Treating Colon Cancer: What Happens After a Diagnosis
The earlier it’s caught, the easier the treatment.
The rise in colorectal cancer in the United States is concerning, but there is a silver lining: Improved treatment methods for this type of cancer are saving lives.
“Overall, we’ve made tremendously great progress in the treatment of colon and rectal cancer,” says Elliot Newman, MD, chief of surgical oncology at Lenox Hill Hospital, Northwell Health System. Not only are the surgeries becoming more advanced and less invasive, but there are also additional, or “adjuvant,” treatments available to help patients.
Surgery is the mainstay of treatment for colon and rectal cancer. “We usually like to remove the area that’s affected,” says Dr. Newman. Surgery for colorectal cancer can be as simple as removing a malicious polyp during a biopsy, or it can be more complex, removing a full section of the colon. Learn more about surgery for colon cancer here.
After surgery for colon and rectal cancer, the removed tissue sample will be sent to pathology, where a pathologist can analyze the sample and determine if further treatment is necessary. “Certain patients with early-stage tumors do not need additional treatments,” says Dr. Newman.
On the other hand, the tissue sample may indicate that the cancer is metastasizing (or spreading) beyond the initial tumor location. Once metastasis occurs, and the cancer affects nearby lymph nodes, the cancer can no longer be cured by surgery alone.
“Patients with later-stage tumors, especially those where there is lymph node involvement, will require additional treatment in the form of chemotherapy,” says Dr. Newman. Chemotherapy is a systemic form of treatment, meaning it helps attack cancer cells all throughout the body.
While chemotherapy has historically been a common adjuvant treatment for colorectal cancer, new forms of treatment are increasingly helping patients. Some patients benefit from immunotherapy for colorectal cancer, which revs up the body’s own immune system to better find and target cancer cells. Other patients may be candidates for targeted therapy for colorectal cancer, which targets abnormal gene and protein changes in cells linked to cancer.
“The bottom line is that there are a lot of exciting and new therapies, and nobody should assume that once they have a diagnosis of cancer, that all hope is lost,” says Dr. Newman.
Dr. Newman is the chief of surgical oncology at Lenox Hill Hospital, Northwell Health System, and a professor at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.
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Overall, we've made tremendously great progress
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in the treatment of colon and rectal cancer,
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both in terms of the surgery, in that it's now even less invasive,
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and people are recovering more quickly,
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and in terms of the adjuvant treatments, which are more effective
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and allow people to be cured more often,
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or to have the disease controlled for longer periods of time.
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People should not look at the development of colon and rectal cancer
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as something which is not treatable, as it is most definitely very treatable today,
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and certainly very curable as well.
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Colon and rectal cancer can be treated in a number of ways.
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The mainstay of treatment is generally surgery.
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We usually like to remove the area that's affected.
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After patients have surgery, the piece of the colon or the rectum that is removed
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is sent to pathology, where an analysis of the specimen is done.
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And based on that analysis, we then know what the prognosis is of that patient
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and what additional treatments are needed.
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And then when the patient comes back to the office,
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that will be discussed with them, and then they'll be
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referred to the appropriate physicians for additional treatments,
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based on what was found.
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Certain patients with early-stage tumors do not need additional treatments.
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Patients with later-stage tumors, especially those where there is lymph node involvement,
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will require additional treatment in the form of chemotherapy.
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But the bottom line is that there are a lot of exciting and new therapies
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and nobody should assume that once they have a diagnosis of cancer
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that all hope is lost.
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The most important thing is to find a team of doctors who are experienced
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with the cancer that they have, and they'll have a whole armamentarium
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of options that they can apply so people can ultimately survive longer.
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Colon cancer treatment (PDQR) - patient version. Bethesda, MD: National Cancer Institute, 2019. (Accessed on January 2, 2020 at https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq.)
Treatment of colon cancer, by stage. Atlanta, GA: American Cancer Society, 2018. (Accessed on January 2, 2020 at https://www.cancer.org/cancer/colon-rectal-cancer/treating/by-stage-colon.html.)