07/17/2024
Surgery, medical oncology and radiation oncology are treatments for colon and rectal cancer.
No one wants to learn they or someone they know has colon cancer or rectal cancer. It is common to feel anxious and scared after a colorectal cancer diagnosis. You might also feel overwhelmed about what to expect next and treatment options.
Continue reading for help understanding the three common treatments for colorectal cancer.
What type of colorectal cancer treatment is right for me?
Treatment for colorectal cancer depends on many factors, including type, location and stage of the cancer. For example, is it an adenocarcinoma, the most common type of colorectal cancer? Is the tumor located in the colon or rectum? Did your doctor find the cancer early before it spread, or has it spread to other parts of the body? Age and other health conditions may also affect a treatment plan and your personal preferences.
At Nuvance Health, the colorectal cancer care team will consider these factors and develop a treatment plan that is best for the individual.
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What is surgery for colorectal cancer?
Surgery is the most common treatment for colorectal cancer. A colorectal surgeon will remove the cancerous tumor during the cancer surgery.
If you have colon or rectal cancer, you will first undergo staging to determine the extent of the disease. This will involve imaging, such as CT scans, MRIs, ultrasounds or PET scans to see if the cancer has spread.
“Surgery is usually the first line of treatment for colon cancer if there is no evidence the cancer has spread to other parts of the body,” said Dr. James McClane, chief of colorectal surgery at Norwalk Hospital, part of Nuvance Health. “Rectal cancer management is somewhat different. Depending on the staging, we may treat it with chemotherapy and/or radiation therapy before proceeding with surgery.”
“We usually perform a colectomy to treat colon cancer,” Dr. McClane said. “During the operation, we remove the segment of the colon with the cancer as well as its adjacent lymph nodes. Then, if possible, we reconnect the colon to restore normal bowel function.”
Surgeons use a variety of techniques to perform a colectomy. The technique used depends on the location and size of the tumor and other individual factors.
“During an open colectomy, we make a single incision along the abdomen. With minimally invasive surgery, we perform the operation through small incisions and use a scope with a video camera at the end of it to see inside the body,” Dr. McClane said. “We always aim to perform the least invasive surgery possible for patients to have less pain and recover faster.”
Laparoscopic and robotic-assisted colorectal surgery (RACS) are two types of minimally invasive procedures. During a laparoscopic procedure, the surgeon places a long, thin tube with a camera on the end called a laparoscope inside the abdomen. RACS is like laparoscopic surgery except it is more advanced because the surgeon uses a robot to control the surgical instruments.
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During the colectomy, the surgeon may need to perform a colostomy if it is not possible to reconnect the colon or if they need to remove the entire colon. During the procedure, the surgeon connects a colostomy bag to the outside of the abdomen through a stoma. The colon is part of the large intestine at the end of the digestive tract. A colostomy is a way for the body to remove waste from the digestive tract as the colon heals from surgery or if the entire colon is removed. The colostomy may be temporary or permanent depending on the individual.
Most people usually stay in the hospital for a few days after colorectal surgery. How long you are in the hospital depends on the extent of the surgery.
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“Your care team will develop a pain management plan to alleviate your discomfort as much as possible after colorectal surgery. We also encourage early mobility such as walking soon after surgery because moving helps with the healing process,” Dr. McClane said.
At Nuvance Health, registered dietitians and oncology nutrition specialists are an important part of the care team.
“Most patients usually follow a modified diet until their intestines recover,” Dr. McClane says. “Patients can usually start eating solid foods a few days after colorectal surgery.”
Related content: Nutrition tips for cancer survivors
What is medical oncology for colorectal cancer?
Medical oncology is a type of systemic therapy. The goal of medical oncology is to attack and eliminate cancer cells wherever they are in the body, and in turn, increase the chances of curing the cancer and lower the risk of it coming back.
Over the past 20 years, there have been substantial advances in treatment for colorectal cancer. There is now a wide range of systemic treatment options including chemotherapy, immunotherapy, targeted therapy and more.
Not everyone with colorectal cancer needs systemic therapy. Surgery alone can usually treat early-stage cancer. We usually recommend chemotherapy after surgery for patients with local spread (cancer that has spread from the primary tumor to nearby tissue or lymph nodes) to destroy micro metastases (small groups of cancer cells).
“For people with later-stage or metastatic colon cancer, chemotherapy can prevent the cancer from spreading even further and improve their quality of life,” said Dr. Radhika Rachamalla, medical oncologist and medical director at the Dyson Center for Cancer Care. ”While chemotherapy has remained a standard treatment for many years, expanded therapeutic options including biologic therapy, immunotherapy and targeted therapy have improved average survival from less than one year in the single agent fluoropyrimidine era (a type of chemotherapy for solid tumors) to more than 2.5 years.”
Immunotherapy is a newer treatment option that uses the body’s own immune system to fight cancer. Recent immunotherapy studies have shown significant improvements in outcomes for people with genetically driven cancer. Learn more about immunotherapy.
Another type of medical oncology is targeted therapy. Unlike chemotherapy, which attacks cancer cells, targeted therapy disables specific molecular features that allow cancer cells to divide and spread. Learn more about targeted therapy.
What is radiation therapy for colorectal cancer?
Radiation therapy is one of the main possible treatment options for people with colorectal cancer. Many people with colon cancer will not need radiation therapy. Radiation therapy is more commonly used to treat rectal cancer. The location and stage of the tumor will help your care team determine whether radiation therapy will be part of your treatment plan.
Your care team may recommend radiation therapy before surgery to shrink the tumor. They may also recommend it after surgery to eliminate residual cancer cells.
Radiation treatment uses beams of energy that destroy cancer cells and shrink tumors. Radiation oncologists target the cancer and areas at risk of microscopic tumor spread while avoiding healthy tissue as much as possible.
You will not feel or see the radiation during treatments. Treatments are usually quick, and you are not radioactive after a treatment. The number of treatments recommended depends on the location and stage of the cancer.
“We carefully consider each individual’s cancer and the potential benefits and side effects of radiation therapy to determine when and how to deliver it,” said Dr. Maryann Mikucki, radiation oncology, Vassar Brothers Medical Center, part of Nuvance Health. “If you or a loved one needs radiation therapy, it may be helpful to know that we create a personalized radiation plan for each patient based on your anatomy, which helps us reduce the risk of side effects during treatment.”
Your care team will help you manage possible side effects from radiation therapy for colorectal cancer. Side effects may include pain or skin changes that feel like a sunburn in the treated area, discomfort during bowel movements, diarrhea and fatigue.
The bottom line: If you or someone you know has colorectal cancer, your care team may recommend surgery as the initial treatment, depending on the type, location and stage of the cancer. Your treatment plan may include medical oncology, such as chemotherapy, and radiation therapy either before or after surgery depending on the extent of the cancer. At Nuvance Health, your care team will develop a treatment plan based on your circumstances while also following the latest guidelines and standards of care.
Frequently Asked Questions
What are the potential side effects of each type of colorectal cancer treatment (surgery, chemotherapy and radiation therapy)?
Each type of colorectal cancer treatment comes with its own set of potential side effects. For instance, surgery can lead to bowel changes. Chemotherapy might cause fatigue, nausea and hair loss. Radiation therapy could result in skin irritation and bowel issues. It is important to discuss potential side effects with your healthcare team to understand how they might affect your treatment plan and what to expect.
Thankfully, there are many ways to manage side effects from different colorectal cancer treatments, whether through medications for nausea from chemotherapy, or topical treatments for skin irritation from radiation therapy. Please share how you feel with your care team because they can offer options for managing side effects or readjusting your therapies, if possible.
Are there any alternative or complementary therapies that can be used alongside the standard treatments for colorectal cancer?
In addition to standard treatments, some people explore alternative or complementary therapies such as acupuncture, dietary supplements or meditation to help manage symptoms and improve quality of life. Always consult with your doctor before starting any new therapies to ensure they are safe and will not interfere with your treatment.
How does the care team decide the sequence or combination of colorectal cancer treatments for an individual patient?
Your care team will tailor the type and order of treatments based on factors like the stage and location of the cancer, and your overall health and preferences. At Nuvance Health, a team of specialists works together to create a personalized treatment plan, ensuring the best possible outcomes while considering your unique situation.