Many colon cancer patients are living longer and quality of life has become an important factor when it comes to treatment options. Medical and surgical advancements have improved and expanded the choices patients have, and as with any cancer, patients should understand all of their treatment options before choosing an approach.
A second opinion is especially important for colon cancer patients who:
- Have liver metastasis (colorectal cancer that has spread to the liver)
- Have been told they need an open operation
- Have a recurrence of colorectal cancer
- Have been diagnosed with rectosigmoid tumors (tumors related to or near the sigmoid colon and upper part of the rectum)
Laparoscopic Surgery for Colon Cancer
Today, the vast majority of colon cancers can be removed using minimally invasive laparoscopic techniques. Studies have shown that small-incision laparoscopic surgery is as effective as traditional open surgery. Laparoscopic surgery also results in less pain, quicker recovery times, shorter hospital stays and cosmetic advantages. Medical College of Wisconsin colorectal surgeon, Kirk Ludwig, MD, is a national leader in training other physicians to perform laparoscopic colon cancer surgery.
Chemotherapy and Radiation Options
In the past decade, several new chemotherapy drugs have become available for treating colorectal cancers. That means there are much more effective first line therapies, as well as effective second and third line therapies to use when other approaches are not effective, or the cancer recurs.
In some cases, physicians can choose a regimen based on a patient’s other medical conditions. For example, we may avoid a drug that may cause neuropathy for someone with diabetes. If a patient has inflammatory bowel disease (IBD), we may steer away from a regimen that may be linked with the side effect of diarrhea.
Advancements in chemotherapy have made treating colon cancer closer to managing a chronic disease for some patients. Certain patients are able to stop treatment—sometimes for years—without any recurrence, and live longer even if the cancer returns.
Radiation is used more selectively to treat colon cancer. Generally, it’s used to treat cancers that have penetrated the wall of the bowel or spread to nearby organs. Radiation can be used to help shrink a tumor before surgery or to kill any microscopic cancer cells that may have been left behind after surgery.
Radiation may be given externally, through a device called a linear accelerator to deliver high-dose X-rays to cancerous tissue. More and more, sophisticated image-guided systems allow radiation oncologists to "shape" the radiation dose exactly to the outer limits of the tumor, delivering a higher dose of radiation with more precision while attempting to minimize dose to adjacent healthy tissues.
Radiation can also be given internally, through a technique called brachytherapy, where physicians place the source of radiation in a special applicator in close proximity to the tumor. The type of radiation therapy used depends on each patient’s situation, and colorectal team members at Froedtert & the Medical College of Wisconsin works closely together to determine the best treatment approach for individual patients.