Colorectal Cancer Coordinated Program Essential to Best Treat Colorectal Cancer Advanced medical and surgical treatments coupled with a coordinated program that integrates the expertise of a multidisciplinary team of specialists is critical to ensuring that patients with colorectal cancer receive the best possible care. has spread to the liver, the program works in tandem with surgeons who are part of one of the world’s leading liver-surgery centers — often enabling the liver- and colon-cancer surgeries to be performed as one procedure. “Too often, patients with these cancers have to find their own surgeon, medical oncologist and radiation oncologist,” says Kevork Kazanjian, MD, chief of Colon and Rectal Surgery at UCLA. “The specialists don’t necessarily know one another and may not communicate with each other or coordinate patient care as well as they should; as a result, the treatment by each specialist is delivered in a vacuum. Patients benefit from an environment in which everyone involved in their care collaborate.” Patients with metastatic disease benefit from newer biologic agents. These include anti- angiogenesis therapy, which starves tumors of the blood flow they need to thrive, and epidermal growth factor receptor (EGFR) inhibitors, which block the EGFR protein believed to contribute to the growth of colorectal cancer. Often these chemotherapeutic treatments are administered in combination with surgery to maximize outcomes, Dr. Kazanjian says. Access to clinical trials also is available to qualified patients. UCLA researchers have conducted clinical trials on experimental drug regimens and new diagnostic techniques that have helped clinicians and scientists establish new treatments for patients with the disease. The program also includes genetic-counseling resources available for patients who may have inherited syndromes or patients diagnosed younger than age 50, as well as relatives of these patients who are concerned about their risk. At the UCLA Colorectal Cancer Treatment Program, the multidisciplinary team includes medical oncologists, gastroenterologists, colorectal surgeons, geneticists, radiation oncologists and pathologists. The team meets weekly to develop and monitor each patient’s plan of care, and provides patients and their referring physicians with written and oral summaries of its recommendations, some of which may be implemented closer to the patient’s home by their local physicians. “Our program brings together a comprehensive team of leading specialists in the field to develop a personalized treatment plan for patients in a simple and efficient manner,” Dr. Kazanjian says. “We work to make it easy for patients to see us, and we do the organizing and communicating among specialists so patients don’t have to worry about that aspect of their care.” The UCLA Colorectal Cancer Treatment Program offers the full gamut of surgical, chemotherapeutic and radiation treatments. On the surgical side, the emphasis is on minimally invasive operations, including laparoscopic and robotic surgery, for appropriate patients. In addition, the program offers trans-anal endoscopic surgery and combined endoscopic laparoscopic surgery, turning what in the past was a major surgery for patients with large colon and rectal polyps into a minimally invasive outpatient procedure. For patients whose cancer The multidisciplinary team of the UCLA Colorectal Cancer Treatment Program includes medical oncologists, gastroenterologists, colorectal surgeons, geneticists, radiation oncologists and pathologists. The program has begun an innovative technology- based initiative, Patient Remote Interactive Medical Enterprise (PRIME), designed to reduce hospital readmissions and improve patient satisfaction after surgery. Patients are given a tablet device during their hospitalization, which they will take home so that they can be monitored remotely through questionnaires and photographic documentation during their recovery. “In looking at the national literature, we found that many readmissions were due to problems that, had they been brought to the team’s attention sooner, could have been easily addressed in the office,” says Anne Lin, MD, co- director of the UCLA Colorectal Cancer Treatment Program. “This gives patients more of a sense of control over their recovery, and it helps to avert any issues that may come up while they’re at home, before they become bigger problems.” For more information about colorectal surgery at UCLA, go to: colorectalsurgery.ucla.edu 3 UCLA Physicians Update