A Conversation in Health
with Ralph Pearlman, MD
Surgeon, Providence
and Providence Park Hospitals
gjOHN
PROVIDENCE
HEALTH SYSTEM
A PASSION FOR HEALING
Ralph Pearlman, MD, is a board-certified colon and rectal
surgeon at Providence Hospital. A Metro Detroit native, he
was raised in Huntington Woods and attended Royal Oak
Schools. He is a graduate of the University of Michigan and
Wayne State University Medical School, and completed his
Fellowship in Colorectal Surgery at Henry Ford Hospital. Dr.
Pearlman has been recognized four consecutive years in Hour
Detroit Magazine as a "Top Doc," and he is currently Chair
of the Colorectal Department at Providence Hospitals. A
member of the Providence Hospital medical staff since 1987,
he received the Caduceus Society Physician of the Year Award
from his fellow physicians for his leadership, contributions and
clinical excellence.
Why should the public be concerned about colon cancer?
Colorectal cancer is the second leading cause of cancer deaths
among both men and women. The good news is that colon cancer is
preventable, by removing pre-cancerous growths called polyps. It is also
curable, if caught early.
What are the symptoms of colorectal cancer?
Colorectal cancer often has no symptoms at all. This is why it is
dangerous, and is the second most deadly cancer. Only with screening
colonoscopies, can it routinely be caught early. When symptoms are
present, they may include abdominal cramping, blood in the stool,
changes in the size and frequency of the stool. Some cancers present
with anemia and fatigue. Some with rectal pain and pressure.
Once a patient is diagnosed with colorectal cancer, then what?
It's a three step process:
First, the patient requires a thorough physical exam, cardiac clearance,
CT scanning. We learn everything about the stage of the cancer, and the
health of the patient before we operate. Getting through the surgery
without complications is our first focus.
Second, the surgery itself. Today, we treat 90% of our patients
with minimally invasive laparoscopic or robotic surgery. With these
techniques, the incision is smaller, heals faster, and the patient
experiences less pain and reduced chance of infection.
Providence has ranked in the top 5% for quality outcomes colorectal
surgeries for the past 8 years in a row.
Thirdly, proper peri-operative treatment with chemotherapy and
radiation treatments if indicated. Again, Providence's survival rates for
Colorectal Surgery and treatment are among the best in the nation.
One reason may be our multi-disciplinary approach. We work closely
with specialized teams of oncologists, pathologists, radiologists and
geneticists to determine the best treatment for each patient.
What contributes to your excellent outcomes?
Following the three steps carefully, with every patient. Tailoring each
operation to each patient, maximizing chances for cure, but altering
some approaches to minimize post-op complications. Patient education
is focus for us also. A new addition to our patient education program is
an after-surgery plan that identifies key concerns the patient is asked to
watch for, such as fever, dehydration or unexpected pain.
it sounds like educating your patients is very important.
Absolutely! We encourage the patient to participate in a step by step
plan to help them successfully recover. I have set up an "education wall,"
filled with over 30 educational leaflets created within our own office, to
help inform my patients.
Without appropriate physical and emotional support, cancer can be
lonely and painful. My staff understands not only the physiological
aspects of colorectal cancer but also the social/psychological issues, such
as isolation and embarrassment, financial strains, and for some..., end of
life issues. We don't run away from these problems.
How does the primary care physician fit into the care continuum?
Our primary care physicians and nurse navigators have important roles.
Pre and post op communication with the patient's primary care physician
so that he or she is "in the loop" facilitates the patient's care needs.
-
How prevalent is the disease within the Jewish community?
Colorectal cancer is prevalent in the Jewish community, especially
among Ashkenazi Jews - Jews of Eastern European background. They are
genetically predisposed to colon and rectal cancer, and carry three times
greater risk than average.
What can we do to prevent colorectal cancer?
We have decreased deaths from colorectal cancer by almost 50% over
the last 10 years because of screening colonoscopy and better treatment.
If everyone were to get screened, following American Cancer Society
guidelines, we could wipe out colorectal cancer.
Regular exercise, proper weight, and even daily aspirin have been
shown to decrease the risk of developing colorectal cancer.
Again, I can't stress enough the importance of screening — if you are 50
years of age, get screened.
Does it matter where you have Colorectal Screening or Surgery
performed?
Metro Detroit is fortunate to be the home of several outstanding
hospitals, and many outstanding physicians. Providence is one of those
hospitals. Our team of physicians have proven to be among the best in
the nation.
TO LEARN MORE ABOUT A ST. JOHN PROVIDENCE HEALTH SYSTEM PHYSICIAN OR ANY OF OUR SERVICES,
PLEASE CALL US AT 866-5O1-DOGS (3627).
March 29 • 2012
57