Colon Cancer (cont.)
Surgery is the cornerstone of treatment for colon cancer.
- You will usually only need to have a portion of your colon removed for colon cancer. In rare circumstances such as in longstanding ulcerative colitis or in cases where large numbers of polyps are found, then the entire colon may need to be removed. Most colon cancer surgery will not result in a colostomy being necessary as the bowel having been cleaned out prior to surgery can then safely be reconnected after a portion is removed. In rectal cancer sometimes a colostomy is necessary if it is not safe or feasible to reconnect the portions of the rectum and anus that remain after the cancer involved area is removed.
- Sometimes only a polyp is found to be cancerous, and removal of the polyp may be all that is necessary.
- Surgery may also be done to relieve symptoms in advanced cancer such as when the cancer has caused a bowel obstruction. The usual procedure is bypass for obstructions that cannot be cured. Rarely a colon cancer presents with such severe blockage (obstruction) or is so massive that a resection cannot be done. Usually then a colostomy is formed after which other treatment is planned.
Sometimes a colorectal tumor can be surgically removed only by creation of a permanent colostomy.
- This is a small, neatly constructed opening in your belly. As part of the surgery, the colon that is left in your body is attached to this opening.
- Fecal matter will exit your body through this hole instead of through your anus.
- You will wear a small appliance or bag, which attaches to your skin around the opening and collects fecal matter. The bag is changed regularly to prevent skin irritation and odor.
- Your surgeon will attempt to preserve your rectum and anus whenever possible. Several surgical procedures have been developed that can preserve evacuation of fecal material through the anus whenever possible.
Whether you need a colostomy depends on individual circumstances.
- In general, tumors on the right side of your colon or on the left side above the level of the rectum may not call for colostomy.
- Tumors in the rectum may require removal of the rectum and anal sphincter and construction of a permanent colostomy to divert your bowel.
Robert J Fingerote, MD, MSc, BSc
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
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