When it comes to taking care of your gastrointestinal health, the best advice is simple: go with your gut. If you’ve noticed a change in your bowel habits—or recent reports about rising colon cancer diagnoses have you concerned—now is the time to talk with your doctor. The good news is that advances in screening, prevention, and treatment are saving lives. Ziad Kronfol, MD, FACS, FASCRS, Director of the Department of Surgery and Chief of the Division of Colon and Rectal Surgery, explains where colon cancer diagnosis and treatment stand today. 

The evolution of colon cancer treatment 
 
You went for a colonoscopy, and the doctor found a polyp.  Now what? Usually, these polyps can be removed during the colonoscopy. But there are instances where surgery is necessary if they can’t be removed during the procedure.  

 “Patients are referred to a surgeon after a colonoscopy for various reasons which include large or complex polyps, early cancer found on biopsy, and high-risk features requiring more complete removal,” said Dr. Kronfol. “In many cases, we are treating precancerous disease or very early cancer — often before it becomes life-threatening.” 

Dr. Kronfol explained that surgical procedures for colon cancer are dramatically different from decades ago. For many colon and rectal cancers, robotic surgery has become the preferred minimally invasive approach. Robotic surgery allows surgeons to operate through small incisions, use enhanced 3D visualization, and perform precise dissection in tight spaces. “The use of this technology reduces blood loss, shortens hospital stays, and offers faster recovery for patients,” said Dr. Kronfol. 

For select, early rectal cancers and large rectal polyps, a doctor may offer Transanal Minimally Invasive Surgery, (TAMIS), which in carefully selected cases, can be both curative and organ-preserving. Through this surgical approach, surgeons can remove tumors entirely through the anus, avoid abdominal incisions, and preserve rectal function. It also prevents the need for more extensive surgery, including colostomy creation, in certain patients.  

Setting the stage for surgery 

If a patient receives a staged diagnosis of colon cancer, the surgical intervention looks different for stages 0 to stage 4 . Early-stage disease (Stage 0–I and some Stage II) is often treated with surgery alone. As stage increases — particularly with lymph node involvement — chemotherapy is added to reduce recurrence risk. 
Every treatment plan is personalized based on tumor biology and patient factors. The breakdown of stages and treatment are as follows:  

Stage 0: 
Often removed during colonoscopy. Some rectal lesions may qualify for TAMIS. 

Stage I: 
Minimally invasive surgery — often robotic — is typically curative. 

Stage II: 
Robotic colon resection. Chemotherapy is considered if high-risk features exist. 

Stage III: 
Robotic surgery and chemotherapy for best long-term outcomes. 

Stage IV: 
Highly individualized. Robotic surgery may still be used in combination with chemotherapy, and in some cases, staged liver or lung procedures. 
 
The power of prevention 

If you’ve been following the news, there has been a national rise in colorectal cancer under age 45. Contributing factors may include: western diet, obesity, sedentary lifestyle, microbiome changes, environmental exposures, and genetic predisposition. But this doesn’t mean you can’t start getting ahead of it today. 

“There are preventative measures you can take, specifically diet-related, that can help prevent colon cancer,” said Dr. Kronfol. “This can include, eating a high fiber diet, limiting processed and red meats, exercising regularly, maintaining a healthy weight and not smoking.” 

But the best prevention is staying up to date with your screening. 
“Screening for colon cancer has been dropped to age 45,” Dr. Kronfol continued. “It is critical to not only know your family history, but listen to your body, as you are eligible for a screening earlier if you’re experiencing symptoms. Colonoscopy remains the most powerful prevention tool — because it removes precancerous polyps before they turn into cancer. So, if you’ve been putting it off, it’s time to make that phone call.”  

For screening information, call Highland Medical, Rockland Gastroenterology and Liver Disease at 845-362-3300.

For a surgical consultation, call Highland Surgical Associates at 845-535-3362.