Why Surgery is Not Always Part of Colorectal Cancer Treatment

5 min read

Why Surgery is Not Always Part of Colorectal Cancer Treatment

Colorectal cancer is a complex disease with several treatment options, primarily based on the stage of cancer. While surgery is the most common treatment, it’s not the best choice for every patient. Learn why you may have non-surgical treatment that can provide your best chance for a cure and normal life. 

Understanding Colorectal Cancer

Colon cancer develops in the large intestine (colon), the last section of the digestive tract. Colorectal cancer is a more inclusive term that includes cancer of the colon and rectum.

Colorectal cancer usually begins with a polyp, a noncancerous group of cells that grows on the colon lining. For reasons not fully understood, a polyp’s DNA can change, start to grow rapidly, and develop into cancer.  

In its early stages, colorectal cancer rarely causes symptoms. That’s why it’s important for people older than 45 (or younger if you have a high risk for colorectal cancer) to be screened regularly. 

Learn more about colorectal cancer screening.

Early diagnosis gives you more treatment options. If cancer is found, early treatment offers the best chance for a cure. Unfortunately, however, it’s often found at a later stage when it’s more difficult to treat. 

The best treatment plan for you depends on several factors, including the stage, location in the colon or rectum, your age and overall health, and your personal treatment goals. 

Download Colorectal Guide for Newly Diagnosed Patients

Surgical Options for Colorectal Cancer

If you have early-stage colorectal cancer, the most common treatment is polypectomy. Early stage means your cancer is very small, localized, and completely encompassed by the polyp. This minimally invasive surgery removes polyps, usually during a colonoscopy. If cancer is found after testing the polyps, an oncologist will discuss whether additional treatments are necessary.

If your cancer has progressed beyond the early stage or has grown into or through your colon, your oncologist may perform surgery that removes a portion of the colon. Only when absolutely necessary is the entire colon removed. This surgery is called a colectomy. 

Colectomy removes the section of the colon that is cancerous and reattaches the two healthy ends. That usually means the removal of one-fourth to one-third of the colon. 

When possible, this surgery is done with a minimally invasive approach using laparoscopic technology. The recovery time is much shorter than open surgery. 

What Happens After Colon Cancer Surgery?

As with most cancer treatments, colorectal cancer surgery comes with some adjustments that may be needed. The most significant is an ostomy or ileostomy. Depending on what had to be removed during surgery, your colon may need time to heal before you can have regular bowel movements. 

In the meantime, an ostomy can be created that allows stool to pass from the large intestine through an opening in the wall of the stomach muscle. The stool passes into a bag that covers the opening. If the opening has to be connected to the small intestine, it’s called an ileostomy. For most patients this is a temporary result and eventually the opening can be surgically closed and the bag removed.

You are likely to have to adjust your diet while you recover. 

Why Surgery to Remove the Cancer May Not Be Part of the Treatment Plan

There are a few different reasons why colorectal cancer surgery isn’t used as part of the treatment plan. 

For patients with early stage colorectal cancers, recent developments in cancer research show that chemotherapy with chemoradiation can be effective in completely removing the cancer in the colon. Surgery is only necessary if it doesn’t completely disappear, and even then the surgery will be less invasive than if it was used first.

For patients with Stage IV cancer which has spread to other organs, it may not be possible to remove all of the cancer with surgery. 

There can also be a situation where the cancer is blocking the colon, making it difficult to have bowel movements. Surgery may be done in this case to clear the blockage, but it’s not intended to remove all of the cancer. 

Some patients have other health conditions that make recovery from surgery very difficult or even life-threatening. In these cases other treatments are used. 

If the cancer has returned in your colon after going through a first round of treatments, you may not have surgery again based on how much of the colon was removed the first time. Other treatments can be used to reduce the size of the cancer whether it’s recurred in the colon or in another area of the body.

Treatments Other Than Surgery for Colorectal Cancer

There are several highly successful approaches to treating colorectal cancer. Some of these are used in combination with surgery, but they can also be used instead of surgery:

  • Folfox chemotherapy is given continuously over the course of 48 hours for each treatment session.
  • Radiation therapy to kill the cancer cells at the site of the tumor. 
  • Targeted therapies based on gene mutations. The drug targets the specific mutation, slowing the growth of the cancer cells. 
  • Immunotherapy drugs use the body’s own immune system to fight cancer cells.

Learn more about colorectal cancer treatments.

You may also be given an opportunity to participate in a clinical trial. Many new therapies are under development that can target cancer cells based on a specific genetic change in the body. These are the most advanced colorectal cancer treatments available today and patients in Colorado have access to them through Rocky Mountain Cancer Centers. 

colorectal cancer education center

Importance of Individualized Treatment Plans for Colorectal Cancer

Treatment plans for colorectal cancer are developed by a multidisciplinary team that includes the medical oncologist, radiation oncologist, surgeon, and you. It’s important to share your personal preferences with the cancer care team. Discuss your concerns and ask questions about their recommendations. If there is something that you don’t want to do, talk about it. There can be other ways to approach the treatment process. 

Developing an individualized treatment and care plan with your team can not only improve your quality of life as you go through colorectal cancer treatment and recovery but also gives you more control over your health and the best outcome. 

The Gastrointestinal (GI) Oncology team at Rocky Mountain Cancer Centers is here to provide a personalized treatment plan specific to your needs which, for some, does not include surgery. Request an appointment at one of our locations in the Denver area, Boulder, Colorado Springs, and throughout the front range. If you’ve already met with an oncologist, we encourage you to schedule an appointment for a second opinion. The next steps are important. You and your loved ones deserve to feel confident in the path forward. 

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