Colorectal cancer can start in the colon or rectum. It is sometimes called either colon cancer or rectal cancer, depending on where it starts. The two cancers have many features in common and are often grouped together.
There are multiple stages of colon cancer, and the stage typically determines treatment.
Surgery is the most common treatment for all types of colorectal cancer, but it is particularly effective in earlier stages. When the cancer is found very early, the surgeon performs a local excision, removing the tumor without cutting the abdominal wall. If the cancer is larger, the surgeon removes parts of the colon and may attach the healthy areas back together.
If the surgeon cannot connect the severed ends of the colon, the patient will need a colostomy. The surgeon makes an opening through the skin and tissue and attaches the colon to it. Waste then collects outside the body in a bag placed over the opening.
Chemotherapy is a potent medication that kills cancer cells. Doctors often recommend it for advanced cases of colorectal cancer that has spread to the lymph nodes.
Chemotherapy can be the primary treatment if cancer has already spread to other organs and surgery cannot cure it. Sometimes, patients get chemotherapy before surgery to shrink the tumor or after surgery to try to eliminate any cancer cells that have spread.
Immunotherapy is a promising area of cancer treatment that has been effective at treating colorectal cancer. One type of immunotherapy is monoclonal antibodies. These treatments flag cancer cells, allowing the immune system to target them for destruction. They work in a few ways: they can trigger cell wall destruction, block cell growth, and interrupt the tumor's blood supply. Some even attack the cancer cells directly.
Immune checkpoint inhibitors are another type of immunotherapy that block certain proteins from binding on the surface of cancer cells so the body's natural T cells can kill them.
Radiation therapy involves high-energy radiation that kills cancer cells or stops them from spreading.
External radiation uses a machine to send radiation into the part of the body where the cancer is. Internal radiation involves implanting or inserting radiation in seeds, wires, or needles directly into the tumor.
Radioembolization is a form of radiation therapy that focuses on blocking the tumor's blood supply. Doctors often use this procedure for people whose colorectal cancer has spread to the liver.
Many patients die from liver metastasis, and radioembolization is a promising treatment that can effectively shrink unresectable liver tumors enough so that a surgeon can remove them.
Chemoembolization is another treatment often used after surgery or to treat inoperable metastases to the liver. This procedure involves injecting chemotherapy drugs directly into the artery that supplies the liver tumor, blocking blood flow.
The drugs stay in the tumor for an extended period, sometimes as long as a month. Some studies indicate that chemoembolization can stabilize colorectal cancer that has spread to the liver and extend survival times by up to nine months.
Ablation treatment destroys tumors inside the body without having to remove them and is often used for liver metastasis. Many types of ablation therapy are used for colorectal cancer. Surgeons can use radiowaves, lasers, or alcohol injections, or they can freeze the tumor.
Studies show that radiofrequency ablation combined with chemotherapy had better results than chemotherapy alone. Microwave ablation is one of the newer technologies for treating inoperable tumors. It is faster than radiofrequency ablation, can be applied to more than one tumor simultaneously, and is more effective with larger tumors.
Cancer vaccines are still being studied, but research is promising. These injections ramp up the patient's immune system to direct it to destroy cancer cells.
One small study showed that a vaccine for colon cancer causes increased killer T cell activation against a specific molecule within colorectal tumors. This helps the cancerous cells stand out from the healthy cells, which encourages the immune system to attack.
Palliative care is another treatment for colorectal cancer that people often misunderstand. Many people believe that palliative care is the same as end-of-life care, but it is quite different. Palliative care aims to treat the person as a whole and can be done in conjunction with other cancer treatments.
The goal of palliative is to prevent or treat the symptoms and side effects of the disease to help the patient feel more comfortable and have the best possible quality of life. Palliative care takes many forms. It might be medicine to treat nausea, pain, or insomnia or therapy to address depression and anxiety. Palliative care also focuses on the caregiver and assisting with practical needs, like insurance questions and financial support.
Clinical trials determine if new treatments are safe and effective, shaping how doctors treat patients in the future. Scientists are constantly developing new medications and therapies, and each one has to undergo testing before being widely used as an acceptable and effective treatment.
Many people with cancer participate in clinical trials because they offer a chance to try a new treatment that may work better than the options currently available. Each clinical trial has unique risks and benefits. Patients with colorectal cancer should talk to their doctor about the pros and cons of participating in a clinical trial.
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