The treatment of bowel cancer depends on the part of the bowel which is affected by cancer and the extension of cancer. Surgery is considered the major treatment for treatment of bowel cancer. Chemotherapy, radiotherapy, or other therapies can work along with the surgery in some cases. If your bowel cancer is diagnosed at an early stage it is possible to treat it with the medication and prevents it to reoccur. Regrettably, no treatment offers complete recovery.
There are chances for cancer to come back at any other stage. The cases in which a successful surgery is not possible have higher chances of reoccurring cancer. However, several treatments help in relieving the symptoms and slow down the projection of cancer.
Your healthcare crew
Once you are diagnosed with bowel cancer, several healthcare providers will work by your side. These are:
- An expert oncologist surgeon
- A radiotherapist or a chemotherapist
- A specialized radiologist
- An expert nurse
The specialist will decide treatment plan after determining the severity and magnitude of cancer.
Surgery for colon cancer
If the cancer is diagnosed at an early age then it can be eradicated by removing a small piece from the lining of the colon’s wall. This is termed local excision.
But if cancer invades the muscles nearby or around the colon, the colon is needed to be removed completely. This is termed colectomy.
A colectomy can be performed in three different ways:
- An open colectomy: In this method surgeon removes a part of the colon by making a large incision in the abdomen.
- A laparoscopic colectomy: Also known as a keyhole. In this method, several incisions are made in the abdomen and the surgeon watches the internal condition of the colon by inserting specially designed tools.
- Robotic surgery: It is a type of laparoscopic surgery in which the instruments guide the robot and eliminates cancer.
In the case of robotic surgery, the patient and the doctor are not connected directly. There is a possibility that the doctor is not in the same hospital as the patient.
- Robotic surgery is not very common till today.
- The observed lymph nodes might also be removed during the procedure. The terminals of the bowel are reconnected and if it is not possible then a stoma is created.
- Laparoscopic and colectomy have the same risks and complications and both provide the same rate of recovery.
- But laparoscopic surgery has the advantage that the patient can recover sooner and he or she experiences less pain.
Rectal cancer surgery
The extension of cancer decides the type of surgery for treating rectal cancer.
In some cases, surgeries start from the bottom and the incisions are not made.
If the cancer is diagnosed earlier the surgeon can remove it by doing an operation known as local resection. The surgeon introduces a tube in the anus and removes out cancer in the rectum.
Total mesenteric excision
- In some cases, a local resection might not be a good option. A large piece of the rectum is needed to be removed.
- This region involves the lining of the healthy rectal tissues, along with the fatty tissues surrounding the bowel.
- This is known as total mesenteric excision
- If the mesentery is removed then there is a guarantee that all the cancer cells have been removed.
- TME has one or two types depending on the location of cancer in the rectum.
- An abdominoperineal resection is an option for treating cancer residing in the lowest part of the rectum.
- Typically, it is advised to remove the complete rectum to minimize the complications and the risks of reoccurring cancer.
- It includes the removal and closing of the anus. The sphincter muscles around the anus are removed. The only solution for this issue is the formation of a permanent stoma.
Stoma formation surgery
When any part of the bowel is removed and the remaining parts are reconnected, in some cases the surgeon distracts the passage of the feces from the colon or bowel to an opening called a stoma. It will remain there until the healing of your stoma.
- The formation of the stoma can be called ileostomy or colostomy.
- A nurse can help you to care for your stoma.
- In some cases, normal functioning of the bowel is not possible that’s why a stoma is needed permanently.
Complication or risks after the surgery
The risks for bowel cancer surgery are:
- Blood loss
- Blood clots in legs or arms
- Cardiac or respiratory issues
- Leakage of the bowel
- Improper reconnection of the bowel parts
- Pelvic pain
- Soreness around anus
- Radiotherapy can be used by several methods for treating bowel cancer, such as:
- Before the surgery: It is used for shrinking the size of cancer in the rectal so that it can be removed easily.
- The alternative of the surgery: Sometimes it is considered an option for minimizing the symptoms and projection of the cancer
- Palliative radiotherapy: It is used in the last stages of cancer to slow down its progress.
Radiotherapy has two types:
- External radiotherapy
- Internal radiotherapy
External radiotherapy is done five days a week except for fort the weekends.
You may need this treatment for one to five weeks depending on the size of your cancer. Every session is almost ten to fifteen minutes long.
Some major side effects of radiotherapy are:
- Feeling ill
- Discomfort and sore skin nearby the rectum and pelvis
- Urge for urination
- Burning feeling during urination
- Other long term effects of radiotherapy are:
- Frequent need of urination and feces
- Blood in urine or stool
- Erectile dysfunction
You can collect sperm or eggs before the treatment in case you want offspring.
Chemotherapy can be done in three ways:
- Before the surgery: It is used along with radiotherapy to shrink the size of the tumor.
- Following the surgery: It is used for minimizing the risk of the reoccurrence of the cancer
- Mollifying chemotherapy: It is used for slowing down the more advanced stages of the cancer
- Chemotherapy involves intravenous or oral intake of chemo drugs. These drugs help in killing cancerous cells.
- This treatment consists of cycles. Each cycle is two to three weeks long. Sometimes chemo is introduced through veins and sometimes the patient needs to take tablets.
Some side effects of the chemotherapy are:
- Ulcers in the mouth
- Hair loss
- Numbness in neck or hands
- Weakening of immune system
These side effects will disappear once your treatment will be completed.
These medicines may affect sperm and eggs. That way you should avoid a baby during chemo as it may influence the health of the baby.
- These therapies are used for treating more than one complication caused due to bowel cancer.
- Such as, cetuximab, and panitumumab are drugs that target the proteins known as EGFRs, found on the lining of the cancer cells.
- These therapies can be used along with chemotherapy when cancer extends yonder the bowel.
Some side effects of these therapies are:
- Burning or sore eyes
Initially, they might cause any allergic reaction anti-allergic medicines are used for solving this issue.