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Treatment: Surgery

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The first treatment option we’re going to discuss is surgery. There are a few different types of surgery, however, depending on location and size of the tumor.

One surgical option is called an Open Colectomy. It’s called ‘open’ if the operation takes place through one large abdominal incision. In this case, the doctors will remove the cancerous section of the colon as well as small portions of healthy tissue on either side, then reconnect the colon. They will probably also remove several nearby lymph nodes, as many as twelve or more. Some say that as many as possible should be taken out.

Special note: in the event an Open Colectomy is done in an emergency type of situation, the doctor may not actually reconnect the colon. They’ll do what’s called a colostomy in which the one end of the colon is connected to an opening in the abdomen and attached to a colostomy bag, which collects waste. This bag is removable and usually temporary. The doctor will need to perform another operation later to reconnect the colon so that the colostomy bag is no longer necessary and the patient will then have normal bowel function.

Another type of colectomy is called a Laparoscopic-assisted Colectomy. This is a newer option in which the doctor makes a few small incisions in the abdomen, then uses a laparoscope to complete the work. It is a long tube with a lighted camera on the end that is inserted through one of the incisions. With the help of other tube-like instruments, the laparoscope removes the diseased section, reconnects the colon, and removes the lymph nodes. With this option, recovery time may be faster and less painful than the traditional open colectomy.

Finally, we have what’s called a polypectomy. This option can be used when the cancer is still very small. Here, the tumor is removed with a colonoscope. The polyp is cut at the base of the stem and removed. A local excision is also performed to take out “superficial cancers” and a little bit of surrounding tissue. These can be done without making an abdominal incision and are also used to treat small rectal cancers.

There are a few things you should be aware of if surgery is a top option. First, preparation for these procedures may follow those of a colonoscopy, in which the patient must completely cleanse the colon, refrain from eating or drinking anything but clear liquids, and possibly adjust medication schedules. Second, expect to spend a little time in the hospital after the procedure. The patient will most likely need IV fluids for a day or two after surgery. Third, the patient may need to follow a modified diet so that the reattached colon can heal.

With regard to side affects, patients must be especially careful. Pain and/or cramping may be present, but shouldn’t need anything more than basic pain relievers. As with any surgery, the risk of infection is a possibility. In this case, because we’re dealing with the colon (and the ‘material’ that passes through it) it’s important to monitor the patient closely. Any tear or separation in the colon wall could create leakage, which could then cause a serious infection. That would probably require more surgery.

I know these things don’t sound pleasant, but keep in mind that if the patient is healthy, the risks are really fairly low and a full recovery is expected. Sometimes surgery is all that’s needed to completely remove the cancer, but that’s something that should be discussed with the doctor. (As always!)

Next up: Radiation therapy.

http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-treating-surgery



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