Advanced Treatment Strategies for Colon and Rectal Cancer

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• Treatment Options for Colorectal Cancer
• Preoperative Staging Goals
• Sphincter-Preserving Surgery
• HIPEC and EPIC Procedures
• Minimally Invasive Techniques
• Global Health Initiatives
• Full Transcript

Treatment Options for Colorectal Cancer

Dr. Nelya Melnitchouk, MD, a leading colorectal surgeon, discusses the many treatment options available for colon and rectal cancer. She emphasizes that choosing the right treatment requires a highly personalized approach. Treatment selection depends on the cancer's stage, location, and the patient's overall health.

Dr. Nelya Melnitchouk, MD, explains that a multidisciplinary team is essential for optimal care. This team includes medical oncologists, radiation oncologists, and pathologists. Their collective expertise ensures each patient receives the most effective and tailored treatment plan.

Preoperative Staging Goals

Preoperative staging is a cornerstone of effective colorectal cancer management. Dr. Nelya Melnitchouk, MD, highlights its primary goal: to accurately determine the extent of the disease. This process involves advanced imaging techniques like CT, MRI, and sometimes PET scans.

Accurate staging allows surgeons like Dr. Melnitchouk to plan the most appropriate surgical procedure. It helps predict whether a patient might benefit from neoadjuvant chemotherapy or radiation before surgery. This strategic approach improves surgical outcomes and overall survival rates.

Sphincter-Preserving Surgery

Sphincter-sparing surgery is a major focus of Dr. Melnitchouk's clinical practice. This advanced technique allows for the removal of rectal cancer without needing a permanent colostomy. The goal is to preserve bowel continuity and maintain a patient's quality of life.

Dr. Melnitchouk's expertise in this area is a key research interest. She utilizes precise surgical techniques to achieve clear margins while saving the anal sphincter. This approach is particularly beneficial for patients with low rectal tumors.

HIPEC and EPIC Procedures

As Director of the Peritoneal Surface Malignancy program, Dr. Nelya Melnitchouk, MD, is an expert in HIPEC and EPIC. Hyperthermic Intraperitoneal Chemotherapy (HIPEC) delivers heated chemotherapy directly into the abdominal cavity during surgery. This targets microscopic cancer cells that remain after tumor removal.

Early Postoperative Intraperitoneal Chemotherapy (EPIC) is another specialized technique she employs. These aggressive procedures are used for cancers that have spread to the abdominal lining. They can significantly improve survival for select patients with peritoneal surface malignancies.

Minimally Invasive Techniques

Dr. Melnitchouk is a strong advocate for minimally invasive surgery for colorectal cancer. Her clinical interests include laparoscopic and robotic-assisted procedures. These techniques use small incisions, which leads to less pain and a faster recovery for patients.

She also performs combined endoscopic laparoscopic surgery for complex cases. Dr. Nelya Melnitchouk, MD, explains to Dr. Anton Titov, MD, that these advanced methods offer high precision. They are integral to providing modern, patient-centered cancer care.

Global Health Initiatives

Beyond her clinical work, Dr. Nelya Melnitchouk, MD, is deeply involved in global health research. She focuses on improving colorectal cancer screening and surgery in low-to-middle-income countries. Her work aims to bridge disparities in cancer care access worldwide.

This commitment to global health complements her surgical expertise. Dr. Melnitchouk's holistic approach ensures her impact extends beyond the operating room. She strives to advance colorectal cancer treatment on both a local and international scale.

Full Transcript

Dr. Anton Titov, MD: Hello from Boston! We are with Dr. Nelya Melnitchouk, who is Assistant Professor of Surgery at Harvard Medical School. She is Director of the Program in Peritoneal Surface Malignancy and HIPEC at Brigham and Women's Hospital and Brigham and Women's Faulkner Hospital in Boston.

Dr. Melnitchouk obtained her MD from Albert Einstein College of Medicine in New York. She completed her general surgery residency at Brigham and Women's Hospital at Harvard Medical School. As a resident, she received the Rudolf Vollman Award for Excellence in Teaching.

Dr. Melnitchouk completed the colorectal surgery fellowship at the combined Memorial Sloan-Kettering Cancer Center and New York Hospital/Weill Cornell Medical Center colorectal surgery program in New York.

Dr. Melnitchouk's research interests are in outcomes research and global health, colorectal cancer screening and surgery for colorectal cancer in low- to middle-income countries, colorectal cancer surgery and gastrointestinal complications in cardiac surgery patients, and sphincter-sparing surgery for rectal cancer.

Her clinical interests also include minimally invasive surgery, laparoscopic, robotic and combined endoscopic laparoscopic surgery, and sphincter-preserving surgery in rectal cancer and inflammatory bowel disorders.

Dr. Melnitchouk, hello and welcome!

Dr. Nelya Melnitchouk, MD: Hi, Anton. Thank you so much for coming here to discuss some of the issues in colorectal surgery.

Dr. Anton Titov, MD: Let's start with colon cancer and rectal cancer. There are many treatment options available today—but how to choose the right treatment? What are the goals of preoperative staging in colon cancer and rectal cancer?