With three fellowship-trained colorectal surgeons now serving patients across UTMB Health campuses, opportunities to receive this valuable care are more abundant than ever. These surgeons are part of a multidisciplinary team of specialists within UTMB, working collaboratively to review complex cases and provide the best treatment options for each patient.
They provide surgical solutions for a variety of disorders – from colon, rectal and anal cancers to conditions that are benign, but still have a significant impact on the patient’s quality of life. These include hemorrhoids; anal fissures; fistulas; fecal incontinence; rectal and pelvic organ prolapse; and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis.
“With all of our patients, if they have complex problems, we present them in a multidisciplinary fashion,” says Anthony D’Andrea, MD, MPH, Assistant Professor in UTMB’s Section of Colon and Rectal Surgery, Department of Surgery. “So I’m not working alone. I actually work quite closely with the other specialties as well as my partners.”
Dr. D’Andrea recently joined UTMB’s existing team of Uma Phatak, MD, MS, and Pamela Daher Tobia, MD, to expand UTMB’s colon and rectal surgery services. He is a Houston native and was first exposed to the specialty prior to medical school, working as a clinical research associate alongside colorectal surgeons.
He observed the surgeons helping patients who felt a great deal of embarrassment or shame around their conditions, developing trust, treating their conditions and ultimately improving their quality of life.
“They had a very unique way to connect with their patients and to gain their trust and to get them through these really difficult situations,” he recalls. “And what was also great was that there was this continuity of care. Colorectal problems are often chronic problems. These were surgeons who had strong relationships with their patients over a long period of time.”
Dr. D’Andrea maintained his interest in colorectal surgery through medical school at the University of Miami, where he also earned a Master of Public Health. He completed his surgery residency at the Mount Sinai Hospital in New York City and colorectal surgery fellowship at the Cleveland Clinic Florida. He is well versed in the full spectrum of colon and rectal surgeries, including open, laparoscopic, robotic and transanal procedures. He also has experience with reoperative surgeries.
March is Colorectal Cancer Awareness Month, an occasion to emphasize the importance of screening, what screening options are available, and the right time for each person to be screened. Dr. D’Andrea says there are guidelines everyone should know, but there’s not a one-size-fits-all approach.
“It’s becoming more and more well known that the new screening age is 45 – and that’s changed from age 50,” says Dr. D’Andrea. “The reason is, we’re actually identifying patients with colon and rectal cancer much younger than 50.”
Many are even younger than 45, he says, stressing that the recommendation to start at 45 applies to those with an average cancer risk and no symptoms. Anyone younger who is experiencing symptoms, like changes in bowel habits or rectal bleeding, should be referred to a gastroenterologist or colorectal surgeon and be scheduled for a colonoscopy right away.
While rectal bleeding can be a sign of benign issues, like hemorrhoids, it is also the most common symptom of colorectal cancer; this possibility means it is critical to be screened.
“A young patient will go a year with bleeding without having had a colonoscopy. By the time they finally get a colonoscopy, it’s often times stage three or four cancer,” Dr. D’Andrea says.
Additionally, if a patient has a close family member (parent or sibling) who was diagnosed with any type of cancer, they should consider that person’s age at the time of diagnosis and consider screening 10 years before they reach that age.
Dr. D’Andrea says colonoscopy is the gold standard for screening but acknowledges there are factors that make it challenging for a patient to have one, like time off work and travel home after the procedure. Each patient should talk to their physician about their concerns, risk factors, and alternatives, which also include the at-home test, Cologuard®, and fecal immunochemical testing (FIT).
Fortunately, just as there are options for screening, there are also more options for treatment than ever before. These include surgical procedures that may be performed laparoscopically or robotically, sometimes with adjuvant chemotherapy, or treatment with chemotherapy and radiation alone without surgery and with close surveillance afterward. The right pathway for each patient depends on a number of factors, so open communication between the patient and physician is critical.
“With all these cases or patients, we discuss them in a multidisciplinary fashion. There’s not one cancer case that goes without this discussion… because what we like to do is provide patients with options and give them the best chance of a successful treatment,” he says.
Dr. D’Andrea sees patients in clinic in Clear Lake, League City, and Galveston. He says the capabilities at the Clear Lake Campus are growing, with surgeons able to perform most colorectal surgeries laparoscopically there. For more complex surgeries, he operates in Galveston, where there is 24/7 support from all specialties.
View Dr. D’Andrea’s Patient Care Profile here
View Dr. D’Andrea’s Research Profile here