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Surgery
Surgery is the most common treatment for all stages of colon cancer. The surgeon may remove the cancer using one of the following procedures:
Colectomy: The surgeon may decide to cut out the part of the colon that contains the cancer as well as a small portion of surrounding normal tissue to get any stray cancer cells. Often, this is accomplished through a long incision in the abdominal wall.
Protectomy without colostomy: Some cancers require the surgical removal of large parts of the bowel. How much of the bowel is removed depends on a variety of factors, including the location of the tumor, the presence of other associated cancer or polyps, the stage of the cancer, and the risk of other colon cancers developing in the future.
The manner in which loops of the intestine are reconnected after the diseased portion is removed can vary. Some surgeons use sutures; others prefer using one of the various stapling techniques. Also, surgeons often take out lymph nodes near the colon to see if the cancer has spread. If the cancer does not appear to have invaded the lymph nodes and is completely removed during surgery, no further treatment may be needed.
When operating on rectal cancer, in the lowest part of the bowel, surgeons are using new techniques to spare surrounding tissue. Today, they often are able to leave intact nerves and sphincter muscles, preserving continence and sexual function. These innovative procedures have not only saved lives; they have greatly enhanced the quality of life for rectal cancer patients.
Protectomy with colostomy: If after resection the surgeon isn't able to reconnect the two ends of the colon, he or she may need to create a stoma, or small opening for wastes to pass through, in a procedure called a colostomy. Sometimes this procedure is later reversed, after the intestine has had time to heal. However, if much of the lower colon is removed, the colostomy will most likely be permanent.
Surgery for metastatic disease: In some cases, even when a cancer has already spread to other organs, surgical removal (resection) of these tumor deposits can be performed. This happens when the metastases are limited in number and sites.
The liver is the most common site of metastatic disease. Liver resection has been shown to prolong survival in many cases. When not removable, other techniques such as radiofrequency ablation, microwave ablation, or cryotherapy can be used.
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