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++++++++++++++++++++ CANCER CARE +++ +++ ++++++++++++++++++++ + + Cleveland Clinic's Multidisciplinary Approach to Cancer Care FEZA H. REMZI, M.D., IS CHAIR OF THE DEPARTMENT OF COLORECTAL SURGERY AT CLEVELAND CLINIC'S DIGESTIVE DISEASE INSTITUTE (DDI). DR. REMZI DISCUSSES CLEVELAND CLINIC'S MULTIDISCIPLINARY APPROACH TO COLORECTAL CANCER. By Keith Jameson together. How does this set apart DDI's colorectal cancer program from others? Q A: First, TCI is a key collaborator and allows us to provide one-stop care. Patients can schedule all their visits in one day, from the colorectal surgeon to an oncologist to a radiologist to a geneticist. This is a rare opportunity for patients, especially for patients who travel from other states or countries. Second, our multidisciplinary structure allows us to observe outcomes and share them quickly. We see more than 400 patients diagnosed with colorectal cancer annu- ally — one of the highest caseloads in the country. The sheer number of our patients and our databases create a unique and valuable depth of knowledge. Finally, it creates an atmosphere that encourages clinicians to work and col- laborate more closely together. Clinicians across the spectrum of colorectal cancer care are up to date on treatments. Q How do you see collabora- tion in everyday care for patients? A: It's not about us as surgeons; it's about the patients. We leave our egos at the door. Cancer specialists across Cleveland Clinic act as a unit regardless 10 | Central New York MD NEWS MDNEWS.COM Cleveland Clinic's Taussig Cancer Institute (TCI) and DDI work closely of the institute in which they work. If I'm operating on a colorectal cancer patient and I notice the tumor is invading a blood vessel, I can depend on vascular surgeons from our Miller Family Heart & Vascular Institute to assist. If a tumor is invading the bladder, I can consult with world-class urologic surgeons. Any questions about close margins are directed to exceptional radiation oncologists for intra-operative radiation therapy capabilities we have at Cleveland Clinic. We have the best doctors available to support us 24/7. We consider it our 'Code of Conduct' — to support each other whenever it's needed. discoveries from "bench to bed- side." How does this contribute to the quality of colorectal cancer care? Q A: Through our translational research programs, we can see how certain treat- ment options work — or don't work — for certain types of patients. For example, some rectal cancer patients might have genetic markers that identify them as candidates for chemo radiation therapy only treatment. So they achieve the same outcomes without the unnecessary risk of surgery or avoiding permanent colostomies or stomas. Combining laboratory-based, clinical and genetics research with daily patient care enables Cleveland Clinic has a strong translational research program, taking FEZA H. REMZI, MD us to provide treatment regimens that are more tailored to patient's specifi c needs. This is something we are working on in collaboration with TCI. Q What do you see for the future of colorectal cancer treatment? A: The No. 1 goal is to eliminate colorectal cancer, and I believe the collaboration between DDI and TCI someday will come close to eradicating it. Translational research, especially the use of genetics, will improve how successful we are in identifying patients who are more likely to develop colorectal cancer so we can provide effective preventive treatments. Unlocking the genetics of colorectal cancer might even lead to a pill that can impact or influence the cancer-causing genes before the disease starts. Innovations and technology will bring new and better ways to predict, diagnose and treat colorectal cancer, and Cleveland Clinic will be among the vanguard. I'm a surgeon, but I would love to give up surgery for the rest of my life if it means we can eradicate colorectal cancer. That's what we're working toward. To refer your patient to Cleveland Clinic, please call the Cancer Answer Line at 1-866-223-8100 or e-mail CancerAnswer@ ccf.org. Physicians may also download cancer treatment guides published by Cleveland Clinic for their patients at www.clevelandclinic.org/cancerguides. s