Colon Cancer Treatment Patient Information

Treatment Option Overview

How cancer of the colon is treated

There are treatments for all patients with cancer of the colon. Three kinds of treatments are available:

• surgery (taking out the cancer)
  
• radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
  
• chemotherapy (using drugs to kill cancer cells)

Surgery is the most common treatment of all stages of cancer of the colon. A doctor may take out the cancer from the colon using one of the following:

If the cancer is found at a very early stage, the doctor may take out the cancer without cutting into the abdomen. Instead, the doctor may put a tube through the rectum into the colon and cut the tumor out. This is called a local excision. If the cancer is found in a small bulging piece of tissue (called a polyp), the operation is called a polypectomy.

If the cancer is larger, the doctor will take out the cancer and a small amount of healthy tissue around it (bowel or colon resection). The healthy parts of the colon are then sewn together (anastomosis). The doctor will also take out lymph nodes near the intestine and look at them under the microscope to see if they contain cancer.

If the doctor is not able to sew the colon back together, he or she will make an opening (stoma) on the outside of the body for waste to pass out of the body. This is called a colostomy. Sometimes, the colostomy is only needed until the colon has healed, and then it can be reversed. However, the doctor may have to take out the entire lower colon and the colostomy is permanent. If a patient has a colostomy, a special bag will need to be worn to collect body wastes. This special bag, which sticks to the skin around the stoma with a special glue, can be thrown away after it is used. This bag does not show under clothing, and most people take care of these bags themselves.

Radiation therapy is the use of x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that contain radiation through thin plastic tubes (internal radiation therapy) in the intestine area. Radiation can be used alone or in addition to surgery and/or chemotherapy.

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by inserting a needle into a vein. A patient may be given chemotherapy through a tube that will be left in the vein while a small pump gives the patient constant treatment over a period of weeks. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the colon. If the cancer has spread to the liver, the patient may be given chemotherapy directly into the artery going to the liver.

If the doctor removes all the cancer that can be seen at the time of the operation, the patient may be given chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy given after an operation to a person who has no cancer cells that can be seen is called adjuvant chemotherapy.

Biological treatment tries to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against disease. Biological treatment is sometimes called biological response modifier (BRM) therapy or immunotherapy.

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