Understanding Colon Cancer -- Diagnosis and Treatment
What Are the Treatments for Colorectal Cancer? continued...
The main types of treatment for colorectal cancer are surgery, radiation therapy, and chemotherapy. Depending on the stage of the cancer, these treatments may be combined.
Surgery is the most effective treatment for local colorectal tumors. Very small tumors can be removed through a colonoscope, but even with small tumors, removing the portion of the colon containing the tumor, the surrounding fat, and nearby lymph nodes is often the best treatment. Surgery may be performed either laparoscopically or by the open method, which uses larger incisions.
Usually, the surgeon can reconnect the healthy sections of the colon and rectum. When this is not possible, the surgeon forms an opening -- known as a stoma -- in the abdomen and reroutes the severed colon to it. Waste is collected in a bag worn over the stoma. This procedure, known as a colostomy, often is only temporary. Once the bowel has had time to heal, a second operation reconnects the colon and rectum. The need for permanent colostomy is more common with rectal cancer, since retaining the rectum may be difficult.
In the immediate period after surgery, the patient can expect to receive painkillers and other medication to ease temporary diarrhea or constipation. After surgery, patients are encouraged to eat nutritious foods, rich in calories and proteins, in order to gain strength and heal properly.
Radiation therapy is treatment with high-energy rays that destroy the cancer cells. For rectal cancer, radiation is usually given after surgery, along with chemotherapy (known as adjuvant therapy), in order to destroy any cancer cells left behind. In addition, it can be used along with chemotherapy before surgery (known as neoadjuvant therapy) in order to shrink a large tumor, making the surgery easier. In advanced rectal cancer, radiation can be used to shrink tumors that cause symptoms of bowel obstruction, bleeding, or pain.
Radiation therapy can be used in people with colon cancer when the tumor has attached to another organ in the abdomen, or if a tumor is found near the margins of the cancer that was removed.
Chemotherapy drugs are used to treat various stages of colorectal cancer. They include 5-flurouracil, Xeloda, Camptosar, and Eloxatin. These drugs are commonly used in combination with one another. Chemotherapy can also be administered directly into the liver if the colon cancer has metastasized there.
The FDA has approved five drugs for treating colon cancer that work an entirely different way. The drugs, Erbitux, Avastin, Stivarga, Zaltrap, and Vectibix are a form of cancer therapy called immunotherapy or biologic therapy. These drugs work by blocking the cancer’s blood supply or blocking a protein made by the cancer to enhance its growth. They can be used to treat advanced colorectal cancer that has spread (metastasized) to other parts of the body.
Once cancer of either the colon or rectum is in remission, follow-up exams to check for recurrence are essential. But hundreds of thousands of people are living comfortable, normal lives even after colorectal surgery and a colostomy. Although adjusting to life after a colostomy requires time, support, and understanding, people with stomata have discovered for the most part they can eat, play, and work as well as they did before.