Colon Cancer Treatment
2 AnswersTreatment for colorectal cancer depends on the extent, or stage, of the cancer and whether it has spread to the lymph nodes or other organs. Colorectal cancer is usually treated first with surgery, which may be followed by chemotherapy and/or radiation therapy.
Surgical options for colorectal cancer depend largely on the location and extent of the cancer. For cancer of the large intestine, removing the cancerous section of the colon and splicing the remaining ends together is usually considered.
This surgery also has the advantage of removing the lymph glands attached to that colon section, in case the cancer has spread. Surgery of this type removes the need for a colostomy or ileostomy.
1 AnswerNorthShore University HealthSystem answeredThere is a genetic mutation called KRAS that we look for within the actual colon cancer specimen once it’s removed.
Forty percent of people with colorectal cancer have a genetic mutation. This genetic mutation can affect the medicine, called EGFR inhibitors, we use because KRAS can block the medication from working. Not only do we know that people with genetic mutations don’t respond to the medicine, but there’s been data that suggests that if we give it to people who have these mutations, they actually might do worse because of it.
1 AnswerChemotherapy uses powerful drugs, which are often delivered intravenously, to kill cancer cells. Though generally given after surgery to help ensure that a cancerous growth does not return, doctors may also use the treatment prior to surgery to reduce the size of a tumor.
While the treatment kills cancer cells, it also damages healthy ones as well. For colorectal cancer patients, it may cause side effects such as vomiting, nausea, diarrhea, or mouth sores. These symptoms have become less problematic over time. Medications, however, do exist to ease a patient's symptoms.
1 AnswerAlthough the techniques vary, minimally invasive surgical procedures employ video cameras and lens systems to provide anatomic visualization within a region of the body.
Achieving such visualization requires the creation and maintenance of an optical cavity, most commonly created with carbon dioxide insufflation. Using short incisions in the skin, narrow tubes are inserted through the abdominal wall so that instruments can be slid through them to perform the maneuvers necessary for the operation. All this is viewed directly on a video monitor that receives its picture from a video camera attached to the laparoscope.
This minimally-invasive procedure has many advantages for patients, including:
•small incisions in the skin;
•less pain associated with surgery;
•reduced hospitalization time;
1 AnswerFor patients with metastatic colorectal cancer (CRC), there have been a number of major advances to improve both quantity and quality of life. In addition to chemotherapy regimens, several other new, effective systemic agents have become available to combat CRC over the past decade. One example is bevacizumab which is in the class of drugs known as vascular endothelial growth factor (VEGF) inhibitors. These medicines block abnormal blood vessel growth, thereby normalizing the blood vessels around the tumor. Neovasculature, new blood vessels formed by the tumor in order to sustain itself, may shrink away dramatically after treatment with bevacizumab. Another type of targeted therapy is the class of drugs that blocks the epidermal growth factor receptor (EGFR) on tumor cells. The intravenous (IV) medication cetuximab is an example of an EGFR inhibitor that improves tumor cell kill when used in combination with chemotherapy against CRC.
1 AnswerThe most likely side effects of colorectal (CRC) chemotherapy medicines are fatigue, diarrhea, and irritation of the lining of the mouth. A rare but sometimes severe side effect of these medicines is severe scaling of the hands and feet (called hand-foot syndrome). Even more rarely, patients may develop significant heart damage including potential heart attack with 5 fluorouracil (5FU).
1 AnswerTumors that are located at least a couple of inches above the anal sphincter are usually able to be removed (quite often after preoperative concurrent chemoradiotherapy or chemoRT) without need for a colostomy. The colorectal surgeon will perform a type of surgery called a total mesorectal excision, which involves removal of the rectal tumor with surrounding tissue and nearby lymph nodes all together in one sharply dissected specimen. The colon is joined to the anus, as long as the tumor can be removed with negative surgical margins, while leaving the anal sphincter muscle functioning. When tumors arise in the very low rectum, sometimes surgery requires creation of a colostomy. The bottom portion of the rectum and the anus are removed in this procedure, called an abdominoperineal resection. Most major cancer centers have support groups for patients who require a colostomy.
For best results, cancer treatments require a team approach. Anyone diagnosed with colorectal cancer should have surgery with a surgeon specially trained in cancer or colorectal surgery. Some patients may need chemotherapy, either before surgery to shrink the tumor, or afterwards to reduce the risk of relapse, and these treatments should be administered under the supervision of a medical oncologist. Patients with colon cancer will generally not require radiation therapy, but those with rectal cancer will be treated by a radiation oncologist. Most major medical centers offer coordinated and integrated cancer services that include counseling, support and educational services in addition to the necessary clinical treatments.
1 AnswerChemotherapy is the mainstay of treatment for colon cancer. Radiation is used for residual tumor or in areas where the tumor is in a fixed position. Depending upon the stage of colon cancer it may also be utilized for palliative treatment. It is utilized with concurrent chemotherapy for rectal cancer.