Colorectal Cancer Care

Stephenson Cancer Center Advances Colorectal Cancer Care
Minimally-invasive Procedure Improves Recovery and Outcomes

It's a cancer that once was seldom talked about, but awareness of colorectal cancer is growing and with good reason. More than 51,000 people in the United States will die of colon and rectal cancer this year alone.

Treating rectal cancer has generally required a somewhat invasive surgery with a sometimes difficult recovery period for patients that can last for several months. Now, a Stephenson Cancer Center physician is pioneering a less invasive approach at the OU Medical Center for patients here in Oklahoma with improved recovery and outcomes.

It's called transanal endoscopic microsurgery (TEM), a procedure that is becoming the technique of choice for patients and surgeons. TEM is a minimally invasive approach, utilizing specialized equipment that provides magnified vision and superior optics for removing tumors throughout the entire rectum. It has been used for some time in Europe, but is still relatively uncommon in this country. Now, OU Medical Center is one of what may be fewer than 100 facilities nationwide that perform the procedure. "We are very pleased to be able to offer this option to our patients," said Gary Dunn, M.D., a colorectal specialist with the Stephenson Cancer Center. "It's a challenging technique because it has a steep learning curve for the surgeon, which may be why more surgeons do not offer it to their patients. It definitely provides benefits for our patients with improved outcomes, less discomfort following surgery and a more rapid recovery."

William "Bill" Logan, 73, of Paden, OK, recently underwent TEM at OU Medical Center. He said he was up and walking the same day and out of the hospital the next. Logan added the procedure is a great improvement over his previous colorectal surgery, which kept him in the hospital for a week and in bed recovering for another month.

"This was so much better. The recovery was faster and much less difficult," said Logan.
In a recent retrospective study, researchers found that the TEM procedure was much more likely to result in a complete resection of the cancer with better margins.  The better the margin, the less likely the cancer is to recur and the rate of recurrence was significantly lower with TEM as compared to transanal excision or TA (5 percent versus 25 percent). The study also found that TEM was also more likely to allow surgeons to remove the entire lesion intact, which makes evaluation easier for the pathologist.

Dunn, who is board certified in colon and rectal surgery as well as general surgery, explained the TEM procedure allows for more precise resection (removal) of the tumor, which is likely a major force behind the lower rates of recurrence.  

"It's a procedure that does require specialized equipment that is expensive and that may be another reason we haven't seen more surgeons in this country move toward TEM for their patients, but the value to the patient is immeasurable. In many patients, you can avoid the need for an invasive abdominal surgery and possibly the need for a colostomy," Dunn explained.

Because the learning curve with TEM is steep, it is important to seek out a surgeon experienced with TEM. For more information on Dr. Dunn and colorectal surgery at OU Medicine, visit www.oumedicine.com

As Oklahoma's only comprehensive academic cancer center, the Stephenson Cancer Center is raising the standard of cancer treatment in the state through compassionate care, innovative research and a commitment to education. Stephenson Cancer Center members are conducting more than 100 cancer-related research projects supported by more than $20 million in annual funding from sponsors like the National Cancer Institute and the American Cancer Society.

In 2011, the Stephenson Cancer Center moved into a state-of-the-art, 210,000-square-foot facility on the OU Health Sciences Center campus in Oklahoma City.  For more information on the Stephenson Cancer Center, visit www.OUCancer.org.