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Colon Cancer Treatment

Choice Cancer Care – Colon Cancer Treatment in Texas

Cancer that begins in the colon is called colon cancer, and cancer that begins in the rectum is called rectal cancer. Cancer that starts in either of these organs may also be called colorectal cancer.

In the United States, colorectal cancer is the fourth most common cancer in men, after skin, prostate, and lung cancer. It is also the fourth most common cancer in women, after skin, breast, and lung cancer.

No one knows the exact causes of colorectal cancer. Many times there is no reason why one person develops this disease and another does not. Colorectal cancer is not contagious. No one can catch this disease from another person.

Research has determined that people with certain risk factors are more likely to develop colorectal cancer. Studies have found the following risk factors could increase the chances of colorectal cancer:

Age over 50: Colorectal cancer is more likely to happen as people get older. More than 90 percent of people with colorectal cancer are diagnosed after age 50. The average age at diagnosis is 72.

Colorectal polyps: Polyps are growths on the inner wall of the colon or rectum. They are common in people over age 50. Most polyps are benign (not cancer), but some polyps (adenomas) can become cancer. Finding and removing polyps may reduce the risk of colorectal cancer.

Family history of colorectal cancer: Close relatives (parents, brothers, sisters, or children) of a person with a history of colorectal cancer are somewhat more likely to develop this disease themselves, especially if the relative had the cancer at a young age. If many close relatives have a history of colorectal cancer, the risk is even greater.

Genetic alterations: Changes in certain genes increase the risk of colorectal cancer.

Personal history of cancer: A person who has already had colorectal cancer may develop colorectal cancer a second time. Also, women with a history of cancer of the ovary, uterus (endometrium), or breast are at a somewhat higher risk of developing colorectal cancer.

Ulcerative colitis or Crohn’s disease: A person who has had a condition that causes inflammation of the colon (such as ulcerative colitis or Crohn’s disease) for many years has a higher risk of developing colorectal cancer.

Diet: Studies suggest that diets high in fat (especially animal fat) and low in calcium, folate, and fiber may increase the risk of colorectal cancer. Also, some studies suggest that people who eat a diet very low in fruits and vegetables may have a higher risk of colorectal cancer. However, results from diet studies do not always agree, and more research is needed to better understand how diet affects the risk of colorectal cancer.

Cigarette smoking: A person who smokes cigarettes may be at increased risk of developing polyps and colorectal cancer.

Because people who have colorectal cancer may develop colorectal cancer a second time, it is important to have checkups. If you have colorectal cancer, you also may be concerned that your family members may develop the disease. If you think you may be at risk, please talk to our doctors. Our doctors at Choice Cancer Care may be able to suggest ways to reduce the risk and can plan an appropriate schedule for checkups.

Screening

Screening tests will help a physician to discover polyps or cancer before you have symptoms. Finding and removing polyps may prevent colorectal cancer. Also, treatment for colorectal cancer is more likely to be effective when the disease is found early.

To find polyps or early colorectal cancer:

  • People in their 50s and older should be screened.
  • People who are at higher-than-average risk of colorectal cancer should talk with our doctors about whether to have screening tests before age 50, what tests to have, the benefits and risks of each test, and how often to schedule appointments.

The following screening tests could be used to identify polyps, cancer, or other abnormal areas:

  • Fecal occult blood test (FOBT): Sometimes cancers or polyps bleed, and the FOBT can detect tiny amounts of blood in the stool. If this test detects blood, other tests are needed to find the source of the blood. Benign conditions (such as hemorrhoids) also can cause blood in the stool.
  • Sigmoidoscopy: Checks inside your rectum and the lower part of the colon with a lighted tube called a sigmoidoscope. If polyps are found, the doctor removes them. The procedure to remove polyps is called a polypectomy.
  • Colonoscopy: Examines inside the rectum and entire colon using a long, lighted tube called a colonoscope. Your doctor removes polyps that may be found.
  • Double-contrast barium enema: You are given an enema with a barium solution, and air is pumped into your rectum. Several x-ray pictures are taken of your colon and rectum. The barium and air help your colon and rectum show up on the pictures. Polyps or tumors may show up.
  • Digital rectal exam: A rectal exam is often part of a routine physical examination. Your doctor inserts a lubricated, gloved finger into your rectum to feel for abnormal areas.

Symptoms

A common symptom of colorectal cancer is a change in bowel habits. Symptoms include:

  • Having diarrhea or constipation
  • Feeling that your bowel does not empty completely
  • Finding blood (either bright red or very dark) in your stool
  • Finding your stools are narrower than usual
  • Frequently having gas pains or cramps, or feeling full or bloated
  • Losing weight with no known reason
  • Feeling very tired all the time
  • Having nausea or vomiting

Most often, these symptoms are not due to cancer. Other health problems can cause the same symptoms. Anyone with these symptoms should request an appointment to see our doctors to be diagnosed and treated as early as possible.

Usually, early cancer does not cause pain. It is important not to wait to feel pain before seeing a doctor.

If tests show an abnormal area (such as a polyp), a biopsy to check for cancer cells may be needed. Often, the abnormal tissue can be removed during colonoscopy or sigmoidoscopy. A pathologist checks the tissue for cancer cells using a microscope.

Staging

If the biopsy shows that cancer is present, our doctors will need to know the extent (stage) of the disease to plan the best treatment for you. The stage is based on whether the tumor has invaded nearby tissues, whether the cancer has spread and, if so, to what parts of the body.

Our doctors may order some of the following tests:

  • Blood tests: Checks for carcinoembryonic antigen (CEA) and other substances in the blood. Some people who have colorectal cancer or other conditions have a high CEA level.
  • Colonoscopy: If a colonoscopy was not performed for diagnosis, then a colonoscopy would be ordered to check for abnormal areas along the entire length of the colon and rectum.
  • Endorectal ultrasound: An ultrasound probe is inserted into your rectum. The probe sends out sound waves that people cannot hear. The waves bounce off your rectum and nearby tissues, and a computer uses the echoes to create a picture. The picture may show how deep a rectal tumor has grown or whether the cancer has spread to lymph nodes or other nearby tissues.
  • Chest x-ray: X-rays of your chest may show whether cancer has spread to your lungs.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of areas inside your body. You may receive an injection of dye. A CT scan may show whether cancer has spread to the liver, lungs, or other organs.

We may also use other tests (such as MRI) to see whether the cancer has spread. Sometimes staging is not complete until after surgery to remove the tumor.

Colorectal cancer is described by the following stages:

  • Stage 0: The cancer is found only in the innermost lining of the colon or rectum. Carcinoma in situ is another name for Stage 0 colorectal cancer.
  • Stage I: The tumor has grown into the inner wall of the colon or rectum. The tumor has not grown through the wall.
  • Stage II: The tumor extends more deeply into or through the wall of the colon or rectum. It may have invaded nearby tissue, but cancer cells have not spread to the lymph nodes.
  • Stage III: The cancer has spread to nearby lymph nodes, but not to other parts of the body.
  • Stage IV: The cancer has spread to other parts of the body, such as the liver or lungs.
  • Recurrence: This is cancer that has been treated and has returned after a period of time when the cancer could not be detected. The disease may return in the colon or rectum, or in another part of the body.

Many people with colorectal cancer want to take an active part in making decisions about their medical care. It is natural to want to learn all you can about your disease and treatment choices. However, shock and stress after the diagnosis can make it hard to think of everything you want to ask. It often helps to make a list of questions before your appointment.

The choice of treatment depends mainly on the location of the tumor in the colon or rectum and the stage of the disease. Treatment for colorectal cancer may involve surgery, chemotherapy, biological therapy or radiation therapy. Some people have a combination of treatments.

Colon cancer sometimes is treated differently from rectal cancer. Treatments for colon and rectal cancer are described separately below.

Our doctors will explain your treatment choices and the expected results. We will work together with you to develop a cancer treatment plan that meets your needs.

Cancer treatment is either local therapy or systemic therapy:

  • Local therapy: Surgery and radiation therapy are local therapies. They remove or destroy cancer in or near the colon or rectum. When colorectal cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
  • Systemic therapy: Chemotherapy and biological therapy are systemic therapies. The drugs enter the bloodstream and destroy or control cancer throughout the body.

Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each person, and they may change from one treatment session to the next. Before treatment starts, our health care team will explain the possible side effects and suggest ways to help you manage them.

At any stage of disease, supportive care from our Choice Cancer Care team is available to relieve the side effects of treatment, to control pain and other symptoms, and to ease your emotional concerns.

Treatment for Colon Cancer

Most patients with colon cancer are treated with surgery. Some people have both surgery and chemotherapy. Some with advanced disease get biological therapy.

A colostomy is seldom needed for people with colon cancer.

Although radiation therapy is rarely used to treat colon cancer, sometimes it is used to relieve pain and other symptoms.

Treatment for Rectal Cancer

For all stages of rectal cancer, surgery is the most common treatment. Some patients receive surgery, radiation therapy, and chemotherapy. Some with advanced disease get biological therapy.

Follow-up care after treatment for colorectal cancer is important. Even when the cancer seems to have been completely removed or destroyed, the disease sometimes returns because undetected cancer cells remained somewhere in the body after treatment. Your doctor monitors your recovery and checks for recurrence of the cancer. Checkups help ensure that any changes in health are noted and treated if needed.

Checkups may include a physical exam (including a digital rectal exam), lab tests (including fecal occult blood test and CEA test), colonoscopy, x-rays, CT scans, or other tests.

If you have any health problems between checkups, you should contact our doctors at Choice Cancer Care.

Source of information: National Cancer Institute – www.cancer.gov

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