Sponsored by: Main Line Health System
There was a time, not so long ago, when patients felt that a colorectal cancer diagnosis meant a choice between death, and life with a colostomy bag. That was then.
“Now we can operate with just a small incision and, in some circumstances, no incision at all,” said Dr. John H Marks, a nationally and internationally recognized colorectal surgeon.
Marks and his associates are pioneers in innovative approaches to treating colorectal cancer, inflammatory diseases of the colon and rectum, and advanced surgical techniques and treatments.
These new surgical advancements are reducing colorectal cancer mortality and leading to better outcomes with less recovery time, he said.
One procedure is called Transanal Abdominal Transanal Proctosigmoidectomy with Descending Coloanal Anastomosis (TATA). This is an example of laparoscopic surgery, which is being used with many diseases of the intestinal tract, including treating rectal cancers.
For these surgeries, the surgeon inserts a laparoscope (a straw-size instrument that has a tiny video camera attached) through a small, typically ½-inch, incision in the abdomen, or directly into a natural orifice. Other small incisions may be made for the surgeon to insert additional laparoscopic instruments to use to perform the surgery.
By avoiding major incisions through the skin, muscle, and nerves of the abdomen, patients recover more quickly, have less pain, and have shorter hospital stays. They experience less postoperative pain and have far less scarring, Marks said.
“The whole operative experience is different now. If the cancer is caught early, 90 percent of patients have an excellent cure rate,” he said.
Marks is Chief of Colorectal Surgery for Lankenau Medical Center, part of the Main Line Health System near Philadelphia, Pennsylvania.
At Marks’ practice, Marks Colorectal Surgical Associates in Wynnewood, PA, he and his father – Dr. Gerald Marks – have been working with chemotherapy and radiation to shrink more advanced cancers since the 1970s to avoid patients’ need for a colostomy bag. He says only about 10 percent of his patients now require one.
For these patients, a conventional (open) colectomy uses a long incision down the center of the abdomen. When this method is required, the recovery period in the hospital is usually much longer.
When a colectomy is needed to treat a cancerous tumor, the surgeon must remove both the tumor and the vascular and lymph structures supplying that portion of the colon.
Dr. Marks said that this operation is usually curative, depending on the stage of the cancer.
Patients who have a colectomy for cancer should meet with a medical oncologist soon after they have recovered from surgery to determine whether or not further treatment, such as chemotherapy, is required.
“When dealing with cancers of the colon or rectum, the key is to catch the cancer early, when it is the most curable,” he said.
That means following the current guidelines and having your first colonoscopy by your 50th birthday. The best part is that if a non-cancerous polyp is found during the quick outpatient procedure, it can be painlessly removed before it becomes cancerous.
If you are diagnosed with colorectal cancer, Marks advises you to learn about all the options for treatment, and if possible, get a second opinion from a specialist who may use multidisciplinary approaches.
Interview with John H. Marks, 4 Mar. 2015
Do you need a colostomy for colon cancer? Oncolink, accessed 10 Mar 2015.
What is a colostomy? Encyclopedia of Surgery.
Reviewed March 10, 2015
by Michele Blacksberg RN
Edited by Jody Smith