If colorectal cancer has not spread beyond the colon or lymph nodes, surgical removal of the tumor is the most common treatment. Surgical procedures for rectal cancer are more complex than for colon cancer. In rectal surgery more tissues and muscles related to urinary and sexual functions are involved.
Patients with a strong family history of cancer, intractable inflammatory bowel disease,
familial adenomatous polyposis (FAP)
, or hereditary nonpolyposis colon cancer (HNPCC) may elect to have their colon removed in advance of developing problems. This procedure can sometimes be done laparascopically, with smaller incisions and shorter recovery time.
A tube is placed up the rectum into the colon, and the cancerous tumor is removed. This procedure is used when the cancer is found at an early stage.
If the cancer is larger, both the tumor and a small amount of healthy tissue and nearby lymph nodes will be removed. This is called a colectomy. In many cases, the healthy portions of the colon and rectum are reconnected. This reconnection procedure is called anastomosis. If your surgeon can possibly preserve your anal function (and ultimately avoid the need for a permanent colostomy), that is generally considered a preferred procedure. A surgical procedure requiring a permanent colostomy has never been shown to be better or more curable than a procedure where you can ultimately still have a normal bowel movement.
Partial Resection or Total Colectomy and Colostomy
If it is not possible to reconnect the colon, a colostomy is necessary. A colostomy is a surgical opening (stoma) through the wall of the abdomen into the colon. This is used as a path for waste material to leave the body. After a colostomy, you will wear a special bag to collect body waste. The colostomy may be either temporary or permanent. In cases where the entire colon is removed (usually because of increased risk of developing additional cancers), the small bowel will be used to create the stoma.
Updated Introductory section on 9/18/2007 according to the following study, as cited by
DynaMed's Systematic Literature Surveillance
: Küchler T, Bestmann B, Rappat S, Henne-Bruns D, Wood-Dauphinee S. Impact of psychotherapeutic support for patients with gastrointestinal cancer undergoing surgery: 10-year survival results of a randomized trial.
J Clin Oncol.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a