HOW TO TREAT COLORECTAL CANCER?
Oncologic diseases are addressed with local treatments – surgery and radiotherapy – and systemic treatments (involving the whole body) – chemotherapy, hormones, and antibodies, among others.
The treatment of colorectal cancer almost always involves surgery. When necessary, radiotherapy and/or chemotherapy treatments can be done before or after surgery, or in rare cases in alternative to surgery.
In the treatment of colorectal cancer, surgical intervention consists in sectioning the intestine and removing the cancerous area, together with the respective blood vessels and lymphatic ganglia. In most cases, an anastomosis of the disease-free intestinal extremities is then created to restore normal intestinal transit.
Most cancers that affect the rectum (final 15 cm of the large intestine or first 15 cm from the anus) are treated surgically. In some cases, large benign polyps and some cancers in early stage can be removed through the anus. However, most rectal cancers are removed through the abdomen. Although, normally, the anastomosis of the sectioned intestine is performed, when the cancer is close to the anus, it may be necessary to remove the whole rectum and the anus. In this case, a permanent colostomy may be required (opening of the intestine through the abdominal wall). In certain circumstances, an ostomy (colostomy or ileostomy) may also be required, although temporary. The most frequent cases are:
- Low rectal cancer, quite close to the anus, may be removed through adequate surgical technique and using the latest technology, with preservation of the anus. However, in most cases, a temporary ileostomy is performed (approximately two months) to protect the anastomosis.
- When the cancer determines the obstruction or perforation of the intestine, a temporary ostomy may be required.
However, nowadays, most colorectal cancers are treated without requiring an ostomy.
In colorectal cancer, chemotherapy plays a fundamental role in controlling the systemic disease, potentially prolonging survival.
In rectal cancer (last 15 cm), radiotherapy (more frequently administered before surgery) plays a fundamental role in controlling the disease locally, reinforcing the effect of surgery.
The key for the prevention or cure of colorectal cancer lays in adequate screening, allowing the removal of the polyps found or the early detection of cancer.
Early detection and timely intervention of colorectal cancer result in a higher rate of cure.