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.