Specialized Colon & Rectal Cancer Care for Your Patients

Multidisciplinary Tumor Board Review

We review colon and rectal cancer cases through a multidisciplinary tumor board, bringing together specialists with expertise in diagnosis, staging, treatment planning, and recovery.

This formal review includes colorectal surgeons, medical oncologists, radiation oncologists, surgical oncologists, radiologists, pathologists, nurses, and other specialists. Together, we evaluate imaging, pathology, tumor location, stage, surgical options, clinical trial eligibility, and the patient’s goals.

This collaborative approach helps ensure each patient benefits from the full team’s expertise and receives a treatment plan tailored to their cancer, overall health, and priorities.

Specialized Colorectal Surgical Expertise

Tumors involving the colon and rectum are treated by colorectal surgeons with specialized training in colon, rectal, and pelvic surgery. This expertise is important especially for patients with rectal cancer where surgery can affect cancer control, bowel function, continence, pelvic floor function, sexual function, and the need for a temporary or permanent ostomy.

Advanced Surgical Options

We offer a range of surgical options. Depending on the tumor’s location and stage, options may include:

• Robotic surgery: A minimally invasive approach that can support precise dissection, especially in anatomically complex areas
• Laparoscopic surgery: A minimally invasive option that may reduce incision size and support recovery for appropriate patients
• Transanal endoscopic surgery: A local surgical approach for early rectal cancers that may allow tumor removal without a larger pelvic operation
• Advanced endoscopic resection: An option for very early cancers or malignant polyps that may be removable through an endoscopic approach

Our team evaluates each patient’s imaging, pathology, staging, and goals to determine whether a minimally invasive, local, endoscopic, or more extensive surgical approach is appropriate.

Watch-and-Wait Program for Rectal Cancer Patients

For patients with stage 2 or 3 rectal cancer, National Comprehensive Cancer Network (NCCN) treatment guidelines include chemotherapy and/or radiation before surgery. For patients who achieve a complete response, the guidelines now support a watch-and-wait option rather than proceeding immediately to surgery.

“About 45% of patients with stage 2 or 3 rectal cancer who receive chemotherapy and radiation may see their tumor completely go away,” says Traci Hedrick, MD, a colorectal surgeon. “For patients who are interested in avoiding surgery, we can enroll them in a watch-and-wait program and monitor them very closely.”

Watch-and-wait offers a chance to avoid rectal surgery and its potential long-term effects, including bowel dysfunction, pelvic floor dysfunction, sexual dysfunction, and permanent ostomy.

Our program follows NCCN’s active surveillance paradigm, which includes careful patient selection, experienced assessment, patient counseling, and close long-term surveillance. Close monitoring is designed to catch recurrence early, which Hedrick notes happens in about 20-30% of patients.

“If we are monitoring patients closely and we pick up regrowth, in most cases we can still do the same surgery we would have done originally,” Hedrick says.

Sphincter Preservation in Rectal Cancer

For patients with rectal cancer, preserving function is an important part of treatment planning whenever it can be done safely.

Our colorectal surgeons evaluate whether sphincter-preserving treatment is possible and work to build a plan that balances oncologic safety with long-term quality of life.

When possible, we use treatment strategies to control the cancer while helping the patient avoid a permanent colostomy. This may involve chemotherapy, radiation, minimally invasive surgery, transanal endoscopic surgery, watch-and-wait surveillance, or another approach.

Treatment for Metastatic Colorectal Cancer

For patients with metastatic colon or rectal cancer, our team has expertise in complex medical and surgical treatment planning.

We offer specialized care for liver metastases by a multidisciplinary team of hepatobiliary surgeons, medical oncologists, and specialized radiologists.

For select patients whose cancer has spread to the lining of the abdominal cavity, we offer cytoreductive surgery and HIPEC.

Quality-of-Life Support After Rectal Cancer Treatment

Rectal cancer treatment can affect quality of life in a variety of ways. Our team focuses on helping patients manage concerns related to bowel function, continence, pelvic floor function, sexual health, and other aspects of daily living throughout treatment and recovery.

For patients who experience bowel or pelvic floor dysfunction after rectal cancer surgery, we offer pelvic floor physical therapy and other functional support options. In select cases, sacral nerve stimulation may be considered.