Radiation Therapy
with Eva Zinreich, MD
What are the advantages to both preoperative and postoperative radiation therapy?
The second leading cause of cancer-related deaths in the United States is colorectal cancer. At GBMC, physicians work together to provide treatment to help patients overcome the disease.
Colorectal cancer can occur anywhere in the large intestine (colon) or rectum. Most colorectal cancer arises from preexisting polyps. Risk factors for the disease include age, inflammatory bowel disease, family history, high-fat diet, diabetes, smoking, heavy use of alcohol and a sedentary lifestyle.
According to Eva Zinreich, MD, Radiation Oncology Specialist at GBMC, there are a few ways to help prevent onset of the cancer. “Prevention can include a change in diet, specifically a reduction in red meat and an increase in fruit and vegetables,” she says.
Dr. Zinreich also emphasizes the importance of detecting colorectal cancer in its earliest, most treatable stages. “Screening should begin at age 50 with fecal occult bold test and/or flexible sigmoidoscopy every five years. Colonoscopy should be done every 10 years if there is no family history of colorectal cancer and every two years if a patient has a family history of the disease,” she says. Patients should not ignore symptoms of colorectal cancer including a change in bowel habits, rectal bleeding, abdominal discomfort and unexplained weight loss.
According to Dr. Zinreich, radiation is used differently in the treatment of colon cancer than it is for rectal cancer. Treatment for colon cancer includes surgery and adjuvant chemotherapy, while radiation therapy is used for slowing the progression of the disease. Radiation therapy uses X-rays to shrink large tumors before surgery for easier removal, or to kill any cancer cells remaining after surgery. Side effects of the treatment may include fatigue, diarrhea and loss of appetite.
Radiation therapy for rectal cancer can be used preoperatively (prior to surgery) or postoperatively (after surgery). Dr. Zinreich says there are advantages to both preoperative and postoperative radiation therapy. “The advantage of preoperative radiation therapy is that the patient can be treated with less toxicity, which gives them an increased chance for sphincter preservation that may help avoid colostomy,” she says. “The primary advantage to giving postoperative radiation therapy is that physicians know the stage of the disease including tumor size, nodal involvement, and how much penetration there was through the bowel wall. We can decide to use radiation therapy on the more advanced diseases and eliminate the option for patients with early disease who will not require radiotherapy.”
At GBMC, physicians believe in offering personalized treatments to obtain the best outcomes. “Patients are discussed during our weekly multidisciplinary conferences,” says Dr Zinreich. “We have a good group of specialists who work well together, which benefits the case management for each individual patient.”
