Pelvic Floor and Rectal Cancer

Dr. Buzas (Director of Colorectal Surgery) talks about the pelvic floor and rectal cancer.  Dr. Buzas explains what is pelvic cancer, colon and rectal cancer, its symptoms, and surgical procedures.
Pelvic Floor and Rectal Cancer
Featuring:
Christopher Buzas, DO
Christopher Buzas, DO, is the Director of Colorectal Surgery at UPMC in Central Pa. He received his medical degree from the Philadelphia College of Osteopathic Medicine and completed his general surgery residency at Geisinger Medical Center, followed by his fellowship in colon and rectal surgery at Lehigh Valley Hospital and Health Network. Dr. Buzas is board-certified by the American Board of Surgery and the American Board of Colon and Rectal Surgery. 

Learn more about Christopher Buzas, DO
Transcription:

Bill Klaproth (host): Too often we hear of people dying from colon or rectal cancer. Yet we have the gold standard in screening. It's called the colonoscopy. And we all should be getting our colonoscopies at the required age colonoscopy, quite frankly, can catch these cancers early. It's so important. But let's learn more about what you need to know when it comes to pelvic floor, colon and rectal cancer. So let's talk with Dr. Christopher. Buzas a colon and rectal surgeon at UPMC. This is Healthier You a podcast from UPMC, I'm Bill Klaproth. Dr. Buzas, thank you so much for your time. I really appreciate it. So let's talk about colon and rectal cancer first off. Why should people choose UPMC for their colon and rectal cancer treatment?

Dr. Christopher Buzas: Well, I just wanted to start by saying thank you very much, bill, for having me on the podcast. And, UPMC in the Central Pennsylvania region we have comprehensive care here in the Harrisburg and York markets. We, not only do the surgeries, but we also can take care of the chemotherapy as well as the radiation oncology type of issues that might be involved with your cancer.

Specifically rectal cancer, you need a multidisciplinary approach. To treat it and have the best chance for a good outcome. And that involves multiple specialties. And here at UPMC in Central Pennsylvania, we have a meeting every week where we talk about patients with rectal cancer. And we come up with a comprehensive plan for their treatment.

Bill Klaproth (host): Yeah, that team approach to colon and rectal cancer care is so important. And then all of your specialists helping to develop a personalized treatment plan. So we've heard of colon and rectal cancer, but one maybe we haven't heard as much about is pelvic cancer. Can you explain to us what is pelvic cancer?

Dr. Christopher Buzas: Well within the pelvis, there's more than just the bowel. And in women, you have the uterus and the ovaries, and men you have the prostate, and in everyone that you have the bladder and the urethra and the ureters. And unfortunately you can develop cancer in every every part of your body. And each. Body parts. The cancer is treated a little bit differently. And so here at UPMC in Central Pennsylvania, we have a comprehensive care team, not only for colon and rectal cancer, but for all types of cancer within the pelvis, because they're all treated a little bit differently.

Bill Klaproth (host): Got it. Okay. And then specifically, what is colon and rectal cancer?

Dr. Christopher Buzas: Well, the colon is the large intestine. It's about four to six feet long. And a meanders throughout the entire abdomen. The last foot of the colon is called the rectum. It's kind of the storage vault for stool. It allows you to be able to drive in your car. Even if you have the sensation to go to the bathroom without having to go. And in the pelvis specifically, there is a contained area. There's Bodhi prominences around the entire pelvis and it's kind of a tight spot with a lot of stuff with it. And it's treated rectal cancer specifically is treated a little bit differently just because of the fact that there's a lot of adjacent organs around the pelvis, near the rectum.

So colon cancer is pretty straight forward in treatment. It's usually treated with cancer upfront and then sometimes chemotherapy afterwards, depending on the stage of the cancer. But when we are talking about the rectum specifically though that last eight to 12 inches of bow. It can be treated much differently depending on what stage the cancer is. And the other great thing about UPMCs in Central Pennsylvania is that we have a great radiology department, which assists us in being able to diagnose the stage of the cancer. so that we can treat it appropriately.

Bill Klaproth (host): Well, that is very helpful. Like I said, we've often heard of colon and rectal cancer. But the way you describe it, I fully understand it. Now, rectal cancer is that last eight to 12 inches of the bowel. So that totally makes sense. So thank you for explaining that to us. And are there symptoms of colon and rectal cancer?

Dr. Christopher Buzas: There certainly is, the symptoms are rectal bleeding. Abdominal pain, change in bowel habits, meaning you're either not going as much as you used to go or you're going more than you used to go, or sometimes the shape of the stool can change depending on where the cancer would be. But the main thing that needs to be told is that once you have symptoms for colon and rectal cancer, you're pretty far along in the cancer diagnosis. So it's usually a higher stage cancer if you have symptoms. So it's best to diagnose the cancer. or even prevent the cancer before you have symptoms, because once you have symptoms, it's usually pretty aggressive and pretty extensive.

Bill Klaproth (host): So once you have symptoms, generally, the cancer is pretty advanced at that point then? So then let's talk about screening and diagnostic tests for colon and rectal cancer. What are those?

Dr. Christopher Buzas: Well, the gold standard is the colonoscopy. So colonoscopy is a camera that's attached to a long scope. And you do a bowel prep the night before to clean the stool out of your colon. And then we can put the camera into your call and then we can evaluate the entire colon. What we're looking for are polyps. Polyps are abnormal growth on the wall of the colon. these polyps, some of them have the ability over time to change into cancer. And so if we can find the polyps before they turn into cancer, that we can take them out using the colonoscope and prevent cancer.

If we do, if we're able to identify the cancer, then we have special techniques. That way we can actually mark the cancer so that when we go and do the operation, we can identify exactly where the cancer is. So that we make sure we take out the appropriate amount of colon.

Bill Klaproth (host): Yeah. Like how do you call it? The gold standard you're really is wonderful tool, a screening to find cancer early. It really, really is a game changer if you find something early, is that right?

Dr. Christopher Buzas: Very much so. So the great thing about a colonoscopy is you just don't, it's not just a diagnostic tool. It can be a therapeutic tool. And what that means is not only can we find if there's something wrong, but sometimes we can take care of it at the same time. And many times avoid surgery completely. And there are other tasks that we can use, to try to screen for colon cancer. And those are Cologuard or fit tests. And, those are tests where you have to take a sample of your stool.

And you send it out in the mail and their company can evaluate your stool and see if you are, either have a special proteins in the stool that are predestined for cancer, or if there's blood in the stool. Then that can also be a risk factor for cancer. But if those tests are positive, then you need a colonoscopy anyways. So might as well just get it Right up front and avoid all the extra work.

Bill Klaproth (host): That's exactly right. And the colonoscopy is not a big deal where people think that it's a big deal. It's not. And I hear people talk about the prep. It's not a big deal. Get the colonoscopy. It is the gold standard for sure. So if someone does need a surgery, can you explain to us some of the surgical procedures for colon and rectal cancer?

Dr. Christopher Buzas: Sure. These days we mostly use minimally invasive techniques. to take out the colorectal cancer. This is either using a laparoscope, which is a camera that we can put into the abdomen and then inflate the abdomen with some air. And then we can put some instruments in through some small ports. And we can do all the work on the inside without making a large incision. And then sometimes we have to make a small incision to take out the part of the colon that has cancer in it.

But then we're able to put the bowel back together. We also have a special robot that can assist us in doing the procedure as well. The robot doesn't mean that there's some computer that's running, what we're doing. It's just a tool to aid in being able to make more precise cuts and, more precise movements within the operating room. And it also has a extremely nice camera. That allows us to visualize everything that we need to see better than if we had to make a large incision.

But some people do need the large operation with a big incision. And the good thing about UPFC here is that we're able to do all three modalities. We do laparoscopic surgery, robotic surgery, as well as, open surgery. So whatever is the most appropriate for you and your care we can offer all these different techniques.

Bill Klaproth (host): Yeah, amazing that technology to treat colon and rectal cancer. So let's talk about, risks. So who is at risk for colon and rectal cancer? And what is the age now we should begin screening?

Dr. Christopher Buzas: Well, everyone is at risk for colon and rectal cancer. So one out of 20 people in the United States will develop colon cancer throughout their life. 80% of those people have no. genetic predisposition to getting cancer. 20% do have family history of cancer and they have to be evaluated. With a colonoscopy sooner than the general population. But we should be starting to screen people at the age of 45. That's changed recently.

We usually said that we would start doing colonoscopies at the age of 50. But we realized that over time, that we're starting to see younger people that have a colon and rectal cancer. And so we moved the age where we start doing screens. From 50 to 45 because of that.

Bill Klaproth (host): Yeah. I mean, that makes sense. And when you say everyone is at risk for colon cancer and one out of 20 people will develop it, that really puts it into perspective. And other risks, I would imagine, poor diet smoking, heavy alcohol use. I mean, those kinds of things are not good either.

Dr. Christopher Buzas: I mean the best thing you can do is do everything in moderation.

Bill Klaproth (host): Right. Yeah, let's talk about that. Yeah. Are there prevention? What can we do to help prevent this?

Dr. Christopher Buzas: If we can stay away from processed foods and red meat. that would be a one good thing that you can do. Obviously smoking is bad for many things, but also people that smoke are at higher risk for developing colon and rectal cancer. Alcohol use does have, some, association with colon and rectal cancer as well. And people that have more sedentary lifestyle. So people that don't exercise much and things like that are also not only are they more likely to get cancer, but their complication rate with treatments is also higher.

So make sure you stay active and eat healthy and don't smoke. And can minimize the chances of developing a colorectal cancer, but you can't completely put them at zero. So you still need to get that colonoscopy.

Bill Klaproth (host): Yeah. Absolutely true, great points. And as we wrap up, Dr. Buzas, thank you so much for your time. anything else you want to add about pelvic floor and rectal and colon cancer?

Dr. Christopher Buzas: I just wanted to make sure everyone knows that it's very important to get your colonoscopy. As you said, Bill, it is not a big deal. You lose a little bit of sleep the night before, because you have to do the preparation. But the procedure itself is you're sleeping. So you don't even know that anything's going on. And the concern that you can injure the colon during the colonoscopy is also there. But using more advanced techniques and a better technology. The chances of having a complication after a colonoscopy. Is extremely low. So get out there, make sure you get your colonoscopy.

Bill Klaproth (host): Yeah, that is so true. And when the Doc comes in and says, Hey, you're good. We'll see it in 10. That's a great feeling. You're like, thank you. All right. I am ready to go. Thank you.

Dr. Christopher Buzas: That's right. It's not only great for the patients, but it's also great for the doctors when we're able to go and tell folks that they are they're good for 10 years.

Bill Klaproth (host): It's just a good feeling to know that, Hey, everything is okay down there. Good. And then do the things like you mentioned everything in moderation, don't smoke, eat a good diet, exercise. Don't be sedentary, moderation, and alcohol, all those things count for sure. Dr. Buzas, thank you so much for your time. This has really been important and informative. Thank you again.

Dr. Christopher Buzas: Well, thanks for having me, Bill. This has been great.

Bill Klaproth (host): And once again, that's Dr. Christopher Buzas. And for more information, please visit UPMC.com/centralPAcoloncare. Once again, UPMC.com/centralPAcoloncare. Go there to learn more. And if you found this podcast helpful, please share it on your social channels. And check out the full podcast library for topics of interest to you. This is Healthier You, a podcast from UPMC. I'm Bill Klaproth. Thanks for listening.