Health Team

New Techniques Allow One Operation for 2 Cancers

Separate surgeries for colon and liver cancers used to be the norm, but doctors now can do one procedure for both.

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RALEIGH, N.C. — White House press secretary Tony Snow's fight with colon and, now, liver cancer isn't unusual. About half of people who've had colorectal cancer will develop liver cancer.

In fact, one-third of newly diagnosed colon cancer cases have already spread to the liver, and two separate surgeries are the norm. For some patients, however, one surgery is better.

In May of last year, Mary Lewis Foote felt a lump in her tummy.

Foote told her doctor, “Hey, I think I have a hernia. Look at it. And of course, I didn't have a hernia.”

Rather, it was advanced colon cancer. An MRI showed it had spread to both sides of her liver.

Several years ago, that might have been the end of the story.

It was, said Dr. Bryan Clary, a Duke surgical oncologist, “profoundly unusual for those people to live more than a couple years.”

Now, Clary said, chemotherapy and liver surgery have both improved. And, for otherwise healthy and active patients like Foote, he said, the prognosis can be even better.

Traditionally, operations for colon and liver cancer were done separately, with chemotherapy for six to nine months in between. Foote had both surgeries done at the same time, however.

Clary reviewed data from Duke and other hospitals who had taken the same approach with some patients.

“The long-term outcomes didn't appear to be any different in patients who had their surgery done up front as opposed to those who had them separated by time,” Clary said.

That worked for Foote, who said the preparation and recovery from one surgery was tough enough.

“Why would anybody want to do that twice instead of once?” Foote said.

Mary is now recovering from surgery to remove the second liver tumor that Clary couldn't get in the first surgery. Her prognosis is good. The past 10 months allowed her liver to regenerate and reduced the risk from additional surgery.

About half of patients with colorectal and liver tumors could be eligible for the simultaneous surgery, experts say. That's about 25,000 patients a year.


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