colon cancer symptom : Treatment options overview

Treatment options for colorectal cancer depend on the stage of the tumor—that is, how far it has spread or how deeply it is affecting the intestinal wall and other tissues. Treatment is also determined by the patient's age, medical history, overall health, and tolerance for specific medications and therapies.

Standard options include:

Partial colectomy (also called partial bowel resection)—The tumor and normal tissue on either side of the diseased area in the colon are removed. The surgeon then reconnects the healthy colon. Sometimes the physician may have to create a temporary colostomy, or an opening for solid waste from the bowel to a special bag a patient wears outside the body, until the healthy tissue has healed. At times, the colostomy is permanent.
Laparoscopic surgery or keyhole surgery—Small tube-like instruments and an extremely small camera are inserted into the abdomen through incisions made in the abdominal wall. The surgeon sees what the camera sees on a television-type screen and can cut out a large section of the bowel and adjacent tissue, called the mesentery.
Radiation therapy—High-energy radiation is used to kill cancer cells. Radiation may be used in conjunction with surgery as definitive therapy, or may be used to reduce, or palliate, the symptoms of colorectal cancer such as pain, bleeding, or blockage. Radiation therapy is usually delivered as external-beam radiation. Radiation comes from outside the patient's body and is directed onto the cancer and surrounding tissues. On rare occasions, these tumors can be treated by placing small pellets of radioactive material directly in or on the cancerous area, a treatment called brachytherapy. For advanced tumors, radiation can be delivered during surgery, a procedure referred to as intraoperative radiation therapy.
Chemotherapy—Drugs are given intravenously or orally to kill cancer cells. Chemotherapy is often given to decrease the chance of the tumor returning elsewhere in the body. Like radiation therapy, chemotherapy can ease disease symptoms and increase length of survival for patients with tumors that have spread. It is usually given over time and alternated with periods of no treatment. This alleviates potential side effects, such as abnormal blood-cell counts, fatigue, diarrhea, mouth sores, and a compromised immune system.
How can I choose from among the options?
You need to rely on the information provided by the team of physicians responsible for your care. Generally, patients undergo a specific therapy because a cancer specialist, after analyzing all available data and the condition of the patient, has decided it is the best way to treat the cancer.

If you are to undergo radiation therapy, a radiation oncologist will determine how much radiation is needed, to which areas of the body it should be delivered, and how many doses of radiation will be necessary.

If I choose surgery, will radiation treatment still be required?
Radiation may be used to shrink a tumor before surgical removal or destroy any remaining cancer cells after removal.

How effective is modern radiation treatment of colorectal cancer?
Surgery remains the most effective treatment for colorectal cancer. Radiation therapy is most effective as additional or adjuvant therapy either before or after surgery. It reduces the chance of cancer spread or recurrence.

Radiation is not normally used as the only, or definitive, treatment for colorectal cancer. Radiation is often used in conjunction with chemotherapy treatments that are given at the same time as the radiation to help the radiation work better. These chemotherapy treatments may be given intravenously or by mouth.

Copyright © 2006 Radiological Society of North America, Inc. (RSNA)