Importance of Colon Cancer Screening

Neurosurgeons at Wellstar MCG Health Medical Center achieved a new surgical approach to treat an aneurysm behind the eye. It’s called endoscopic endonasal clipping of a superior ophthalmic aneurysm. The procedure for an aneurysm in this location is believed to be the first of its kind performed through the nose. This innovative technique offers a promising alternative for patients with complex aneurysms, particularly younger individuals.

Dr. M. Salman Ali, director of Skull Base, Pituitary and Surgical Neuro-oncology and assistant professor of Neurosurgery at Augusta University, led the team in this pioneering procedure performed at Wellstar MCG Health. An aneurysm, as Dr. Ali explains, is a “weak spot in a blood vessel in the brain,” prone to rupture, which can be life-threatening. Located near the eye, the superior ophthalmic aneurysm is a rare and challenging condition.





Image provided by Augusta University Medical College of Georgia Department of Neurosurgery.

“MCG Neurosurgery has been here for many years and we have a long tradition of teaching and research,” said Dr. Fernando L. Vale, neurosurgeon and Department of Neurosurgery chair at Augusta University. “We bring teams together, use advanced technology and pay close attention to the complex details for the better outcome of our patients. Working as a team can create better science.”

The best thing for the patient

Traditionally, superior ophthalmic aneurysms were treated with open brain surgery and significant brain tissue manipulation. While endovascular techniques with the use of stents—tubes that support weak artery walls—are now more common, they carry a recurrence risk and require lifelong medication.

This was a concern for Dr. Ali, whose patient was only 36 years old. Thus, he and his team proposed clipping the aneurysm through the nasal cavity instead. This minimally invasive technique offered a treatment with no incisions or brain tissue manipulation, a significantly lower recurrence rate and no need for long-term medication.

"I thought it was the best thing for the patient," Dr. Ali emphasized, explaining his decision to pursue this approach.

The procedure required a multidisciplinary team including ENT surgeons, interventional vascular surgeons, neuro-anesthesiologists and neuromonitoring specialists—and a carefully executed surgical plan.

“This could not have been possible without this wonderful team,” Dr. Ali said. 

The patient, who found out about her aneurysm from routine imaging after a car accident, was discharged only two days after the surgery and is recovering well. Dr. Ali stressed the importance of offering patients options and empowering them to make informed decisions.

"This prioritizes the patient and surgical excellence,” he continued.

Dr. Ali hopes this procedure will become a treatment option for people with hard-to-reach aneurysms in the future, offering them a better quality of life.

Academic hospital paves way for doctors of the future

This achievement not only benefits patients but also serves as a valuable learning experience for medical residents and fellows who were in the operating room that day. 

“Seeing is believing,” Dr. Ali said, highlighting the importance of academic medicine in advancing surgical techniques. “When students see someone else do it, why can’t they do it? It’s our duty to be better than the surgeons before us. The students now have more technology and better anatomical understanding—their outcomes will be even better than ours.”

Learn more about neurosurgery at Wellstar MCG Health Medical Center.

Wellstar Kennestone Regional Medical Center has earned another three-year accreditation from the National Accreditation Program for Rectal Cancer (NAPRC), a quality program of the American College of Surgeons. This accreditation demonstrates our commitment to providing personalized, high-quality cancer care close to home for patients in Georgia.

To achieve voluntary NAPRC accreditation, a rectal center must demonstrate compliance with the NAPRC standards addressing program management, clinical services and quality improvement for patients. Centers are required to establish a multidisciplinary rectal cancer team that includes clinical representatives from surgery, pathology, radiology, radiation oncology and medical oncology.

At Wellstar, rectal cancer patients have a multidisciplinary team on their side through every step of treatment. Each patient works with a nurse navigator to schedule appointments with specialists. Patients meet with a medical oncologist, as well as a surgical oncologist or colorectal surgeon. Imaging and lab tests are reviewed by a multidisciplinary board of rectal cancer physicians, efficiently providing patients with input from several experts in cancer care. During the course of treatment, that multidisciplinary board will continue to follow the patient and discuss the best next steps, tailoring care to fit each patient’s individual needs.

Additionally, the program at Wellstar Kennestone met standards addressing the clinical services that the rectal cancer program provides, including Carcinoembryonic Antigen (CEA testing), Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) imaging for cancer staging, which allow patients to start treatment within a defined timeframe. Rectal cancer programs accredited by the NAPRC undergo a site visit every three years and are also accredited by the American College of Surgeons Commission on Cancer.  

“Our patients are surrounded by a team of experienced rectal cancer experts who provide the highest level of personalized care,” said Wellstar Surgical Oncologist Dr. Sahir Shroff, who serves as the rectal cancer program chair.  “We are proud to be the first medical center in metro Atlanta to receive this important accreditation. Our pioneering efforts to adhere to the most rigorous standards and combine the latest technologies and techniques help us achieve excellence in rectal cancer care for our patients.”

Accreditation by the NAPRC is granted only to those programs that are committed to providing the best possible care to patients with rectal cancer. The NAPRC provides the structure and resources to develop and operate a high-quality rectal center. Accredited programs follow a model for organizing and managing a rectal center to ensure multidisciplinary, integrated, comprehensive rectal cancer services. Wellstar Kennestone earned its first accreditation in 2022.

Richard Knox isn’t afraid to trust his gut. When the Hiram resident began experiencing abnormal bowel habits, he instantly knew something was off. What happened next involved advocating for his health, finding the right team of specialists to meet his needs and understanding the lifesaving role of a colonoscopy in catching colon cancer early.

Becoming an advocate

Born and raised in Smyrna, Richard spent a fulfilling career with AT&T and called many different cities “home” before his retirement in 1998. He moved back to Georgia and settled in a house by the golf course at Creekside Golf & Country Club.

Richard enjoyed an active lifestyle and managed to stay healthy; in fact, the only time he could remember staying in the hospital was in 1952 when he had his tonsils removed. However, his maternal grandfather died of colon cancer at age 65, so Richard wanted to stay proactive about his colon health, knowing his family history. He had his first routine colonoscopy in his 50s, per his physician’s recommendations—“just trying to be preventative,” he said. (Updated guidelines from the American Cancer Society now recommend that individuals at average risk for colorectal cancer start screening at age 45.)

His third colonoscopy, in 2018, showed no major cause for concern—though a blood test at the time revealed anemia. A few years later, Richard noticed some changes in his bowel habits, including persistent constipation, that made him question his health. He consulted a gastroenterologist, who instructed him to stop taking Tylenol at night to help alleviate his symptoms.

But everything wasn’t fine. “It went on for several months. It wasn’t changing, and it wasn’t getting any better,” said Richard. That’s when he knew it was time to seek a fresh perspective.

Right care, right time

Richard turned to his Wellstar primary care physician, Dr. Roderick Rhyant, whom he and his wife had seen regularly since moving to Hiram. Dr. Rhyant helped coordinate care by referring Richard to a Wellstar specialist, board-certified gastroenterologist Dr. Benjamin Renelus.

During his first appointment with Dr. Renelus, Richard shared the results of his previous colonoscopies and recounted the recent gastrointestinal issues he’d been having. He described Dr. Renelus as someone who “lights up the whole atmosphere” and made him feel at ease discussing what can be a sensitive or difficult topic for many people.

“Richard was by and large very healthy for his age,” Dr. Renelus explained. But something wasn’t quite adding up: “What I saw in his labs was that his hemoglobin started to trend down, [indicating] there may be a GI bleed going on… but he’s not complaining of any abdominal pain. I thought, ‘This may be a tumor.’”

Like Richard, Dr. Renelus trusted his instincts—and when he didn’t feel confident with his patient’s prior colonoscopy report, he recommended a diagnostic colonoscopy. This screening test would allow him to directly examine the inside of the colon and rectum, and take a biopsy of any abnormal colon tissue.

“[Dr. Renelus] just looked at me and said, ‘You know what I’m going to say,’” Richard recalled with a laugh. “And I said, ‘That’s fine, doc. Whatever we’ve got to do. I’ve got to figure out what’s causing this.”

Knowing Richard was fit and healthy enough to undergo the procedure, Dr. Renelus scheduled the colonoscopy at the Outpatient Surgery Center at Wellstar Vinings Health Park. As it turned out, those gut feelings were right: The screening detected obstructive colon cancer.

Collaborative approach

Dr. Renelus shared the diagnosis with Richard, explaining that he had a malignant tumor originating from his colon.

“Breaking bad news, unfortunately, is something that’s not foreign to us as gastroenterologists,” he said. “But the good news is we have all the people in place at Wellstar.”

The physician promptly referred Richard to two of his Wellstar colleagues: Colorectal Surgeon Dr. Anushka Arumugasaamy, who would remove the tumor; and Hematologist/Oncologist Dr. William Forehand, who would oversee Richard’s colon cancer treatment and management.

“He was able to be seen so quickly,” Dr. Renelus said. “And I saw him in the office in between everything that was going on. He was always in good spirits. He trusted the process; he trusted me. There has to be trust on both sides. He did everything that we laid out for him.”

Richard first met with Dr. Arumugasaamy to assess the tumor. She ordered several imaging tests, including a lower abdominal CT scan and an MRI, to help stage Richard’s colon cancer and determine the most effective surgical approach. She then performed surgery to remove the tumor at Wellstar Cobb Medical Center.

The surgery was a success, and Richard experienced minimal pain afterward. Several months later, he saw Dr. Forehand to discuss next steps. Thankfully, Richard’s cancer levels looked good, so Dr. Forehand said they would continue to monitor for any signs of cancer recurrence.

When he returned to Dr. Forehand’s office six months later, the CT scan was “perfectly clear,” said Richard. As a final step, Dr. Renelus performed a post-surgery colonoscopy, where he removed one polyp and confirmed all cancer had been removed.

Richard will continue to see Dr. Forehand annually to ensure he remains cancer-free. “People who develop colon cancer have a 3% risk of developing another cancer within 10 years, so that’s a sizable number considering what they’ve already been through,” explained Dr. Renelus. “Ongoing surveillance is very important.”

Throughout his colon cancer treatment, Richard said he was treated with respect and compassion by every member of his Wellstar care team.

He especially appreciated Dr. Renelus’ expertise and guidance at every step. “He was great,” Richard shared. “The colonoscopy experience with him and the folks at Wellstar Vinings Health Park was fantastic.”

Screening saves lives

As colon cancer continues to rise—it is now the third most common cancer worldwide and ranks second in cancer-related death—regular screenings have become even more important.

“Colonoscopy is unique in the sense that it can prevent colon cancer by removing cancerous polyps,” explained Dr. Renelus. “And if you are diagnosed with colon cancer and we’re able to catch it at an earlier stage, your chance of survival exponentially increases.”

“I want people to trust themselves and if something feels off, go to the doctor,” he continued. “The reality is early detection is best.”

It’s also essential that patients feel comfortable bringing up any concerns with their healthcare providers, as open communication can make a big difference in treatment outcomes. In Richard’s case, Dr. Renelus said that “had he not trusted his gut or not mentioned some of these cue words with me, I don’t know if the colonoscopy would have even been explored with someone like him.”

In sharing his story, Richard hopes he can encourage others to let go of their fears and go get screened.

“If you start noticing something is different—[that] a normal process of your body changes—you need to understand why,” he shared. “That’s what happened to me, and I was fortunate to get my appointment with Dr. Renelus.”

“And if it is colon cancer, don’t give up,” he continued. “It’s very treatable when caught early. The doctors and the facilities are well equipped to do it. So get it taken care of before it gets worse.”

Learn more about colon cancer care at Wellstar and how colorectal cancer screening saves lives.