Memorial Sloan Kettering has recognized that patients need a specialized diagnostic and treatment center to assess both cancerous and noncancerous problems (such as injuries associated with childbirth or surgery) of the anus and lower rectum. At the Anorectal Diagnostic Center, which was established in 1997, physicians can now perform a detailed assessment of normal and tumor anatomy using endorectal ultrasound. During this procedure, doctors insert a probe into the rectum that bounces sound waves off the rectal wall to produce an anatomic image of the area. Such data are vital for determining what kind of surgery and preoperative adjuvant treatment a patient might need.
In addition, doctors can conduct a computerized assessment of nerves to the anus and various aspects of rectal function, thus allowing an extensive analysis of a patient’s function before and after complex treatments. Such detailed assessments also allow physicians to more accurately advise patients on how dietary changes and medications can help control their bowel function.
Physicians at the Anorectal Diagnostic Center are also using the most advanced surgical procedures to restore function. For example, some patients with a weak sphincter are now being helped by a procedure that places an artificial sphincter around the anus. Anorectal Diagnostic Center doctors have led a national program assessing the efficacy of this procedure.
At Memorial Sloan Kettering, the rate of sphincter preservation — the ability to save the anal sphincter in rectal cancer patients — is very high. Surgeons are also investigating a procedure that would rebuild the entire anal sphincter in those patients with rectal cancer who now need a permanent colostomy.