Treatment of Colorectal Cancer

The type of treatment recommended for colorectal cancer depends largely on the stage of the cancer. The three primary treatment options are: surgery, chemotherapy and radiation.

In the cancer is at a very early stage and is localised in a small polyp, the surgeon may be able to remove it completely during a colonoscopy. A pathologist will check that the cancer doesn't involve the base of the polyp (where it joins to the bowel wall) to make sure that it has been completely eliminated.

Larger polyps may be removed using laparoscopic surgery, where the surgeon performs the operation using instruments with attached cameras that are inserted into the colon thorough small incisions in the abdominal wall. They may also take a sample from the lymph node that drains the cancerous area to ensure that the cancer has not spread.

For the majority of cases, the affected part of the bowel must be removed in an operation known as a colectomy. The surgeon removes the cancerous part of the colon along with a margin of healthy tissue on either side. The two healthy edges are then joined. However, if this is not possible, for example if the cancer is very low in the rectum, a colostomy must be performed, creating an opening in the wall of the abdomen from a portion of the remaining bowel. The waste material from the body is eliminated from this opening into a special bag. A colostomy is occasionally created temporarily to allow the colon or rectum time to heal after surgery. However, in some cases, the colostomy may be permanent.

Radiation or chemotherapy therapy is often prescribed to destroy cancer cells after surgery, to shrink large tumours before an operation or to relieve symptoms of advanced colorectal cancer. The two treatments may also be combined in a process known as chemoradiotherapy.

Other treatments include monoclonal antibody therapy, used in cases where the cancer has spread (metastaic cancer). These drugs can be used in conjunction with chemotherapy or radiation to help slow tumour growth and even shrink tumours. One such drug known as Avastin has been shown to add an average of five months to patients' survival time.

Follow-up care after treatment for bowel cancer is extremely important. Regular check-ups will be necessary, along with blood tests chest X-rays and perhaps colonoscopies. The patient will also be encouraged to report any new symptoms to the doctor immediately.