Most of the time, surgery is the best option for the treatment of colon cancers. The type of the surgery depends on:
Stage of your cancer
Location of cancer in the colon
The objective of the surgery
The colon must be clean and empty for any kind of surgery. You should use some specific foods, enemas, and laxatives to clean your bowel thoroughly. This cleansing is not the same as in colonoscopy.
If the colon cancer is at an early stage like 0 or 1 stage then these tumors can be removed by colonoscopy. Colonoscopy is a procedure in which a camera is inserted into the rectum and reaches the colon through a long tube. Following surgeries can be performed under colonoscopy:
In the case of a polypectomy, the cancer is eliminated as a section of the polyp, which is a cut at its base. This procedure involves passing a wire loop by using a colonoscope to cut the polyp from the wall of the colon with an electric shock.
In the case of local excision, tools are introduced along with a colonoscope to eradicate minor cancer in the linings of the colon with a small number of healthy tissues residing on the colon’s wall.
If the polyps are removed using this technique, then the surgeons don’t need to cut the abdomen externally. The objective of these methods is the removal of the tumor as a single piece. In the situation when any part of cancer is still left, or the lab tests indicate that cancer might spread more, then a colectomy is a next option.
Colectomy
A colectomy is performed for the removal of all parts of a colon. Even the surrounding lymph nodes are also eradicated. The removal of a single part is called hemicolectomy, a partial colectomy, and segmental resection. Usually, a cancerous part of the colon is removed and sometimes surgeon may also remove the normal colon at both ends. Typically, about 1/4th to 1/3rd part of the colon is removed. It depends on the size and location of cancer. The left (remaining) parts are then reconnected. Around twelve lymph nodes are taken out also. These are then sent to labs for testing (cancer).
If the whole colon has to be removed, this is termed total colectomy. It is very rare for the treatment of colon cancer. It is applicable when their cancer attacks any other part rather than the colon such as several or hundreds of polyps, or in the case of IBD.
Procedure:
Colectomy can be performed in two ways:
Open colectomy: In this surgery, a single but long incision is made in the abdomen.
Laparoscopic colectomy: In this surgery, four to five small incisions are made. This procedure involves some special tools. A surgeon can view inside the abdomen by using a camera with a torch at one end. The camera is inserted using one incision and the other one is used to introduce the tools for the removal of lymph nodes.
Since the incisions made in the case of laparoscopic surgery are small in size the patients can heal sooner than in open colectomy. And patients can leave the hospital sooner than open colectomy patients. But it can’t work for everyone and it needs a very expert surgeon. If you are looking for this method then you need to look for a very expert surgeon with a lot of experience.
The chances for cancer to come back and survival rates are the same for both kinds of surgeries.
What happens if the colon gets blocked?
If cancer has blocked your colon, it occurs very slowly and the person feels ill for a long period. In such a situation, a stent may be involved. A stent is placed before the surgery. A stent is a tiny and expandable metallic tube that the surgeon place inside the colon through a small orifice using a colonoscope. This will help you in preparing for the surgery and it keeps the colon wide and gets rid of the blockage.
If the stent can’t work for a blocked colon or there is a hole due to the tumor, surgery needed to be done. This is called colectomy. It is the same as colectomy but despite connecting both ends with the colon, the above terminal is attached with the stoma (an opening). Sometimes the ileum is connected with the stoma instead of the colon; this process is called an ileostomy.
Surgery is done in case of colon cancer spread to other parts of the body, this helps in removing the blockage without eliminating the colon that contains cancer. Despite that colon is cut above the tumor and is attached to the stoma. This process is called diverting colostomy. It helps is recovering to a large extent and allows the patient to start treatment such as chemotherapy.
If cancer has not spread widely and it has reached only a few areas in the lungs and liver, surgery may be done to remove it. It may increase the life span depending on the stage of cancer. Surgery might be done by considering the following options:
Size of cancer
Location of the cancer
Number of tumors
Side effects of the surgery:
The risks after the surgery depend on your health condition and the stage of your cancer. Some issues like bleeding, infection, and blood clots in the legs can occur after the operation.
When you will get fully conscious after the surgery, you will experience severe pain. You have to use painkillers for that. For the first few days, you need to eat soft foods and drink simple fluids.
Occasionally, the bowel takes a bit longer to be active after the surgery. This is called ileus. It may be due to anesthesia or due to some changes during the operation. Sometimes a severe pain may slow down the functioning of the bowel. If you experience ileus doctor will prohibit eating solid foods and even liquids, in case of nausea and vomiting.
In some rare cases, it happens that the ends of the colon are not connected properly and cause leakage. It may lead to:
Severe pain
Temperature
Hard belly
Loss of appetite
Infection
Need of another surgery
Scar tissues may be formed after the surgery that causes the sticking of the other organs or tissues. These scars are called adhesions. In some rare cases, adhesions may block or twist the bowel. This leads to pain and bloating in the bowel. Surgery is needed to remove these scar tissues.
