Patients travel to Lankenau from all over the world for the renowned
colorectal cancer surgical care that has been perfected by Lankenau’s
own physicians. The father/son team of Dr. Gerald Marks and Dr. John
Marks has pioneered significant breakthroughs in colorectal cancer
management. In fact, their techniques and procedures have dramatically
improved the lives of patients and are today considered the world-wide
standards of care for colorectal cancer treatment.
When it comes to colorectal cancer, early detection is critical for a
successful outcome. Colorectal cancer is the only cancer that is
preceded by a benign lesion, called a polyp. Polyps can be detected and
removed by minimally invasive methods such as colonoscopy, thus
interrupting the development of the cancer.
In addition to a physical examination and a review of personal medical
history, family history, risk factors and potential symptoms, patients
at Lankenau may also receive one or more of the following tests:
Digital rectal examination – By inserting a
gloved, lubricated finger into the rectum, the doctor can feel
for lumps or unusual masses in the rectum.
Fecal occult blood test – This test is
completed by the patient in the privacy of his or her own home
and returned to the doctor for evaluation of hidden blood in the
Sigmoidoscopy – This outpatient procedure uses
a long, flexible tube to check the rectum and lower part of the
colon for polyps and cancerous tumors.
Colonoscopy – This outpatient procedure uses a
colonoscope, a long, flexible tube (longer than a sigmoidoscope)
to inspect the entire colon and rectum. The American Cancer
Society recommends screening with a colonoscopy beginning at age
50, earlier for those individuals with a personal family
Barium enema – This is an X-ray examination of
the entire colon and rectum.
Virtual colonoscopy – This technique employs
3-D computed tomography (CT). Virtual colonoscopy may be used in
combination with more definitive diagnostic tests in selected
Treatment for colorectal cancer is based on the type, stage and size of
the tumor, the patient's prognosis, and the patient's ability to
tolerate certain medical procedures or medications. The goals of
treatment are to preserve normal function, minimize the need for a
colostomy and eliminate cancerous cells at the primary tumor site and
wherever they have spread throughout the body.
Colorectal cancer treatment options offered at Lankenau include:
Surgery – The board-certified colorectal
surgeons at Lankenau Medical Center use minimally invasive
procedures, such as laparoscopy, as well as conventional open
surgery. Laparoscopic procedures may minimize blood loss and
scarring and reduce recovery time. In both conventional and
minimally invasive surgery, the surgeons remove cancerous cells
and some of the nearby healthy tissue with adjacent lymph nodes.
Marks-Mohiuddin method – This method is a
rectal cancer management program of preoperative radiation and
sphincter preservation. It helped establish the current
worldwide standard and has allowed 93 percent of our patients to
avoid a colostomy bag, well below the national average.
Transanal endoscopic microsurgery (TEM) –
Lankenau surgeons were the first to perform local excision of
rectal cancer after preoperative radiation using TEM. Employed
by John Marks, MD, the TEM technique allows a transanal approach
to lesions that otherwise would require an abdominal or
transsacral approach for resection. Dr. Marks heads one of two
TEM training centers in the United States. Lankenau's Section of
Colorectal Surgery serves as a teaching center for surgeons
nationally and internationally and enjoys the status as the
headquarters of the International Network of Comprehensive
Rectal Cancer Centers.
Medical Oncology (Chemotherapy) – Chemotherapy
may be provided before or after surgery, used alone, or used in
combination with radiation therapy. Chemotherapy enhances the
effects of radiation, which together can reduce the size of
rectal cancer so that diverse surgical options can be explored.
Medical oncologists and oncology-certified nurses provide the
latest therapies in a supportive and caring environment.
Radiation – The Radiation Oncology Program at
Lankenau Medical Center is equipped with sophisticated
technology, including Intensity Modulated Radiation Therapy
(IMRT). Preoperative treatment for rectal cancer may result in
dramatic tumor shrinkage, increasing the cure rate and the
likelihood of preservation of normal function. The staff of the
Radiation Oncology Department offers each patient education,
care and encouragement in a supportive and understanding
Lankenau Medical Center has a long-standing tradition of medical
education and was one of the first hospitals in the country to offer a
minimally invasive colorectal surgical fellowship program. To continue
this tradition of teaching, Lankenau established the Gerald J. Marks,
MD, Annual Rectal Cancer Lectureship. The lecture is held in conjunction
with the International Rectal Cancer Consensus Conference. These two
collaborative educational events are held each year at Lankenau and
bring together experts from universities and medical centers around the
world. The conference is critical to defining standards of rectal cancer
The Harry Paul Mirabile, Sr. Colorectal Cancer Center at Lankenau was
established in June 2011. A “virtual center without walls,” the Mirabile
Colorectal Cancer Center’s mission is to provide a framework for basic
scientists and clinicians to exchange ideas for solving the most
demanding problems in the struggle to prevent, treat and subdue
colorectal cancer through clinical research. The center is under the
direction of Dr. John Marks.
Lankenau’s database of over 1,000 rectal cancer patients treated with
neoadjuvant therapy and sphincter preserving surgery is one of the
largest in the world of its kind and serves as the basis for much of the
research performed at Lankenau.
For more information, call 1.866.CALL.MLH.