Early diagnosis and treatment are key to surviving colon cancer — cancer that affects the large intestine, including the rectum — and several different treatments are available.
Your treatment will depend on the exact type of cancer you have, and how far it has spread.
Colon Cancer Surgeries
Surgeons can often remove small tumors, as well as abnormal growths called polyps, using a minimally invasive technique that doesn’t require cutting into the body.
For this procedure, your surgeon will insert a colonscope — a type of endoscope containing a light and a small camera — into your rectum until it reaches the site of the cancer.
Cutting tools inserted through the colonoscope can then be used to remove the tumor (called local excision) or polyp (called polypectomy).
For larger tumors still confined to your colon, your surgeon will perform a colectomy — a surgery to remove affected parts of your colon along with a small margin of healthy tissue.
Nearby lymph nodes are also often removed for examination.
In an open colectomy, your surgeon will create a large incision through your abdomen to reach the colon and remove the cancer.
A less invasive technique, called laparoscopic-assisted colectomy, uses several small incisions — one for a laparoscope (a viewing instrument similar to a colonoscope) to guide the surgery, and others for cutting cools.
If possible, your surgeon will stitch the remaining parts of your colon together.
If this isn’t possible, your surgeon will have to create an opening on the outside of your body (called a stoma) for waste to pass through.
This waste is caught in a colostomy bag, an airtight plastic pouch that can be emptied into a toilet or disposed of.
If your cancer has spread to only a few spots in your lungs or liver, your surgeon may be able to remove it from those organs as well.
Side effects of these surgeries can include:
- Blood clots in the legs
- Infections from intestinal leaks (when the newly connected segments of the colon don’t hold together well)
- Scar tissue
Chemotherapy drugs may be used to treat colon cancer after surgery, to kill or stop the spread of any remaining cancer cells.
Chemotherapy may also be used before surgery to reduce the size of tumors — or, without surgery, to help shrink tumors of colon cancer that has spread, and to relieve symptoms.
Chemotherapy drugs may be given orally — in which case they affect the whole body — or intravenously (by IV) to a localized area, which helps reduce side effects.
Chemotherapy drugs commonly used for colon cancer include:
- 5-FU (5-fluorouracil)
- Campstosar (irinotecan)
- Eloxatin (oxaliplatin)
- Lonsurf (trifluridine and tipiracil)
- Xeloda (capecitabine)
Because these drugs can affect non-cancerous cells in the body, they may cause a range of side effects, including mouth sores, hair loss, diarrhea, and neuropathy (nerve damage).
So-called targeted therapy is another type of medicine-based treatment for colon cancer.
These drugs have fewer side effects than chemotherapy and work by affecting only cancer cells, such as by targeting cancer growth factors (hormone-like substances the cells need to grow).
Targeted therapy drugs for colon cancer include:
- AVastin (Bevacizumab)
- Cvramza (ramucirumab)
- Erbitux ( cetuximab)
- Stivarga (regorafenib)
- Vectibix (panitumab)
- Zaltrap (ziv-aflibercept)
Radiation therapy, which uses high-energy X-rays or other types of radiation to destroy cancer cells, is typically used when colon cancer has spread.
It’s also used before surgery to help lower the risk of colon cancer returning after the surgery.
This treatment may either use an external machine or radioactive substances that are placed near the cancer using needles, seeds, wires, or catheters.
Radiation therapy may cause various side effects, including:
- Bowel incontinence
- Sexual dysfunction
Other techniques to destroy cancer cells include cryotherapy (freezing them with a metal probe), radiofrequency ablation (using a probe to deliver high-frequency radio waves that heat and destroy them), and ethanol ablation (injecting concentrated cancer-destroying alcohol directly into tumors).
Colon Cancer Prognosis
In the 1940s and early 1950s, colon cancer was the most common cause of cancer death in the United States, according to a 2014 article in the journal CA: A Cancer Journal for Clinicians.
Although improved cancer screening and treatment have reduced the number of people who die from colon cancer, the disease is still the third most common cause of cancer deaths in the United States, according to the National Cancer Institute (NCI).
About 65 percent of people live at least five years after being diagnosed with colon cancer, according to NCI data.
But your chance of survival decreases significantly as the cancer spreads.
Only about 20 percent of people with colon cancer live for at least five years if it’s detected once the cancer has spread to other organs.
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