What Are the Treatment Options for Colon Cancer?

What is staging?

Staging explains the extent of your cancer, meaning how big the cancer is, and how much the cancer has spread. Knowing the stage of your cancer helps the doctor to understand how serious your cancer is, your chance of survival, and it helps the doctor to decide the best treatment options for you.

The staging of colon cancer is most often done with the help of an abdominal and chest CT scan. In some situations, it is hard to stage the cancer until after the colon surgery.

The staging of the cancer includes:

Stage 1 - The cancer has grown through the superficial mucosal lining, but has not spread beyond this lining.

Stage 2 – The cancer has spread through the full thickness of the wall of the colon or rectum, but has not spread to the lymph nodes.

Stage 3 – The cancer has invaded the nearby lymph nodes, but has not yet spread to the other parts of the body.

Stage 4 – The cancer has spread to distant organs, such as the liver and lungs.

After staging the cancer, your doctor will decide on the most appropriate treatment options for you. The three major treatment options available are surgery, chemotherapy, and radiation.

Surgery

There are different types of surgeries involved depending on the staging of your cancer. If your cancer is very small and is in its early stages, then your doctor will recommend a minimally invasive surgical procedure, such as the removal of a polyp. If your cancer is invasive, then the recommendations will differ greatly.

The potential recommendations will be considered if the cancer has already invaded all mucosal layers:

• Partial colectomy – This is the removal of a part of your colon carrying the cancerous tissues, including a small part of the healthy tissue. Next, the healthy ends of the colon are reconnected.
• Colostomy – Sometimes it is impossible to connect the ends of the colon together. In these situations, one end of the colon is connected to a small opening on your abdomen which is connected to a colostomy bag outside. This is done to provide a way for your faeces to leave your body. This colostomy can be temporary or permanent. A temporary colostomy is put to allow your colon to heal. Sometimes the colostomy can be permanent.
• Removal of the lymph nodes – The nearby lymph nodes are removed and sent for histology to check if the cancer has spread in to them.

In cases where the cancer is very advanced and has already spread to distant organs, your surgeon may recommend you surgery to just improve the signs and symptoms. Releasing the blockage of your colon can reduce the pain and other symptoms. However, this will not cure the cancer.

If the cancer has spread to your liver and if your overall health condition is good, then your surgeon may suggest removal of the cancerous cells from the liver.

Chemotherapy

Chemotherapy use drugs that kill the cancer cells. Usually in colon cancer, chemotherapy is given after surgery if the cancer has spread to the nearby lymph nodes. This is to prevent recurrence of the cancer. In some cases, chemotherapy is given before the surgery to shrink the tumor to make it operable. 

Radiotherapy

Radiation uses x-rays to kill cancer cells. This is usually used after surgery to kill the remaining cancer cells. Using radiotherapy after surgery also helps to reduce the rate of recurrence.

Sometimes it is also given before surgery to reduce the size of the tumor to make it operable and sometimes just to relieve the signs and symptoms.

Palliative care

Palliative care is provided by a multi-disciplinary team, which includes doctors, nurses, care takers, psychiatrist, social workers, etc.  They focus on providing pain relief and other symptomatic care for those suffering with serious illness.  This form of care will be provided along with the other curative therapy you will receive. With palliative care, your quality of life can be greatly increased and even prolong your survival of life.