Endoscopic submucosal dissection – a new, highly complex technique with a 90% success rate in the removal of advanced colorectal polyps.
Colon cancer is the most common malignant tumor in the country, with more than 32,000 new cases diagnosed every year. However, in spite of the high incidence rate of this cancer, specialists insist on it being one of the most easily prevented and with better prognosis, largely thanks to screening for advanced polyps or cancer in the early stages, and to new endoscopic removal techniques, whose success rate is above 90%.
“To be more precise, endoscopic submucosal dissection is a new advanced technique that reduces the risk of relapse in large polyps to less than 5%, contrasting with relapse rates of 20%-30% for the classical techniques that remove polyps in fragments”, explains Dr. Alberto Herreros de Tejada, of MD Anderson Cancer Center Madrid Gastroenterology Service.
For that reason, experts recognize that a combination of screening programs allowing for early diagnosis, and the adoption of these more modern techniques may turn the treatment of advanced colon polyps around. “Once these large, flat lesions are detected in the early stages, previously unnoticed until symptoms appeared, and thanks to endoscopic submucosal dissection, surgery to remove part of the colon, the usual practice in traditional approaches, can be avoided”, states Dr. Herreros de Tejada. On removal of the entire tumor, the tissue can be more fully analyzed.
Due to the complexity of the technique, extensive training is required and so, only about ten centers in Spain, among which is MD Anderson Cancer Center Madrid, currently use the method as a standard treatment for their patients.
The technique is particularly indicated for large, flat polyps “which must be removed whole for two fundamental reasons: because there is a risk of there being localized, superficial cancer, or because sometimes it is difficult to remove polyps be means of the standard techniques in fragments”, the doctor pointed out.
Detection in the early stages - vital
In the light that a positive prognosis is possible with the treatments available, healthcare professionals insist on making people more aware of this type of tumor to encourage the detection of lesions early on and that it is important to undergo screening at the recommended age and to consult a specialist about any worrying symptoms: rectal bleeding, changes in bowel movements or persistent anemia.
Colon cancer affects men and women equally, and is more common over 50 years of age, where there is a history of colon cancer in the family, and in patients with inflammatory intestinal disease (ulcerous colitis, Crohn’s disease). In general, most cases begin with a small polyp – a non-cancerous mark on the wall of the intestine, that takes from 10 to 15 years to fully develop into an invasive cancer. Approximately half those over 50 years of age have polyps in the colon, most with no apparent symptoms. According to statistics, only 5% - 10% of polyps become malignant; the problem lies in not knowing which polyps will do so, and therefore, preventive removal is always recommended.
Although colon cancer does not generally produce symptoms in the early stages, as it grows larger and begins to invade the wall of the intestine, it may cause bleeding, affect bowel movements, cause anemia or, in extreme cases, block the bowel.