Colon Cancer; Treatment.Surgery is often required to treat colorectal cancer colorectal cancer Malignant tumour of the large intestine (colon) or rectum. Risk factors include age (after age 50), family history of colorectal cancer, chronic inflammatory bowel diseases, benign polyps, physical inactivity, and a diet high in fat. . The surgical procedure used depends on where the cancer is located. Occasionally, early cancerous changes may be limited to a portion of an otherwise non-cancerous polyp polyp, in medicine, a benign tumor occurring in areas lined with mucous membrane such as the nose, gastrointestinal tract (especially the colon), and the uterus. Some polyps are pedunculated tumors, i.e. . It is sometimes possible to remove some very early colon cancers during a colonoscopy. If the cancerous polyp is in the rectum, occasionally this polyp can be removed through the anus by a simple procedure so the surgeon doesn't have to cut into the abdomen. In right-sided cancer, the right side of the colon is removed. In left-sided cancers, the left side of the colon is removed. If a cancer is in the middle transverse colon transverse colon n. The part of the colon that lies across the upper part of the abdominal cavity. , either the right or the left colon is removed along with the transverse colon. In rectal cancer Rectal Cancer Definition The rectum is the portion of the large bowel that lies in the pelvis, terminating at the anus. Cancer of the rectum is the disease characterized by the development of malignant cells in the lining or epithelium of the rectum. , the rectum is removed. If the cancer is found early, surgically removing the tumor can result in a five-year survival rate of approximately 72 to 93 percent of cases depending on the stage of the cancer. If the cancer invades the muscles that help you control your bowels, those muscles have to be removed and a permanent colostomy colostomy Surgical formation of an artificial anus by making an opening from the colon through the abdominal wall. It may be done to decompress an obstructed colon, to allow excretion when part of the colon must be removed, or to permit healing of the colon. created. A colostomy (stoma stoma or stomate Any of the microscopic openings or pores in the epidermis of leaves and young stems. They are generally more numerous on the undersides of leaves. ) is where a piece of the bowel is brought to the abdominal wall and a bag is kept over this piece to collect the stool. Occasionally, temporary stomas are created until the bowel has a chance to heal. The post-surgical use of colostomy bags is declining, however. Today, stomas do not restrict daily activities in any way. The National Comprehensive Cancer Network (NCCN NCCN National Comprehensive Cancer Network NCCN North Carolina Center for Nursing (Raleigh, NC) NCCN Nevada County Community Network ) guidelines recommend that people with rectal cancer be referred to an enterostomal therapist Enterostomal therapist (ET) A specialized counselor, usually a registered nurse, who provides ostomy patients with education and counseling before the operation. (a health care professional, often a nurse, trained to help people with their colostomies) as part of their initial work-up. The enterostomal therapist can address concerns about how a colostomy might affect your daily activities. If the cancer is not detected until a later stage after it has spread to other tissue, you may receive chemotherapy first. Intravenous 5-fluorouracil (5-FU) in combination with leucovorin is the chemotherapy regimen most often used to treat colorectal cancer. There are also newer options that may be more convenient than standard intravenous treatment, including capecitabine (Xeloda). For cancer that has spread to distant sites such as the liver or lung, other chemotherapeutic agents in addition to 5-FU are given. In addition to chemotherapy, radiation therapy is recommended if the cancer has become attached to an internal organ or the lining of the abdomen. In fact, you may be treated with a combination of chemotherapy and radiotherapy prior to surgery for rectal cancer. This combination helps shrink the tumor, allowing the sphincter muscles (which control the rectum) to be saved. Two drugs, bevacizumab (Avastin) and cetuximab (Erbitux), stop cancerous tumors from growing. Bevacizumab (Avastin) is used in combination with 5-FU chemotherapy and stops cancerous tumors from developing new blood vessels, eventually shrinking or killing the tumor. The drug cetuximab (Erbitux) blocks the growth factor that tells cancer cells to divide and has been approved for metastatic Metastatic The term used to describe a secondary cancer, or one that has spread from one area of the body to another. Mentioned in: Coagulation Disorders metastatic pertaining to or of the nature of a metastasis. colon cancer colon cancer, cancer of any part of the colon (often called the large intestine). Colon cancer is the second most common cancer diagnosed in the United States. . It can be given along with other chemotherapy drugs or alone if you can't tolerate other chemotherapy drugs. Cetuximab (Erbitux) is also effective in shrinking tumors and delaying tumor growth. It has also been approved for the treatment of head and neck cancers. Erbitux carries a "black-box warning" because of the risk of severe infusion reactions. Discuss this risk with your health care professional if he or she suggests Erbitux. For those whose colorectal cancer has metastasized to a few areas in the liver, lungs or elsewhere in the abdomen, surgically removing or destroying these metastases Metastasis (plural, metastases) A tumor growth or deposit that has spread via lymph or blood to an area of the body remote from the primary tumor. Mentioned in: Malignant Melanoma can increase the lifespan. Liver metastases may be destroyed by cryosurgery cryosurgery (krī`ōsr'jərē), bloodless surgical technique using a supercooled probe to destroy diseased or superfluous tissue. (freezing) or radio frequency ablation (heating the tumors with microwaves). If the cancer comes back in only one part of the body, you may need surgery again. If it has spread to several parts of the body, you may receive chemotherapy or radiation therapy. References "FDA Approves XELODA, First Oral Chemotherapy for the Treatment of Metastatic Colorectal Cancer." http://www.rocheusa.com. "Xeloda Fact Sheet." 2005 Roche Pharmaceuticals. http://www.rocheusa.com. "How is Cancer Found?" American Cancer Society. Revised May 2004. http:www.cancer.org. Accessed September 9, 2004. "Can Colorectal Cancer be Prevented?" American Cancer Society. Revised May 2004. http://www.cancer.org. Accessed September 9, 2004. Family Colorectal Cancer Registry. Thomas Jefferson University Hospital. Jefferson Health System. http://www.jeffersonhospital.org. Accessed September 9, 2004. "FDA Approves Erbitux for Colorectal Cancer." FDA Newsletter. U.S. Food and Drug Administration. February 12, 2004. http://www.fda.gov. Accessed September 9, 2004. "Overview: Colon and Rectum Cancer." American Cancer Society. Revised May 2004. http://www.cancer.org. Accessed September 9, 2004. "Colon and Rectal Cancer." CancerNet. National Cancer Institute. National Institutes of Health. http://www.cancer.gov. Accessed September 9, 2004. NCCN Colon and Rectal Cancer Treatment Guidelines for Patients. Version III< September 2003. National Comprehensive Cancer Network. http://www.nccn.org. Accessed September 9, 2004. "Biological Therapies for Cancer: Questions and Answers" National Cancer Institute, National Institutes of Health: Cancer Facts. Reviewed August 16, 2004/ http://cis.nci.nih.gov/fact/7_2.htm. Accessed September 9, 2004. "Colon Cancer Drug Investigated" ACS (Asynchronous Communications Server) See network access server. News Today. American Cancer Society. Oct. 2001. http://www.cancer.org. Accessed September 9, 2004. Veritas Medicine: Colon Cancer. Reviewed Dec. 2002. http://www.veritasmedicine.com. Accessed September 9, 2004. Smith RA, et.al., ACS Guidelines For the Early Detection of Cancer. CA Cancer J. Clin. 2001:51:38-75 "Drug Shows Promise Against Advanced Colon Cancer" American Cancer Society. June 4, 2003. http://www.cancer.org. Accessed September 9, 2004. "NCI-Funded Clinical Trials Show Aspirin Reduces Recurrence of Polyps" National Cancer Institute News Center. March 2003. http://www.cancer.gov. Accessed September 9, 2004. "Cetuximab." The American Cancer Society. 2004. http://www.cancer.org. Accessed March 2006. "Cancer Facts and Figures 2005." The American Cancer Society. 2005. http://www.cancer.org. Accessed March 2006. "Fitting in Fitness: Simple Steps Add Up." The American Cancer Society. 2006. http://www.cancer.org. Accessed March 2006. "Recommendations and rationale: Screening for colorectal cancer." U.S. Preventative Services Task Force." July 2002. http://www.ahrq.gov. Accessed March 2006. "What's New in Colorectal Cancer Research and Treatment?" The American Cancer Society. March 7, 2006. http://www.cancer.org. Accessed March 9, 2006. "Colorectal cancer: early detection." The American Cancer Society. February 2006. http://www.cancer.org. Accessed March 2006. "New Recommendations by the American College of Gastroenterology Call for Changes in Colorectal Cancer Screening of African Americans." The American College of Gastroenterology. March 2005. http://www.acg.gi.org. Accessed March 2006. "Colorectal Cancer Rates Higher in African Americans." The American Cancer Society. April 21, 2000. http://www.cancer.org. Accessed March 2006. "Can colorectal polyps be found early?" The American Cancer Society. March 7, 2006. http://www.cancer.org. Accessed March 20, 2006. "How is colorectal cancer staged?" The American Cancer Society. March 7, 2006. http://www.cancer.org. Accessed March 20, 2006. Keywords: colostomy, stomas, colostomy bag, enterostomal therapist, polyp, chemotherapy, radiation |
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