What happens once cancer is diagnosed?
If you are found to have colorectal cancer, a team of specialists is there to help. You will be advised to have blood tests and scans to determine what is known as the stage (extent) of the cancer. Not only will the size of the primary tumor be assessed thoroughly, but the specialist will also want to know if there is any sign of secondary spread. Armed with all the relevant information they have gathered about the cancer, the specialists will decide how best to advise you on the most appropriate treatment.
How are cancers of the colon and rectum treated?
Once tests have confirmed that the cancer has not spread anywhere else, most colon cancers are treated by surgery. This will usually involve removing the cancer together with the lymph glands along the blood vessels supplying that section of the bowel. In most cases, the two ends of the bowel are joined together again (anastomosis) but if the cancer has led to an emergency, it may not be possible to join the bowel together right away. Once the colorectal cancer and surrounding tissue have been removed they will be examined under the microscope and only then will it be possible to fully determine the stage of the cancer. If the cancer is confined to the bowel wall, then surgical removal alone may be all that is needed. If there is any sign of spread to the local lymph glands a course of chemotherapy postoperatively may well be advised.
Unless they are very small and can be removed by a local operation, most cancers of the rectum need to be very carefully checked preoperatively by various scans. This will help decide whether or not the cancer should be treated by radiation therapy. Cancers in the lower part of the rectum will be removed together with the immediately surrounding tissue called the mesorectum. This operation which aims to cure the cancer is called total mesorectal excision (often abbreviated to TME).
Will a colostomy be necessary?
A cancer of the rectum very near the anal canal will be difficult to remove completely and in this situation it may be necessary to remove the rectum and the anus, and make a permanent stoma (opening of the colon) into the skin of the abdomen—this is called a colostomy. Fortunately, modern surgical techniques have made the need for a stoma to be much less likely than it used to be in the past.