When a patient gets the diagnosis of colon cancer, their life is changed forever. They will be facing various tests, treatment options, potential side effects of treatment and wondering if they will be cured of this disease. Colorectal surgeons are an essential part of the team of doctors who treat patients with colorectal cancer.

Degree of treatment

When cancer is found in the colon, additional tests are performed to determine the extent of the disease. These may include blood tests or imaging tests such as a CT or MRI. The extent of disease will play a role in determining the best course of treatment.

Whenever possible, surgery is recommended, as this is the only way to completely remove the cancer and decrease the risk of recurrence. The goal of surgery is to remove all of the cancer as well as the lymph nodes that drain the section of bowel where the cancer is located. Once the cancer is removed, the pathologist will then determine the specific characteristics about the cancer as well as look for cancer in the lymph nodes. They can also do genetic testing on the tumor, such as KRAS testing, which can be useful in selection of chemotherapeutic agents if these are indicated.

"The most important point to remember about colon cancer is that it is preventable and, if caught early enough, curable."

Mind your meds

Patients with a more advanced stage of cancer, such as those with cancer in the lymph nodes, may be candidates for treatment with chemotherapy. 

Some of the most common drugs used in the treatment of colorectal cancer include 5-FU, leucovorin, oxaliplatin and capecitabine. Patients that have their disease spread to other organs may be candidates for various treatments which may include surgical resection, ablation, chemotherapy or targeted chemotherapy.

Targeted chemotherapy refers to newer medications that work specifically on either genes or proteins that help tumor cells grow. An example of this is cetuximab, an epidermal growth factor receptor (EGFR) inhibitor. EGFR is a protein found in some tumors that help the tumor to grow. Cetuximab blocks this protein and can inhibit tumor growth. Regorafenib is another target chemotherapy which can block several proteins thereby helping to stop tumor growth.  

Cutting edge

New advances in surgery have led to minimally invasive options for surgical treatment, such as laparoscopic and robotic surgery. These approaches use a small camera and thin instruments placed through the abdominal wall so the procedures can be performed without the need for large incisions. The patients typically will have less post-operative pain, a shorter hospital stay as well as quicker overall recovery time.

These approaches are typically more demanding and should be performed by those that have had additional training in mastering these techniques. The most important point to remember about colon cancer is that it is preventable and, if caught early enough, curable.