Diagnosis: Rectal cancer
Treatment: TEMS surgery
When 84-year-old Seattle resident Barbara Allan saw a bit of blood in her stool last summer, she called her Seattle gastroenterologist and scheduled a colonoscopy.
That was a smart decision, as it revealed a precancerous lesion on her rectum.
"My gastroenterologist told me it would have to come out because it could turn malignant," Barbara recalls.
The doctor thought Barbara might be a candidate for a minimally invasive procedure called transanal endoscopic microsurgery, or TEMS.
He referred her to EvergreenHealth Surgery Care's Dr. Harry Kahn – who was the only surgeon performing TEMS in the entire state of Washington.
Avoiding major abdominal surgery
"TEMS is a clean, precise technique that's used for patients who have a precancerous growth in the rectum or a very-early-stage rectal cancer," Dr. Kahn explains.
"Before transanal techniques, the standard procedure would have been a major abdominal surgery and a much more involved bowel resection. The benefit of TEMS is there's no major surgery, no large incision, no colostomy, less pain, faster recovery and a shorter hospital stay."
The TEMS procedure involves a microscope and a videoscope, and specialized microsurgical instruments, which allow Dr. Kahn to remove lesions in the rectum by operating through the anus.
"In the case of early-stage cancer, it is critical to get clear margins, which this equipment facilitates," he adds.
Though the TEMS technique has been around a while, Dr. Kahn says it's being used more now because of advances in the equipment that stages the tumors.
"We can now tell whether the growth is precancerous, early-stage cancer or late-stage cancer," he says. "That's critical, because TEMS is not appropriate for advanced cancers, especially if the lymph nodes might be involved."
In those cases, standard surgery is necessary to make sure all of the cancer is removed.
Barbara Allan met with Dr. Kahn and had an ultrasound conducted by a gastroenterology specialist to determine the staging of her tumor.
It turned out that she was an ideal candidate for TEMS.
Recovery with little or no pain
The lesion was located in the upper third of Barbara's rectum, and Dr. Kahn was able to remove it without any problem.
Barbara spent just one night in the hospital and didn't even need pain medication.
Dr. Kahn says that is common. "Most TEMS patients just need Tylenol," he says, "and they get back to work much more quickly."
Just a few weeks after her surgery, Barbara was back to her busy, active life – painting watercolors, taking long walks and enjoying a full calendar of social activities with family and friends.
Looking back, Barbara says the decision to leave the Seattle medical community for the pioneering procedure at EvergreenHealth was an easy one to make, because the benefits of TEMS are enormous.
"I'm very grateful that EvergreenHealth offers this procedure," she says, smiling. "It's such a great solution to a very difficult surgery, which could have caused all kinds of problems for a person my age and maybe left me not being able to really enjoy my life."
For more information about TEMS surgery
To learn more about TEMS surgery, please contact the EvergreenHealth Surgery Care at (425) 899-5500.