How to treat colo-rectal cancers?

Cancer of the colon or rectum is the second most common type of cancer in the United States. It is estimated that 156,000 new cases of colorectal cancers are diagnosed in this country every year. The incidence of the disease increases with age (usually over 50 years). People with family history of colon cancer and in those with polyps or chronic inflammatory bowel disease are more prone to this type of cancer. Studies also show that the incidence of cancer in the rectum has decreased, whereas the incidence of cancer in the colon has increased.

Though there is a wide variety of treatments available for cancer of colon and rectum, it is unfortunate that half of 156,000 people diagnosed each year die. The exact cause of colon and rectal cancer is still unknown. But diet, family history of cancer colon or polyps, history of inflammatory bowel disease put such people at risk.

Symptoms are greatly determined by the location of the cancer and its stage. Change in bowel habits, blood in stools, loss of appetite, weight loss, fatigue and unexplained anaemia are the most common symptoms that indicate tumor in colon or rectum. Some of the other symptoms are dull abdominal pain, abdominal distension, cramping, constipation, narrowing of stools and black stools.

The treatment of the colorectal cancer depends on the stage of the cancer and the related complications. They are both medically and surgically treated according to the person's general status. Medically, the person is relieved of their symptoms by administering IV fluids, applying naso-gastric suction and blood transfusions. Adjuvent therapy is usually administered in addition to surgical treatment which include chemotherapy, radiation therapy and immunotherapy.

Some of the chemotherapy drugs used in the treatment of colorectal cancers are 5-Fluorouracil or levamesole regimen and methyl CCNU with doses of pelvic radiation. Radiation therapy is now used predominently before, during and after the surgery to reduce the size of the tumor and reduce the risk of recurrence. Recent data demonstrate that recieving some form of adjuvent therapy increases the survival rate and delays the recurrence of tumor.

Surgery is the primary treatment for most colon and rectal cancers. Surgery may be curative or palliative (relieve symptoms). The type of surgery depends on the location and size of the tumor. The surgical procedures of choice are:

SEGMENTAL RESECTION WITH ANASTOMOSIS which is removal of tumor and connecting the remaining portions of the bowel on either side along with the blood vessels and lymphatic nodes.

ABDOMINOPERINEAL RESECTION WITH PERMANENT SIGMOID COLOSTOMY which is removal of the tumor and a portion of the sigmoid and all of the rectum and anal sphincter.

TEMPORARY COLOSTOMY FOLLOWED BY SEGMENTAL RESECTION AND ANASTOMOSIS, this allows initial bowel decompression and bowel preparation before resection.

PERMANENT COLOSTOMY OR ILEOSTOMY is a palliative surgery done for unresectable tumors.

Laproscopic colotomy with polypectomy (opening the colon and removing the polyp or tumor by a laproscope) is the most recent recently developed procedure that is used to minimize the extend of surgery needed in some cases. This is applicable only if the tumor is confined to one site. Bowel resection is the surgery of choice for most cases.

About three out of four people having colon and rectal cancer can be saved by early diagnosis and early treatment. The low survival rate is only because of the late diagnosis which results in metastasis (especially to the liver) that leads to death. Being aware of the symptoms and the various treatments available, it is better to seek early treatment before complications occur.