Surgery for Advanced Colon Cancer

Surgery is a common treatment to help ease symptoms of advanced colon cancer. But not all colon cancer surgeries are alike. They vary based on the cancer’s stage, its location, and why the operation is being done.

Colectomy

This involves removing part or all of the colon (to get rid of the cancer itself) plus nearby lymph nodes (to see if the cancer has spread).

It can be done either as an open surgery through a single, long cut in the abdomen or with the assistance of a laparoscope, a tool that lets the surgeon see inside the abdomen and make smaller cuts.

People who have laparoscopic-assisted colectomy often leave the hospital faster, but the procedures require special expertise. Survival rates are about the same either way.

Robotic surgery, done at some hospitals with special systems, can also ease pain after surgery and allow you to go home sooner. But its use in treating colon cancer is fairly new.

When only part of your colon is taken out, the procedure is known as hemicolectomy, partial colectomy, or segmental resection. About a quarter to a third of your colon is taken out. Then the ends are rejoined.

A total colectomy, on the other hand, is when all of your colon comes out. It’s rarely done to deal with just cancer. Usually, it’s for people with other conditions like inflammatory bowel disease.

Stent Placement

As your cancer grows, it can sometimes block your colon. A hollow tube known as a stent can be placed inside you using a colonoscope. This tube keeps your colon open in preparation for surgery.

Colostomy and Ileostomy

People with either a blocked colon or a hole in it might need to have one of these procedures, where either the end of the colon (colostomy) or small intestine (ileostomy) is connected to an opening on the outside of your abdomen. Stool is then held in a bag.

A colostomy or ileostomy is usually not permanent and can be undone with another surgery.

Liver Surgery

Between 60% and 70% of people who have colon cancer surgery will have the cancer spread to their liver. For some, when colon cancer is diagnosed, it’s found to have already spread there. Depending on how far your cancer has advanced, you could have those tumors removed at the same time as your colon surgery.

This can be combined with chemotherapy, and it can lessen complications and shorten recovery time.

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Recovery

Most people who have colon cancer surgery recover well. For the first few days, you’ll need to take pain medicines and you may either not be able to eat or only be able to have liquids. But you’ll be able to eat solid food soon after.

That said, colon cancer surgery does carry risks, including bleeding, infection, and blood clots in the legs.

It’s possible, but rare, that the places where your colon is rejoined may leak. This can lead to infection and another surgery. Symptoms of a leak include:

  • Severe stomach pain
  • Fever
  • A hard abdomen

In less severe cases, the leak could lessen your appetite or make recovery take longer.

Scar tissue could form inside your abdomen. This could make your organs and tissues stick together or make your intestines twist so your bowel is blocked. If that happens, you’ll feel some pain and have some swelling.

This too, might require surgery.

Follow-up

After your procedure, you’ll need to keep in close touch with your care team. How close depends on your situation.

With advanced cancer, the goal of surgery is often to help with symptoms more than to cure. In many cases, your doctor will recommend other treatments like chemo in addition to surgery.

WebMD Medical Reference Reviewed by Louise Chang, MD on August 08, 2018

Sources

SOURCES:

American Cancer Society: “Surgery for Colon Cancer.”

Memorial Sloan Kettering Cancer Center: “Colon Surgery,” “Metastatic Colon Cancer,” “Surgery for Liver Metastases.”

Cancer.net: “Follow-up Care for Colorectal Cancer.”

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