Saving lives at the ‘right place, right time’

February 28, 2019

Dr. Seneshen shares her passion for surgery and what you should know about colorectal cancer risk and treatment

In the nearly two decades that Dr. Sandra Seneshen has been with Clark Memorial Health as a general surgeon, she has performed many different types of surgeries, and it’s this variety that makes her love what she does. “It’s the mix that keeps it interesting,” she says. “I do wound care, breasts, hernias, colorectal care. I think when you’re doing just one thing all the time, you start to see the disease instead of the patient.

“There’s a bunch of people I’ve operated on multiple times for multiple things. It is a totally different feeling to look after this person you know as opposed to a disease state wrapped up in a person.”

It was clear in medical school that surgery wanted Dr. Seneshen even if she didn’t want it. “I walked into the OR in second year medicine, watched my first operation, and it was like falling in love,” she says. Over her many years in practice, that feeling hasn’t changed: “[Surgery is] elegant, all-involving, and sometimes you get to be in the right place at the right time and save someone’s life.”

In her years of practice, Dr. Seneshen has seen colon cancer screening, diagnosis, and treatment change. Where at one time, typically middle-aged and older patients were screened and diagnosed with colon cancer, she’s now seeing more people in their 20s and 30s have to undergo surgery and chemotherapy.

The staging of colon cancer is determined by many factors, one of which is how many layers of bowel wall the cancer goes through. “The staging of colon cancer has become more complex because we know more,” Dr. Seneshen says. “We genetically test the tumor now.”

Dr. Seneshen is an advocate for colonoscopy because members of her own family, including her mother, have been diagnosed with and treated for colon cancer. However, Dr. Seneshen notes that 20 percent of colorectal cancers happen in people with no family history of colon cancer.

Even if no one in the family has had colon cancer, having first- or second-degree relatives with other forms of glandular cancer such as breast, uterine, ovarian, stomach or pancreatic cancer put an individual at a higher risk for developing colon cancer. “The glandular cancers are all related,” Dr. Seneshen says. “We know they travel in packs. If you have a family history of any adenocarcinoma, you are at increased risk and need to be screened.”

Everyone diagnosed with colorectal cancer is also screened for Lynch syndrome, a hereditary condition that increases risk of certain cancers, so that their families can be screened as well. Dr. Seneshen says that in Southern Indiana, Lynch syndrome has an even stronger link to colon cancer than the BRCA gene has to breast cancer.

While a Stage IV diagnosis might have once been a death sentence, there have been advances in treating metastatic cancer. “For some patients with colorectal cancer, there’s curative therapy at Stage IV,” Dr. Seneshen says. “It’s important to find out your diagnosis because you can be pretty far along the road and not be hopeless.”

Whether you have a family history of colorectal cancer or not, preparing for a colonoscopy and the procedure itself are easier than they used to be, she adds. “That’s the key to a screening program. We’re falling short on that because people have this idea that colorectal cancer screening is so awful,” Dr. Seneshen says.

To schedule a colonoscopy call 800.424.DOCS.