Surgery for colorectal cancer
Surgery is the main treatment for early colorectal cancer. Often, a piece of the colon or rectum with the tumor is removed and the ends are sewn back together. Surgeries using this method go by different names, such as colectomy (kuh-lek-tuh-me), segmental resection (seg-men-tuhl re-sek-shun), low anterior resection (low an-teer-ee-yer re-sek-shun), and proctectomy with colo-anal anastomosis (pros-tuh-TECK-tuh-me with ko-lo-a-nul uh-nas-tuh-MO-sis).
Sometimes, especially with rectal cancer, there isn’t enough tissue left on one side to sew the ends back together. In that case, one end is attached to the wall of the belly so that stool can empty into a bag outside the body. This is called a colostomy (kuh-lahs-tuh-me). An abdominoperineal (AP) resection (ab-dah-muh-no-pair-uh-NEE-uhl re-sek-shun) is a surgery for rectal cancer where one end comes out to form a colostomy.
Sometimes, if there is a problem like the cancer growing through the wall of the colon or rectum, a colostomy is needed at first. Sometimes instead of the end of the colon forming a colostomy, the end of the small intestine must be used. This is called an ileostomy (ill-ee-OSS-tuh-me). Then later, after the belly has a chance to heal, the ends of the colon can be reconnected again.
If the rectal cancer is growing into nearby organs, a surgery called a pelvic exenteration (ex-en-ter-A-shun) is needed. In this operation the rectum as well as affected nearby organs such as the bladder, prostate, or uterus are removed. A colostomy is needed after this operation. If the bladder is removed, a urostomy (yur-ahs-tuh-me – an opening to collect urine) is also needed.
Some colorectal cancers are just in the end of a polyp. These cancers are treated by just removing the polyp completely (often during colonoscopy). If there may be cancer left behind (like in the stalk of the polyp), you may need surgery to remove part of the colon or rectum. The doctor bases this on looking at the polyp under the microscope.
Side effects of colorectal surgery
Side effects of surgery depend on several factors like the extent of the operation and a person's general health before surgery. Most people will have at least some pain after the operation, but it most often can be controlled with medicines if needed. Eating problems usually get better within a few days of surgery.
Other problems may include bleeding from the surgery, blood clots in the legs, and damage to nearby organs. Rarely, the new connections between the ends of the intestine may not hold together and may leak, which can lead to infection. After the surgery, you might have scar tissue forming around the bowel that can cause organs or tissues to stick together. These can later lead to the bowel becoming blocked.
Surgery for colorectal cancer that has spread
For cancer that has spread to other organs, sometimes surgery can help you to live longer or, depending on the extent of the disease, may even cure you. If the colorectal cancer has spread to a few areas in the liver or lungs but not anywhere else, the cancer can sometimes be removed by surgery.
For spread to the liver, there are methods other than surgery which might be used to destroy the cancer. These include things like blocking the blood supply to the tumor or destroying the cancer by freezing it or killing it with high-energy radio waves. These methods are less likely to cure the cancer.
Since these cancers can often be hard to treat, you may also want to talk with your doctor about clinical trials of newer treatments that might be right for you.
For more information about surgery for colorectal cancer, please see our document Colorectal Cancer.
Last Medical Review: 08/15/2013
Last Revised: 01/31/2014