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Laparoscopic Surgery for Colon Cancer Halves Recovery Time

Early diagnosis and laparoscopic colon surgery put Carlos Genardini on a fast track to recovery.

Carlos Genardini believes in the value of a regular physical because the last one he had saved his life.

For more than 14 years, Genardini and his wife, Susie, who live in Boca Raton, Fla., made the trip to Mayo Clinic in Jacksonville for their annual checkup through the clinic's comprehensive Executive Health Program. Going through the many tests had always given them the peace of mind that comes with having a thorough assessment and getting a clean bill of health.

"There's the constant debate about if you would or wouldn't want to know if there's something wrong with you," says Genardini. "I'm on the side of wanting to know. Knowledge is power."

During their annual trip in September 2004, he got a little more knowledge than he bargained for following his screening colonoscopy. Otherwise healthy with no symptoms to complain about, Genardini, 58, thought he was home free. He had recently retired and had gotten into a structured exercise routine, consistently working out with a personal trainer and taking care of himself better than ever before. He had never felt better in his life.

"I had a rude awakening" coming to after the colonoscopy, he says. "Here I was thinking I was perfectly healthy, and I was told I had colon cancer."

Indeed, during the screening, doctors discovered and biopsied a half-inch tumor in his ileum, the tail end of the small intestine where it meets the colon. The small growth was tucked away in the folds of bowel, silently growing. It turned out to be a neuroendocrine tumor, a rare but slow growing malignancy. Doctors were unsure how long it had been there but recommended surgery to have it removed.

"It was not your standard, run-of-the-mill cancer," says Dr. Heidi Chua, the Mayo Clinic colon and rectal surgeon who performed Genardini's surgery. "This type of tumor produces enzymes that can affect normal body function. They also are difficult to find because they're small and there's no good screening test for them."

Eight weeks after the diagnosis, Genardini had a laparoscopic colectomy — a minimally invasive surgery to remove the growth.

During the three-hour operation, Chua created three, half-inch incisions, one for a small video camera and the other two for small surgical instruments. She made another incision to access the diseased part of the colon, removed the portion containing cancer, then reconnected the two healthy parts. The benefit of laparoscopic surgery over its traditional counterpart is that it's done with smaller incisions, which means less pain and recovery time for the patient, as well as fewer infections and adhesions (scar tissue). With standard surgery, an incision of 6 to 8 inches or longer is required.

Genardini and his wife, Susie, are looking forward to a future of travel.

"Laparoscopic surgery affords an earlier discharge from the hospital and quicker return to work for patients," says Chua. "It seems to cause fewer adhesions as well. Not only are the incisions smaller, but there's less manipulation in the intestine with laparoscopic surgery."

The use of laparoscopic surgery began in the 1980s for appendix and gallbladder removal and was successful enough for doctors to begin using it in 1990 for colon cancer. Four years later, however, surgeons stopped using it for that due to concerns that the procedure might not be effective in cancer patients. The position was reversed in 2004 following the results of a seven-year international study that followed 872 cancer patients. The findings showed that laparoscopic surgery is a safe and effective treatment for colon cancer patients.

Since this was his first surgery of any kind, Genardini says, he has nothing to compare this experience to. But his recovery was quick. He was out of the hospital in just a few days.

"The greatest feeling was walking outside," he says. "My goal was to get out of the hospital a day earlier than expected, and I did."

Genardini also credits being physically fit to his quick recovery. Good muscle tone helped him get moving again. Ultimately, he is thankful that his colonoscopy caught his cancer early.

"One of the best things you can do for yourself is to know what you're up against," he says.

Info:
Section of Colon and Rectal Surgery
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