With national accreditation, highly trained cancer experts, access to clinical trials and six regional locations, patients with colorectal cancer can receive the same high level of care that’s available at national cancer centers – right here at Avera.
“At Avera, patients can get the cancer care they need without having to travel out of state for top quality care,” said Jesse Guardado, MD, surgeon and director of Avera's participation in the national accreditation program for rectal cancer at Avera Cancer Institute in Sioux Falls.
Depending on the type and stage of colorectal cancer, there are nationally recognized, evidence-based standard of care treatments that may include surgery, chemotherapy and/or radiation therapy. Patients may also qualify for clinical trials.
Nationwide, five-year survival rates for colorectal cancers that are localized or stage 1 are 90%, and Avera meets and often exceeds these outcomes. Yet there are more reasons that patients choose Avera.
“Avera is very good at oncology and cancer care because we have an excellent staff of physicians who trained at world-renowned programs. Patients appreciate the caring atmosphere at Avera. We can pray with patients if they request. We have an amazing support staff who make the experience of cancer care the best it can be from the time patients come in the front door, including our social workers, patient advocates, pharmacists, providers and infusion staff,” said Heidi McKean, MD, Avera Medical Group medical oncologist and Avera Gastrointestinal (GI) Oncology Medical Director.
Since Avera has six regional cancer centers, most patients can begin their cancer care at the site that’s closest to home.
Accredited Rectal Surgery Center
Avera Cancer Institute earned full, three-year accreditation as part of the National Accreditation Program for Rectal Cancer (NAPRC) from the American College of Surgeons; it's the first and only regional program to achieve it. Having a multidisciplinary team of gastroenterology, radiology, pathology, colorectal surgery, radiation and medical oncology colleagues was a big part of the effort; that team that meets weekly to discuss treatment plans.
“Lots of hard work and more than two years of effort went into earning this distinction. It’s not just a logo on a website,” McKean said. “The accreditation we earned shows every patient will receive the highest quality of care for their cancer.”
Since the abdomen is dense with important muscles and digestive organs, surgeries can affect how patients live. Surgeries that are lower in the intestinal tract are more challenging.
"The quality of surgical resection and rates of sphincter preservation are important to earning accreditation," Guardado said. "Fewer patients face life with permanent colostomies.”
Shrinking Tumor to Improve Colorectal Cancer Outcomes
One newer approach is now standard of care that’s often recommended as a patient’s treatment plan. It’s called total neoadjuvant treatment (TNT), and it means that chemotherapy and radiation occur before any surgery.
“Care for colorectal cancer has changed. Now, patients have chemotherapy and radiation treatment sooner. Most of it can occur closer to home. In the past, surgery in Sioux Falls was almost always part of a patient’s treatment,” Guardado said. “Now, some patients can avoid surgery and travel. Less travel means less stress.” Avera Cancer Institute’s six sites provide treatments like chemotherapy and radiation.
“After diagnosis, we try to use all possible methods to shrink the tumor. That’s TNT,” McKean said. Avera met nationally set guidelines in the shift to the TNT approach. “We’re seeing improved outcomes with this approach,” she added.
Surgery is then the next step, in most cases. With Guardado, Avera offers a fellowship-trained colorectal surgeon for these complex cases. Yet in 20-30% of cases, the tumor is eliminated or reduced enough so that surgery is not required. "We’ve seen complete clinical response in 30-60% of patients,” Guardado added.
“Not having to have surgery is a big deal,” McKean said. Care teams carefully monitor each patient after treatment.
“Our patients live in rural Iowa, Minnesota, Nebraska and South Dakota, yet benefit from our national accreditation,” Guardado said. About 90% of Avera patients can get total neoadjuvant treatment near their hometowns.
McKean said treating patients spread over a wide area is an Avera strength in part due to collaborative efforts. “Multidisciplinary teams include experts in all locations who collaborate on each case.” In addition to standard of care approaches like TNT, Avera offers leading-edge treatments through clinical trials.
Learn More
When to consider a clinical trial if you have colorectal cancer
What to expect with treatment for colorectal cancer
How Avera’s cancer care program helps patients
