Colon cancer operations are low risk, and in recent years major surgical advances, like the increasing use of minimally invasive laparoscopic techniques, have been helping patients live longer with fewer side effects. In this excerpt of an article from our Health After 50 newsletter, Michael A. Choti, M.D., the Jacob C. Handelsman Professor of Surgery at Johns Hopkins and Director of the Johns Hopkins Colon Cancer Center talks about colon cancer surgery.
Colon cancer is first diagnosed in most patients through a colonoscopy and biopsy. Then blood tests and body scans help doctors determine whether the colon cancer has spread. Surgery to remove tumors is typically the next step.
"Surgery often cures colon cancer without any further treatment, particularly when caught early," Dr. Choti says. "Colon operations are also very safe. The risk of complications is low, and surgical mortality is under 1%."
In patients with evidence that colon cancer has spread, chemotherapy may be administered first; it often shrinks tumors and makes them more surgically manageable. "Before we decide to operate, we must be confident that all tumors can be removed; if cancer has spread too far to make that possible, then we don't recommend surgery unless the primary tumor is causing pain or blockage," explains Dr. Choti.
Getting ready for colon cancer surgery. Before your operation, the colon must be cleaned out as thoroughly as possible. You will be asked to take laxatives and go on a clear liquid diet. Even when the bowels are thoroughly cleansed, incision-site infections remain a particular risk during surgery on the colon or rectum." This is because those areas of the body contain considerable bacteria," Dr. Choti explains. "All patients should go on intravenous antibiotics within one hour of the beginning of the operation; this has been shown to lower the risk of post-operative infection."
Should you choose open or laparoscopic colon surgery? Conventional open surgery requires a 4- to 8-inch incision in the abdomen. Laparoscopic surgery is an alternative that can shorten recovery times. Instead of opening up and exposing a large portion of the abdomen, the surgeon makes a few smaller incisions and inserts cameras, which orient the operating team.
In some cases, surgeons may use a hybrid of the two techniques, called the hand-assisted laparoscopic approach. During this procedure, the surgeon inserts his or her hand through a small incision into the abdominal cavity to help guide surgical instruments."
All three of these techniques work," says Dr. Choti. "Which one you choose should depend in part on what your surgeon has experience with."
