Is Colon Cancer Curable?

Ask a Doctor

My dad just got diagnosed with colon polyps. They took out all the polyps they could see during the colonoscopy and he has a bunch of other diagnostic tests in process. I’m really scared for my dad. What are his chances? Is colon cancer curable?

Doctor’s Response

If colon cancer is caught in the early stages before it has spread (metastasized) to other parts of the body it may be curable.

In stages 0 and 1, the cancer has not spread beyond the colon and it may be removed. In stage 2 colon cancer, the cancer may have spread through the wall of the colon but has not spread to lymph nodes. Surgery and chemotherapy may cure the cancer at this stage.

Stage 3 colon cancer has spread to lymph nodes. It may still be curable at this stage, but the cure rate is much lower than in earlier stages. In stage 4 colon cancer, the cancer has spread to other organs, and it is unlikely to be cured with surgery.

Currently, the best way to improve your chances of surviving colon cancer and living cancer-free starts with surgery. Colon polyps, if suggestive of being either cancer-related or cancer-specific in appearance and if few in number, may be removed during colonoscopy (polypectomy). Although the primary treatment of colon cancer is to surgically remove part of your colon or all of it (colectomy) in some patients, chemotherapy after surgery can improve your likelihood of being cured if your colon cancer has spread to nearby lymph nodes.

Radiation treatment (radiation therapy) after surgery does not improve cure rates in people with colon cancer, but it is important for people with rectal cancer.

  • Given before surgery, radiation may reduce tumor size. This can improve the chances that the tumor will be removed successfully.
  • Radiation before surgery also appears to reduce the risk of the cancer coming back after treatment.
  • Radiation plus chemotherapy before or after surgery for rectal cancer can improve the likelihood that the treatment will be curative.

Surgery for Colon Cancer

Surgery is the cornerstone of treatment for colon cancer.

  • Sometimes only a polyp is found to be cancerous, and removal (polypectomy) of the polyp may be all that is necessary.
  • 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 (piece of colon is diverted and opens through portion of the abdominal wall) being necessary as the bowel having been cleaned out prior to surgery can then safely be reconnected (resection) 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.
  • 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.

In addition, some patients with metastatic colon cancer may undergo either radiofrequency or cryoablation procedures. These procedures are designed to remove or kill most of or all of the tumor and save the function of most of the remaining organ tissue (for example, liver or lung tissue).

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References
Charles Patrick Davis, MD, PhD coauthored this article

REFERENCE:

American Cancer Society. Treatment of Colon Cancer, by Stage. 19 October 2018. 3 January 2019 .