Colorectal Cancer Unique Treatment Options
At UC San Diego, we employ a comprehensive approach to the treatment of colon cancer with integrated use of surgery, radiation when applicable and chemotherapy. This comprehensive approach, along with the most advanced treatment options, provides the patient with the best chance to fight this disease.
For an overview of colorectal cancer and treatment strategies, see Colorectal Cancer.
Our Gastrointestinal Cancer Unit is also one of only a few sites in the U.S. offering unique procedures, technological advancements, and clinical trials specifically for colorectal cancer. For example, we have drug therapies that attack the abnormal signaling processes that cause colon cancer cells to grow, innovative therapies that boost the immune response, antibodies to attack cancer, and drugs to stop blood flow to tumors.
Heated intraperitoneal chemotherapy (HIPEC)
Another option for patients with colon cancer that has spread to the peritoneal surface (the smooth membrane that lines the colon) is heated intraperitoneal chemotherapy (HIPEC).
HIPEC is performed at the end of surgery to remove abdominal tumors. Once any tumors and all visible disease have been removed (called “cytoreduction”), the surgeon continuously circulates a heated, sterile chemotherapy solution throughout the peritoneal cavity for up to 90 minutes. The HIPEC procedure is designed to attempt to kill any remaining cancer cells that cannot be seen. The solution is then removed and the incision closed.
Giving the chemotherapy at the time of surgery allows for greater concentrations of the drug where it is needed. Adding heat has a threefold advantage:
- Heat at 42 degrees Celsius kills cancer cells while not affecting normal cells.
- Heat allows the chemotherapy to penetrate a few millimeters and kill cancer cells that cannot be seen.
- The chemotherapy dose can be higher because it is not absorbed by the body in the same way as traditional chemotherapy.
The procedure also improves drug absorption and effect with minimal exposure to the rest of the body. In this way, the normal side effects of chemotherapy can be avoided.
Learn more about HIPEC treatment at UC San Diego Moores Cancer Center
Rectal cancer and the da Vinci Robot
Although the da Vinci robot is available throughout the U.S. for prostate cancer patients, its use in rectal cancer is unique to only two or three sites, including the UC San Diego Moores Cancer Center. Dr. Sonia Ramamoorthy notes that the robot is especially effective in tight, narrow spaces, such as the rectum or esophagus, where a laparoscope won’t work. An additional benefit to minimally invasive procedures (with robot or laparoscope) is that the immune system is not as traumatized as with major surgery. If the immune system is suppressed, residual cancer cells left behind can continue to grow. Studies have shown that there is less immunosuppressive with minimally invasive procedures, so that the body fights any cancer cells that remain after surgery. See UCSD's robotic surgery website.
Video: Colorectal Cancer Screening and Colonoscopy
Tom Savides, MD, talks with David Granet, MD on UCSD-TV about screening for colorectal cancer, when to start screening, the various tests available and what to expect.