Colorectal Cancer (cont.)
IN THIS ARTICLE
The first step in treating colorectal cancer is usually an operation to remove the tumor. Sometimes a simple operation can be done during a colonoscopy or sigmoidoscopy to remove small polyps and a small amount of tissue surrounding them. But in most cases a major operation, in which the cancer and part of the colon or rectum around it are removed, is needed. If cancer has spread to another part of your body, such as the liver, you may need more far-reaching surgery.
After the cancer has been examined under a microscope, it will be staged. Staging is a way for your doctor to tell how far, if at all, your cancer has spread. It also helps your doctor decide what your treatment should be.
There are several different types of staging systems, so it's important to ask your doctor to explain carefully what stage your cancer is in and what that means.
You and your doctor will work together to decide what your treatment should be. You will consider your own preferences and your general health, but the stage of your cancer is the most important tool for choosing your treatment.
Surgery is almost always used to remove colorectal cancer. Your doctor may use one of the following types of surgery:
Sometimes it is possible to have laparoscopic surgery to remove the cancer. This is surgery where very small incisions are made in the belly. A tiny camera and special instruments are used to remove the cancer. For the best results, it is important to have an experienced surgeon and to have this surgery at a hospital where many of these surgeries are done.3
Even after removing all the cancer that can be found with surgery, your doctor may say you need other treatment. This may be chemotherapy, radiation, or both (chemoradiation).
Chemotherapy uses medicines—given either as pills or through a needle—to destroy cancer cells throughout the body. Several medicines are often used together. Research studies continue to look for the best combinations of medicines. Your doctor will recommend treatment based on the type and stage of cancer that you have.
Radiation therapy, which uses X-rays to destroy cancer cells, is standard treatment for some types of cancer in the rectum. Radiation therapy is often combined with surgery or chemotherapy. Radiation may be given from a machine outside the body that targets the cancer (external radiation). Or it may be given inside the body, with radiation sealed in seeds or wires (internal radiation).
Compared to surgery alone, radiation therapy given before surgery for rectal cancer may reduce the risk that the cancer will return and may help you live longer.4
Side effects of treatment
The side effects of treatment for colorectal cancer will depend on the type of treatment you have and your age and overall health. The side effects of surgery, chemotherapy, or radiation may be mild enough that you can do things at home to manage them. See the Home Treatment section of this topic for more information.
Some of the treatment side effects can be avoided. For example, your doctor may prescribe medicines to control nausea and vomiting caused by chemotherapy. Other problems may be more serious, such as pain or tingling in your hands or feet that gets worse (peripheral neuropathy). These problems may be a sign that your medicines need to be changed. Be sure to talk to your doctor about all the side effects that you have.
For more information about specific treatments, see the following topics:
After your treatment, you will need regular checkups by a family doctor, general practitioner, medical oncologist, radiation oncologist, or surgeon, depending on your case. During your follow-up visits you may have one or more of these tests:
Treatment if the condition gets worse
Colorectal cancer comes back after surgery in about half of people who have surgery to remove the cancer.4 The cancer may be more likely to come back after surgery if it was not discovered in an early stage. Cancer that has spread or comes back is harder to treat. A cure is less likely, but treatment can help you feel better and live longer. For more information, see the topic Colorectal Cancer, Metastatic and Recurrent.
What to think about
After you have had colorectal cancer, your chances of having it again go up. It's important to continue to see your doctor and be tested regularly to help find any returning cancer or new polyps early.
Clinical trials are designed to find better ways to treat people with cancer and are based on the most current information. Some people who meet the criteria for participation choose to enroll in such clinical trials.
eMedicineHealth Medical Reference from Healthwise
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