Published On: Tue, Dec 25th, 2018

Colon Cancer Treatment

The cancer colorectal refers to both colon cancer (which represents 60% of cases) and rectum cancer (40%). It corresponds to abnormal cell proliferations on the inner side of the large intestine or rectum. Like most cancers, it can spread to other parts of the body when cells come off the original tumor.

On the inner wall of the colon or rectum, small, yet benign tumors (called polyps) develop. In time, some of them become cancerous. They then attack the intestinal wall, then the ganglia, and finally the rest of the body (liver and lung). Most often, this cancer is caused by environmental factors (poor nutrition, overweight, alcohol …). However, in less than 5% of cases, it is linked to a genetic predisposition and develops early, before the age of 40 years.

What are the symptoms?
Different symptoms may suggest colorectal cancer:
– severe pain in the abdomen, by a crisis of two or three days,
– sudden constipation or prolonged diarrhea,
– the presence of blood in the stool,
– anemia, weight loss and / or mild persistent fever,
– occlusion, perforation of the intestine,
– an alteration of the general state.
Nevertheless, this cancer can remain for a long time without symptoms and, when they appear, the disease is already at an advanced stage.

How to track it?
If in doubt, consult your doctor. In general, screening is advised between 50 years and 74 years. The latter can be done at home by spreading stool on a test capable of detecting very slight bleeding caused by tumors. If the result is negative, the test will have to be repeated after two years. Otherwise, a colonoscopy (visual examination of the colon using a probe) will confirm or not the diagnosis.

How to prevent?
Overall, a healthy lifestyle can reduce the risk of cancer: play sports, avoid eating too much fat (red meat or cold cuts) or drink too much alcoholic beverages. In addition, some factors increase the risk of colorectal cancer such as smoking, taking toxic substances (such as polychlorinated biphenyls, PCBs), age (around 65 years), chronic inflammatory bowel disease (Crohn’s disease). Crohn’s, ulcerative colitis).

What is the treatment?
Surgical removal of the tumor is the first of the treatments. The affected area as well as the surrounding areas are removed and a suture is made between both ends of the colon. In some cases, an artificial anus must be put in place to allow healing. Sometimes even this derivation can become definitive in case of complications or when the cancer is located too close to the anus.chemotherapy, and in some situations radiotherapy, may complement this initial treatment. Surgery is the gold standard treatment for colon cancer.

Surgery is the main strategy for treating colon cancer . However, other approaches are sometimes used, alone or in combination with surgery.
In the earliest stages of the disease, when tumors of the colon are still very superficial, they can be removed during a simple colonoscopy . But as soon as the tumor invades the tissues too deeply, it is necessary to carry out an additional surgery called hemicolectomy.

What is a hemicolectomy?
Hemicolectomy is a surgical procedure that involves removing the portion of the colon with a tumor. Both ends of the colon located on each side of the removed fragment are sutured to restore continuity of the digestive tract. During this operation, the surgeon will also remove the vessels and lymph nodes close to the tumor: they are indeed likely to contain cancer cells that have left the tumor and could lead to the development of metastases.
Hemicolectomy can be performed in a conventional manner, by opening the patient’s belly (laparotomy) or by laparoscopy . In this case, miniaturized instruments are introduced by very small incisions . This method, less invasive, can shorten the convalescence of patients.

What is a colostomy?
In some cases, it is not possible to connect the two ends of the colon located on either side of the area where the tumor is located. It is then necessary to perform a colostomy: a bypass that connects the upper end of the colon to an opening in the skin of the abdomen (artificial anus). A pocket is attached to the hole to collect the stool.

A colostomy can also be temporary: often, the continuity of the intestinal transit can not be restored immediately after the hemicolectomy because the sutures connecting the two parts of the colon are too fragile. A colostomy is temporarily necessary until the colon is healed.

And chemotherapy?
The chemotherapy may be associated with surgery. In some cases, drugs capable of destroying tumor cells are administered to patients before the operation, so as to obtain a decrease in the size of the tumor to be removed. This is called neoadjuvant chemotherapy. The same type of drugs can be prescribed after hemicolectomy, in order to eliminate cancer cells that would have escaped the surgeon.

This approach (adjuvant chemotherapy) reduces the risk of local cancer recurrence and metastases.

In case of metastatic colon cancer, doctors will almost always use chemotherapy : this is the only approach that can tackle the cancer cells scattered in the body of the patient.

What is targeted therapy?
The drugs used in chemotherapy destroy tumor cells but also healthy cells that divide a lot (cells of the skin, mucous membranes, blood …). This is the reason why these treatments are associated with important side effects. Targeted therapy drugs act specifically on tumor cells or those in their environment.

In the case of colon cancer, there are in particular targeted treatments called “antiangiogenic”. These drugs will attack the cells of the vessels that irrigate the tumors. The vessels in question are needed to supply the tumor cells with oxygen and nutrients . Anti-angiogenic treatments therefore act by asphyxiating and starving the tumors . Other targeted treatments act directly on the tumor cells, blocking different mechanisms necessary for their multiplication. These drugs are often used in combination with conventional chemotherapy.

What are the sequels?
After treatment, some signs may appear:
– disabling diarrhea for two / three months corrected by a very restrictive diet (no raw vegetables, fruits and vegetables rich in fiber, meat in sauce),
– possible erectile dysfunction,
– side effects of possible chemotherapy or radiotherapy.

It takes 5-7 years to talk about healing, which is psychologically complicated for the patient who fears relapse. If an artificial anus is permanently installed (colostomy), the patient can resume a normal life. However, it should avoid soft drinks and fermentable foods such as cabbage or beans.

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