Colon cancer treatment

Our patients work with their care team to develop a colon cancer treatment plan. The plan addresses the medical concerns and preferences of each patient.

Colon cancer treatment options

These options may be a part of your colon cancer treatment plan.

Colon cancer chemotherapy

Colon cancer chemotherapy uses drugs given by mouth or injection to kill cancer cells.

• Chemotherapy may shrink tumors or polyps before surgery. This can help ensure a successful surgery.
• After surgery for colon cancer, chemotherapy may help ensure the cancer is gone.
• Chemotherapy may also help relieve symptoms of advanced colon cancer.

Surgery

Surgery for colon cancer treatment includes many methods.

• Colon resection removes some or all of the colon. When the colon and rectum are removed, it's called a proctocolectomy. Resections can be done with an open approach or laparoscopically.
• Transanal endoscopic microsurgery (TEM) is when a tiny microscope is used to remove polyp or, in some cases, early stage tumors from the rectum. Instead of cutting through the skin, the surgeon operates with instruments placed into the anus.

Radiation therapy

Radiation therapy uses high powered X-rays or radioactive seeds to kill cancer cells. Colon cancer treatments that involve radiation therapy include:

• External radiation therapy sends cancer-killing rays into the body from a machine outside the body.
• Internal radiation therapy (brachytherapy) places a radioactive seed inside the body, near the cancer. This pares the normal tissue and surrounding organs from damage.

Cancer treatment can cause many side effects. Here's how to deal with some common side effects.

Understanding your colon or rectal surgery

The colon (large intestine) is a long, muscular tube. It is four to five feet long. The colon removes water and nutrients from partially digested food. Then it turns the rest into stool (waste). The stool goes through the rectum and then leaves the body through the anus.

Parts of the colon

Cecum: This is the beginning of the colon. It is located in the lower right side of the abdomen.

Ascending colon (right colon): This is the first part of the colon.

Transverse colon: This is the middle part of the colon.

Descending colon (left colon): This is the third part of the colon.

Sigmoid colon: This is the last part of the colon.

Rectum: The stool goes through the rectum. The rectum ends at the anus.

Anus: This is the opening at the end of the colon. Stool leaves the body through this opening.

The rectum and anus have muscles and nerves that control bowel movements.

Blood supply to the colon

There are three main arteries that supply (give) blood to the colon.

• The first artery (ileocolic) supplies blood to the first part of the colon.
• The second artery (middle colic) supplies blood to second part of the colon.
• The third artery (inferior mesenteric) supplies blood to the third part of the colon.

There are also veins that go with each of these arteries.

Lymph nodes

Lymph nodes act like filters that remove dead cells, bacteria (germs) and even cancer cells from the body and keep them out of the bloodstream. They are found near the arteries and veins of the colon.

You may need to have lymph nodes removed. If cancer is found in the colon, the lymph nodes can be tested for cancer cells. This well help decide the stage of cancer and if more treatment is needed.

Types of surgery

Below are descriptions and diagrams of the different types of surgery for colon cancer:

Right hemicolectomy

A right hemicolectomy removes the ascending (right side) colon. The rest of the colon will be attached to the small intestine.

This surgery can be done two different ways.

• Open surgery: An incision (cut) is made on your abdomen to reach the colon.
• Minimally invasive surgery: Small incisions are made on your abdomen. The surgeon will insert medical instruments and a camera through the incisions to do the surgery.

You and your surgeon will decide which way to do the surgery is right for you.

If cancer is found in this part of your colon, it is also important to remove the lymph nodes during surgery. The main blood supply to this part of the colon will also need to be removed.

Left hemicolectomy

A left hemicolectomy removes the descending (left side) colon. The right side of the colon will be attached to the sigmoid colon.

This surgery can be done two different ways.

• Open surgery: An incision (cut) is made on your abdomen to reach the colon.
• Minimally invasive surgery: Small incisions are made on your abdomen. The surgeon will insert medical instruments and a camera through the incisions to do the surgery.

  You and your surgeon will decide which way to do the surgery is right for you.

  If cancer is found in this part of your colon, it is also important to remove the lymph nodes during surgery. The main blood supply to this part of the colon will also need to be removed.

Subtotal colectomy

A subtotal colectomy removes the ascending (right side) colon and the descending (left side) colon. The small intestine will be attached to the sigmoid colon or the rectum. You may need to have an ostomy pouch.

This surgery can be done two different ways.

• Open surgery: An incision (cut) is made on your abdomen to reach the colon.
• Minimally invasive surgery: Small incisions are made on your abdomen. The surgeon will insert medical instruments and a camera through the incisions to do the surgery.

You and your surgeon will decide which way to do the surgery is right for you.

If cancer is found in this part of your colon, it is also important to remove the lymph nodes during surgery. The main blood supply to this part of the colon will also need to be removed.

Low anterior resection

A low anterior resection removes the rectum and the sigmoid colon. The rest of the colon will be attached to the remaining part of the rectum. You may need to have an ostomy pouch, but this is usually only for a short time.

This surgery can be done two different ways.

• Open surgery: An incision (cut) is made on your abdomen to reach the colon.
• Minimally invasive surgery: Small incisions are made on your abdomen. The surgeon will insert medical instruments and a camera through the incisions to do the surgery.

You and your surgeon will decide which way to do the surgery is right for you.

If cancer is found in this part of your colon, it is also important to remove the lymph nodes during surgery. The main blood supply to this part of the colon will also need to be removed.

Abdomino-perineal resection

An abdomino-perineal resection removes the rectum and anus. Since these parts of the colon are removed, you will no longer have an anus. You will need to have an ostomy pouch.

This surgery can be done two different ways.

• Open surgery: An incision (cut) is made on your abdomen to reach the colon.
• Minimally invasive surgery: Small incisions are made on your abdomen. The surgeon will insert medical instruments and a camera through the incisions to do the surgery.

You and your surgeon will decide which way to do the surgery is right for you.

If cancer is found in this part of your colon, it is also important to remove the lymph nodes during surgery. The main blood supply to this part of the colon will also need to be removed.