Surgery for Colon Cancer: Wha... Video Transcript

Participants

, Michael Lieberman MD, David R. Marks MD, Mark Pochapin MD

Summary

Surgery is one of the most common treatment options for patients with colorectal cancer. But there are many surgical techniques out there, each appropriate for different patients with different stages of cancer. How do you and your doctor determine the best procedure for you? Join our panel of specialists as they discuss the various available techniques, and when they should be used.

Webcast Transcript

DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. Colon cancer is one of the many cancers that can be treated surgically. But whether you're a candidate for surgery depends on how advanced your disease is. Today we'll be talking about the various surgical options, when each is most appropriate, and what the risks are. Joining me are two experts. First is Dr. Mark Pochapin. He's a gastroenterologist at the Weill Cornell Medical College. Welcome.

MARK POCHAPIN, MD: Thanks, David.

DAVID R. MARKS, MD: Next to him is Dr. Michael Lieberman. He's a colorectal surgeon, also at the Weill Cornell Medical College. Thanks for being here.

MICHAEL LIEBERMAN, MD: Thank you, David.

DAVID R. MARKS, MD: When is surgery used to treat colon cancer?

MICHAEL LIEBERMAN, MD: Surgery is predominantly used to treat colon cancer in two different scenarios. One is when we're attempting a curative resection, and that would be in a situation where the tumor is confined to the colon or the draining lymph nodes in the region of the colon. And secondly when we're operating for palliation, to relieve obstruction.

DAVID R. MARKS, MD: Describe what palliation is.

MICHAEL LIEBERMAN, MD: Palliation, in the case of colon cancer, is typically one of three possibilities. One is obstruction, two is perforation, and three is significant bleeding. In those situations, we will be in a situation where we will recommend surgery, regardless of where the disease is.

DAVID R. MARKS, MD: So it's not to cure, but to make the person feel better.

MICHAEL LIEBERMAN, MD: It could be for cure, under those scenarios. But in many times, it can be palliative, if there's metastatic disease along with the primary tumor.

DAVID R. MARKS, MD: You were going to add something?

MARK POCHAPIN, MD: Just that, very often, if there's a situation where you don't think you can cure a person, surgery still may be indicated, and that's where the palliation comes in, to try and help make their symptoms better, make them feel better.

DAVID R. MARKS, MD: What are the most common procedures that you perform?

MICHAEL LIEBERMAN, MD: I think, in terms of colon cancer, the conventional open procedure, or exploratory laparotomy with resection of part of the colon where the tumor's situated, and the draining lymph nodes. Recently, an exciting area of surgery has been laparoscopy, where we've been utilizing laparoscopic techniques to accomplish the same surgical principles for resection of the primary colon cancer and its draining lymph nodes that travel along the blood vessels.

DAVID R. MARKS, MD: And the advantage with laparoscopy is --?

MICHAEL LIEBERMAN, MD: The potential advantage of laparoscopy, which is being investigated presently, is reducing the side effects of the surgery, and perhaps getting people back to their daily life routine faster.

MARK POCHAPIN, MD: Laparoscopy is when they put a tube literally inside the abdomen, and do the surgical procedure with little probes going through small incisions, so the incisions are much smaller. And cosmetically, and in healing rates, both sort of improved. But we don't know right now, because there are studies that are ongoing, whether or not that's as effective as conventional surgery yet.

DAVID R. MARKS, MD: Do people that have surgery for colon cancer lose the function of their anal sphincter automatically?

MICHAEL LIEBERMAN, MD: No. That's a common misconception, is the idea that, when you have colon cancer and that you're having colon surgery, that you'll end up with a colostomy, which is the colon being exteriorized through the abdominal wall.