Leading the Charge: BIDMC's Rectal Cancer Clinic
Although gastrointestinal disease may not be the subject of polite dinner conversation, colorectal surgeon
Dr. Deborah Nagle has no trouble getting her patients to open up about these kinds of problems, which can be some of the most debilitating in medicine.
"The reason why is that we're comfortable with it ourselves," says Nagle of fellow experts in her field. "We know what the issues are, and we know what to ask. With a little experience under your belt, you can communicate to patients that you're comfortable and confident, and they respond."
The response to Nagle's appointment as chief of colorectal surgery at Beth Israel Deaconess Medical Center has been overwhelmingly positive, perhaps because her experience is so wide-ranging. With a focus on gastrointestinal cancers, she complements her technical proficiency in the operating room with a passion for research and an appreciation for creative approaches to patient management. The unusual opportunity to infuse all these interests into an academic surgical division from virtually the ground up is what sold her on BIDMC.
"It's a really stimulating environment," says the Philadelphia native. "You meet people from every possible subspecialty and research area you can think of, and they are all committed to interacting and connecting and making progress."
And it's progress in this area that is foremost on Nagle's mind. With noticeable enthusiasm and a predilection for speed, she has quickly made it her mission to capitalize on the medical center's assets to make its treatment of colon and rectal cancer state of the art. As an expert in laparoscopic colectomy, the medical center's strategic focus on minimally invasive surgery had particular appeal.
Laparoscopic colectomy is a less invasive approach to removing part of the large intestine for the treatment of conditions like diverticulitis, colitis, hernias, and increasingly colon cancer. While it offers multiple benefits to patients, including quicker recovery times and shorter hospital stays, the procedure is one of the most technically challenging in the field of surgery. Because the colon is not a fixed target, it's rather like picking up spaghetti with chopsticks-successful only with lots of practice and even then you don't always know what to expect.
"The level of complexity becomes revealed to you as you go further along and do more and more cases," says Nagle. "You have to think constantly about how you're doing it."
Still that's what she finds so gratifying. "It's fun to do things that not everyone else can do," she says with a knowing smile. "Frustrating sometimes, but fun."
Even more rewarding for Nagle is the effect she can have on her patients' lives. "The reason I love what I do is that I cure people," she says, noting that there are more happy endings with gastrointestinal cancer than many other forms of the disease. "When people come back and say, 'Thank you, you saved my life,' that's the greatest feeling in the world. So I'm really interested in all the other things that I do, but that's the driver."
This credo was the momentum behind Nagle's creation of a new clinic at BIDMC for the management of tumors and growths of the rectum, including advanced rectal cancer. She notes that rectal cancer is an area where the medical center's hallmark multidisciplinary approach can significantly improve patient outcomes and maintain their quality of life.
"Patients who had literally a 25 to 30 percent chance of surviving 15 years ago now have a 75 percent chance with what we can do," she asserts. Just as she wants to save the lives of those with late-stage disease, Nagle also has her sights on catching cancer earlier, or even preventing it altogether, with a new focus on the fledgling field of hereditary colon cancer. With the genetics of inherited colon cancer syndromes still nascent, she believes BIDMC's expertise in cancer risk and translational research will offer unique opportunities to shape the field from the ground up.
This wannabe landscape architect likes to get her hands dirty and watch things grow, and although she doesn't get to enjoy the great outdoors as much as she might like, Nagle is proud of the job she's done transforming the terrain of her new division. The Rectal Cancer Clinic just celebrated its two-year anniversary, and patient volume has doubled in the last year alone.
"There's been a lot of positive feedback," she says, "and I'm hopeful-and actually believe-that the growth we've seen so far is just a small part of the growth we can expect over time."
While she'd love a minimally invasive operating room dedicated for colorectal surgery and ponders what she could do with more staff, Nagle doesn't sweat the small stuff. "Let's face it, you can't let life's hassles get in the way of your overriding plan and vision," she says. "Then you'd just give up all the time." Instead, she'd rather just give it her all.
Above content provided by Beth Israel Deaconess Medical Center.
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Posted March 2009