Surgery is the most common treatment method for colon cancer. The type of surgery will depend on the stage of the tumor and the area it is located in.
Colon cancers in very early stages can sometimes be eliminated through local resection. The surgeon removes the cancer from the mucosa of the intestine using a colonoscope.
A pathologist will examine the tumor that has been eliminated; if they see that it is high-grade, you may be recommended to have a second operation.
Removal of part or all of the colon
Removal of the entire colon is called total colectomy.
Removal of part of the colon is called hemicolectomy. During a left hemicolectomy, the left half of the transverse colon and the descending colon are removed. During a right hemicolectomy, the transverse colon and the ascending colon are removed.
Sometimes, the sigmoid colon is removed; this is called sigmoid colectomy. Other times, the transverse colon is removed; this procedure is called transverse colectomy.
During the surgery, the part of the intestine containing the cancer is removed, and the two open ends are joined during a procedure called anastomosis. Usually, the surrounding lymph nodes are also eliminated, as this is the first place where cancer may spread to.
Open or laparoscopic surgery
The operation may be performed as open surgery or laparoscopic surgery.
Open surgery means the surgeon makes an incision that causes a wound that extends from the sternum to the navel or from one side of the abdomen to the other.
In laparoscopic surgery, four or five small incisions are made in the abdomen, and a laparoscope is inserted inside one of the holes and surgical instruments are inserted in the others.
Recovery from laparoscopic surgery is normally faster than for open surgery. Your surgeon will talk to you about what type of surgery is appropriate.
In some cases of surgery to remove colon cancer, after the operation an opening is made in the abdomen to allow the bowels to be emptied through the hole.
If the stoma is made in the colon, it is called a colostomy; if an opening is made in the small intestine (ileum), the procedure is called an ileostomy.
Stomas can be temporary or permanent, though only a small percentage of colon-cancer patients need a permanent stoma.
A temporary stoma can be performed to allow the intestine to rest after colon surgery. After, a second surgery will be done to close the stoma up.
- Surgery for liver metastases
If the colon cancer has spread to the liver, the most common treatment is chemotherapy to reduce its size and keep the size under control for the longest time possible.
Some patients may have surgery to remove the pat of the liver that has been affected by cancer; this operation is called liver resection.
Liver resection is major surgery, and the operation lasts 3-7 hours.
- Lung metastases surgery
The main treatment for cancer that has spread to the lungs is chemotherapy. From time to time, however, surgery may be performed to remove the part of the lung that has been affected. This can only be performed if the cancer is in just one area of the lung and in no other part of the body.