasts the tristate region’s largest number of board-certified colon and rectal surgeons, who perform 600 to 700 procedures annually – the most significant volume of any health care provider in the area.

“A focused group of surgeons with specialized training and expertise gives the best outcome for the patient,” said John Procaccino, MD, director of the Center for Colon and Rectal Diseases.

There are many significant interactions that require a continuum and team approach to patient care, said Dr. Miller. Depending on a lesion’s location and stage when it’s removed, colorectal cancer patients sometimes require post-surgical care from a medical oncologist or radiologist. Or, he added, “A radiation oncologist may need to ‘downsize’ a tumor first – before surgery. We would then proceed to surgery after a waiting period.”

Dr. Rivadeneira noted that “the vast majority of patients” – as many as 90 percent – are candidates for minimally invasive laparoscopic or robotic surgery, which the Center for Colon and Rectal Diseases specializes in.

James Sullivan, MD, associate chair of surgical oncology at North Shore University Hospital, is passionate about the benefits of robotic colorectal surgery. “With the da Vinci Xi, a fourth-generation robotic surgery system that just came out this year, we can create a 3D, ‘open’ view – without a large, ‘open’ incision. For patients, we are extending the terms of minimally invasive. The robotic surgery incision only needs a Band-Aid.”

Early detection saves lives. Learn your risk for colorectal cancer with a free online assessment at

Read the next article, Organ-Sparing Pancreatic Cancer Treatment.

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