The best way to “treat” colorectal cancer is to prevent it, through regular colonoscopy screenings during which any suspicious polyps can be removed. However, if your doctor does find evidence of colorectal cancer, your treatment options include surgery, chemotherapy, and radiation. In this Health Alert, Johns Hopkins gastroenterologist Sergey V. Kantsevoy, M.D. explains what you should expect if you are diagnosed with colorectal cancer.
Cancer treatments and outcomes have greatly improved over the past few decades as a result of advances in surgery and medicine and also because of increased knowledge about how cancer progresses and responds to therapies. A diagnosis of colorectal cancer is serious, but there are options for treatment at any stage.
In most cases, a colorectal cancer diagnosis is not an emergency situation requiring immediate surgery or treatment. There is time to meet with a team of medical specialists to hear about treatment options and time to discuss and consider their recommendations. You also have time to interview doctors, to get a second opinion, and to choose a treatment center that is experienced in treating your type and stage of colorectal cancer.
Surgery for Colorectal Cancer -- Colorectal cancer surgery is typically performed using open surgery, in which one large incision is made in the abdomen to gain access to the colon or rectum. In recent years, there has been interest in performing colorectal cancer laparoscopically, which involves insertion of small surgical instruments with cameras through a few small keyhole-like incisions made in the abdomen.
With either the open or laparoscopic procedures for colorectal cancer, surgeons remove not only the part of the colon or rectum that contains the cancer but also some of the healthy tissue that surrounds it. Surgeons also remove any lymph nodes near the colorectal cancer for later study under a microscope to see if the colorectal cancer has spread to the lymphatic system. Afterward, the surgeon sews together the remaining healthy parts of the colon or rectum.
Chemotherapy for Colorectal Cancer -- Chemotherapy uses medications to attack cancerous cells throughout the body. It sometimes follows surgery to increase the chance that all cancer cells have been eliminated. When used in this way, patients generally begin chemotherapy about one month after surgery and continue for about six months. Chemotherapy may also be administered before surgery to help shrink a tumor.
When colorectal cancer has spread to the lymph nodes or beyond the colon or rectum, physicians may use chemotherapy to slow progression of the cancer and to relieve the symptoms of colorectal cancer without expecting to achieve a cure.
Radiation Therapy for Colorectal Cancer -- Radiation therapy involves the use of x-rays to target cancer cells. This approach is used for rectal -- but not colon -- cancer. As with chemotherapy, physicians may use radiation to destroy any cancer cells that remain after surgery, to decrease the size of a cancer before surgery, or for symptom relief. Unlike chemotherapy, which affects the entire body, radiation therapy is designed to target cancer cells while minimizing damage to healthy tissues.
