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Colorectal Cancer

Bringing you comprehensive information about different types Colorectal Cancer

Colorectal Cancer

Bringing you comprehensive information about different types Colorectal Cancer

AOI > Cancer Types > Colorectal cancer > Treatment

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    What are the different types of treatments for colorectal cancer?

    Colorectal cancer treatment depends on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health.

    However, colorectal cancer treatment options generally include surgery, radiation therapy, therapies using medications such as immunotherapy and targeted therapy, chemotherapy and combined therapies.

    Colorectal cancer surgery

    Surgery is considered the most common treatment for the early stage or resectable colorectal cancers. Besides tumor, part of the healthy colon or rectum and nearby lymph nodes will also be removed during the operation, if required.

    Your oncologist will evaluate which type of surgery — open, laparoscopic or robotic is best, depending on the extent of the tumor and where it is located.
    Surgery must be conducted on an empty colon. Post-surgery, patients can expect pain, which can be managed with medicine.

    Most patients are able to eat solid food within a few days.

    At American Oncology Institute, the best hospital for treatment of colorectal cancer in India, we offer patients the latest advances in minimally invasive surgical techniques.

    What is Polypectomy?

    Polypectomy is relatively a non-invasive treatment option and is used to remove polyps from the inside of the colon, also called the large intestine or rectum. A polyp is an abnormal lump of tissue. While some polyps are usually benign (non-cancerous) and may not cause any symptoms, others may develop into cancer (tumor).

    Polypectomy is usually carried out at the same time as a colonoscopy which is the first step to detect the presence of polyps. If detected, a polypectomy is performed and the infected tissue is removed.

    How polypectomy for treating colorectal cancer is performed?

    During the procedure, a colonoscope is inserted by the physician in the rectum. Colonoscope is a thin, long tube to which a small camera is attached. The camera helps the doctor to locate polyps in the body on the monitor screen. The whole procedure takes anywhere between 30 minutes to one hour. In case a polyp is detected, polypectomy is performed.

    Some polyps, due to their large size, location, or configuration are considered to be more technically challenging or are associated with an increased risk of complications. In such cases, endoscopic mucosal resection (EMR) is recommended.

    Types of polypectomy for treating colorectal cancer

    There are two most common types of polypectomies to remove polyps:

    • Snare polypectomy: During this technique, the doctor forms a thin loop of wire and fixes it at the base of polyp. It is then heated up to cut off its growth and burn the bleeded wound.
    • Piece-meal polypectomy: Polyps that have grown large can be removed by this type of polypectomy. It is recommended for patients who cannot go for bowel surgery as this approach can remove polyp’s growth during the colonoscopy process itself. However, this type of polypectomy is only reserved for larger polyps.

    Risks of polypectomy

    Certain risks associated with polypectomy may include:

    • Fever or chills
    • Heavy bleeding
    • Severe pain or bloating in the abdomen
    • Vomiting
    • Irregular heartbeat

    Though rare, one should contact their doctor immediately if they experience any of these symptoms.

    What to expect before, during, and after polypectomy?

    Pre-Polypectomy

    Before the procedure starts, you’ll be seen by an anesthetist, who’ll administer anesthesia for the treatment. Make sure to point if you’ve ever had any bad reactions to anesthesia before.

    During Polypectomy

    The doctor will perform colonoscopy and if any polyp is found, polypectomy is performed.

    Post-Polypectomy

    After the procedure is completed, your doctor will remove colonoscope. Soon after the procedure you may not be in a condition to drive, so make sure you are accompanied by an attendant or someone to drive you back comfortably.

    Results of the test will be given to you within a few weeks.

    Special diet needs before and after polypectomy

    About two days before the procedure you will be asked to prepare for bowel cleaning so that you have a clear colon which causes no visual obstruction during the procedure. Hence you should be on clear food diet which may include clear broths, juices without any pulp and gelatin.

    After Polypectomy:

    • Have high fibre foods and extra liquids to prevent constipation.
    • Choose healthy foods such as whole-grain bread, cereal, rice, and pasta.
    • Eat a variety of fruits and vegetables and include dairy products such as low-fat milk, yogurt, and cheese.
    • Choose various sources of proteins, such as chicken, fish, beans, eggs and nuts.
    • Also, drink lots of water and stay hydrated every day.

    How much polypectomy for colorectal cancer costs?

    In India, the cost of polypectomy for colorectal cancer is typically a fraction of the cost for the same procedure and care in the US and other European countries. However, the cost can vary as per the diagnosis and condition of the patients along with the facilities availed.

    Polypectomy for colorectal cancer success rate

    Most polyps can be treated using conventional polypectomy. These do not pose a significant challenge for resection to an adequately skilled and trained endoscopist. And for a few polyps which are considered to be difficult, multiple techniques are available for the resection.

    Endoscopic mucosal resection (EMR)

    What is endoscopic mucosal resection?

    Endoscopic mucosal resection (EMR) is a minimally invasive technique to remove large polyps which are challenging to remove endoscopically. It is performed via colonoscopy conducted under conscious sedation.

    How endoscopic mucosal resection for treating colorectal cancer is performed?

    Endoscopic mucosal resection (EMR) is performed with the help of endoscope — a long, thin narrow tube to which camera is attached. When the upper digestive tract is treated with EMR, then doctor passes the endoscope from your throat into the esophagus, stomach and then to the small intestine.

    To reach the colon, the doctor guides the tube up through the anus and performs the procedure.

    How endoscopic mucosal resection works against colorectal cancer?

    EMR is usually recommended as a treatment modality for colorectal cancer. But if your doctor feels the need, he/she may also collect samples of tissue during the procedure. This helps in correct diagnosis of the condition and also aids in planning the treatment pathway ahead.

    Types of endoscopic mucosal resection for treating colorectal cancer

    The EMR techniques can be broadly divided into ‘suck-and-cut’ (suction) or ‘lift-and-cut’ (nonsuction) techniques. In certain cases, however, both techniques are used together.

    In the ‘lift-and-cut’ technique, a submucosal injection is used to separate the muscularis propria from the lesion as this helps to reduce the chances of perforation.

    But during suck-and-cut technique, it does not require a submucosal injection and is done using a multi-band mucosectomy device.

    Risks of endoscopic mucosal resection

    Though EMR is generally a very safe procedure, some of the potential but rare complications include bleeding and puncture in the lining of the gastrointestinal tract, etc.

    Also, if you develop any of the signs or symptoms following the EMR procedure, inform your surgeon immediately:

    • Fever
    • Chills
    • Vomiting
    • Black stool
    • Blood in the stool
    • Chest or abdominal pain
    • Shortness of breath

    What to expect before, during, and after endoscopic mucosal resection?

    Before the procedure, you will be explained the risks and benefits of EMR well in advance.
    During the procedure, you can expect the following:
    Numbing medication: If the endoscope is passed down through your throat, you may be asked to gargle a solution that numbs your throat. This local anesthetic makes insertion of the endoscope more easy.

    Sedation: You’ll receive a sedative before the procedure begins. Moderate sedation makes you feel relaxed, however, you may feel slight movement or pressure during the procedure.

    Monitoring: Nurses or other professionals will monitor your heart rate, blood pressure, blood oxygen level while the doctor performs the procedure.

    If your procedure is for the colon, you may need to take a laxative before the procedure.

    EMR is grouped into two general categories: suction or lift method. These require a surgical cut to remove the abnormal tissue.

    After the procedure:

    Once the effect of the sedative has worn off, your doctor will explain you more about when to start eating and drinking and to resume normal activities.

    You’ll be advised not to do any of the following activities until the next day:

    • Drive
    • Return to work
    • Make important decisions

    EMR is generally an outpatient procedure and you may experience mild side-effects for the first 24 hours of the procedure. These include:

    • Reaction to the sedative
    • Sore throat
    • Gas or cramps

    How much endoscopic mucosal resection for colorectal cancer costs?

    The cost of EMR procedure can vary as per the stage and grade of colorectal cancer and your general health profile.

    Endoscopic mucosal resection for colorectal cancer success rate

    Large colonic polyps can be managed safely and effectively by EMR which has high success rates and minimal morbidity and mortality, but that’s possible only if your surgeon where you have endoscopic mucosal resection is skilled and experienced. At AOI, we have the best and highest success rate when treating colorectal cancer patients with EMR.

    Laparoscopic surgery

    What is laparoscopic surgery?

    Laparoscopic surgery is a minimally invasive, effective and safe alternative to conventional surgery for the treatment of early colorectal cancer. However, it is important to get treated by the doctor who is skilled in laparoscopic techniques in order to offer optimal outcomes.

    Also, the procedure is recommended for polyps that can’t be removed by colonoscopy.

    How laparoscopic surgery for treating colorectal cancer is performed?

    In laparoscopic surgery, a few small incisions are made in the patient’s abdomen. A small tube that holds a video camera can then be inserted through the incisions, creating a live picture of the inside of the patient’s body. This picture is continually displayed on a screen and it helps the surgeon to perform the surgery. The tumor is then removed through a larger incision.

    This type of procedure prevents the need for large surgical incisions, and may reduce the risk of infection, healing complications, pain and/or blood loss.

    Types of laparoscopic surgery for treating colorectal cancer

    Laparoscopic surgery is performed using either of the two types of laparoscope:

    • Telescopic rod lens system which is connected to a video source.
    • Digital laparoscope has a miniature digital video camera. It is placed at the end of the laparoscope.

    The digital laparoscope is the preferred choice as it enhances the image quality of flexible endoscopes. Nevertheless, laparoscopes are rigid endoscopes.

    Risks of laparoscopic surgery

    Some of the risks associated with laparoscopic surgery may include:

    • Wound infection
    • Abdominal ulcers
    • Skin and bladder infections
    • Blood clotting
    • Nerve blockage
    • Damage in the organs of the body

    What to expect before, during, and after laparoscopic surgery?

    Before laparoscopic surgery

    A day prior to the surgery, it is important to follow the directions carefully and take prescribed laxative medicine. Also, refrain from eating or drinking anything on a night before surgery.

    During laparoscopic surgery

    A small cut is made in the abdominal wall and then small tube called cannula is inserted through incision. Cannula fills the abdomen with carbon dioxide which makes it inflated. Your doctor can easily see your abdominal organs through this gas.
    After this laparoscope is inserted when abdomen is in inflated condition. The camera attached to laparoscope will help the doctor to visualize inside of the abdomen in a real-time scenario.

    After laparoscopic surgery

    It is a normal practice to place the abdominal drain at the end of the procedure. All the wounds will be covered with stitches which do not need to be further covered with any antiseptic dressing.

    How will I recover after this surgery?

    Once your surgery is over, you will be observed for several hours. There will be constant monitoring of your heart beat and blood pressure, etc. Hospital staff will also keep a close check on the side effects of anaesthesia if any.

    Your relieving from hospital will depend on several factors like:

    • How are you are responding to your medications
    • Your overall physical condition
    • Your response to the surgery
    • What kind of anaesthesia is used and if there are any side effects

    How much laparoscopic surgery for colorectal cancer costs?

    While the cost for laparoscopic surgery for colorectal cancer depends on a couple of factors like the stage of cancer and the extent to which it has spread, at American Oncology Institute, we offer cutting-edge treatments like laparoscopic surgery and robotic surgery for colorectal cancer.

    Colostomy

    What is colostomy?

    A colostomy is a procedure that brings one end of the large intestine out through the abdominal wall. During this procedure, one end of the colon is diverted through an incision in the abdominal wall to create a stoma; an opening in the skin where a pouch for collecting feces is attached. People with temporary or long-term colostomies have pouches attached to their sides where feces can be easily disposed.

    How laparoscopic surgery works against colorectal cancer?

    An important point to consider is that during the conventional or open surgery, the surrounding area inside the body cavity is not readily visible to the surgeon, which limits the number of lymph nodes that can be removed. However, in intracorporeal laparoscopic surgery, the incision, while small, is large enough to enable the laparoscope to travel further into the body and magnify the view. This ensures that all the lymph nodes are removed during colorectal cancer surgery.

    Besides, during laparoscopic-assisted surgery there is less bleeding, less risk of infection, less pain and less scarring for the patient who undergoes the procedure. The procedure also reduces the risk of adhesions, which can lead to small bowel obstruction even after years or decades after the surgery is performed.

    What is AOI’s expertise in laparoscopic colorectal surgery?

    Because laparoscopic colorectal surgery takes place entirely inside the body, it requires extensive and highly specialized training. In India, only a few colorectal surgeons are qualified to perform this procedure, therefore, the hospital where you have laparoscopic surgery should be internationally recognized.

    American Oncology Institute is one of the few centers in India to perform this advanced procedure.

    Laparoscopic surgery for colorectal cancer success rate over open surgery

    Patients who undergo laparoscopic surgery for colorectal cancer generally demonstrate better results and report less intr-aoperative blood loss, postoperative complications, postoperative hospital stay, and have higher retrieved lymph nodes as compared to patients who undergo open surgery for colorectal cancer.

    How colostomy for treating colorectal cancer is performed?

    During the procedure, your surgeon will make an incision in your abdomen – it could be large, or a series of smaller incisions.

    This type of surgery involves using small tools and a camera that’s inserted into an incision. The camera is used to guide your doctor while performing the surgery.

    During the procedure, your doctor will locate the ideal part of the large intestine for the opening, or stoma and will cut the intestine and bring it through your abdominal wall. Followed by this a ring onto your abdominal wall will be surgically implanted. The ring helps to hold the end of the intestine in place. It may be permanent or placed temporarily to help your skin heal around your exposed intestine.

    After everything is in place, your doctor will close your wound with stitches.

    How colostomy works against colorectal cancer?

    Colostomy is performed to treat the problems with the lower bowel. Colostomy successfully helps to move the stool of the body when colon or rectum parts have been surgically removed after cancer surgery.

    It is used to remove part of lower bowel which may be damaged or infected due to the ruptured colon.

    Types of colostomy for treating colorectal cancer

    Colostomy is named for the section of the colon in which it is needed.

    Sigmoid colostomy: This is the most common type of colostomy performed in the bottom part of the large intestine. Sigmoid colostomy produces the stool that is regular and normal.

    Transverse colostomy: The transverse colon crosses the top of the abdomen. Stool in this area is usually soft. This is because only a small portion of the colon has absorbed water from the indigestible material. This type of colostomy has three versions:

    A loop colostomy: In this type of colostomy, the colon stays connected to the rectum which is why people will sometimes pass stool or gas through the rectum.
    A single-barrel colostomy: This type of colostomy is permanent, and it removes the colon, including the rectum and anal opening.

    A double-barrel colostomy: This divides the colon into two ends that form separate stomas. Stool exits from one of the stomas, whereas mucus made by the colon exits from the other. This type of transverse colostomy is rare.

    Descending colostomy: The descending colon takes waste down the left side of the abdomen. The stool there is usually firm.

    Ascending colostomy: The ascending colon runs from the beginning of the large intestine to the right side of the abdomen. In this procedure, only part of the colon works. As a result, little water is absorbed from the waste. This means the stool is usually liquid. This type of colostomy is rare.

    Risks of colostomy

    Colostomy may include the following risks as listed below:

    • Bleeding inside the colon
    • Damage to nearby organs
    • Infection
    • Bleeding from the stoma

    What to expect before, during, and after colostomy?

    Before surgery:
    Your doctor will take blood samples, perform a physical examination, and review your complete medical history. At this stage, inform your doctor about any prior surgeries you’ve had and any medications you’re taking, including over-the-counter medicines and supplements.

    Your doctor will ask you to fast for at least 12 hours before the surgery. You may also be given a laxative or an enema, night before the surgery. This is to help cleanse your bowels.

    The procedure requires hospital stay for about three to seven days.

    During colostomy

    After general anesthesia, the surgeon attaches one end of the colon to a stoma which is then attached to the colostomy bag.

    The procedure may be done with either of the two ways listed below:

    • A surgical incision, which is a large cut in the abdomen.
    • Laparoscopic surgery, which involves less invasive small cuts. This method reduces pain and recovery time.

    After colostomy

    Once you have recovered from surgery, you will need to empty the colostomy bag several times a day. You will not be able to control when stool and gas moves into the pouch.

    Colostomy pouches come in many sizes and shapes such as one-piece pouch, two-piece pouch, open-end or drainable and closed-end or disposable pouches, etc.
    Caring for your skin. The skin surrounding the stoma will look red and may bleed occasionally, which is normal. But bleeding should not continue for long.

    It is important to make sure your pouch is correctly connected to your stoma. Pouches that do not fit well can irritate the skin. As a rule, keep this area clean and dry and if this skin appears wet, bumpy, itchy, or painful, contact your doctor.

    You will be given instructions on diet, medications and your activity level and you need to be very particular about these instructions and keep a track of your appointments with doctor to check on your improving condition.

    Special diet needs before and after colostomy

    Few diet modifications are required for the first few weeks after your colostomy. This helps to prevent discomfort while your colon still heals.

    It is best to eat mostly bland, low-fiber foods for the first few weeks after your surgery. Bland foods are easy-to-digest and help in avoiding uncomfortable symptoms such as diarrhea, bloating and gas.

    In milk and dairy, include low fat or non-dairy milk such as soy milk, cheese, yogurt, low-fat ice-cream, etc.

    High fibre, high-fat foods, such as fried meat, poultry should be limited.

    Whole grains, such as whole-wheat bread, brown rice, bran cereal, quinoa, and buckwheat should be avoided.

    Have pulp free juice and peeled fruits. You can avoid raw fruits with skin such as apples, grapes, strawberries, etc.

    Consume lots of water, tea, coffee, buttermilk, and non-carbonated drinks.

    How much colostomy for colorectal cancer costs?

    While the cost of colostomy depends on various factors including your type and stage of colorectal cancer, at AOI our services are at par with international standards.

    We offer world-class medical facilities under one roof and all our hospitals boast of the most extensive diagnostic and imaging facilities including Asia’s most advanced MRI and CT technology.

    Colostomy for colorectal cancer success rate

    Colostomy has come a long way and is now usually conducted laparoscopically which reduces the mortality and morbidity risk by a significant amount.

    Ileostomy

    What is ileostomy?

    An ileostomy is a surgically made opening that connects your lower end of the small intestine, the ileum to your abdominal wall.

    The procedure is recommended when the ileum either stops functioning properly or gets infected to an extent that it needs to be removed. The procedure helps to remove solid waste and gas without having to pass through the colon or the rectum. As a result, the waste is collected in a pouch worn on the outside of your body.

    How ileostomy for treating colorectal cancer is performed?

    The procedure is performed under general anesthesia. Once unconscious, your surgeon will either make a cut down your midline or will perform a laparoscopic procedure using smaller cuts. Based on your condition, the surgeon will decide if your rectum or colon needs to be removed.

    The surgeon will then make an incision in the abdomen and identify the main areas of the bowel, including ileum which will then be attached to an opening in the abdominal wall.

    He’ll pull a loop of your ileum through the incision. The part that sticks out is called a stoma. It may protrude up to 2 inches.

    Types of ileostomy for treating colorectal cancer

    Standard ileostomy: Also called as Brooke ileostomy, this is the most common type of ileostomy performed for the treatment of colorectal cancer. The end of the small intestine is pulled through the right lower part of the abdomen and secured to the outside skin. You are made to wear a pouch all the time to collect the stool that moves through the opening.

    Continent ileostomy: This procedure does not require you to wear a collection bag. Instead, the surgeon creates a pocket and valve in the end of the small intestine. You then insert a catheter several times a day into the pocket to drain the waste.

    Ileoanal reservoir: This is also called a J-pouch or pelvic pouch. The surgeon creates a pouch from the small intestine and rectum which is then connected to the anus to store waste. Stool can then be passed from the pouch through the anus.

    Loop ileostomy: During the procedure a loop of the small intestine is pulled out through a cut in your abdomen, before being opened up and stitched to the skin to form a stoma.

    End ileostomy: The ileum during this technique is separated from the colon and is brought out through the abdomen to form a stoma.

    Risks of ileostomy

    As with any surgical procedure, having an ileostomy carries possibility of certain complications.

    Some of the common problems that people with an ileostomy experience are as follows:

    • Bowel obstruction
    • Vitamin B12 deficiency
    • Stoma problems

    Risks that are specific to ileostomies include

    • Damage to surrounding organs
    • Internal bleeding
    • Inability to absorb enough nutrients from food
    • Urinary tract, abdominal, or lung infections
    • Intestinal blockage due to scar tissue
    • Wounds that take a long time to heal

    What to expect before, during, and after ileostomy?

    Getting an ileostomy can get really challenging. However, you’ll be given training that will make this transition easier.

    Before going ahead, make sure to inform your doctor about the supplements, medications, and herbs you’re taking. Many drugs, including the OTC drugs affect the function of the intestine by slowing it down. So, your doctor may ask you to stop taking certain drugs two weeks prior to your surgery. It is essential to prepare for some drastic changes that result post procedure.

    After the surgery

    Post procedure, you may be hospitalized for a week or even longer, especially if your ileostomy was done under emergency circumstances. Recovering from the procedure can be challenging as during this time you’ll also be taught how to look after your stoma. The bags must be changed frequently, so don’t forget to discuss that with your doctor or hospital where you have ileostomy procedure done.

    Many people experience short-term physical and psychological problems.

    In the early days you may have excessive intestinal gas which will decrease as your intestines heal. Some people have found that eating four to five small meals per day is better than having three larger meals.

    During your recovery, whether you have an internal or external pouch, you’ll start to learn how to manage the pouch that will collect your waste.

    You’ll also learn to care for your stoma and the skin around it. With practice and support, many people learn to adjust and find their quality of life improves after surgery.

    Special diet needs before and after ileostomy

    Having an ileostomy can change dietary choices as well. Nutrition is an important consideration after surgery. Soon after the surgery, your doctor may recommend a low-fiber diet to give the bowel time to heal.

    Some of the diet changes that you need to make are as follows:

    • Drink plenty of water throughout the day
    • Limit the consumption of dehydrating beverages, such as the ones that contain alcohol or caffeine
    • Cut down foods that cause gas, such as cabbage and broccoli
    • Have small meals at regular intervals

    How does Ileostomy work against colorectal cancer?

    People with colorectal cancer sometimes may need ileostomy. While most people need ileostomy only for a few months till the time the colon or rectum heals, some may need a permanent ileostomy.

    How much ileostomy for colorectal cancer costs?

    The cost of ileostomy can vary depending on the stage of cancer and other medical conditions of a patient.

    Ileostomy for colorectal cancer success rate

    For some colorectal patients whose bowel function has lowered their quality of life, a permanent ileostomy can bring positive change. Infact, once you learn to take care of your new elimination system, you’ll be able to participate in most of your regular activities.

    What is partial colectomy vs. total colectomy?

    Partial colectomy involves removal of a part of the colon. It may also be called subtotal colectomy.
    During a partial colectomy, a surgeon removes the infected portion of your colon along with a small portion of surrounding healthy tissue. Followed by this, the cut ends of the colon are joined together so that waste leaves your body normally.

    Or, in some cases, it becomes necessary to connect the colon to the stoma which is connected to a bag that collects the waste from the body.

    To the contrary, total colectomy involves removal of the entire colon.

    How partial colectomy vs. total colectomy works against colorectal cancer?

    In total colectomy, after you have received general anesthesia, your surgeon will make a surgical cut in your belly to remove your large intestine leaving your rectum and anus in place. After that your surgeon will sew the end of your small intestine to your rectum.

    Whereas in a partial colectomy, a surgeon removes the diseased portion of your colon along with some nearby lymph nodes. The cut ends of the colon are joined in a way that waste leaves your body normally. There could be times, when it might be necessary to connect the colon to an opening (stoma) in the abdominal wall, where waste leaves the body and collects in a bag attached to the opening.

    What is open colectomy vs. laparoscopic-assisted colectomy?

    Open colectomy is done through a long, vertical incision on your belly. Whereas, laparoscopic-assisted colectomy is done with small incisions. To help the surgeon see the colon, the tiny video camera is put into one of the incisions. Laparoscopic-assisted colectomy leads to faster recovery and is less painful.

    Risks of open colectomy vs. laparoscopic-assisted colectomy

    Common risks of a colectomy may include:

    • Reaction to anesthesia
    • Blood clots in the legs or lungs
    • Internal bleeding
    • Infection at incision site
    • Damage to nearby organs

    What to expect before, during, and after open colectomy vs. laparoscopic-assisted colectomy?

    Here is what to expect before surgery:

    • Your bowels must be empty for the surgery.
    • You may need to do bowel preparations one or two days in advance, including having the laxative and enemas to clean out the bowel.
    • You may be asked to drink clear liquids or broth the day before surgery. You may also be told to refrain from eating or drinking at least 12 hours before the procedure.
    • You may need to stop taking some medicines.This includes any medicines that thin the blood.

    During the procedure

    You will be given general anesthesia for the surgery.
    For an open colectomy, the surgeon will make a long cut on your stomach, but in case of a laparoscopic-assisted colectomy, several smaller incisions will be made.

    The surgeon will remove a part of your colon followed by which two open ends of the colon will be attached, to create a stoma.

    The lymph nodes near the site of the cancer will also be removed.

    The incision is closed once the surgery is completed.

    After the procedure

    You will likely be in the hospital for 3 to 7 days. You’ll also need to take pain relieving medicine for several days. Soon after the surgery, you may be allowed to have liquid diet, as your colon begins to recover.

    After a few days, you may be able to get back to solid diet again.

    Ablation

    What is ablation?

    When colorectal cancer has spread and there are a few small tumors in the liver or lungs left, these metastases can sometimes be removed by surgery or destroyed by other techniques, such as ablation or embolization. Ablation technique is well suited to destroy small tumors, ones that are smaller than 4 cm.

    How ablation for treating colorectal cancer is performed?

    When all of the primary cancer in the colon or rectum is removed with surgery, ablation is used to destroy small tumors that have spread to other parts of the body. Ablation is considered to be good option for people whose metastatic tumors come back after surgery or whose cancer can’t be cured with surgery, or who can’t have surgery for other reasons. This increases the survival rate of the patient and helps to relieve them of certain symptoms, like pain.

    There are many different types of ablation techniques that are performed differently.

    Types of ablation for treating colorectal cancer

    Radiofrequency ablation: This is one of the most common methods to treat cancer that has spread to the liver. It uses high-energy radio waves to kill cancer cells. A CT scan or ultrasound is used to guide a thin, needle-like probe through the skin and into the tumor.

    Microwave ablation: This method is used to treat cancer that has spread to the liver. Various imaging tests are used to guide a needle-like probe into the tumor. Electromagnetic microwaves are then sent through it to create high temperature that kills the cancer cells.

    Ethanol (alcohol) ablation: During this technique, concentrated alcohol is injected right into the tumor to damage cancer cells. This is usually done using a needle, which is guided by ultrasound or CT scans.

    How ablation works against colorectal cancer?

    When colorectal cancer has metastasized, there are a few small tumors in the liver or lungs which can sometimes be removed by surgery or destroyed by techniques such as ablation or embolization.

    Also, the technique is used to destroy small tumors in other places in the body, post surgery.

    Ablation is a good option for people whose metastatic tumors come back after surgery, whose cancer can’t be cured with surgery, or who can’t have surgery for other reasons. This often helps a person to live longer.

    Risks of ablation

    Serious complications or risks associated with ablation are rare. However, the technique may have minor side-effects such as abdominal pain, infection in the liver, fever, bleeding into the chest cavity or abdomen, etc., depending on where you have ablation or for which body part.

    How much ablation for colorectal cancer costs?

    The cost of ablation depends on various factors including: tumor’s size, stage and health conditions of the patient being treated.

    Ablation for colorectal cancer success rate

    Ablation technique provides survival benefit to patients with colorectal cancer whose liver metastases are inoperable, do not respond to systemic chemotherapy, or both.

    Radiation Therapy

    What is radiation therapy?

    Radiation therapy is a treatment that uses high-energy rays to destroy cancer cells. It’s often used to treat rectal cancer than colon cancer. During the procedure, the radiation is aimed directly at the tumor which damages cancer cells in such a way that they can’t multiply.

    Radiation therapy is not a substitute for surgery but in some advanced cases it can be used as a treatment option where cancer can’t be removed with surgery.

    How radiation therapy for treating colorectal cancer is performed?

    For colorectal cancer, the most common way to receive radiation is from a machine that sends X-ray beams to the tumor. This is called external radiation.

    But in a few selective rectal cancer patients, a radioactive source is put right into or next to the tumor to give off radiation for a short time. This is known as internal radiation.

    What are the different types of radiation therapy for colorectal cancer?

    Based on the type, location and size of your cancer, your radio-oncologist will decide which kind of radiation therapy is best suited for you. Typically, there are two types of radiation therapy for treating colorectal cancer:

    External-beam radiation therapy: This is the most common form of radiation therapy prescribed for people with colorectal cancer. During the procedure, a machine is used to deliver X-ray beams that is targeted at the tumor site. The frequency of treatment may depend on stage and grade of cancer. It’s a lot like getting an X-ray, but the radiation is more intense as it aids in destroying the cancer cells.

    Interstitial radiation therapy: This is also known as brachytherapy and is often used to treat some rectal cancers. The technique uses a tube to place small pellets of radioactive material directly into the tumor. After 15 minutes, they’re taken out.

    Risks of radiation therapy

    Radiation therapy has no serious risks associated with it, however; you may experience some side-effects depending on factors such as where you have radiation therapy or which part of your body is being exposed to radiation and how much radiation is used, etc.

    Common side effects of radiation therapy include:

    • Fatigue
    • Diarrhea, nausea, bladder irritation, feeling the need to urinate often
    • Blood in stool
    • Pain and burning sensation on skin
    • Problem having sex
    • Most side-effects of radiation therapy go away after the treatment. But some continue to come back or may develop later.

    What to expect before, during, and after radiation therapy

    Preparing for radiation therapy

    Before your first session, you’ll have an appointment to plan for the treatment. This is called simulation.
    During the simulation you may be asked to drink a cup of a contrast agent such as barium that allows your doctor to see your colon on a CT scan or X-ray image. Some barium may also be put in your rectum with a soft, small rubber tube.

    During radiation therapy

    A radiation therapist uses a machine to find exactly where the radiation will be aimed.

    The therapist may mark your skin with ink dots which helps radio-oncologist to aim the radiation at the exact same place each time.

    You may have other imaging tests such as a CT scan to help locate the tumor.

    After radiation therapy

    Radiation therapy affects normal cells as well as cancer cells. This can cause some side-effects, depending on the amount and type of radiation. Some people have few or no side effects at all. But if you experience any problem, inform your doctor as he/she may change the dose or the frequency.

    Special diet needs before and after radiation therapy

    Radiation therapy can change how your body accepts certain foods and absorbs nutrients. Therefore, while you are on radiation therapy, it’s advisable to change your eating habits and times.

    • Eat smaller meals more frequently.
    • Plan ahead for changes to your diet
    • Pay attention to your side effects and how they affect your appetite. Discuss the changes with your doctor or nutritionist.
    • Stay hydrated. All body cells need water to function. If you don’t take in enough fluids or if you lose fluids through vomiting or diarrhea, you can become dehydrated.

    Some of the foods you may include in your daily diet include

    • Oatmeal is rich in nutrients and it helps to heal your body.
    • Eggs are rich source of protein and fats.
    • Nuts and almonds are rich source of protein, healthy fats, vitamins, and minerals.
    • Fruits and vegetables should be the focal point of every meal. Have it raw or in steamed or cooked form.
    • Whole grains include brown rice, Quinoa and white rice. Make them part of your meals to increase your protein intake.
    • Lean proteins are low in fat. Include seafood, poultry, eggs, beans, soy products, and unsalted nuts and seeds.

    How much radiation therapy for colorectal cancer costs?

    Cost for radiation therapy for colorectal cancer depends on the stage of cancer and also if the radiation prescribed is external beam radiation therapy or low and high dose brachytherapy (HDR) and if there are other therapies or treatments required in conjunction with radiation therapy.

    Radiation therapy for colorectal cancer success rate

    Though surgery remains the most effective treatment for colorectal cancer, radiation therapy is most effective as additional or adjuvant therapy either before or after the surgery as it arrests the progression of cancer cells or its recurrence.
    Radiation is not normally used as the only treatment for colorectal cancer as it is usually given in combination with chemotherapy to help the radiation work better.

    Chemotherapy

    What is chemotherapy treatment for colorectal cancer?

    Chemotherapy is a treatment with anti-cancer drugs that travel through the bloodstream and reach most parts of the body. It that may be injected into a vein or taken by mouth.

    Chemo is often used to treat colorectal cancer.
    A chemo schedule usually consists of a specific number of cycles given over a set period of time.

    How chemotherapy for treating colorectal cancer is performed?

    Chemotherapy drugs can be given in a variety of ways:

    Systemic chemotherapy: Drugs are put right into your blood through a vein, or you take them in a pill form by mouth.

    Chemotherapy infusions: Chemo is commonly given as an infusion into a vein (intravenously). The drugs can be given by inserting a tube with a needle into a vein in your arm or into a device in a vein in your chest.

    Chemotherapy shots: Chemo drugs can be injected with a needle, just as you would receive a shot.

    Regional chemotherapy: Drugs are put right into an artery that leads to the part of the body with the cancer. It reduces side effects by limiting the amount of drug reaching the rest of your body.

    Chemotherapy creams: To treat certain types of skin cancer, creams or gels containing chemotherapy drugs can be used.

    Chemotherapy given directly to the cancer: Chemo can be given directly to the cancer or, after surgery, where the cancer once was.

    How chemotherapy works against colorectal cancer and what are common risks of chemotherapy?

    Chemo drugs attack cells that divide quickly, which is why they work against cancer cells. But other cells in the body, such as those in hair follicles and in the lining of the mouth and intestines, are also dividing quickly. Sometimes they destroy healthy cells, too. Different chemotherapy drugs have different effects, but most of these side effects tend to go away over time after treatment ends.

    Common side-effects of chemotherapy include:

    Fatigue: As the chemo drug destroys your red blood cells, you may feel fatigued during and after the chemo session. Fatigue peaks the first few days after a round of chemotherapy and then it gets better until the next round.

    Hand-foot syndrome: This starts out as redness in the hands and feet, and then might progress to pain and sensitivity in the palms and soles.

    Infection: Chemo drugs tend to decrease your white blood cell count, which increases your risk for infection.

    Hair loss: Most, but not all chemotherapy drugs can cause hair loss.

    Bleeding or bruising: One common side effect of chemo drugs is that it destroys blood platelets; the cells that help your blood clot to prevent bleeding.

    What to expect before, during, and after chemotherapy?

    Before chemotherapy

    Stock up on healthy groceries and stay hydrated as it can ease some side effects of chemotherapy. Also have plenty of low-calorie drinks on hand, all the time.
    Before you start chemotherapy, your medical oncologist will review your medical records and do a physical examination.

    Preparing for side effects

    Depending on the most common side effects of chemotherapy which include nausea and vomiting, hair loss, reproductive issues, and other side-effects, your doctor may suggest some pre-planning tips.

    During treatment

    Chemotherapy is either administered through a needle into a vein, or it can be given as pills that you take by mouth. This is called oral chemotherapy. In case of few cancer types such as skin cancer, it is to be applied on your skin as a cream of gel, called topical chemotherapy.

    After chemotherapy

    After chemotherapy treatment your risk for infection, bleeding, and skin problems may be high. Therefore, to stay healthy after chemotherapy, you’ll need to take good care of yourself and especially of your mouth as chemo sessions can cause dry mouth or sores.

    After chemotherapy ends, make sure to have regular appointments with your oncologist to monitor your health, manage any long-term side effects, and check that the cancer hasn’t come back or spread.

    Special diet needs before and after chemotherapy

    Nutrition plays a vital role in treatment of cancer and even during the recovery phase. Therefore, it is recommended that you eat light meals on your chemotherapy day. Otherwise too, it is recommended to have small portions, every few hours. Avoid eating fatty, greasy or spicy foods.

    What do I eat before going to chemotherapy?

    Before going for your chemo session, eat light, bland and non-spicy foods as they seem to work best. Choose anything from the options listed below:

    • Plain/fruit yogurt
    • Fresh fruit and cottage cheese
    • Poached egg and toast
    • Cereal and milk
    • Drink fluids frequently as this will prevent dehydration and remove some of the byproducts of the chemotherapy.

    Chemotherapy for colorectal cancer success rate

    Chemotherapy is used after surgery in many colon and rectum cancers which are stage II, III, and IV as it has been shown that it increases the survival rates. This is not the case in stage I cancers as the majority of stage I cancers are cured with surgery alone.

    How much chemotherapy for colorectal cancer costs?

    The cost of chemotherapy treatment may vary depending on type and intensity of your cancer, the rate at which it has spread over your body and of course your general well-being.

    Targeted Therapy

    Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that causes cancer growth. This type of treatment blocks the growth and spread of cancer cells while limiting damage caused to the surrounding healthy cells.

    What is immunotherapy treatment for colorectal cancer?

    Immunotherapy is a type of cancer treatment that boosts the body’s natural defenses to fight cancer. It uses medicines to improve a person’s immune system such that it works to recognize and destroy cancer cells. Immunotherapy works well for advanced colorectal cancer patients.

    How immunotherapy for treating colorectal cancer is performed?

    Immunotherapy medications may be given into a vein, by mouth, or by injection, either under the skin or into a muscle. Therapies may also be given directly into a body cavity to treat a specific site.

    Depending on the type and stage of cancer, some patients may be treated with immunotherapy alone, while others may receive immunotherapy with other therapies, such as, chemotherapy, surgery, or radiation therapy as some immunotherapy treatments help the immune system stop or slow the growth of cancer cells. Others help the immune system to destroy or arrest the spread of cancer cells to other parts of the body.

    How immunotherapy works against colorectal cancer?

    Immunotherapy is treatment that uses medicines to help a person’s own immune system better recognize and destroy cancer cells. Immunotherapy is a new and exciting modality of cancer treatment. Its role in gastrointestinal malignancies has proven to be promising, especially in advanced disease.

    Types of immunotherapy for treating colorectal cancer?

    Biological Response Modifiers: Even though these substances do not directly destroy the cancer cell, they are able to trigger the immune system to indirectly affect tumors. Non-specific biological response modifiers include cytokines which are chemicals produced by cells to instruct other cells.
    Colony-Stimulating Factors: These are substances that stimulate the production of bone-marrow cells, which include both red and white blood cells and platelets.

    White blood cells fight infection: red blood cells carry oxygen to and carbon dioxide from organs and tissues, and platelets are cell fragments that help the blood to clot. Often, other cancer treatments cause reduction in these cells.

    Monoclonal Antibodies: Produced in the lab, these substances can locate and bind to cancer cells wherever they are in the body. These antibodies can be used to detect the tumor or can be used as therapy to deliver drugs, toxins, or radioactive material directly to a tumor.

    Risks of immunotherapy

    Immunotherapy can cause a number of side effects which can vary from person to person, but the common ones include:

    • Fatigue
    • Joint pain
    • Coughing
    • Nausea
    • Itching or skin rashes
    • Decreased appetite
    • Constipation or diarrhea

    In some cases, the immune system may begin attacking non-cancerous cells in other parts of the body, resulting in other serious side effects of the lungs, liver, kidneys, intestines or other organs. So it’s important to always inform your doctor if you feel any of these symptoms during or after the treatment.

    What to expect before, during, and after immunotherapy?

    Preparing for immunotherapy

    Before you begin immunotherapy, it’s important you tell your doctor if you have:

    • Autoimmune disease
    • Organ or stem cell transplant
    • Breathing problems
    • Liver disease
    • Pregnant or plan to become pregnant
    • Breastfeeding

    Also, be sure to tell your cancer specialist about your medical history, including any changes in medications.
    Besides, eat healthy and sleep well as this can affect your healing and recovery process.

    During immunotherapy

    Before the treatment begins, you’ll be given few drugs to reduce certain side effects of immunotherapy.

    If you have the treatment as part of an infusion, you can expect it to take up to three or four hours. Also, your condition will be monitored for any immediate side effects or adverse reactions. If there is no reaction after the infusion, you are allowed to go home.

    After immunotherapy

    Understanding what’s likely to happen after immunotherapy will help you prepare for a successful recovery.

    Your recovery from therapy depends on several factors, including the type of immunotherapy you had and the type and stage of cancer.

    Some types of immunotherapy may destroy both healthy immune cells as well as cancer cells, so your body may need more time to recover and rebuild its defenses.

    Special diet needs before and after immunotherapy

    Eat a range of healthy foods while you are seeking immunotherapy. Fruits, vegetables, and protein are all important for faster recovery. The goal, however, should be to get different nutrients to strengthen your immune system. Even if you feel loss of appetite during treatment, try to have at least small portions of foods.

    How much immunotherapy for colorectal cancer costs?

    Apart from various other factors such as the stage of cancer, to what extent it has spread, etc., cost of immunotherapy is also based on the type of immunotherapy drug used for the treatment.

    Immunotherapy for colorectal cancer success rate

    The advent of immunotherapies has opened a potential new avenue of treatment for patients of colorectal cancer. As with other targeted approaches, there may be specific populations who are more responsive to immunotherapy. For instance, patients with defective DNA mismatch repair system tend to have immunogenic potential.

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