Colorectal Cancer

Colorectal cancer is one of the most common cancers in Australia with over 15,000 cases being diagnosed each year. Through early detection, surgical innovation, and ongoing developments in both chemotherapy and radiotherapy survival rates are continuing to climb. However, it is still the second most common cause of cancer death.

The cornerstone of colorectal cancer treatment is surgical resection of the segment of bowel in which the cancer has been found along with the associated blood vessels and lymph nodes. The exact operation and amount of bowel to be removed varies from case to case.

The vast majority of cases performed by Dr Mackrill are laparoscopic (keyhole) including the anastomosis (where the two cut ends of the healthy bowel are joined back together). This means that the cancerous segment of bowel can then be removed via a small incision just above the pubic area. This reduces the amount of pain a patient is in after surgery and reduces the risk of hernia formation (a common issue in patients with larger incisions). Patients with less post op pain have a quicker recovery and spend less time in hospital.

Although in most patients a bowel resection is required there are some situations in which this can be avoided. If discovered early some cancers in the rectum can be resected with Trans Anal Minimally Invasive Surgery (TAMIS procedure) with long term cancer outcomes being the same as a major bowel resection. There is also a growing body of evidence that selected patients who undergo combined chemotherapy and radiotherapy for their rectal cancers (commonly used to shrink down rectal cancers prior to surgery) will be cured of their disease without the need for a major bowel resection. This concept of ‘organ preservation’ leads to better long term bowel function. The deep pelvic resection of the rectum in low rectal cancers often leads to significant changes in how patients open their bowels, and this can be avoided in organ preservation via TAMIS or Total Neoadjuvant Therapy.