Despite the fact that removing and testing at least 12 nearby lymph nodes during colorectal cancer surgery improves accurate staging and survival, most US hospitals are not reaching that goal.

In a recent study of nearly 1,300 hospitals, only 38 percent tested at least 12 nodes in 75 percent of colorectal cancer surgeries performed in 2004 and 2005. Read the rest of this entry »

Self-expanding metal stents can help patients with an obstruction from advanced colon cancer avoid surgery.

When a large tumor blocks the left side of the colon, surgeons can remove the tumor or put in a stent to move bowel contents around the obstruction.  According to a recent study, patients live as long with either technique but spend less time in the hospital and have fewer complications with stents. Read the rest of this entry »

Five randomized studies have shown that chewing gum after colon surgery reduces the time it takes for patients to pass gas and have a bowel movement.

Patients in the studies chewed sugarless gum from 5 to 45 minutes, three times a day after surgery.  Control groups had similar surgeries but didn’t chew gum.

There was a trend toward leaving the hospital sooner, but the studies were too small to definitely show fewer hospital days for the gum chewers.

Still, the study authors wrote,

The potential cost savings from the reduction of even one postoperative day compared with the cost of several sticks of chewing gum are huge.

During intestinal surgery, the bowels stop moving contents forward, a situation known as ileus.  After surgery doctors listen for sounds in the bowel and wait for gas to pass through the rectum as signs that bowel activity is resuming.

Overall in the five studies, patients who chewed gum passed gas about half a day sooner and had their first bowel movement a day sooner.

The team concluded,

Chewing gum may enhance intestinal recoveryfollowing colectomy and reduce the length of hospital stay. Owing to the potential for substantial cost savings, larger-scale,blinded, randomized controlled trials with placebo arms are warranted.

Previously, C3 News has reported post-surgical gum chewing studies in California and Dallas and Pittsburgh.

More information about the overview of gum studies is on Medpage Today.

SOURCE: Purkayastha et al., Archives of Surgery, Volume 143, Number 8, August, 2008.

Experts in treating colorectal cancer that has spread to distant sites say that the need for a better staging system for advanced disease is urgent. More specific staging could identify patients whose cancer could be cured with surgery.  For others, modern chemotherapy might make curative surgery possible.

In addition, a more precise staging system, with more categories, would provide better survival prognosis.

Currently all patients whose cancer has spread beyond their colon or rectum to distant sites (metastatic colorectal cancer) are lumped together in one group, classified as stage IV or Dukes D.  No difference is made for those who have liver tumors that could be surgically removed or those where chemotherapy might make surgical cure possible. Read the rest of this entry »

The FDA has approved Entereg® (alvimopan) to speed the restoration of normal bowel function after intestinal surgery.

However, the approval comes with a Risk Evaluation and Mitigation Strategy (REMS) to be sure that the benefits of using Entereg outweigh any potential risks.  Under the REMS, the drug can only be used only in hospitals for inpatients.  Hospitals that use it must be certified and materials developed for the health care professionals who administer it.  Its effectiveness must be regularly assessed. Read the rest of this entry »