Surgical oncologist who specializes in colon and rectal cancers touts the multidisciplinary approach patients receive at Roswell Park
By Chris Motola
Q: I understand you bring a multidisciplinary approach to cancer care at Roswell Park Comprehensive Cancer Center. Can you elaborate on that?
A: I’m a fellowship-trained, board-certified colorectal surgeon. My specialty really deals with complex rectal cancers, along with inflammatory bowel disease-related malignancies, such as Crohn’s disease and ulcerative colitis, along with hereditary polyposis syndromes. Roswell Park is mostly surgical oncologists who are trained to deal with some of these problems, but both of our skill sets together really get to provide a multidisciplinary approach for these complex patients to make sure they get the best care. We really pride ourselves here on the multidisciplinary approach. All of our patients get presented at our MDC.
Q: What’s an MDC?
A: That’s our multidisciplinary conference where we have myself, colorectal surgeons, surgical oncologists, medical oncologists, pathologists and radiation oncologists specialized in dealing with complex pathologies. That allows us to provide very individualized, customized care plans for each patient. And that’s something we really pride ourselves on. Another aspect that we bring here is that, as a colorectal surgeon, I’m very fluent and experienced in robotic surgeries and minimally invasive surgeries in general, so we can make sure that patients receive that and help expedite their care. They have a shorter length of stay, they recover faster, have less pain. It’s really phenomenal.
Q: What relationship do inflammatory diseases like Crohn’s and ulcerative colitis have to colorectal cancer?
A: Patients with inflammatory bowel disease such as Crohn’s and ulcerative colitis have an elevated risk of developing colorectal cancers. They present a lot of times in an unusual fashion. These patients have chronic colitis and chronic abdominal pain and GI symptoms in general. So we really need a multidisciplinary approach to these patients. A lot of them are on different medications to control their ulcerative colitis or Crohn’s disease, but we haven’t found the magic bullet just yet. So a lot of these patients require surgeries at times. And these surgeries can become even more complex when there are associated malignancies. And that’s some of the expertise and specialization that I bring here.
Q: What kind of contact do you have with patients through this process?
A: We have a very robust and organized model for the patient. We have a motto: “Spend Just One Day With Us and See the Difference.” We really try to coordinate the patients plan in a way that we can have it done in one day. So a lot of times they will meet the oncologist, the radiation oncologist, the gastroenterologist, the surgeon, social work, physical therapists, dietitians, whatever needs they may have, we try to get it done the same day. That includes imaging, MRIs, CAT scans. We really try to make it convenient for the patient to come in, get everything done so that they can have a true comprehensive plan at the end of the day. And we really pride ourselves on that. That’s a major difference between being a center versus being a community practice.
Q: Does that include screening?
A: Screening is a different part. Screening usually requires a colonoscopy, which is the standard screening for colorectal cancers. But we do set that up here, whether that be locally or in injunction with their community GI doctor, whatever’s more convenient for the patient.
Q: How replicable do you think Roswell Park’s model is in other institutions?
A: It’s difficult to answer that. I can tell you that we’re able to do it here because we’re all located in one center and frequently communicate with each other. In the community, certain physicians when they work with other oncologists, have to bounce the patient back and forth from office to office. And that can sometimes delay care and create confusing circumstances. Here we kind of have everything at one site where we can really focus in on taking care of the patient. So it’s probably difficult to replicate unless you have everyone in the same center.
Q: What kind of effect does this approach have on outcomes?
A: Our outcomes here at Roswell are among the best in the country. We are a national cancer institute, a recognized center by the Commission on Cancer. Next step will be getting our accreditation to be a national credited program for rectal cancer. These are all things made possible by our multidisciplinary approaches.
Q: Correct me if I’m wrong, but it seems like colorectal cancer surgery has very good results compared to a lot of other kinds of cancer surgery. Why is that?
A: The screening process has increased significantly over the last 15, 20 years. So we’re finding a lot of cancers earlier on. For that reason, a lot more of them are able to be cured. Colorectal cancers are one of the types of cancers that are curable with surgery, which is one of the reasons we have such a robust team dedicated to that goal. Secondarily, the age requirement for screenings in the community has decreased. Historically, screenings were at 50 years of age. We’re finding over the last 15 to 20 years that there’s an increased trend of colorectal cancers in younger adults, from ages 35 to 45. For that reason, the American Cancer Institute reduced the screening age down to 45. So we’re seeing the secondary effects of all that.
Q: You’re originally from Buffalo, right?
A: Yeah, I’m from the Buffalo area. I went away for training in general surgery in New York City and then went on to do my fellowship in Tampa. After that I worked for a few years for the University of Florida until an opportunity came up to come back to my community. And what better place to work than Roswell? So everything kind of worked out.
Q: Was the plan always to return to Buffalo?
A: I still have a lot of family here. So there’s a lot of benefit to raising my family here. I get to see my family and friends still, so that’s definitely a positive.
Name: Anthony Dakwar, M.D.
Position: Surgical oncologist at Roswell Park Cancer Center
Education: Medical degree: Techinion — Israel Institute of Technology, Haifa, Israel (2008-2012); residency: general surgery, NewYork-Presbyterian Hospital, New York (2012-2018); fellowship: colon and rectal surgery, University of South Florida Morsani College of Medicine, Tampa
Affiliations: Roswell Park Cancer Center (2018-2019)
Organizations: American College of Surgeons; American Society of Colorectal Surgery; Society of Surgical Oncology
Family: Married, three sons
Hobbies: Travel, cooking, music