Dad, Let’s Talk Colorectal Cancer

DANBURY — It may not be an easy subject to discuss with your dad this Father’s Day, but hey, he had to have a few tough conversations with you back in the day. And discussing colorectal cancer, the third largest cancer killer, might just help keep him around a long, long time.

This is a disease where early detection can all but eliminate the need for extensive surgery, chemotherapy, and radiation. Certainly early detection can essentially remove the threat of death, according to the former executive director, Rhode Island Cancer Council, Inc, Arvin S. Glicksman, MD.

The cancer council authority pointed out that almost all colorectal cancers start with a very small nonmalignant outgrowth of the bowel wall called a polyp. This polyp grows slowly before it transforms into a cancer and invades the bowel wall and, if it remains undetected, will grow deeper and then spread to the lymph nodes, the liver, and the rest of the body.

If the polyp is removed, the cancer won’t develop. It is as simple as that. Every person over the age of 50 should be screened regularly for colorectal cancer.

A simple procedure is looking for hidden blood in the stool (fecal occult blood test, or FOBT). This should be done every year. Locally, those who are diagnosed with early stage polyps may be able to benefit from a study being conducted at Danbury Hospital. Physicians at the Praxair Cancer Center are participating in a clinical trial with a new treatment for rectal cancer, in partnership with the American College of Surgeons Oncology Group with funding from the National Institutes of Health (NIH).

Stuart Bussell, MD, Danbury Hospital’s site investigator for this clinical trial, was credentialed to participate by demonstrating expertise in the surgical procedure. This study will evaluate whether giving patients chemotherapy and radiation prior to surgery (called neoadjuvant therapy), and then removing the cancer through local excision, is as effective as other surgical options.

The hope of this study is that chemotherapy and targeted radiation will shrink the tumor prior to surgery, allowing the surgeon to remove the cancer and leave as much of the rectum and lower intestine intact as possible.

The benefit of this trial, if successful, is patients may have the cancer completely removed, achieve low recurrence rates, and return to normal life without the need for a colostomy. A colostomy is the surgical construction of an artificial opening in the abdominal wall, allowing waste to pass outside the body, and is a quality of life issue for many survivors of rectal cancer.

“Many patients facing colorectal surgery are very concerned about the potential need for colostomy, and how that might affect their lives in the future,” Dr Bussell said. “It is uncommon for us to require a permanent colostomy for rectal cancer, but there are instances when this is the only good option for cure. We hope this new procedure allows us to remove cancer completely, while returning the body’s function to normal, because permanent colostomy is not required.”

Cancers of the colon and rectum are the third most common type of cancer and the third most common cause of cancer deaths in the United States; more than 112,000 people will be diagnosed with colon cancers and 40,000 with rectal cancer this year. The current standard therapy for most rectal cancers is full or partial removal of the rectum. In most cases, bowel function can be restored.

For those cancers located very close to the anus, however, a permanent colostomy is performed.

“The treatment offered in this study may increase the quality of life for patients by avoiding the radical resection. We do not know whether the treatment offered in this study will be more or less effective than standard therapy or whether it will have any effect, positive or negative, on the patient’s overall health and quality of life,” said Dr Bussell. 

Danbury Hospital is one of three sites in the tri-state area participating in this study. About 85 people will take part in the study nationally.

The director of Colon and Rectal Cancer Program at Danbury Hospital, Dr Bussell is a board-certified surgeon specializing in colon and rectal cancer, laparoscopic surgery, inflammatory bowel disease, diverticulitis, and advanced proctology, such as fecal incontinence, prolapse, fistulae, and fissures.

Danbury Hospital’s Praxair Cancer Center provides comprehensive treatment of cancer, minimally invasive surgery, and a range of support services including complementary medicine. The hospital was recently named one of the Top 100 Hospitals in the United States by Solucient, based on high quality outcomes, financial performance, and patient growth.

For information on Danbury Hospital cancer services or screenings, call 797-7893 or visit www.danburyhospital.org. For physician referral, call 866-374-0007.