Colon Cancer

Colorectal cancer is the second leading cause of cancer death for both men and women in the United States. Approximately 150,000 new cases are diagnosed each year in the United States and there are ∼50,000 deaths due to the disease. The disease has, for years, lived in obscurity. Only recently, primarily as the result of publicity generated by diagnosis in several celebrities, has the general public taken notice of this major cancer killer, with each March marked as Colon Cancer Awareness Month. This issue of Clinics in Colon and Rectal Surgery focuses on some of the issues surrounding the diagnosis and surgical and medical management of colon cancer.

The issue starts with an overview of the epidemiology and risk factors for colorectal cancer from Clifford Ko and his colleagues. Next, James Church, from the Cleveland Clinic, presents data and his thoughts on the very important issue of screening and how to manage the often troublesome malignant polyp. Neil Ellis provides an overview of the major inherited colorectal cancer syndromes, and Matthew Lynch and Marc Brand from Rush University outline the basic concepts of the pre- and intraoperative management of colon cancer. The contentious issues surrounding laparoscopic colon cancer surgery are then addressed by Ricardo Bonnor and myself.

The following four articles deal with some of the more challenging surgical issues in colon cancer surgery. Management of locally advanced or locally recurrent disease is reviewed by Ron Landmann and Martin Weiser from Memorial Sloan-Kettering Cancer Center, and management of carcinomatosis from colon cancer and mucinous tumor of the appendix are addressed by Paul Sugarbaker from the Washington Cancer Institute. Bryan Clary, Chief of Hepatobiliary Surgery at Duke University Medical Center, and Ketan Sheth then share with us the latest thinking on management of hepatic metastasis.

Mike Morse, also from Duke, then brings us up to date on the changes in adjuvant treatment of colon cancer. Finally, Don Buie, who was one of the authors of the recently published American Society of Colon and Rectal Surgeons Practice Parameters for Surveillance and Follow-Up of Patients with Colon and Rectal Cancer, and Jo-Anne Attard provide an excellent summary on this important topic.

I am grateful to Dr. Beck for the invitation to guest edit and to the authors and coauthors for sharing their time and talent. I hope that this issue will be a useful resource for those who care for patients with colon cancer. As colorectal surgeons, if we are to make an impact on colon cancer, our goals should be to educate the public and our colleagues about this disease, strongly emphasize the need for screening, and provide the best, and most advanced, operative care. In addition, we should work toward rational follow-up programs so that metastatic disease can be identified and optimally treated, both surgically and medically.