Treatment of Colorectal Cancer

Treatment options for colorectal cancer are dependent on many different factors. You and your doctor need to consider the type of colorectal cancer, the stage at diagnosis and the aggressiveness of the disease. A variety of options are available including surgery, radiotherapy (radiation), chemotherapy, and targeted therapy. Each patient’s disease is unique and therefore, medical management should be personalized for each patient. Below is an explanation of treatment options that your doctor may recommend.

Treatment of colon cancer by stage:

Stage 0 colon cancer has not grown beyond the inner lining of the colon. Surgery is typically performed to take out the cancer. This stage may only require a polypectomy (removal of the polyp) and no additional surgery.

Stage I colon cancer has grown into the layers of the colon wall, but has not spread outside of the wall. Surgery may be performed to remove the cancer. Additional surgery may be required if there are cancer cells found at the edges of the area that is removed.

Stage II colon cancer has grown through the colon wall and possibly into surrounding tissue, but has not yet spread to lymph nodes. Surgery is recommended to remove the cancerous section of the colon along with nearby lymph nodes (partial colectomy). Adjuvant chemotherapy (chemotherapy after surgery) may be recommended if your cancer has a high risk of returning.

Stage III colon cancer has spread to nearby lymph nodes, but has not reached other parts of the body. The standard treatment for this stage includes a partial colectomy (removal of the cancerous section of the colon along with nearby lymph nodes) followed by adjuvant chemo therapy.

Stage IV colon cancer has spread from the colon to distant parts of the body such as liver, lungs, peritoneum (lining of the abdominal cavity), or distant lymph nodes. If the spread is only in a few small areas within the liver or lungs they may be removed with surgery to alleviate symptoms and improve outcome. Radiation therapy and chemotherapy may also be offered to help relieve symptoms caused by the cancer. (cancer.org)

Treatment of rectal cancer by stage:

Stage 0 rectal cancer has not grown beyond the inner lining of the rectum. Treatment usually involves surgery or polypectomy (removal of the polyp).

Stage I rectal cancer has grown deeper into the rectal wall layers, but has not spread outside of the rectum. Surgery may be performed to remove the cancer. Additional surgery may be required if there are cancer cells found at the edges of the area that is removed.

Stage II rectal cancer has grown through the rectum walls and could extend into nearby tissues, but has not spread to the lymph nodes. Treatment for this stage involves chemotherapy, radiation therapy and surgery. The order may differ depending on the patient’s needs.

Stage III rectal cancer has spread to nearby lymph nodes, but has not reached other parts of the body. Treatment for this stage involves chemotherapy, radiation therapy and surgery. The order may differ depending on the patient’s needs.

Stage IV rectal cancer has spread from the rectum to distant parts of the body such as the liver or lungs. Treatment of this stage may involve surgery depending on the location(s) of the cancer. Radiation therapy and chemotherapy may also be offered to help relieve symptoms caused by the cancer.

Surgical Therapy for Colon Cancer

Surgery is often the main treatment for early stage colon cancer. The type of surgery depends on the stage and location of the cancer.

Types of Colon Cancer Surgery

Polypectomy- cancer is removed as part of the polyp, usually via a colonoscope (a long, thin, flexible tube with a camera and a light on the end)

Local excision– removal of superficial cancer and a small amount of nearby colon wall tissue

Colectomy– surgery to remove all or part of the colon and nearby lymph nodes

Surgical Therapy for Rectum Cancer

 

Surgery is often the main treatment for rectum cancer. Radiation and chemotherapy may also often be given before or after surgery.

Types of Rectum Cancer Surgery

Polypectomy- cancer is removed as part of the polyp, usually via a colonoscope (a long, thin, flexible tube with a camera and a light on the end)

Local excision– removal of superficial cancer and a small amount of nearby colon wall tissue

Resection- surgical removal of part of the rectum. Resection would be considered depending on the location of the tumor within the rectum and how advanced the disease is

Pharmacological therapy – administered by Medical Oncologist

Chemotherapy

Chemotherapy treatment is the use of cytotoxic drugs to destroy cancer cells. There are a large variety of chemotherapy drugs available to treat colorectal cancer. Some chemotherapy may be taken by mouth and others are infused directly into a vein. Occasionally the tumor will be very large and chemotherapy will be prescribed before surgery to shrink the tumor; this is called neo-adjuvant therapy. Neo-adjuvant therapy makes it easier to remove as much of the tumor as possible during surgery. After surgery you may be prescribed chemotherapy to kill any remaining cancerous cells; this is called adjuvant therapy. (http://www.cancerresearchuk.org/about-cancer/type/colorectal-cancer/treatment/surgery-for-colorectal-cancer) and (www.cancer.org)

Common chemotherapy drugs:

  • 5-Fluorouracil (5-FU)– Often given with the drug leucovorin (also called folinic acid) or a drug called levo-leucovorin, which helps 5-fluorouracil work more effective.
  • Capecitabine (brand name: Xeloda®)- Is in pill form of 5-FU. The pill is processed into active 5-FU when it gets to the liver.
  • Irinotecan (brand name: Camptosar®)
  • Oxaliplatin (brand name: Eloxatin™)
  • Trifluridine and tipiracil (brand name: Lonsurf®)

Common side effects:

  • Nausea and vomiting
  • Loss of appetite
  • Loss of hair
  • Increased chance of infection
  • Bleeding or bruising after minor cuts or injuries
  • Fatigue
  • Mouth sores
  • Diarrhea
  • Low blood cell counts

Treatment options for colorectal cancer are dependent on many different factors. You and your doctor need to consider the type of colorectal cancer, the stage at diagnosis and the aggressiveness of the disease. A variety of options are available including surgery, radiotherapy (radiation), chemotherapy, and targeted therapy. Each patient’s disease is unique and therefore, medical management should be personalized for each patient. Below is an explanation of treatment options that your doctor may recommend.

Treatment of colon cancer by stage:

Stage 0 colon cancer has not grown beyond the inner lining of the colon. Surgery is typically performed to take out the cancer. This stage may only require a polypectomy (removal of the polyp) and no additional surgery.

Stage I colon cancer has grown into the layers of the colon wall, but has not spread outside of the wall. Surgery may be performed to remove the cancer. Additional surgery may be required if there are cancer cells found at the edges of the area that is removed.

Stage II colon cancer has grown through the colon wall and possibly into surrounding tissue, but has not yet spread to lymph nodes. Surgery is recommended to remove the cancerous section of the colon along with nearby lymph nodes (partial colectomy). Adjuvant chemotherapy (chemotherapy after surgery) may be recommended if your cancer has a high risk of returning.

Stage III colon cancer has spread to nearby lymph nodes, but has not reached other parts of the body. The standard treatment for this stage includes a partial colectomy (removal of the cancerous section of the colon along with nearby lymph nodes) followed by adjuvant chemo therapy.

Stage IV colon cancer has spread from the colon to distant parts of the body such as liver, lungs, peritoneum (lining of the abdominal cavity), or distant lymph nodes. If the spread is only in a few small areas within the liver or lungs they may be removed with surgery to alleviate symptoms and improve outcome. Radiation therapy and chemotherapy may also be offered to help relieve symptoms caused by the cancer. (cancer.org)

Treatment of rectal cancer by stage:

Stage 0 rectal cancer has not grown beyond the inner lining of the rectum. Treatment usually involves surgery or polypectomy (removal of the polyp).

Stage I rectal cancer has grown deeper into the rectal wall layers, but has not spread outside of the rectum. Surgery may be performed to remove the cancer. Additional surgery may be required if there are cancer cells found at the edges of the area that is removed.

Stage II rectal cancer has grown through the rectum walls and could extend into nearby tissues, but has not spread to the lymph nodes. Treatment for this stage involves chemotherapy, radiation therapy and surgery. The order may differ depending on the patient’s needs.

Stage III rectal cancer has spread to nearby lymph nodes, but has not reached other parts of the body. Treatment for this stage involves chemotherapy, radiation therapy and surgery. The order may differ depending on the patient’s needs.

Stage IV rectal cancer has spread from the rectum to distant parts of the body such as the liver or lungs. Treatment of this stage may involve surgery depending on the location(s) of the cancer. Radiation therapy and chemotherapy may also be offered to help relieve symptoms caused by the cancer.

Surgical Therapy for Colon Cancer

Surgery is often the main treatment for early stage colon cancer. The type of surgery depends on the stage and location of the cancer.

Types of Colon Cancer Surgery

Polypectomy- cancer is removed as part of the polyp, usually via a colonoscope (a long, thin, flexible tube with a camera and a light on the end)

Local excision– removal of superficial cancer and a small amount of nearby colon wall tissue

Colectomy– surgery to remove all or part of the colon and nearby lymph nodes

Surgical Therapy for Rectum Cancer

Surgery is often the main treatment for rectum cancer. Radiation and chemotherapy may also often be given before or after surgery.

Types of Rectum Cancer Surgery

Polypectomy- cancer is removed as part of the polyp, usually via a colonoscope (a long, thin, flexible tube with a camera and a light on the end)

Local excision– removal of superficial cancer and a small amount of nearby colon wall tissue

Resection- surgical removal of part of the rectum. Resection would be considered depending on the location of the tumor within the rectum and how advanced the disease is

Pharmacological therapy – administered by Medical Oncologist

Chemotherapy

Chemotherapy treatment is the use of cytotoxic drugs to destroy cancer cells. There are a large variety of chemotherapy drugs available to treat colorectal cancer. Some chemotherapy may be taken by mouth and others are infused directly into a vein. Occasionally the tumor will be very large and chemotherapy will be prescribed before surgery to shrink the tumor; this is called neo-adjuvant therapy. Neo-adjuvant therapy makes it easier to remove as much of the tumor as possible during surgery. After surgery you may be prescribed chemotherapy to kill any remaining cancerous cells; this is called adjuvant therapy. (http://www.cancerresearchuk.org/about-cancer/type/colorectal-cancer/treatment/surgery-for-colorectal-cancer) and (www.cancer.org)

Common chemotherapy drugs:

  • 5-Fluorouracil (5-FU)– Often given with the drug leucovorin (also called folinic acid) or a drug called levo-leucovorin, which helps 5-fluorouracil work more effective.
  • Capecitabine (brand name: Xeloda®)- Is in pill form of 5-FU. The pill is processed into active 5-FU when it gets to the liver.
  • Irinotecan (brand name: Camptosar®)
  • Oxaliplatin (brand name: Eloxatin™)
  • Trifluridine and tipiracil (brand name: Lonsurf®)

Common side effects:

  • Nausea and vomiting
  • Loss of appetite
  • Loss of hair
  • Increased chance of infection
  • Bleeding or bruising after minor cuts or injuries
  • Fatigue
  • Mouth sores
  • Diarrhea
  • Low blood cell counts

Cancer Caregiver:

A caregiver is anyone who provides physical, emotional, spiritual, financial, or logistical support to anyone suffering from a disabling or life threatening illness. Caring for a loved one with cancer is the role of caregivers but it is also important that caregivers take care of themselves. Finding a balance between helping your loved one and helping yourself is imperative for all caregivers.

Every caregiver is at a different point in their journey. Understanding the important role caregivers hold helps them be effective at embracing their new life. Caregivers may face many obstacles while adapting to their new role, but there are resources to help them along the way. Some online resources include the American Cancer Society (cancer.org), the National Cancer Institute (cancer.gov), Cancer Support Community (cancersupportcommunity.org), OncoLink (oncolink.com), and Breastcancer.org.

Some tips that may help include:

Find support from others in similar positions: Communicating with other caregivers may help you relieve stress and become a better caregiver.

Educate yourself on their specific situation: Learning about what your loved one is going through will enable you to help them in many different ways.

Embrace new life changes: It is normal to feel like things are different and that they may never be how they once were. It is important to embrace your new situation and learn to adapt to the changes in life. Learning to balance what you have control of and what is out of your control may help remove some of the stress from your life.

Take time outs: It is ok to take time for yourself. Rejuvenating yourself is imperative to becoming the best caregiver you can be.

Remain connected with community, friends, and family: Becoming a caregiver should not involve you abandoning your old life. Being around people that love and care about you can recharge you and uplift your spirit. The level of involvement you have with friends and family may vary, but keeping them close can help give you strength and a positive attitude.

Allow help from others: Accepting help from others will take strain off of you and allow others to feel a part of caring for someone in need. People around you may want to help but don’t know how. If they ask to help, learn to say yes.

Maintain yourself physically, mentally, and emotionally: Taking care of yourself allows you to be a better resource to those in need. It is easy to overlook your personal wellbeing while taking on the role of a caregiver, but allowing time to keep yourself healthy will make you a more effective helper.

Find ways to relieve stress: It is important to plan stress relieving activities into busy schedules. Learning different ways that allow your body to relax can enhance the way your mind and body function.

Understand your limits: You can’t do everything, and that is ok. It is easy to get caught up feeling like you need to take care of every single responsibility. Ask for help when you need it, take a break when it’s hard, and try not to overwork yourself.

(Cancer.org)

(10 tips for caregivers: www.cancersupportcommunity.org)

Sources: Cancer.org, radiologyinfo.org, NCCN guidelines, cancersupportcommunity.org, cancer.gov, oncolink.com, breastcancer.org

Xeloda, Camptosar, Eloxatin, Lonsurf, Avastin, Cyramza, Zaltrap, Erbitux, Vectibix, Stivarga, therascreen, pharmDx, and cobas are either trademarks or registered trademarks of their respective owners.

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