When we go to a surgeon, we often don’t ask them how many surgery he has done for the same disease but may be we should.
For colon cancer, there is in fact a specialization fellowship to become a colorectal surgeon. A recent analysis of 17 studies from nine countries has shown that the quality of the surgeon and the surgery is associated with better outcome.
How can you evaluate the surgeon?His reputation is important which is often built on volume and quality of his surgery. We only refer our colon cancer patients to colorectal surgeons. The quality of surgery is shown at the extend of removal of lymph node and low complication after surgery.
University of Southern California Medical Center has one of the lowest complications rate after colon resection in the USA. Studies have repeatedly shown that the more lymph nodes that are removed and examined during surgical treatment of colon cancer, the better the outcome appear to be for patients. The study suggests that removal of the nodes takes away a reservoir for potentially lethal cancer, and that knowing how far a cancer has spread leads to tailored and more beneficial treatment. According to researchers at the University of Texas M. D. Anderson Cancer Center, only about a one-third of colon cancer patients in the United States are getting an adequate lymph node evaluation.
These data are striking and should help support efforts now ongoing by some medical professional societies and expert panels to consider a minimum number of lymph nodes be extracted and examined during the surgery. Patients had significant lower risk of tumor recurrence when they had more than 20 lymph nodes removed compared to the patients with less than 11. Removing colon tissue during surgery in a way that captures all of the tumor-associated lymph nodes requires attentiveness. Patients should ask surgeons how many operations they have done, but I think in this case they should ask how often they do colon cancer surgery.
Studies have found that 70 percent of colon cancer resections are performed by general surgeons who do less than 10 of these surgeries a year, and that colon cancers removed by surgeons who perform colon cancer surgery more frequently are more likely to have more lymph nodes examined.
Please do your homework and make sure your surgeon is qualified to do the colon resection.
January 20, 2009 at 2:55 am, Patsy White said:
So glad to find your blog again. My husband has Stage IV cancer (11/06), 5 spots in one lung, 2 in other since 7/07. Chemo has kept same number, same size with necrosis in center until Dec 08. 3 weeks no chemo Dec progressed from less than 1 cm to 1.4cm (jan 09 scan results) and CEA went from 3 to 8.6. Took FolFox w/Avastin until lung spots then took Erbitux weekly, Erbitux/Avastin/Irinotecan bi weekly since Oct 07 then just Erbitux/Irinotecan. CEA started rising from 1.5 slowly August 1.5 to 2. to 2.3 2.5. Sept 08 scan showed no change. Other organs show no cancer on Jan 09 scan. Is VAT surgery a possiblity for patients like him? Is there another chemo available. Thank you
January 20, 2009 at 11:34 am, Heinz-Josef Lenz said:
since these lesions seems to be in the same spot and no cancer has shown up any where else you should discuss the options with a thoracic surgeon i think that is a possibility depending on how difficult the surgery would be. HJL