Surgical oncologist vs colorectal surgeon?

[bboynation]

Hello everyone, I was browsing the web looking for something else and came across this form. I think this is an amazing way for people to share information, experiences, and support.

I did, however, want to correct a few inaccuracies that were conveyed in regards to surgical oncology. Fair disclosure, I am a general surgery chief resident at a large academic center with an interest in oncology. Currently debating between specializing in surgical oncology vs transplant.

Surgical Oncology is an ACGME certified fellowship much like colorectal surgery. The difference is that it is a dedicated 2 years of additional training vs the 1 year for colorectal. As you suggested, training is not limited by organ system, rather, it is focused on the disease process. What makes surgical oncology different and unique is the multidisciplinary approach they take to patient care. Oncology patients require not just a surgical oncologist, but medical oncology, radiation oncology, and pathology specialists to come together. Surgical oncology is one of the most competitive fellowships a surgeon can choose, second only to pediatric surgery. While surgicial oncologist are trained in the surgical treatment of a variety of malignancies (e.g breast, melanoma, liver, pancreas, colon... etc) most elect to tailor their practice to a few.

So while you can certainly have a colorectal surgeon perform your colon surgery and a transplant surgeon perform you liver surgery, a surgical oncologist can do both.

Hope that helps.

Cheers

[NHMike]

..... Studies are starting to show that seeding from poor surgical technique has a more than minimal effect on the recurrence rates.

Do you have an article or paper link? I'm curious about the numbers. It seems reasonable though. LAR is difficult surgery from what I've read and having someone with a ton of experience that can deal with the unexpected is preferable.

[rockhound]

With the prevalence of colorectal cancers, it is not difficult to find a colorectal surgeon that is also a surgical oncologist. It is generally easier to find such a surgeon at a major cancer center with a GI cancer specialty. Again, this shouldn't be difficult to find based on the number of cases of colorectal cancers, then combined with gastric and esophageal these GI cancer centers are well staffed and easy to find.

Also, I cannot stress enough going to a high volume center, if available. The surgeons there are practiced and have experience in case the surgery turns difficult. One of the keys to a clean resection and preventing peritoneal, abdominal or pelvic mets/recurrence is good technique on cancers still contained in the colon/rectum. Studies are starting to show that seeding from poor surgical technique has a more than minimal effect on the recurrence rates.

My surgeon is a surgical oncologist, but also a colorectal board-certified colorectal surgeon. He's at a high-volume NCI center and does a lot of surgeries, of course focused on colon-rectum. You want experience and expertise in my opinion, esp. given the data that others have cited which show better outcomes.