Grace Shih, MD and
Patrick Wagner, MD.
Colorectal cancer (CRC) is the SECOND leading cause of cancer deaths in
the United States, effecting both men and women equally. Yet, few Americans
know that CRC can be both prevented and detected by a colonoscopy. For
example, only 1 in 3 Medicare beneficiaries get screened. CRCs start as
precancerous growths called polyps in the colon. A colonoscopy can detect
those polyps and remove them! This leads to prevention of colorectal cancer.
A colonoscopy can also detect cancer too, but the hope is to remove the
polyp before that happens.
Prevention – Get Screened
Screening should start for most Americans at age 50 but may be earlier
if there is a family history of CRC/polyps or a personal history of certain
conditions like inflammatory bowel disease. The American College of Gastroenterology
also recommends African Americans start at age 45 because they are more
likely to be diagnosed with CRC at a young age. In addition, there has
been an alarming trend of increasing colorectal cancers in Americans younger
than 50 years of age!
There has been a lot of advertisement regarding alternative tests for screening.
These tests such as the fecal DNA test (e.g. Cologuard®) and fecal
blood tests are NOT preventative. Because they only detect polyps and
cancer with a lower sensitivity, these tests should be offered only if
a colonoscopy cannot be done. The preferred preventative test is the colonoscopy
every 10 years.
Advanced Treatments – Robotic Surgery
Surgery remains the primary treatment modality for most patients with cancer
of the colon or rectum. Robotic surgery is being used increasingly in
the United States for treatment of colorectal cancer. The advantages of
robotic surgery include enhancements in surgical visualization (3-D) and
dexterity (wristed motion), and it is hoped that these innovations will
contribute to improvements in surgical safety and optimal cancer-related
outcomes. Surgeons at the Valley Health Cancer Center began performing
robotic surgery in 2016 and have, to date, completed more than 60 robotic
colorectal operations. While not all patients are candidates for robotic
surgery, the advanced technology may expand the number of patients eligible
for a minimally invasive operation for colorectal cancer.
Patrick Wagner, MD, Valley Health Surgical Oncology, has extensive experience in minimally
invasive and robotic cancer surgery, complex gastrointestinal surgery,
and management of advanced cancers using regional therapeutic techniques.
He completed training in cancer surgery and pathology at Weill-Cornell
Medical Center, Memorial Sloan Kettering Cancer Center and the University
of Pittsburgh Medical Center and received his MD from Harvard Medical School.
Grace Shih, MD is a gastroenterologist with Winchester Gastroenterology Associates.