3 Major Developments Shaping Treatment in Colon Cancer

Significant developments continue to be experienced in the diagnosis and treatment of colon cancer, which is among the most preventable cancers. Reminding that within the scope of Colon Cancer awareness month, the rate of catching colon cancer in a person is 6 percent, regardless of risk, the General Surgery Specialist emphasized that the 5-year survival rate in colon cancer has increased to approximately 65-70 percent thanks to the developments in recent years... The specialist pointed to the developments in this regard…

Most colon cancers begin as small, noncancerous clumps of cells called adenomatous polyps. Over time, some of these polyps can develop into colon cancer. Yeditepe University Koşuyolu Hospital General Surgery Specialist stated that 90 percent of colon cancers can be prevented when polyps are caught in the large intestine before cancer occurs and that the developments in colonoscopy, medical treatment, and surgery have given hopeful results for patients. He listed the developments as follows…

1-Advances in Colonoscopy Method and Technology

Recently, much higher resolution devices have started to be used with colonoscopy techniques, which have come a long way in the diagnosis of colon cancer. In this way, it is possible to understand whether a polyp is benign or malignant at the biopsy or polypectomy stage. However, polyps that are flatter in structure and difficult to remove can be removed thanks to these technically superior technologies.

Explaining that sometimes when polyps are large, laparoscopy-assisted polypectomy can be performed because there is a risk of perforation when a colonoscopy is performed alone, our specialist said, “While the gastroenterologist is performing a colonoscopy, the general surgery team provides support with laparoscopy. These are called hybrid or combined interventions. The number, structure, and size of the polyp also determine the time of the second colonoscopy after the polypectomy for that patient.”

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2-Determination of Subtypes of Colon Cancer and Targeted Treatments

Stating that in addition to the developments in the diagnostic methods for colon cancers, the second development in medicine is targeted drugs and the determination of subtypes of colon cancers, our specialist gave the following information: “First, we apply genetic testing to colon cancer. Known gene mutations are investigated. Afterward, we know which chemotherapy will benefit more and what results will be achieved. Tumors that can benefit from targeted medications have a better survival rate. However, accurate staging is also extremely important in the success of treatment. As the stage progresses, the success rate in solid tumors decreases further. The survival time of the patient is shortened and it becomes more problematic. It is important to catch the patient at the first stage and to make an early diagnosis, but it is more important to be able to make planning according to the stage.”

3-Advances in Surgery

Saying, "We have been able to better understand and treat the patient with the techniques that have been developed recently," Yeditepe University Koşuyolu Hospital General Surgery Specialist gave the following information: “Although the methods are different, we can now perform surgeries through smaller incisions and holes. Fewer incisions mean that the patient's bowel functions begin earlier and that the person can stand up and go to work sooner.

In these laparoscopic operations, abdominal or rectal access is possible. We apply a new surgical approach, which is defined as intersphincteric resection and which has been on the agenda recently. Especially in lower rectal cancers, we protect the outer muscle by removing the inner muscle from the two muscle groups that allow us to hold the stool in our anus. Thus, patient satisfaction increases as the patient do not have to live with the bag. In addition, there have been significant developments in anus-sparing surgery in recent years. It is preferred in tumors of the rectum region, which constitute approximately one-third of colon cancers.” In addition to laparoscopic operations, the specialist informs that the patient can be followed up with anus-protecting non-surgical treatment, which can be called non-operative management, that is, non-surgical monitoring, but this method is still in the experimental stage.

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24 February 2023