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There are treatments for all patients
with cancer of the rectum. Four 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), and biological therapy (using
materials made by the body or in the laboratory to kill cancer
cells).
Surgery is the most common treatment
of all stages of cancer of the rectum. A doctor may take out the
cancer from the rectum using one of the following:
- If 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 into the rectum
and cut the cancer out. This is called a local excision.
Sometimes, the doctor may take out the cancer using high-energy
electricity. This is called electrofulguration.
If the cancer is larger, the doctor will take out the cancer and
a small amount of healthy tissue around it. The healthy parts of
the rectum are then sewn together (anastomosis). If only a small
amount of tissue is removed, this is called a wedge resection.
If a larger amount of tissue is removed, this is called a bowel
resection. The doctor will also take out the lymph nodes near
the rectum and look at them under the microscope to see if they
contain cancer.
If the doctor is not able to sew the rectum 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 rectum and make the colostomy
permanent. A patient, who has had a colostomy, will need to wear
a special bag 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 provides 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 rectum. If cancer has spread to the liver,
a patient may be given chemotherapy directly into the artery going
to the liver. Chemotherapy or other drugs may be given with
radiation therapy to make cancer cells more sensitive to radiation (radiosensitizers).
If the doctor removes all the cancer
that can be seen at the time of the operation, a 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 therapy 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 therapy is sometimes called
biological response modifier (BRM) therapy.
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