The treatment of colorectal cancer varies depending on the stage (or size) and location of the tumor. In addition, your oncologist will consider your age and state of health in general. Today, there are several therapeutic approaches to combat colorectal cancer: surgery, chemotherapy and radiotherapy. However, when it comes to colorectal cancer, surgery is the most effective therapy.
Surgery remains the essential treatment for colorectal cancers. It consists of the removal of the bowel segment affected by the disease, the lymph nodes and a small portion of healthy tissue surrounding the cancer. After the removal, the ends of the two healthy bowels will be joined together.
Colostomy – the type of surgery performed depends on the size and location of the tumor. In most cases, however, your surgeon will perform a colostomy. If the tumor is less aggressive, the colostomy will be temporary; however, in advanced rectal colorectal cancers or those located close to the anal sphincter, the colostomy is sometimes permanent. Depending on the localization and the size of the tumor, removal of the anus can be inevitable.
If the cancer has spread to other organs or the lymph nodes, chemotherapy combined with radiotherapy will be necessary to increase the chance of survival and reduce the risk of recurrence.
Chemotherapy is a systematic treatment that affects your entire organism. The drugs travel in all parts of your body to destroy cancer cells or prevent them from multiplying. These drugs can be taken by injection, infusion or tablet form. Unlike surgery chemotherapy can be performed to treat advanced colorectal cancer associated with metastases in the liver, lungs, etc. Chemotherapy is often associated with radiotherapy.
Chemotherapy side effects may include:
- hair loss
- low blood cells count
- And more …
Radiotherapy is the use of high-energy radiation ( energy X-rays or gamma rays) to destroy cancer cells. During the procedure, your physician delivers precise doses of radiation in the area being treated, measured according to the volume of the tumor. Unlike chemotherapy, most surrounding healthy tissues are not affected by the therapy. Radiation therapy may be performed before or after the surgery; however, in the treatment of colorectal cancer, it is often performed before the surgery to reduce the size of the tumor to make the surgical intervention easier and more effective.
Side effects of radiation therapy vary from person to another. The most common discomforts you may experience after a colorectal cancer radiation therapy include:
- redness of the treated area
- urgent need to urinate
- burning sensation during urination
- Erectile dysfunction (temporary).
All is not finished after the treatment; your doctor will recommend regular monitoring to prevent or detect early relapse or complications. Usually, at least once a year, your oncologist will do a chest x-ray to determine the response of your body to the treatment. In addition, liver ultrasound and/or abdominal CT scan can be performed every four months for two years following the treatment.
Blood tests will be also necessary to monitor your white and red blood cells. These blood tests also allow your physician to detect abnormal liver function. Your oncologist may also recommend a colonoscopy a few months after the treatment to visualize the lining of your intestine. If there are multiple polyps, they will be removed and a new colonoscopy will be performed in 9 to 12 months. If the new colonoscopy reveals no polyps, another colonoscopy will be performed five years later.