Colon and Rectal Cancer

Cancer treatment usually involves a team of experts—and with colorectal cancer, you will likely receive care from one or more of the following medical specialists:

• Gastroenterologist
• Surgeon
• Medical oncologist
• Radiation oncologist
• Mental health counselors
• Dietitians
• Social workers

If you have received a diagnosis of colorectal cancer, the next step is to determine the best course of treatment for your disease. Your doctor will discuss your options for treatment, and will adise on the most optimal course of action to take. The following treatments will likely be discussed, either alone or in combination:

• Surgery
• Chemotherapy
• Radiation
• Biologic Therapy

Surgical options for colorectal cancer typically depends on how far advanced the cancer is—the invasiveness of the surgical procedure can span from the removal of small tumors while having a colonoscopy to having a section of the colon or rectum removed. If the cancer has metastasized, or spread to other parts of the body, then surgery may be done to remove whatever cancer can be excised from these other areas outside the colon and rectum.   Here are some of the most common types of surgery done to treat this type of cancer:

• Local excision.  If the cancer is found at a very early stage, your doctor may be able to remove it via use of a colonscope, without having to cut through the abdominal wall.. If the cancer is found in a polyp (a small bulging piece of tissue), the operation is called a polypectomy

• Bowel resection.  If the cancer cannot be removed via local excisiton, then a bowel resection may be done. In this type of surgery, the cancer in either the color on rectum is cut out, along with adjacent portions of the colon or rectum—this is known as a partial colectomy. The two “healthy” ends of the colon or rectum are then joined together to re-form the tube-shaped organ. Adjacent lymph nodes near the colon may also be removed and examined for signs of cancer.

• Resection and colostomy.  If too much of the colon needs to be removed, and the two ends are not able to be sewn back together, an opening, or stoma, is made outside the body to allow for waste to pass through. This is known as a colostomy—a bag is placed around the opening to collect the waste, and special care needs to be taken to properly learn how to change and care for the colostomy. Sometimes, the colostomy is not permanent, and is needed only until the ends of the colon have healed sufficiently to reattach. However, if the entire lower colon is removed the colostomy may be permanent.

Other forms of surgery include:

• Radiofrequency ablation. A special probe that contains tiny electrodes is insterted directly through the skin, which sends impulses that kill cancer cells.  Usually only local anesthesia is needed, but in other cases, the probe may need to be inserted through an incision in the abdomen, and with this type of procedure, general anesthesia is required.
• Microwave ablation.  Using heat generated by microwaves, microwave ablation destroys tumors that have metastiszide to the liver with microwave energy.
• Cryosurgery or Cryotherapy.  An instrument is used to freeze and destroy abnormal tissue, usually in the early stages of colorectal cancer.

Adjuvant therapy

Patients are often given chemotherapy or radiation treatement, even if all signs of cancer are cut out at time of surgery to ensure that all cancer cells which might possibly be left do not have the opportunity to peoliferate and create new cancerous growths. This treatment, post-surgery, is known as adjuvant therapy.

Chemotherapy

Chemotherapy is a drug-based cancer treatment intended to stop the growth of cancer cells by killing the cells or by stopping the cells ability to divide and proliferate. The way chemo is given depends on the stage and type of cancer, your doctor will advise you on what the best course of treatment is for you. Sometimes chemo is taken orally, sometimes it is injected into the bloodstream, and sometimes chemo is injected directly into the spinal column, organ or body cavity, where the drugs can act more locally and kill cancer cells in the area.

Radiation Therapy

Radiation therapy uses high-energy radiation like x-rays to kill cancer cells or stop them from growing or proliferating. The method of delivery depends on the type and severity of the cancer. There are two main types of radiation therapy:

• External radiation therapy uses a mechanism outside the body to send radiation towards the cancer
• Internal radiation therapy uses a radioactive substance, delivered via a needle, catheter, or suppository, which are placed into or near the cancerous growth.

Biologic Therapy or Immunotherapy

Biologic or immunotherapy is a type of cancer treatment that sees to use the body’s own immune system to fight the cancer

Immunotherapy is a type of treatment that uses the body’s own immune system to fight cancer. Here’s how it works: the therapy stimulates your immune system to fight the cancer itself, with the hope of harnessing the power of your own body’s defense system to eradicate the cancer. While some forms of this type of therapy are being used, many are still in the clinical trial stage.

There are various types of biologic therapy, among them:

• Biological Response Modifiers. Delivered via injection or infusion, this type of immunotherapy is intended to trigger the immune system to indirectly affect tumors, in the hopes of stimulating one’s own immune system to defend itself more successfully against the invading cancer cells.
• Colony-stimulating factors. Man-made agents, similar to substances in the body that stimulate the production of blood cells, like bone marrow, can help blood-forming tissue recover from the effects of chemotherapy and radiation therapy, and improve immune response to cancer.
• Tumor vaccines. Still in clinical trials, researchers are working on developing vaccines that can better immune system response to cancer cells by helping the body to better recognize the cancer cells. This is a preventive treatment, which would be given to prevent the cancer from returning, or teach the body to reject the cancerous cells, much like vaccines for diseases like polio, measles, and more.
• Monoclonal Antibodies. These antibodies, produced in a labe, locate and bind to cancer cells in the body—and can be utilized to detect cancer, or as a therapeutic modality to deliver treatment for the cancer in a very targeted way.