In this short video, Haniee Chung, fellowship-trained colorectal surgeon, discusses the importance of the tri-modality approach to treating colorectal cancers, total neoadjuvant therapy for rectal cancers and the importance of sphincter-sparing surgery.
I'm Hani chang. I'm an assistant professor of surgery and I practice as a colorectal surgeon in the greater Washington area at Sibley Memorial Hospital and at suburban hospital specifically for rectal cancers. We know that a tri modality approach is the most appropriate in order to downstage cancers that are locally aggressive. So try modality approach involves radiation chemotherapy and surgery. By getting radiation oncologists, medical oncologists, radiologists and pathologists on board early on were able to determine when is the best timing for surgery for each patient in the treatment of rectal cancer. We've adopted an approach called total neo adjuvant therapy, where we treat patients with radiation and systemic chemotherapy all before they're considered for surgery. In a portion of these patients, we see complete response to radiation and chemotherapy alone and in these patients were able to avoid surgery altogether and survey them closely for local recurrence. I work with other cancer specialists who have expertise in radiation therapy and chemotherapy to try to reduce the um tumor size and bulk prior to surgery. So that sphincter sparing surgery becomes more feasible. Sphincter sparing surgery refers to our attempts to maintain normal bowel function in patients who are treated for rectal cancer. Many patients are resistant to the idea of having a permanent colostomy or a bag for the rest of their lives in sphincter sparing surgery, we attempt to connect the colon down low into the pelvis, sometimes down to the anal sphincter itself in order to allow patients to have normal bowel function and continents minimally invasive surgery refers to um both laparoscopic robotic and transnational approaches to try to minimize the size of incisions and the postoperative pain associated with those incisions. For patients, we know that minimally invasive approaches reduces the length of stay and complications related to wounds, which ultimately lead to better patient satisfaction. I communicate frequently with referring providers by phone or email, so that um referring physicians can be involved in the decision making for the best possible treatment plan for the patient and I keep them updated on the patient's progress throughout their treatment so that when a patient is ready to return to their care, they're aware of everything that's happened during their treatment.
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