Colorectal cancer Treatment is no longer a one-size-fits-all approach

The first surgeons may have been mediaeval barbers wielding nothing more than clean, sharp razors. But surgeons today use highly sophisticated instruments, state-of-the-art operating systems, and imaging devices to perform highly complex and intricate procedures.

In surgery to remove colorectal cancer, surgeons aim for the best patient outcomes by offering smaller wounds and rapid recovery after surgery with minimal complications, while achieving complete cancer clearance with low recurrence rates. With modern medicine, these ideals are possible, and most planned procedures in this field are safe and effective. The quality of life of a colorectal cancer patient has vastly improved over the past two decades, and this has largely been due to technological advancements in the medical field.

Over the last few decades, the management of colorectal cancer, especially rectal cancer, has evolved, with treatment and surgery no longer a one-size-fits-all approach. "The treatment of colorectal cancer is individualised to each patient, based on the stage, location and extent of spread of each cancer, as well as patient factors," says Dr Cherylin Fu, Consultant at the Department of Colorectal Surgery, Singapore General Hospital, a member of the SingHealth​ group.​

Accurate staging

For the right treatment to be prescribed, it is critical to dete​rmine the stage of the cancer correctly. The current use of 3D high-resolution ultrasound and high-resolution magnetic resonance imaging (MRI) allows surgeons to identify how deep the tumour has penetrated, and whether the disease has spread to the lymph nodes and adjacent organs.

Surgical staplers

​The surgical stapler – another milestone in the development of colorectal surgery – allows surgeons to perform secure anastomoses (joining the cut ends of the intestine after the cancer has been removed) with fewer complications. Previously, anastomoses were hand-sewn and difficult to perform. With surgical staplers, colorectal anastomoses are consistent, safe, and heal well with fewer complications such as leaks.

Modern staplers are constantly being improved, resulting in powered devices, adjustable heights and graduated compression. These enhance patient safety and surgical outcomes.

See ne​xt page for other colorectal cancer treatments such as energy devices, radiot​​herapy, and more​.

​Ref: O17