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Dr. Joseph DiRocco with a patient

Less is More with Recent Advances in Rectal Cancer

By:

Joseph DiRocco

January 24, 2018
Colorectal cancer is the second most common cancer-related cause of death in this country. (Lung cancer tops the list.) Overall, there were 135,000 people diagnosed with colorectal cancer last year. Of this group, 40,000 had rectal cancer.

Historically, surgical treatment of rectal cancer was associated with high morbidity, and a permanent colostomy was the rule rather than “the exception.” Fortunately, there has been an historical progression toward more precise surgical technique and the addition of therapies like radiation and chemotherapy, as well as new diagnostic devices and techniques to better stage our patients upon diagnosis. As a result, patients today have more options and better outcomes, and a permanent colostomy has become the exception rather than the rule. At GBMC, there is a system-wide commitment to providing high quality care, from initial diagnosis to survivorship, using the latest research, techniques, and technology.

Since GBMC graduated its first colorectal fellow in 1974 under the guidance of Jack Rosin, MD, our program remains the only accredited colorectal surgical residency in Maryland.

Robotic surgery:  At GBMC, the majority of rectal cancers are removed using this technique.

Endoscopic mucosal resection: This endoscopic procedure uses advanced instruments to remove polyps and tumors that would otherwise require major abdominal surgery.

Transanal minimally invasive surgery (TAMIS): This is a technique that allows more advanced tumors to be removed from inside the rectum.

TAMIS for total mesorectal excision: This hybrid surgical approach uses minimally invasive techniques to remove lower rectal cancers, which allows for precise division of the bowel below the tumor.

Short course radiotherapy: This course of radiotherapy is given before surgery for one week, as opposed to five weeks. Surgery follows one to two weeks later. This shortened course of radiation for locally advanced cancers provides accelerated care and is widely adopted in Europe.

Sphincter preservation: A variety of techniques are used by our surgeons to avoid permanent colostomy whenever possible
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