“Optimal collaborative treatment and customized treatment… a great medicine to increase colon cancer survival rate” [로컬 인터뷰]

“Colon cancer has a high incidence rate among cancers in Korea. At the end of last year, it was announced as third place. If discovered early, the cure rate is over 90%, but if it has metastasized to other organs or is diagnosed at stage 4, the survival rate is low and surgery is often not easy.”

Kim Chang-woo, director of the Colon Cancer Center (Colon and Anal Surgery) at Ajou University Hospital, emphasized the importance of early diagnosis of colon cancer.

According to the latest data from the National Cancer Information Center, which announces the current state of cancer in Korea every December, colorectal cancer ranked third in incidence in 2020 and was also third in cancer mortality after lung cancer and liver cancer. Colon cancer does not have any symptoms in the early stages, and when symptoms appear, it has often progressed to stage 3 or higher. For early detection of colon cancer, the national cancer screening system recommends a fecal occult blood test starting at age 50, and if a positive result is obtained, a colonoscopy is performed. If it is diagnosed through a checkup when there are no symptoms, it is likely to be in the early stages and the probability of complete recovery is very high. However, if you have a family history or symptoms, it is better to get a colonoscopy instead of waiting for the national cancer screening period.

For colon cancer, endoscopic resection is possible in some cases in stage 1, but stage 2 and 3 require surgery for complete cure. Stage 4 requires surgery and chemotherapy if complete resection is possible with the naked eye, and if not, chemotherapy or radiation treatment first. Consider.

Ajou University Hospital’s Colorectal Cancer Center performs about 400 surgeries a year, 90% of which are minimally invasive surgeries, which is far higher than the national average of 80%. Unlike traditional open surgery, minimally invasive surgeries such as laparoscopy and robotic surgery have the advantage of causing small wounds, causing less pain and allowing a quick return to daily life.

Additionally, the Colorectal Cancer Center is improving patient treatment outcomes through a multidisciplinary treatment system. When multiple departments come together to meet a patient who needs to decide on the direction of treatment, medical staff from various departments, including colorectal surgery, gastroenterology, oncology and hematology, radiation oncology, radiology, and pathology, gather together to synthesize opinions to provide optimal customized treatment for the patient. Make a plan.

Center Director Kim said, “Korea already ranked first in the world for colon cancer treatment survival rate five years ago,” and added, “To maintain this, we are quickly sharing the latest knowledge and experience with various medical departments and working closely together to suggest the best treatment.” explained.

Discuss with the gastroenterology department whether endoscopic procedures are possible for early-stage colon cancer and whether endoscopic stent insertion is possible for obstructive colon cancer. In addition, if there is distant metastasis, we closely collaborate with the medical department related to the metastatic organ, the oncology and hematology department, and the radiation oncology department. The Department of Gastroenterology at Ajou University Hospital performs more than 8,000 colonoscopies a year and approximately 2,000 endoscopic polypectomies and early-stage colon cancer resections.

Center Director Kim said, “In particular, for stage 4 colon cancer, the results vary greatly depending on how the medical staff you meet for the first time determines the direction of treatment.” He added, “Therefore, in case of stage 4 colon cancer, we provide prompt and close consultation outside of clinic hours between specialists in each field with abundant experience and the latest knowledge. “It is going through,” he emphasized.

As a result, Ajou University Hospital achieved high treatment results with a 5-year survival rate of 100% for stage 1 colon cancer, 87% for stage 2, and 71% for stage 3.

Regarding this, Center Director Kim said, “We are trying to complete difficult colon cancer surgery areas with minimally invasive surgery as much as possible.”

Robotic surgery is a robot arm that creates 4 to 5 1cm-sized holes and moves freely with almost no angle restrictions. Using a 3D screen that enlarges the surgical area 10 times, it can precisely cut and connect difficult-to-access lesions. there is. Surrounding organs and nerves can be well preserved, greatly improving the quality of life of patients after surgery. In particular, in the case of rectal cancer, recovery of urinary and sexual functions is rapid by minimizing damage to the autonomic nerves and surrounding organs such as the bladder, prostate, uterus, and ovaries located within the narrow pelvis. In the past, open surgery was performed in a narrow pelvis where the surgeon’s hand could not fit, and laparoscopic surgery had improved visibility, but still had many limitations.

He said, “Now that we have achieved first place in survival rate, the issue of quality of life for the rest of our lives has come to the fore,” and added, “The issues of urination and sexual intercourse, which are very important but not often talked about, are getting satisfactory results with robots.”

For the convenience of patients, the Colorectal Cancer Center provides one-on-one cancer treatment companion services and one-stop treatment services. This is a system where a professional coordinator accompanies patients diagnosed or suspected of cancer one-on-one to the treatment department and examination room during their first visit, helping them to receive treatment and testing quickly and comfortably.

In addition, in order to provide mental support and return to daily life for patients after surgery, we are taking into consideration not only the physical health of patients but also their emotional and psychological stability in connection with the Cancer Survivors Integrated Support Center.

Center Director Kim said, “To prevent colon disease, we recommend consuming enough vegetables and fruits high in dietary fiber, reducing red meat or processed meat, and consuming dairy products rich in lactic acid bacteria.” He added, “Anyone can do exercise such as walking for at least 30 minutes every day.” “is essential,” he advised.

He continued, “Recently, the age at which colon cancer occurs is dropping to under 50s. If you have any suspicious symptoms such as bloody stool, abdominal pain, or a feeling of residual stool, you should promptly get tested for colon cancer. Alcohol and cigarettes are always bad. “There are many research results showing that it increases surgical complications and increases the risk of cancer development and recurrence, so of course it should be stopped,” he added.