Colorectal cancer treatment
1. Initial surgery (tumor removal)
The first step in treating colorectal cancer is usually an operation to remove the tumor. Sometimes a simple operation can be done during a colonoscopy or sigmoidoscopy to remove small polyps and a small amount of tissue surrounding them. But in most cases a major operation is needed, in which the cancer and part of the colon or rectum around it are removed. If cancer has spread to another part of your body, such as the liver, you may need more far-reaching surgery. Some of the types of surgery used for colorectal cancer include:
Electrofulguration - destroys a cancer by burning it with electrical current.
Local excision - removes superficial cancers and a small amount of nearby tissue from the inner layer of the rectum.
Local full thickness resection involves cutting through all layers of the rectum to remove invasive cancers as well as some surrounding normal rectal tissue.
Polypectomy is a method used to remove mushroom-like growths that contain stage 0 cancer. The cancer is cut out across the base of the stalk.
For more advanced stages of rectal cancer, other types of surgery may be preformed. If you are having surgery, ask your doctor if you will need a colostomy. A colostomy is used much more often in the surgical treatment of rectal cancer than for colon cancer.
2. Cancer treatments
Almost any cancer treatment can have side effects. Some may last for a few weeks to several months, but others can be permanent. Don't hesitate to tell your cancer care team about any symptoms or side effects that bother you so they can help you manage them.
Chemotherapy uses anti-cancer drugs to kill cancer cells. The drugs are given through an IV infusion or in the form of pills. They enter the bloodstream and reach all areas of the body. Studies have shown that chemotherapy after surgery can increase the survival rate for patients with some stages of colorectal cancer. Chemotherapy can also help relieve symptoms of advanced cancer. Chemotherapy can have some side effects. These side effects will depend on the type of drug, how much you have, and how long you take it. Most of the side effects go away when treatment is over. For example, hair will grow back after treatment ends, though it may look different.
After surgery, radiation can kill small areas of cancer that may not be seen during surgery. If the size or location of a tumor makes surgery hard, radiation may be used before the surgery to shrink the tumor. Radiation may also be used to ease (palliate) symptoms of advanced cancer, such as intestinal blockage, bleeding, or pain.
Radiation therapy is a form of cancer treatment that uses high-energy radiation to kill cancer cells. External-beam radiation therapy uses radiation from outside the body to focus on the cancer. Local radiation therapy or brachytherapy, uses a small pellet of radioactive material placed directly into the cancer. Side effects of radiation therapy for colon or rectal cancer include mild skin irritation, nausea, diarrhea, or tiredness. These often go away after a while. If you have these or other side effects, talk to your doctor. There are ways to lessen many of these problems.
3. Follow-up care
During and after treatment for colorectal cancer, your doctors will ask about symptoms, perform physical exams, and may order blood tests (tumor-markers) or imaging studies such as CT scans or PET scans in order to monitor your progress. Follow-up is needed to check for cancer recurrence or spread, as well as possible side effects of certain treatments. Be prepared to ask your medical team any questions and to discuss any concerns.
Some studies have pointed to things people can do, that might help reduce the risk of colorectal cancer returning.
Diet - In a large study of patients with stage 3 colon cancer, those with the highest intakes of meat, fat, refined grains or sugars, and desserts, were about 3 times more likely to have a recurrence than those who ate the lowest levels. More research is needed to confirm these results and to determine which of these factors are most strongly linked to cancer recurrence.
Physical activity - Two recent studies of people with earlier stage (1, 2, or 3) colorectal cancers, showed that increasing recreational physical activity after diagnosis reduced the risk of death from colorectal cancer by as much as half. The level of activity needed to reduce risk was about 4 to 5 hours of brisk walking per week. More studies are needed to further define this possible benefit.
Once your treatment ends, you may find yourself overwhelmed by emotions. This happens to a lot of people. You may have been going through so much during treatment that you could only focus on getting through your treatment. Almost everyone who has been through cancer can benefit from getting some type of support. What's best for you depends on your situation and personality. Some people feel safe in peer-support groups or education groups. Others would rather talk in an informal setting, such as church. Others may feel more at ease talking one-on-one with a trusted friend or counselor. Whatever your source of strength or comfort, make sure you have a place to go with your concerns.