In a discussion with CancerNetwork® at John Theurer Cancer Center, Gregory Charak, MD, highlighted advancements in surgical treatment strategies for patients with colorectal cancer (CRC) as well as other ongoing challenges in the field.

Specifically, Charak, a board-certified colorectal surgeon at Palisades Medical Center and Hackensack University Medical Center of Hackensack Meridian Health, described how minimally invasive strategies such as laparoscopic and robotic surgery have become more prevalent in the field, which have appeared to confer improvements in pain and length of hospital stay for patients. Although these minimally invasive techniques are typically preferred in this population compared with open surgery, Charak stated that he would still employ the latter depending on factors such as tumor size.

Charak also discussed the rise in CRC incidence among younger populations, which has impacted how practices conduct screening. He highlighted that patients who are in their late 20s or 30s receive recommendations to undergo colonoscopy in the event of weight changes or blood appearing in their stool, noting that he would not hesitate to perform screening even if there’s a small but real possibility of disease.

Regarding other treatment modalities in this population, Charak emphasized the potential benefits of neoadjuvant therapy. Administering neoadjuvant treatment with agents including cytotoxic chemotherapy and immunotherapy, for example, may help achieve negative-margin resections, thereby yielding less morbidity for patients.

“It’s a very exciting time to be a surgical oncologist. [There are] tremendous new treatment modalities coming down the pike. Immunotherapy, in particular, is extremely exciting because it’s such an elegant way to treat cancer: to harness and augment the body’s own defense system to eliminate a cancer rather than using cytotoxic chemicals or invasive surgery,” Charak said. “It’s a beautiful thing. If we can get it to apply to more and more tumors and figure out how to make it work, it couldn’t be more exciting.”