Colorectal cancers are the third most common type of cancer and the second most common cause of death in Europe. The month of March has been chosen as “Colorectal Cancer Awareness Month”, to raise awareness about this disease, as detecting it as early as possible can save many lives.
As a surgical oncologist, I can only say that a research-driven multidisciplinary approach is crucial to treat this type of malignancies. If surgery is the only treatment modality which has a curative potential by itself for solid tumours, inadequate cancer surgery can hinder the chances for a potentially curable patient to be rendered long-term disease-free.
Doing surgery “right” is essential in the complex area of cancer management. It is not only a matter of how to perform a surgical operation, but mostly whether and when to do it, and under which circumstances. This is why “cancer surgery” has evolved into “surgical oncology”, a term which highlights the healthcare professional’s knowledge of tumour biology and other oncology treatments, as well as his/her belonging to a multidisciplinary team.
Surgery applied in the oncologic field should be therefore performed by fully trained surgical specialists in cancer care, and this is even more necessary when we consider the complexity involved in learning the latest trends in colorectal cancer (CRC) surgery. Techniques such as laparoscopic and robotic surgery, as well as trans-anal excision, are now very sophisticated and ensure the same level of effectiveness of the open surgery approach.
Thanks to minimally invasive surgery (MIS), there is a clear shift from the necessity of mutilating anatomic structures, such as the anal sphincter, to their functional preservation. This new approach ensures eligible patients a shorter hospital stay, a quicker return to normal activities, and less pain following surgery. Nowadays, some healthcare specialists (e.g. interventional radiologists) are even able to perform ablative techniques to treat some types of metastatic colorectal cancers without recurring to surgery.
Is the future going towards “less but better surgery”? Yes, I think so. These new trends will become the next standards of care for the treatment of CRC and of the other solid tumours. However, if we want this high-quality surgical cancer care to be made available to all patients, the European healthcare sector should also increase its investments in education and state-of-the-art equipment to cover the sophistication and costs entailed by these innovative techniques.