Treatment of Colon Cancer

Surgery: It is the mainstay of treatment for majority of patients especially when the cancer is localized to the site of origin. The different types of surgery done are:

1> Polypectomy – In this procedure, the colonoscope is introduced into the large intestine as described above and small growths or polyps are removed surgically through the colonoscope. It does not require anesthesia and can be done in the outpatients department.

2> Local Resection of Cancer – It is generally suitable for small rectal cancer restricted to superficial area. With patient under suitable anesthesia, the surgeon dilates the anal opening. The surgical instrument is now introduced into the rectum through dilated anal opening and a circle of cancerous tissue with a small surrounding margin of healthy tissue is excised. The defect is closed with stitches.

3> Resection and Anastomosis – The patient is given general anesthesia. An incision is taken on abdomen to reach the large intestine. The diseased part of colon is felt between the fingers to determine the site of cancer. The diseased part of colon is resected i.e. cut with a margin of healthy tissue and the cut ends are anastomozed i.e. joined together by stitches. As the cancer makes the tissues fragile, an alternative pathway is needed for the stools to pass until the stitches taken on large intestine heal completely. This is done by means of colostomy wherein an opening is made onto the abdominal wall for the stools to come out either temporarily or permanently. After about 3 months, when the stitched ends have healed properly, colostomy can be closed.

4> Abdominoperineal Resection – This surgery is done when local resection is not sufficient or preserving anal opening is not advisable due to advanced stage of disease. In this procedure, complete rectum & anal canal are removed. One surgeon operating through abdominal incision frees the upper end of rectum while the second surgeon operating through the perineum i.e. anal area frees the lower end of anal canal. Hence the name – Abdominoperineal Resection.

Chemotherapy – It uses medications to destroy rapidly growing cells like cancer cells. It is especially useful in cases where the cancer has spread outside of large intestine. It is administered orally in the form of pills or given intravenously in the form of injections. It is a systemic treatment for cancer as it can kill the cancer cells present anywhere in the body system. It sometimes may affect healthy cells such as

I> Cells in the inner lining of intestine causing diarrhea.

II> Cells in the hair follicles causing baldness.

III> Cells in bone marrow causing anemia and feeling fatigue and lassitude.

These adverse effects of chemotherapy are usually temporary and revert back to normal on completion of treatment.

Radiation Therapy – It uses high energy x ray radiation to destroy the cancer cells locally. It is used pre operatively to kill the tumor cells. After radiation therapy, the dead cells are replaced by tough fibrous tissue. As the fragile cancer tissue becomes tough, it becomes easier to handle it during surgery. As a result, the colostomy procedure may be avoided altogether. It is also used post operatively to minimize the chances of recurrence of tumor at the site of origin. It can be given in following ways…

I> By using linear accelerator, high energy beams of x ray are created & then targeted to the small concise diseased part of large intestine thus reducing injury to the surrounding healthy tissues.

II> By planting minute metal particles impregnated with radio active material into the tissue at the site of tumor either during surgery or post operatively by inserting needles into the tissue.

Adequate and radical surgery with adjuvant chemotherapy and radiation therapy produces best results in the treatment of colon cancer. Avoidance of smoking and alcohol, regular exercise and healthy eating habits are the best co-therapeutic measures that patient can undertake to augment the results further.

My next article will be on “Testicular Cancer and it’s Causative Factors“.

Disclaimer: The information contained in this article is for the general public awareness only. The patient is advised to take proper medical opinion before undergoing any treatment mentioned herein. The author and publisher are not responsible for any consequences thereof.