How is colon cancer treated?

Treatment of colon cancer depends on the stage of the cancer, its location and on the patient’s general health. Several different types of treatment are used; sometimes different treatments are combined.

The main treatments for colon cancer are surgery and chemotherapy. Rectal cancer (cancers located in the lowest 6 inches of the large bowel) also is treated with radiation therapy.

Surgery

Surgery is the treatment used most often for colorectal cancer. Colon and rectal cancers require surgery if they are to be cured. Surgery usually involves removal of the cancer and some of the surrounding tissue. In most cases, the surgeon can reconnect the remaining healthy portions of the colon (anastomosis) after removing the cancer.

If the surgeon cannot reconnect the healthy portions of the colon, a colostomy will be necessary. A colostomy is an opening (stoma) through the abdominal wall into the colon. This opening provides a new passage for waste to leave the body. The colorectal cancer patient wears a special bag to collect the waste. In most cases, the stoma and colostomy bag are temporary, though for some patients they will be permanent.

The surgical procedures for colon cancer include the following:

  • Polypectomy: polyps are removed during a colonoscopy.
  • Local excision: This procedure is performed when the cancer is in an early stage. It does not require major abdominal surgery; instead, the cancer is removed through the anus.
  • Resection: total removal of parts of the colon and surrounding tissue which requires a major surgery.

Laparoscopic Surgery

Cleveland Clinic provides state-of-the-art laparoscopic surgery for a variety of colorectal conditions, including Crohn’s disease, ulcerative colitis, diverticular disease, familial polyposis, chronic constipation, colon cancer and rectal prolapse.

A minimally invasive approach to surgery, laparoscopic procedures afford patients the benefit of smaller incisions, less pain, fewer heart, lung and wound complications and shortened hospital stay. “The best thing about laparoscopic colon surgery is that we can offer patients the results of a traditional, open surgery but with incisions that are only two inches long,” remarks Cleveland Clinic Chairman of the Department of Colorectal Surgery Victor Fazio, M.D.

Radiation Therapy

In radiation therapy, high-energy x-rays damage or destroy cancer cells in order to shrink tumors. The radiation may be delivered by special equipment that directs the radiation from outside the body (external radiation). Rarely radiation may also come from an implant, a small container of radioactive material placed into or near the tumor.

Chemotherapy

Chemotherapy drugs are cancer-killing medicines given either intravenously (injected into a vein) or by mouth. Chemotherapy might be given before surgery to reduce the size of the tumor in order to make it easier to remove. Chemotherapy may also be administered after surgery to kill any cancer cells that might be left in the body.

How are the different stages of colon cancer treated?

Treatment of colon cancer varies depending on the stage of the disease:

  • Stage I: resection and polypectomy for the smallest and for larger tumors.
  • Stage II: resection and anastomosis, sometimes followed by clinical trials of chemotherapy, radiation (or radiation for rectal cancers).
  • Stage III: resection and anastomosis followed by either chemotherapy or clinical trials of chemotherapy (Radiation is used for rectal cancers stage III).
  • Stage IV: resection and anastomosis, removal of parts of other organs to which the cancer has spread, radiation and standard chemotherapy, clinical trials of chemotherapy or experiment biologic therapy.

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