Patient care conditions, diseases
Treatment of colon cancer:
There are several ways to treat colon or rectal cancer. This includes surgery, chemotherapy and radiation depending on the type of cancer, location and stage. Usually, a team of doctors and nurses work together to treat the cancer. Physician specialists who treat this disease include surgeons, medical oncologists, gastroenterologists, and radiation oncologists.
Treatments are usually used in combinations. However, the earlier cancers are detected the less treatment is needed and the more effective it is. The choice of treatment for each patient depends upon the stage of the disease, the location of the disease and the patient's general state of health.
It helps if the patient learns as much as possible about the treatment options. Feel free to make a list of questions to ask the treatment team. Second opinions are appropriate if the patient wishes.
Surgery to remove tumors is the most important part of treatment. The type of surgery depends on the location and stage of the tumor. The part of the colon with the tumor is removed or resected as well as some of the surrounding tissue. Nearby lymph nodes are removed so that a pathologist can examine them under a microscope. If cancer has reached the nodes, additional treatment may be needed. If the cancer is detected early enough, surgery is often the only treatment needed for colorectal cancer. The normal portions of the colon or rectum can usually be reconnected. That part of the procedure is called making an anastomosis. When the bowel cannot be anastomosed, the doctor creates an opening called a stoma in the abdominal wall. This procedure is called a colostomy, ileostomy or stoma. A colostomy may or may not be needed depending on the stage and invasiveness of the tumor. Most often this colostomy is reversible and temporary. If a colostomy or stoma is needed, the patient then uses a special bag to collect the waste. Enterostomal nurses help patients manage this special bag.
Usually an abdominal incision is used to remove rectal cancers. If the cancer is in the low or middle rectum and it is found early, surgery can be performed through the anal canal. This avoids an abdominal incision.
If necessary an abdominal incision is used. Often the tumor can be resected and the bowel placed together or anastomosed. This allows natural defecation. If the tumor is extensive or very low the entire rectum and anus are removed and a permanent stoma placed.
Minimally invasive surgery is being investigated as a new procedure to remove certain colon or rectal tumors. Laparoscopic surgery reduces the pain and recovery time from surgery to resect part of the colon. Studies show that laparoscopic or minimally invasive surgery is being increasingly performed for colon cancer.
Chemotherapy is giving medications to reduce the size of the cancer or treat metastasis. They work by decreasing the rate of growth of the cells in the cancer. They are usually given intravenously. Chemotherapy can be used after surgery to help prevent the cancer from spreading or possibly destroying cancer cells left over.
Oncologists are specialists that treat patients with chemotherapy drugs. Depending on the stage of the cancer, chemotherapy may or may not be given. Side effects include but are not limited to diarrhea, nausea and hair loss. New chemotherapy studies are underway.
Radiation is given for the treatment of rectal cancers. Radiation therapy is the use of high-energy rays to treat cancer. Special machines are design to generate then concentrate the radiation beam to the area of the cancer. Radiation reduces the size of tumors by reducing the growth rate. It may be given before or after surgery for rectal cancer. Side effects include but are not limited to bleeding and dermatitis or inflammation of the area.
Sometimes, a combination of radiation and chemotherapy are used to shrink the tumor before it is surgically removed or to destroy remaining cancer cells after surgery. Radiation therapy can also be used to alleviate pain when tumors cannot be removed with surgery.
FOLLOW-UP OF COLON CANCER
Regular follow-up exams are very important after treatment for colorectal cancer. The cancer can recur at or near the site of the original tumor or can spread to another area of the body. The spread may not become evident for years.
The doctor will continue to check closely so that, if the cancer comes back, it can be treated again as soon as possible. Often, a social worker or enterostomal therapist at the hospital or clinic can suggest groups that can help with rehabilitation, emotional support, financial aid, transportation, or home care.