Colorectal Cancer Treatment Program

Learn more about colorectal cancer

For more information, call the Vince Lombardi Cancer Clinic Hotline at 800-252-2990.

Colorectal cancer is the 3rd most diagnosed cancer in the U.S. among both men and women. About 105,000 new colon cancer cases and 42,000 new cases of rectal cancer are diagnosed annually.

Fortunately, the survival rate has been increasing. Several factors account for this:

• More polyps are found through screening before they can develop into colorectal cancer
• More colorectal cancers are found early, when treatment can be most effective
• Treatments for colorectal cancer have improved tremendously

Aurora St. Luke's Medical Center, in Milwaukee, WI, has developed a colorectal cancer treatment program to bring patients advanced treatment options and enhance outcomes. Our team includes surgeons, medical and radiation oncologists, radiologists, genetic counselors and others. Together, they work with patients to develop individualized treatment plans.

Diagnostics

Physicians use a variety of diagnostic tools to evaluate the small and large colon and rectum for cancer. Among the most advanced are:

Capsule Endoscopy -- Visualizing the small intestine has always presented a challenge. While the large intestine is easily visualized via colonoscopy, the technology has not, until now, been available to optically examine the small intestine.

During Capsule Endoscopy the patient swallows a small wireless camera housed in a capsule not much larger than an antihistamine pill. During the capsule's 8-hour passage through the small intestine, it transmits images to special antennae attached to the body. These images are recorded on a device the patient wears like a portable tape player. The patient then returns the recording device to his or her physician, who downloads the images onto a PC, where they can be reviewed.

Colonoscopy/Virtual Colonoscopy -- Traditional colonoscopy is available at St. Luke's, as well as virtual colonoscopy. This is a procedure that uses special X-ray equipment to produce pictures of the colon. A computer then assembles these pictures into detailed images that can show polyps and other abnormalities. Virtual colonoscopy may cause less discomfort and take less time than a conventional colonoscopy. If a polyp is found, however, an additional procedure such as a traditional colonoscopy is needed to remove the polyp or biopsy an area.

Ultrasonic Endoscopy -- This technique combines the optical benefits of endoscopy with the diagnostic advantages of ultrasound imaging. A small ultrasound transducer, mounted in tandem with an endoscope, is guided to the region of interest within the body. The technology yields more detailed images of a small area than is possible with ultrasound scanning done from outside the body.

PET/CT -- The combination of Positron Emission Tomography (PET) with Computed Tomography (CT) represents the frontier of diagnostic cancer imaging. The technology provides physicians with 2 sets of information from a single scan: the anatomical data yielded by a CT scan and the metabolic information provided by PET. This relatively new technology is helpful in localizing smaller cancers and in defining areas to which primary cancers have metastasized.

Genetic counseling

Certain types of cancer can be passed from generation to generation. Our Genetics Counseling Program helps identify individuals who may be at high risk for developing cancer. Armed with this information, individuals and their physicians can plan preventive measures, or a cancer can be identified early when it is most curable.

The Cancer Genetics Counseling Program provides:

• Confidential hereditary cancer risk assessment
• Access to on-going local and national cancer research studies
• Education for patients, health care professionals and the community
• Genetic testing and DNA banking when appropriate

About 5% - 10% of all cancers can be attributed to a hereditary factor. Ask yourself the following questions. If you answer “yes” to any of them, ask your doctor for a referral for a cancer genetics assessment.

1. Are you over age 40?
2. Is there a history of colorectal cancer in your family?
3. Do you have a family history of endometrial and/or ovarian cancer?
4. Is there a history of multiple colonic polyps in your family?

Advanced treatment and technologies

St. Luke's participates in national clinical trials of new drugs and treatments that promise to significantly advance the fight against cancer. Our experts can often suggest colorectal cancer treatment options that no other hospitals may be able to provide.

Surgery -- Surgery is the primary form of treatment used with colorectal cancer. Our surgeons specialize in removal of tumors, applying techniques focused on reducing the rate of local recurrence and improving survival rates that also preserve the integrity of the bowel and minimize the need for a permanent stoma (an external outlet to the stomach).

Specialized surgical procedures include anal sphincter repair and reconstruction, total mesorectal excision (TME), laparoscopic and open colon resection, coloanal and “J pouch” construction, ileoanal pouch procedures, transanal excision, transanal endoscopic microsurgical excision (TEMS), sentinel lymph node mapping, hepatic resection/cryotherapy, radiofrequency ablation and hepatic artery infusion pumps.

Minimally invasive surgical option(laparoscopic surgery) -- Hand-Assisted Laparoscopic Surgery (HALS) Tumor Surgery is a minimally invasive surgical approach that requires only a few small incisions in the abdomen. A 12-inch incision is required for traditional open surgery. A thin, lighted tube and tiny video camera are inserted to allow magnified views of the surgical site on a video monitor. A unique collapsible port holds open one of the small incisions in the patient's abdomen. It fits around the surgeon's fingers, allowing access to the tumor site so the cancerous section of the colon can be cut and removed while the remaining colon segments are repaired. Because the surgeon can grip and feel the tumor site, HALS provides advantages over traditional laparoscopic surgery that utilizes only surgical instruments:

• Same time-tested results as open surgery
• Reduced blood loss and need for transfusions
• Reduced pain
• Faster recovery and return to normal activities
• Less scarring

[ Learn more -- PDF file ]

Radiation oncology. A sophisticated and effective way to treat many kinds of cancer, radiation oncology uses highly advanced technology and innovative treatment techniques to destroy cancer cells or to prevent diseased cells from growing. Our team includes radiation oncologists at the forefront of their field who specialize in intraoperative radiation therapy (IORT), intraoperative catheter brachytherapy, gamma knife and intensity modulated radiation system technologies. [ Learn more ]

Immunotherapy. The ability of the immune system to identify and destroy tumor cells has led to its use in cancer treatment. By stimulating the body's immune system, cancer cells may be destroyed without damaging healthy tissue.

Immunotherapy is relatively non-toxic, so it can be used in combination with radiation or chemotherapy to enhance cancerous cell killing activity. [ Learn more ]

Chemotherapy. Advances in the effectiveness of cancer-fighting drugs has kept chemotherapy at the forefront in the fight against cancer. Often used in combination with other therapies, chemotherapy is frequently used to combat cancers with or without radiation therapy and surgery.

Autologous Stem Cell Treatment (ASCT). Some cancers once considered untreatable are being successfully treated with ASCT. While research has shown that certain cancers are more effectively treated (and the risk of recurrence can be dramatically reduced) by treating them with higher doses of chemotherapy, higher doses of chemotherapy can result in bone marrow failure.

With ASCT, bone marrow failure is prevented by removing stem cells from the bone marrow and preserving them before the patient receives chemotherapy. The stem cells are reinfused into the system after chemotherapy. They then migrate to the bone marrow where they begin to produce healthy new blood cells. [ Learn more ]

Chemoembolization. Used to treat cancer that has metastasized to the liver, chemoembolization delivers treatment directly to the malignant tumor. In this procedure, a catheter is inserted into an artery in the groin and guided (using X-ray imaging) to the artery that supplies blood to the tumor. Once the catheter is in place, chemotherapy agents are administered to the tumor along with particles that block the flow of blood to it.

Chemoembolization attacks cancer in 2 ways: by delivering agents toxic to cancer cells and by depriving the cells of oxygen and nutrients.

Radiofrequency ablation (RFA). This minimally invasive treatment is used to destroy tumors from within. A hollow-core needle is guided into the tumor's center using imaging technology such as CT or x-ray. Small tines are then deployed from the placement needle's tip, penetrating the volume of the tumor. Radio frequency energy is then sent through the needle into the tines, destroying the cancerous cells in the tumor.

Case conferences

Our experts meet during a weekly case conference to discuss the diagnosis, treatment and prognosis of patients. The conference is attended by surgeons, medical and radiation oncologists, gastroenterologists, radiologists, genetic counselors and other specialists. The case conference is an example of the collaboration that occurs across medical specialties at St. Luke's.

Personalized treatment plans are developed for patients and include the most effective treatment options and latest innovations available.

Resources on preventing colorectal cancer

For more information, call the Vince Lombardi Cancer Clinic Hotline at 800-252-2990.