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
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
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
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
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
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.