Surgery

Surgery to remove cancer is almost always the main treatment for colorectal cancer. The type of surgery depends on the size and location of your cancer.

Side effects are common after surgery. You may be able to reduce the severity of your side effects at home. See Home Treatment for more information.

Surgery choices

• Local excision. When colorectal cancer is discovered in its very early stages, it can be removed during a sigmoidoscopy or colonoscopy. The surgeon cuts out not just the polyp, but also a small amount of tissue around it. The surgeon does not need to cut into the abdomen.
• Bowel resection. This operation involves cutting out the cancer as well as the sections of the colon or rectum that are next to it. Then the two healthy ends of the colon or rectum are sewn back together. The surgery can be done in two ways:
  • Open resection. The surgeon makes a long incision in the abdomen, completes the bowel resection, and closes the incision.
  • Laparoscopic surgery. This is done with several small incisions in the belly for a tiny camera and special instruments. But laparoscopic surgery cannot always be done, such as when the cancer has spread to areas outside the colon.

Your doctor may suggest radiation therapy or chemotherapy if he or she thinks the cancer may come back (recur). If the cancer has spread to nearby lymph nodes, you may need chemotherapy after your surgery. Or if your surgery shows that the cancer has spread outside your colon or rectum, you may need radiation therapy.

What to think about

Polypectomy or local excision is used when the cancer has been caught in its early stages. Bowel resection is used when the cancer is larger. Sometimes after this major operation, the two ends of the colon or rectum cannot be sewn back together. When this happens, a colostomy is performed. Most people do not need a colostomy.

Bowel Disease: Caring for Your Ostomy