Colorectal Cancer Program

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.

Jump to: Team | Diagnosis | Treatment | Research & Teaching

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How Does Lankenau Compare Nationally?

% of colorectal surgeries performed as laparoscopic, minimally invasive procedures:

• National average 20%  vs. Lankenau 90-95%

Sphincter preservation rate – preventing the need for a colostomy bag:

• National average 40-60% vs. Lankenau 93%

Local recurrence rate of cancer:

• National average 10-25% vs. Lankenau 2.3%

Survival rate:

• National average 68%; vs. Lankenau 88%

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Colorectal Cancer Team

• Bob Etemad, MD, Gastroenterology

• Gerald J. Marks, MD, Colorectal Surgery

• John H. Marks, MD, Chief, Section of Colorectal Surgery

• Joseph L. Frenkel, MD, Colorectal Surgery

• Robert B. Noone, Jr., MD, Colorectal Surgery

• Erik L. Zeger, MD, Medical Oncology

• Albert S. DeNittis, MD, Chief, Radiation Oncology

To schedule an appointment with a Lankenau cancer specialist, call 866.CALL.MLH or use the online appointment request form.

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Making an Accurate Diagnosis

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 stool.

• 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 history.

• 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 clinical situations.

To schedule an appointment with a Lankenau cancer specialist, call 866.CALL.MLH or use the online appointment request form.

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Finding the Right Treatment

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 environment.

To schedule an appointment with a Lankenau cancer specialist, call 866.CALL.MLH or use the online appointment request form.

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A Commitment to Research and Teaching

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 treatment.

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.

Find more information about clinical research trials.