Colon Cancer Treatment Options
Your treatments and surgical options for colon cancer depend on the location of the tumor, stage of the disease and your overall health. Treatments and surgical options may include one or more of the following:1 colonoscopy, chemotherapy, biological therapy, radiation therapy or surgery.
Your doctor will discuss your options in detail, the expected side effects and results. You and your doctor can work together to decide on a treatment plan that is best for you.
A colonoscopy examines the full lining of the colon and rectum to screen for early signs of cancer. During your colonscopy, small potentially cancerous polyp can also be removed (polypectomy).
Your doctor will give you important instructions on how to cleanse your bowels prior to the colonoscopy. The day of the procedure, patients are often given a light sedative, although deeper sedation may be needed in some cases. The doctor inserts a colonoscope (long, flexible tube with a small camera attached) into the anus and slowly guides it through the rectum and colon. Once the scope reaches the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is examined again.
The procedure typically lasts thirty to sixty minutes. Cramping or bloating may occur the first hour afterwards. Colonoscopy is an out-patient procedure and full recovery is expected the next day.
Chemotherapy uses anticancer drugs in an effort to kill cancer cells. Anticancer drugs are usually given through a vein, but some may be given by mouth. You may be treated in as an out-patient, in the doctor's office, or at home. In rare cases, a hospital stay is needed.
The side effects of chemotherapy depend mainly on the specific drugs and the dose. Side effects can include: infection, bruising or bleeding easily, fatigue, hair loss, poor appetite, nausea and vomiting, diarrhea or mouth sores. Your health care team can suggest ways to control many of these side effects. Most side effects usually go away after treatment ends.
Some people with colon cancer that has spread receive a monoclonal antibody - a type of biological therapy. The monoclonal antibodies bind to colon cancer cells. They interfere with cancer cell growth and the spread of cancer. People receive monoclonal antibodies through a vein at the doctor's office, hospital, or clinic. Some people receive chemotherapy at the same time.
Side effects depend mainly on the monoclonal antibody used. Side effects may include rash, fever, abdominal pain, vomiting, diarrhea, blood pressure changes, bleeding, or breathing problems. Side effects usually become milder after the first treatment.
Radiation therapy (also called radiotherapy) uses high energy x-rays to kill cancer cells. It affects cancer cells only in the treated area. Doctors use different types of radiation therapy to treat cancer. The two more common types of radiation patients receive include:
External radiation comes from a machine. The patient is positioned on a table and the machine or arm of the machine is directed to the part of your body that will receive radiation – similar to what happens during an X-ray. Treatment is given at a hospital or clinic five days a week for several weeks.
Internal radiation (implant radiation or brachytherapy):
Internal radiation comes from radioactive material placed in thin tubes put directly into or near the tumor. The patient stays in the hospital, and the implants generally remain in place for several days. Usually they are removed before the patient goes home. Intraoperative radiation therapy (IORT) is a type of radiation given during surgery.
Side effects depend mainly on the amount of radiation given and the part of your body that is treated. Radiation therapy to your abdomen and pelvis may cause nausea, vomiting, diarrhea, or urgent bowel movements. Talk to your doctor about all potential benefits and risks of radiation.
The goal of colon surgery is to remove the cancer. Your surgeon will also check the rest of your intestine and nearby organs to see if the cancer has spread. Colon cancer surgery is known as a colectomy, colon resection or hemi-colectomy, depending on how much of the colon is removed.
After the cancerous part of the colon is removed, the remaining sections of the bowel are joined together. This reconnection of the colon is known as an anastomosis. The reconnection is not always possible. In this case, the surgeon creates a new path for waste to leave your body. The surgeon makes an opening (stoma) in the wall of the abdomen, connects the upper end of the intestine to the stoma, and closes the other end.
The operation to create the stoma is called a colostomy. A flat bag fits over the stoma to collect waste, and a special adhesive holds it in place. For most patients, the stoma and colostomy bag are temporary and needed only until the colon heals from surgery. After healing, the surgeon reconnects the healthy parts of the intestine and closes the stoma.
Colon surgery can be performed using open surgery (through a large incision) or using minimally invasive laparoscopic surgery (through a few small incisions).
With open surgery, also called laparotomy, your surgeon must make a large abdominal cut/incision to reach your colon and other organs. The incision must be large enough for your surgeon to fit his or her hands and surgical instruments inside your body. While open surgery allows your surgeon to see and touch your organs, it is invasive and can be traumatic on your body due to the large incision.
Minimally Invasive Surgery
Traditional Laparoscopic Surgery
Laparoscopic surgery is minimally invasive – meaning surgeons operate through a few small incisions instead of a large open incision. During traditional laparoscopy, long-handled instruments are inserted through the incisions. One of the instruments is a laparoscope – a thin, lighted tube with a tiny camera at the end. The camera takes images inside your body and those images are sent to a video monitor to guide surgeons as they operate on your colon.
da Vinci® Surgery
Another minimally invasive surgical option is da Vinci Surgery. With the da Vinci System, surgeons make just a few small incisions instead of a large open incision - similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your doctor to operate with enhanced vision, precision, dexterity and control.
da Vinci is a minimally invasive approach that uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body.
All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/da-vinci-surgery/safety-information.php.
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