From hemorrhoids and diverticulitis to inflammatory bowel disease, a colorectal surgeon treats a wide range of disorders affecting the colon and rectum. While not all conditions are cancerous, colorectal cancer is a different story. At Bridgeport Hospital and the Smilow Cancer Hospital Care Center in Trumbull, colorectal surgeons treat all of these medical issues and perform hundreds of surgeries each year.

“We treat a lot of diseases of the colon and rectum, but not everything is cancer,” said Amit Khanna, MD, director, Colon and Rectal Surgery, Bridgeport region, and associate professor of surgery (colorectal surgery), Yale School of Medicine. “Of course, one thing we do a lot of is colon and rectal cancer surgery.”

Colorectal cancer is a disease in which cells in the colon or rectum grow out of control. It is the second leading cause of cancer and, in Connecticut, is the fourth most common cause of cancer death.

Who gets colorectal cancer?

It used to be that men and women at higher risk for colorectal cancer were those older than 50 years of age. “While rates for colorectal cancer seem to be going down in populations 60 and over, we’re seeing the rates going up in patients 30 to 50 – and that’s a very troubling pattern,” Dr. Khanna said. “We are now pushing to screen patients at an earlier age.”

The American Cancer Society has lowered the age for screening colonoscopy from 50 to 45. “We now offer patients from 45 years and up a screening colonoscopy, and we’re asking patients who have a family history of colon cancer or rectal cancer to get screened 10 years earlier than the diagnosis of their family member involved,” he said.

If you experience rectal bleeding, a change in your bowel functions, or have an unexplained weight loss, see your primary care physician or gastroenterologist, advises Dr. Khanna, who also sees patients at Yale New Haven Health’s new Digestive Health Center in Westport, 325 Riverside Ave., as well as in Trumbull. “Early diagnosis is important.”

Treatment approaches

Although surgery is the mainstay of treatment for colon cancer, rectal cancer requires a different, multi-pronged approach.

“The rectum is special and requires a lot of care to get good outcomes,” Dr. Khanna explained. “We have a multidisciplinary rectal cancer program that we launched about a year ago with the help of Smilow Cancer Hospital Care Center’s leadership in Trumbull, so we see patients with rectal cancer as a team.”

This includes the colorectal surgeon, the medical oncologist and the radiation oncologist, among others.

“We all see the patient together in the same place, on the same day and develop a coordinated care plan. Patients appreciate this because they don’t have to run to multiple appointments on multiple days,” he said.

Learn more about services available at Smilow Cancer Hospital Care Center at Park Avenue Medical Center, 5520 Park Ave., Trumbull.

5 things to know before colon surgery

Facing colon cancer surgery? Dr. Khanna offers the following tips:

1. Get engaged in your care plan. “We want to educate our patients on what they can do to improve their sense of well-being, physical health, and optimize their condition prior to surgery,” Dr. Khanna said. “This may include quitting smoking, or engaging in a walking program, or moving toward a healthier diet. Accessing our integrative services programs, nutritionists, genetics team and patient care navigators to support our preoperative phase is valuable to patients, too.”
2. It is a care journey not an event. “We leverage our nurse educators to reduce patient uncertainty and anxiety and educate patients on ways to access resources available to support their care, including pain management and enhanced recovery programs,” he said. “We also maintain effective communication throughout recovery.”
3. Great surgeons do great work; exceptional teams create excellent outcomes. “In the operating room, our team works hard to gain optimal performance,” Dr. Khanna said. “Surgeons and race car drivers are similar in this respect. They appear to be alone in their performance, but it requires a great team effort from their crew, mechanics and leadership sponsors to be able to win a race.”
4. Quality care is custom care supported by an expert community. “Minimally invasive options, such as robotic-assisted surgery and laparoscopic surgery, as well as open approaches to colon surgery may all be appropriate options for patients,” he said. “Organ preservation may be an option in selected cases. Our specialty surgeons work with patients’ gastroenterologists and primary care physicians to create a care plan based on best evidence.”
5. Colon surgery is highly specialized. “Outcomes from surgery may be improved with high-volume providers with specialty training in colon and rectal surgery,” Dr. Khanna noted. “Support programs in ostomy care, genetics, gastrointestinal oncology, and gastroenterology specialists all remain critical ingredients to restore digestive health to our patients.”

Learn more about digestive services at Bridgeport Hospital.