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Treatment

The type of treatment your doctor recommends will depend largely on the stage of your cancer. The three primary treatment options are: surgery, chemotherapy and radiation.

Surgery (colectomy) is the main treatment for colorectal cancer. How much of your colon is removed and whether other therapies, such as radiation or chemotherapy, are an option for you depend on the location of your cancer, how far cancer has penetrated into the wall of your bowel, and whether it has spread to your lymph nodes or other parts of your body.

Surgical procedures

Your surgeon removes the part of your colon that contains the cancer, along with a margin of normal tissue on either side of the cancer to help ensure that no cancer is left behind.

Side effects of colon cancer surgery may include short-term pain and tenderness, and temporary constipation or diarrhea. If you have a colostomy, you may develop an irritation on the skin around the opening (stoma).

 

Colon Cancer

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Colorectal Cancer, also called colon cancer or bowel cancer, includes cancerous growths in the colon, rectum and appendix. It is the third most common form of cancer and the second leading cause of cancer-related death in the Western world. Colorectal cancer causes 655,000 deaths worldwide per year.[1] Many colorectal cancers are thought to arise from adenomatous polyps in the colon. These mushroom-like growths are usually benign, but some may develop into cancer over time. The majority of the time, the diagnosis of localized colon cancer is through colonoscopy. Therapy is usually through surgery, which in many cases is followed by chemotherapy.

Symptoms


Colon cancer often causes no symptoms until it has reached a relatively advanced stage. Thus, many organizations recommend periodic screening for the disease with fecal occult blood testing and colonoscopy. When symptoms do occur, they depend on the site of the lesion. Generally speaking, the nearer the lesion is to the anus, the more bowel symptoms there will be, such as:

 

  • Change in bowel habits

  • change in frequency (constipation and/or diarrhea)

  • change in the quality of stools

  • change in consistency of stools

  • Bloody stools or rectal bleeding
    Stools with mucus

  • Tarry stools (melena) (more likely related to upper gastrointestinal eg stomach or duodenal disease)

  • Feeling of incomplete defecation (tenesmus) (usually associated with rectal cancer)

  • Reduction in diameter of feces

  • Bowel obstruction (rare)



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Surgery to prevent cancer

In cases of rare, inherited syndromes such as familial adenomatous polyp sis, or inflammatory bowel disease such as ulcerative colitis, your doctor may recommend removal your entire colon and rectum in order to prevent cancer from occurring in the future. Then, in a procedure known as ileal pouch-anal anatomizes, your surgeon will likely construct a pouch from the end of your small intestine that attaches directly to your anus. This allows you to expel waste normally, although you may have several watery bowel movements a day.

Surgery for early-stage cancer

If your cancer is small, localized in a polyp and in a very early stage, your surgeon may be able to remove it completely during a colonoscopy. If the pathologist determines that the cancer in the polyp doesn't involve the base — where the polyp is attached to the bowel wall — then there's a good chance that the cancer has been completely eliminated.

Some larger polyps may be removed using laparoscopic surgery. In this procedure, your surgeon performs the operation through several small incisions in your abdominal wall, inserting instruments with attached cameras that display your colon on a video monitor. He or she may also take samples from the lymph nodes that drain the area where the cancer is located. Studies have found that people undergoing this procedure need less pain medication and leave the hospital a day earlier on average. Also, people who have this procedure don't have higher rates of recurrence than those who choose the open surgery.

Surgery for advanced cancer

If your cancer is very advanced or your overall health very poor, an operation to relieve a blockage of your colon or other conditions in order to improve your symptoms may be the best option. This type of surgery is referred to as palliative surgery. The goal of palliative surgery isn't to cure your cancer, but to relieve signs and symptoms, such as bleeding and pain.

In specific cases where the cancer has spread only to the liver and if your overall health is otherwise good, your doctor may recommend surgery to remove the cancerous lesion from your liver. Chemotherapy may be used before or after this type of surgery. This treatment may improve your prognosis.

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells. Chemotherapy can be used to destroy cancer cells after surgery, to control tumor growth or to relieve symptoms of colon cancer. Your doctor may recommend chemotherapy if your cancer has spread beyond the wall of the colon. In some cases, chemotherapy is used along with radiation therapy.

Possible side effects of chemotherapy include nausea and vomiting, mouth sores, fatigue, hair loss and diarrhea. Discuss the side effects and risks as well as the potential benefits with your doctor.

Radiation therapy

Radiation therapy uses powerful energy sources, such as X-rays, to kill any cancer cells that might remain after surgery, to shrink large tumors before an operation so that they can be removed more easily, or to relieve symptoms of colon cancer and rectal cancer.

Radiation therapy is rarely used in early stage colon cancer, but is a routine part of treating early stage rectal cancer, especially if the cancer has penetrated through the wall of the rectum or traveled to nearby lymph nodes. Radiation therapy, usually combined with chemotherapy, may be used after surgery to reduce the risk that the cancer may recur in the area of the rectum where it began.

Side effects of radiation therapy may include diarrhea, rectal bleeding, fatigue, loss of appetite and nausea.

Targeted drug therapy

Three drugs that target specific defects that allow cancer cells to proliferate are available to people with advanced colon cancer. The drugs bevacizumab (Avastin), cetuximab (Erbitux) and panitumumab (Vectibix) can be administered along with chemotherapy drugs or alone. Bevacizumab works to prevent tumors from developing blood vessels, which can deliver the oxygen and nutrients cancers need to survive. Cetuximab and panitumumab target a chemical signal that tells cells to divide and reproduce. Cetuximab and panitumumab can't cure colon cancer and currently remain experimental.