Rectal cancer treatment: a multidisciplinary approach
06 August 2007 - Owing to the close proximity of the rectum to other bodily organs, rectal cancer provides a massive challenge for the medical community. The condition requires a multidisciplinary team for the best chance of success, and even then team members can disagree on the best course of management. Luckily recent advances and better communication between consultants has led to not only more treatment options, but better outcomes too.
Although surgery is still necessary for rectal cancers that have spread beyond local structures, only the more extensive cancers require a completely radical approach. Smaller tumours can now be removed by using techniques such as Transanal Endoscopic Microsurgery, in which instruments are inserted through the anal opening rather than abdominal incision. Even tumours located further from the anus can be carefully removed without severing nerves which aid sexual and urinary function; 20 years ago, this would not have been the case.
Further advancements have been made with minimally invasive laparoscopic surgery. Although requiring a skilled surgeon to perform, it only requires small incisions rather than a long midline abdominal incision, with a recovery period a fraction of the traditional 4-8 weeks.
The future of surgery will continue to focus on minimally invasive access. The natural orifices such as the stomach or the rectum seem to provide a feasible entry point for surgical interventions in the peritoneal cavity, thereby avoiding abdominal wall incisions.
This highlight is based on the research of Professors Sir Ara Darzi and David Cunningham. Read more about their work in The Institute's Annual Research Report 2006.
Find out more about The Institute's Gastrointestinal Unit.
