Deborah Nagle, MD, and Stony Brook University Cancer Center’s Colorectal Oncology Management Team: Passion for Advanced Patient Care

By Elesa Swirgsdin
Thursday, July 29, 2021

At Stony Brook University Cancer Center, patients with colorectal cancer receive cutting-edge treatments and compassionate care thanks to a highly specialized multidisciplinary team.

Deborah Nagle, MD

Deborah Nagle, MD

Statistics on colorectal cancer in the United States have improved steadily over the past few decades, yet it remains the second-leading cause of cancer-related deaths for men and women combined. Deborah Nagle, MD, Chief of the Division of Colorectal Surgery, and the Colorectal Oncology Management Team at Stony Brook Cancer Center work tirelessly to improve patient outcomes by taking a multidisciplinary approach to care and continuing to develop more advanced treatments, especially robotic-assisted surgery options.

“We are focused on minimally invasive, innovative techniques,” Dr. Nagle says. “We continue to lead and have the best robotic program in the area.”

A Collaborative Care Approach

The colorectal oncology team at Stony Brook works in partnership with other hospital disciplines to create comprehensive prevention and treatment plans. Primary care physicians and internal medicine physicians refer patients for screening and often order non-invasive tests, such as stool sample kits. Gastroenterologists and colorectal surgeons then perform the screening, including colonoscopies and other endoscopic procedures.

“Screening must reach across multiple disciplines to help overcome barriers to detection of colorectal cancer,” Dr. Nagle says. “Screening has high impact for patient well-being.”

When a patient is diagnosed with cancer, three specialists generally participate in care: a colorectal surgeon, a medical oncologist and a radiation oncologist. The specifics of the patient’s cancer determine which physician will lead the team on each particular case.

“Not all patients need all three specialists, but one of the beauties of our multidisciplinary approach to disease management is that we collaborate on the plan for the patient and identify who will be the primary physician for that patient during the treatment process. It’s a dynamic process that’s really customized to the patient’s disease stage,” Dr. Nagle continues.

Continuous Innovation

Specializing in minimally invasive cancer surgery, the Colorectal Oncology Management Team uses techniques that have the least impact on the patient, including laparoscopic and robotic procedures that make the smallest possible incisions. The goal is to get patients back on their feet and ready for the next stage of treatment quickly. The team also utilizes unique combined endoscopic and laparoscopic procedures whenever possible to limit the amount of surgery and recovery time needed.

The quest for leading-edge techniques and treatments that have the potential to improve patient outcomes is ongoing and primary.

According to Dr. Nagle, “We are very interested in and participate in trials for innovation of devices, as well as medications, for advanced therapies for our patients.” She notes that several such trials are currently taking place: “For example, there is a test that can identify tumor cells that are circulating in patients and can be matched up directly with the tumor that the patient had removed.”

Dr. Nagle adds that this capability could help physicians track patient response to treatment, as well as help them determine the duration of treatment.

“This would be a customized, personalized surveillance regimen that would rely exactly on the genetic profile of the individual patient’s tumor,” she says.

“It’s important to be driven to innovation and new techniques and new ways of doing things. We must continue to ask, Why are we doing it this way? Is there a better way? Is there a path that will help patients more during recovery and in obtaining a cure?”
— Deborah Nagle, MD, Chief of the Division of Colorectal Surgery

Community Outreach

The Colorectal Oncology Management Team also takes every opportunity to interact with and educate the community. While the COVID-19 pandemic has put a temporary stop to public events, the team continues to meet with different community groups virtually.

“We really enjoy doing community events and educating people about this very common cancer — how it affects multiple people from different age groups and backgrounds,” Dr. Nagle says. “We want to let people know what they can do to truly help themselves prevent colorectal cancer.”

Screening Colonoscopy Program

Despite the fact that colorectal cancer is one of the most preventable forms of cancer, many people are reluctant to get screened.

“We still see patients at later stages because they aren’t being screened,” says Deborah Nagle, MD, Chief of the Division of Colorectal Surgery. “So even in a relatively urban environment where people have access to health care, you still see patients in the later stages because they just never checked.”

Dr. Nagle urges physicians to let patients know that there are other available forms of screening than the traditional colonoscopy, including the virtual colonoscopy, since many people have an aversion to having a colonoscopy, which prevents them from getting screened.

“While we consider colonoscopy the gold standard, because it both finds and removes any polyps that might be in the colon, there are other methods that are more user-friendly, such as stool testing,” she says. “These can be good adjuncts for patients who just can’t get themselves to have a colonoscopy.”

To help make it easier for patients to schedule a colonoscopy, Stony Brook University Cancer Center offers a direct access program for healthy individuals who are due for screening to schedule the procedure without having to consult a gastroenterologist. Primary care physicians determine whether patients qualify for the program and direct them on how to schedule.

For more information, visit cancer.stonybrookmedicine.edu/Screening_Colonoscopy_Program.


For more information, visit cancer.stonybrookmedicine.edu/colorectal-oncology-team/overview.