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Colorectal cancer program
Colorectal cancer is the 3rd most diagnosed cancer in the U.S. among both men
and women. About 105,000 new colon cancer cases and 42,000 new cases of rectal
cancer are diagnosed annually.
Fortunately, the survival rate has been increasing. Several factors account
for this:
- More polyps are found through screening before they can develop into
cancer
- More colorectal cancers are found early, when treatment can be most
effective
- Treatments for colorectal cancer have improved tremendously
Aurora BayCare Medical Center brings patients advanced treatment options and
enhanced outcomes. Our team includes surgeons, medical and radiation
oncologists, radiologists, genetic counselors and others. Together, they work
with patients to develop individualized treatment plans.
Diagnostics
Physicians use a variety of diagnostic tools to evaluate the small and large
colon and rectum for cancer. One important concept that should not be overlooked
is having your primary care provider perform screening stool guaiac tests to
look for occult blood when doing routine physical exams and rectal exams. This
test detects hidden (occult) blood in the stool. Such blood may come from
anywhere along the digestive tract. Hidden blood in stool is often the first,
and in many cases the only, warning sign that a person has colorectal disease,
including colon cancer. This screening tool may be done annually beginning at 50
years of age.
Some of the more advanced diagnostics are:
Capsule Endoscopy. Visualizing the small intestine has
always presented a challenge. While the large intestine is easily visualized via
colonoscopy, the technology has not, until now, been available to optically
examine the small intestine.
During Capsule Endoscopy the patient swallows a small wireless camera housed
in a capsule not much larger than an antihistamine pill. During the capsule’s
8-hour passage through the small intestine, it transmits images to special
antennae attached to the body. These images are recorded on a device the patient
wears like a portable tape player. The patient then returns the recording device
to his or her physician, who downloads the images onto a PC, where they can be
reviewed.
Colonoscopy. Traditional colonoscopy is available at Aurora
BayCare, as well as virtual colonoscopy. This is a procedure that uses special
X-ray equipment to produce pictures of the colon. A computer then assembles
these pictures into detailed images that can show polyps and other
abnormalities. Virtual colonoscopy may cause less discomfort and take less time
than a conventional colonoscopy. If a polyp is found, however, an additional
procedure such as a traditional colonoscopy is needed to remove the polyp or
biopsy an area.
Ultrasonic Endoscopy. This technique combines the optical
benefits of endoscopy with the diagnostic advantages of ultrasound imaging. A
small ultrasound transducer, mounted in tandem with an endoscope, is guided to
the region of interest within the body. The technology yields more detailed
images of a small area than is possible with ultrasound scanning done from
outside the body.
PET/CT. The combination of Positron Emission Tomography
(PET) with Computed Tomography (CT) represents the frontier of diagnostic cancer
imaging. The technology provides physicians with 2 sets of information from a
single scan: the anatomical data yielded by a CT scan and the metabolic
information provided by PET. This relatively new technology is helpful in
localizing smaller cancers and in defining areas to which primary cancers have
metastasized.
Genetic counseling
Certain types of cancer can be passed from generation to generation. Our
genetic counselor helps identify individuals who may be at high risk for
developing cancer. Armed with this information, individuals and their physicians
can plan preventive measures, or a cancer can be identified early when it is
most curable.
The Cancer Genetics Counseling Program provides:
- Confidential hereditary cancer risk assessment
- Access to on-going local and national cancer research studies
- Education for patients, health care professionals and the community
- Genetic testing and DNA banking when appropriate
About 5% - 10% of all cancers can be attributed to a hereditary factor. Ask
yourself the following questions. If you answer “yes” to any of them, ask your
doctor for a referral for a cancer genetics assessment.
- Are you over age 40?
- Is there a history of colorectal cancer in your family?
- Do you have a family history of endometrial and/or ovarian cancer?
- Is there a history of multiple colonic polyps in your family?
Advanced treatment and technologies
Aurora BayCare participates in national clinical trials of new drugs and
treatments that promise to significantly advance the fight against cancer.
Our experts can often suggest treatment options that no other hospitals may be
able to provide.
Surgery. Surgery is the primary form of treatment used with
colorectal cancer. Our surgeons specialize in removal of tumors, applying
techniques focused on reducing the rate of local recurrence and improving
survival rates that also preserve the integrity of the bowel and minimize the
need for a permanent stoma (an external outlet to the intestines).
Specialized surgical procedures include anal sphincter repair and
reconstruction, total mesorectal excision (TME), laparoscopic and open colon
resection, coloanal and “J pouch” construction, ileoanal pouch procedures,
transanal excision, transanal endoscopic microsurgical excision (TEMS), sentinel
lymph node mapping, hepatic resection/cryotherapy, radiofrequency ablation and
hepatic artery infusion pumps.
Minimally invasive surgical option. Hand-Assisted
Laparoscopic Surgery (HALS) Tumor Surgery is a minimally invasive surgical
approach that requires only a few small incisions in the abdomen. A 12-inch
incision is required for traditional open surgery. A thin, lighted tube and tiny
video camera are inserted to allow magnified views of the surgical site on a
video monitor. A unique collapsible port holds open one of the small incisions
in the patient’s abdomen. It fits around the surgeon’s fingers, allowing access
to the tumor site so the cancerous section of the colon can be cut and removed
while the remaining colon segments are repaired. Because the surgeon can grip
and feel the tumor site, HALS provides advantages over traditional laparoscopic
surgery that utilizes only surgical instruments:
- Same time-tested results as open surgery
- Reduced blood loss and need for transfusions
- Reduced pain
- Faster recovery and return to normal activities
- Less scarring
Radiation oncology. A sophisticated and effective way to
treat many kinds of cancer, radiation oncology uses highly advanced technology
and innovative treatment techniques to destroy cancer cells or to prevent
diseased cells from growing. Our team includes radiation oncologists at the
forefront of their field who specialize in intraoperative radiation therapy
(IORT), intraoperative catheter brachytherapy, gamma knife and intensity
modulated radiation system technologies.
Immunotherapy. The ability of the immune system to identify
and destroy tumor cells has led to its use in cancer treatment. By stimulating
the body's immune system, cancer cells may be destroyed without damaging healthy
tissue.
Immunotherapy is relatively non-toxic, so it can be used in combination with
radiation or chemotherapy to enhance cancerous cell killing activity.
Chemotherapy. Advances in the effectiveness of
cancer-fighting drugs has kept chemotherapy at the forefront in the fight
against cancer. Often used in combination with other therapies, chemotherapy is
frequently used to combat cancers with or without radiation therapy and surgery.
Chemoembolization. Used to treat cancer that has
metastasized to the liver, chemoembolization delivers treatment directly to the
malignant tumor. In this procedure, a catheter is inserted into an artery in the
groin and guided (using X-ray imaging) to the artery that supplies blood to the
tumor. Once the catheter is in place, chemotherapy agents are administered to
the tumor along with particles that block the flow of blood to it.
Chemoembolization attacks cancer in 2 ways: by delivering agents toxic to
cancer cells and by depriving the cells of oxygen and nutrients.
Radiofrequency ablation (RFA). This minimally invasive
treatment is used to destroy tumors from within. A hollow-core needle is guided
into the tumor’s center using imaging technology such as CT or x-ray. Small
tines are then deployed from the placement needle’s tip, penetrating the volume
of the tumor. Radio frequency energy is then sent through the needle into the
tines, destroying the cancerous cells in the tumor.
Our physicians
- Jack Swelstad, MD
- Jeffery Keller, MD
- Matthew Moorman, MD
- Per Anderas, MD
- Jeffrey Blink, MD
- David Rohde, MD -
medical director for radiation oncology
- Dhimant Patel, MD -
medical director for medical oncology
- Robert Kohl, MD
- Edward Barylak, MD
- Osama Halaweh, MD
For more information, call the Vince Lombardi Cancer Clinic Hotline at
800-252-2990.
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