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Treatment for colon cancer usually involves surgery. The type of surgery you need will depend on:
- The size of the tumor
- How far it has progressed—the stage of your cancer
- The location of the tumor
If You Have an Early Cancer
Doctors can remove small cancers that are found during a colonoscopy. During colonoscopy, the doctor inserts a long, flexible tube inside the rectum and colon. The tube has a light and tiny camera on one end. The doctor can view images from this camera on a monitor. Then, the doctor puts special tools through the tube to remove any growths.
Doctors may use a similar procedure to remove larger polyps. The name for that procedure is endoscopic mucosal resection (EMR). EMR involves a long tube with a light and camera and other instruments the doctor inserts through the rectum.
These procedures require sedatives. However, patients do not have to stay overnight in the hospital.
If You Have Advanced Colon Cancer
You may need more invasive surgery if cancer has grown into or through your colon.
Sometimes laparoscopic surgery is an option. Doctors do this minimally invasive surgery through small incisions in the belly. They insert instruments equipped with a light and camera to remove cancerous growths. This usually requires a shorter hospital stay than open surgery. Most people go back to their normal routines more quickly after laparoscopic surgery than open surgery.
Open surgery is a more conventional way to operate on the colon and rectum. For open colon surgery, the doctor makes a large incision in the abdomen.
Types of surgery to remove colon cancer include:
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Colectomy (total or partial): A surgeon would remove the part of your colon that has a cancerous growth. The doctor may also remove lymph nodes and some healthy colon tissue on either side of the cancer. The surgeon then reattaches the remaining parts of your digestive system. This procedure can take 1 to 4 hours.
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Low anterior resection (LAR): This surgery treats cancers that are in the upper part of the rectum. A surgeon makes an incision in the lower part of the belly to reach the tumor and removes the part of the rectum with the cancerous growth. Next, the surgeon reattaches the colon so the bowels still work normally. This operation lasts about four hours.
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Proctectomy: This operation treats cancers that have not spread too high or deep in the colon. A surgeon would remove all or part of the rectum. The surgeon may put surgical tools through the anal opening if the tumor is near the anus.
Before Surgery
You may need to stop taking some medications about a week before surgery. Make sure your doctor knows everything you take, including supplements. You also may need to:
- Follow a special diet.
- Take antibiotics.
- Clean out your colon with enemas, laxatives and clear liquids.
Also, be sure to arrange for someone to take you to and from the hospital.
After Surgery
People who've had colon cancer surgery usually need to stay in the hospital until they regain use of their bowels. This could mean up to a week's stay. Eating solid foods may be difficult after surgery. You may get nutrition through an intravenous (IV) tube as you gradually return to your normal diet.
Sometimes the colon can’t be sewn back together during surgery. In these cases, doctors change how solid waste leaves the body. They may attach the colon or small intestine to an opening in the belly. This procedure is a colostomy. Waste then leaves the body through the hole. Stool is collected in a bag placed over the hole. A colostomy may be temporary or permanent.
You will need to rest for a few weeks after a colostomy. Your care team at the hospital will teach you how to care for the hole in your belly and the bag that collects waste.
