Jose G. Guillem - Management of Hereditary Colorectal Cancer: A Multidisciplinary Approach

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During the past three decades, tremendous advances have been made in our understanding of hereditary colorectal cancer in terms of the genetic basis, the clinical presentation, and natural history of several distinct hereditary syndromes. During this time, advances in endoscopic and surgical techniques as well as chemopreventive approaches have also occurred that have allowed us to better manage these complex cases in a multidisciplinary manner. However, these numerous specialty-specific advances have often only been presented in specialty journals and therefore publications on how a multidisciplinary team integrates all these advancements are lacking.

This book, comprised of chapters written by leading experts, addresses this deficit by focusing on six distinct groups, namely: patients with early age-of-onset colorectal cancer and adenomas, patients with hamartomatous colorectal polyps, patients afflicted with familial adenomatous polyposis (FAP), attenuated familial adenomatous polyposis (AFAP), MYH associated polyposis (MAP), and Lynch syndrome (LS). Coauthors represent the disciplines that work together to manage these patients and families and include surgeons, gastroenterologists, geneticists, medical oncologists, genetic counselors, and epidemiologists.

Since the focus of this book is state-of-the-art clinical management, authors describe how they utilize current technologies in genetic testing, pathological review, and endoscopic, surgical, and chemotherapeutic/immunotherapeutic approaches to manage these patients. Details on causation and molecular basis are not a focus. Rather, details on timing of genetic testing, endoscopic screening and surveillance, prophylactic surgical options, and chemopreventive interventions when available are discussed in terse, but precise detail.

The overriding goal is to present an expert and timely protocol for clinical management of these complex entities. The target audience includes surgeons, gastroenterologists, genetic counselors, geneticists, medical oncologists, and any health-care provider involved with the management of patients and families afflicted with a hereditary form of colorectal cancer. We include early age-of-onset colorectal cancer because it is a common feature for all forms of known hereditary colorectal cancer syndromes and because of the recently noted worldwide rise in its incidence.