Your colorectal cancer treatment plan may include surgery, radiation therapy, interventional radiology or chemotherapy. Your doctor will discuss treatment options that are right for you.
Surgery is the primary form of treatment for colorectal cancer. We can remove tumors in either open or minimally invasive (laparoscopic) surgery, with techniques that save the rest of your bowel so you won't need a permanent colostomy. Specialized surgical procedures include:
- Partial colectomy: A section of the colon containing the cancer is removed, along with nearby lymph nodes. This can be done through an open, robotic-assisted laparoscopic or hand-assisted laparoscopic surgery (HALS) approach.
- Hand-assisted laparoscopic surgery (HALS) requires only a few small incisions in your abdomen, rather than the long single long incision in traditional open surgery. The surgeon uses a thin, lighted tube and tiny video camera to see the surgical site on a video monitor. HALS and laparoscopic surgery mean less blood loss, less pain and scarring, decreased rates of infection and a faster recovery time.
- Single-incision laparoscopic surgery (SILS) is another laparoscopic option in which your surgeon makes just one small incision through your navel.
- Transanal resection: The surgery can be done through your anus without an incision in the abdomen if you have stage I rectal cancer
- TEMS (transanal endoscopic microsurgical excision): This technique allows your surgeon to remove some tumors higher up in the rectum through the anus without an incision in your abdomen.
- Low anterior (LA) resection: This surgery is used for cancers found in the upper and middle rectum. After surgery, the colon is attached to the lower rectum and you can pass stool in the usual way.
- Proctectomy with coloanal anastomosis/J-pouch: This surgery is used for cancers in the lower part of the rectum. During this surgery, your surgeon removes your entire rectum and attaches the colon to your anus. A pouch is constructed (using part of the colon) allowing stool to pass in the normal way. Your surgeon will also use TME (total mesorectal excision) to remove lymph nodes and reduce your risk of recurrence.
- Abdominoperineal (AP) resection: This surgery is used for cancers found in the lowest part,or anal area, of your rectum. During this surgery, your surgeon removes your anus, so you'll need a permanent colostomy.
- Robotic surgery: This is like laparoscopic surgery, but with special robotic technology. The robot allows your surgeon to perform more complex procedures with more precision than laparoscopic surgery alone.
- NOTES (natural orifice transluminal endoscopic surgery): This isn't used yet, but it's on the horizon. It's a technique that allows for abdominal surgery without scars because it's performed with a scope passed through a natural opening (orifice) such as the mouth or vagina.
After surgery, we may recommend chemotherapy or radiation to try to prevent the cancer from recurring. Our cancer specialists use radiation therapy primarily for rectal cancer. We use:
- External beam radiation therapy (EBRT)
- CyberKnife radiosurgery may be used to treat colorectal tumors that have spread to other organs such as the liver, lungs, brain or spinal cord.
- Interventional radiology, where specialized radiologists provide treatment options for colorectal cancer that has spread to the liver, such as:
- Therasphere: Tiny glass beads called microspheres, injected through a catheter from the groin into the liver artery supplying the tumor, deliver radiation directly to tumors in your liver.
- Radiofrequency ablation (RFA) is a nonsurgical, local treatment that kills tumor cells with heat.
- Chemoembolization delivers a high dose of chemotherapy directly to the liver, while also depriving the tumor of its blood supply by blocking or embolizing the arteries feeding the tumor.
- Cryoablation uses an extremely cold liquid to freeze your tumor.
- Hepatic artery infusion pumps deliver chemotherapy through the blood vessel that supplies the liver.