Colorectal Cancer
Treatment
Colorectal cancer is highly curable when found in its early stages. The
specialists who treat colorectal cancer include gastroenterologists (doctors who
specialize in diseases of the digestive system), surgeons, medical oncologists,
and radiation oncologists. The treatment mainly depends on the location of the
tumor in the colon or rectum, size and the stage of the disease. Treatment
methods for colorectal cancer are surgery, radiation therapy or chemotherapy.
Some have a combination of these treatments.
Surgery:
It is the most common treatment for colorectal cancer. A colonscope is used
to remove small malignant polyp. For larger cancer, surgeon makes an incision
into the abdomen to remove the tumor and after that the two open ends are joined
together. When a section of the colon or rectum is removed, the surgeon can
usually reconnect the healthy parts. If it is not possible, then a colostomy may
be needed.
Colostomy - The surgeon makes an opening (a stoma) in the
wall of the abdomen, connects the upper end of the intestine to the stoma, and
closes the other end. This operation to create the stoma is called colostomy. It
is the opening into the colon from the outside of the body. A bag is worn over
the stoma to collect the stool. A colostomy provides a new path for waste
material to leave the body after part of the colon has been removed.
Side Effects - Patients feel tiredness and uncomfortable and to control their
pain, medicines are given. Surgery sometimes causes bleeding, constipation or
diarrhea. People who have a colostomy may have irritation of the skin around the
stoma.
Chemotherapy:
Chemotherapy uses anticancer drugs to kill cancer
cells. They are usually given through a
vein, but some also may be given by mouth. These drugs enter the bloodstream
and can affect cancer cells throughout the body. The patient may have
chemotherapy alone or combined with surgery, radiation therapy, or both.
Chemotherapy before surgery may shrink a large tumor and it is called
neoadjuvant therapy. Adjuvant therapy, i.e. chemotherapy after surgery, can
destroy any remaining cancer cells and prevent the cancer from coming back in
the colon or rectum, or elsewhere.
Side Effects - Side effects of chemotherapy vary from patient to patient and
it depends mainly on the specific drugs and doses received. Chemotherapy drugs
can affect blood cells resulting in bruising, bleeding, weakness and feeling
tired. Other possible side effects are hair loss, poor appetite, nausea,
vomiting, diarrhea, mouth and lip sores. Most side effects can be controlled
with drugs and will disappear when treatment ends.
Radiation Therapy:
Also called radiotherapy, it uses high-energy rays to kill cancer cells. Radiation
therapy affects cancer cells only in the treated area. Some patients may
have radiation therapy before surgery to shrink the tumor and others may have it
after surgery to kill cancer cells that may remain in the area. External
radiation and internal radiation or implant radiation are the two types of
radiation therapy used for the treatment of colorectal cancer
External radiation: Radiation is produced by a machine outside the
body. The machine targets a concentrated beam of radiation directly at the tumor
area. This form of therapy is usually spread out in short treatments given 5
days a week for 5-7 weeks. In some cases, external radiation is given during
surgery.
Internal radiation: The radiation comes from radioactive material
placed in thin tubes put directly into or near the tumor. During the
entire treatment, the patient must stay in the hospital and the implants
generally remain in place for several days. When the treatment is done, they are
removed. Once it is removed, no radioactivity is left in the body.
Side Effects - The side effects of radiation mainly depends on the dose and
the part of the body where the radiation is given. Common effects include
extreme tiredness, vomiting, increased susceptibility to infections, hair loss,
easy bruising or bleeding. Radiation therapy to the abdomen and pelvis may cause
nausea, vomiting, diarrhea, bloody stools, rectal leakage, or urinary
discomfort. Apart from these, the skin in the treated area may become red, dry,
and tender.
Colon cancer and rectal cancer are sometimes treated separately.
Most patients with colon cancer are treated with
surgery. But some have chemotherapy along with surgery. A colostomy is seldom
needed for people with colon cancer. Radiotherapy is not commonly used to treat
colon cancer, but it is used to relieve pain and other symptoms.
Surgery is the most common treatment for rectal cancer. Most
rectal cancer patients need a permanent colostomy. Some patients receive the
combination of all the treatments. Some patients may have radiation therapy
during surgery and it is called IORT (Intraoperative radiation therapy).
After Treatment:
If undetected cancer cells remains somewhere in the body, there are
possibilities for the return of the disease. Follow-up care after treatment is
very important. Checkups may include a physical exam, lab tests, colonoscopy,
x-rays, CT scans, or other tests. The patients should visit their physician
between regular scheduled and if any health problems appear.
Getting regular check-ups may be the best way to prevent colorectal
cancer.
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