Treatment of colon cancer

You have been told that you have colon cancer, or a suspicion about it. Below you can read more about the treatment of colon cancer.

Treatment of colon cancer

Treatment of colon cancer can have two goals: cure or reduce complaints. If a treatment has the purpose to heal, it is called a curative treatment. In addition to the primary treatment, there are also additional treatments (adjuvant treatments). For example, if a tumor is removed by surgery, then you may also receive chemotherapy. This additional treatment has the aim to combat possible non-observable metastases. If the condition cannot be cured (anymore), palliative treatment can be started. This type of treatment focuses on the inhibition of the disorder and / or reduction or prevention of complaints.

Treatment options

When drafting a treatment plan for colon cancer, several factors are important: the stage of the disorder, the location, size and eventual growth of the tumor, any heredity, previous bowel operations and your physical condition. The different treatment options for colon cancer are:

Operation

Systemic therapy (chemotherapy and targeted therapy)

Combined treatments of colon cancer with metastases

The curative treatment of colon cancer consists of surgery and, depending on the stage, additional chemotherapy. Metastases in the liver and / or lungs can also be treated curatively with combinations of different treatments, as well as metastases on the peritoneum. If there are no curative options, the treatment consists of palliative systemic therapy.

Operation

In an operation for colon cancer, the part of the intestine with the tumor removed, including the lymph nodes, lymph vessels and blood vessels that belong to this part of the colon. These can also contain cancer cells and are therefore examined after the operation. This operation can be both curative and palliative.

The operation is preferably carried out via a viewing operation, if technically possible. This promotes recovery after the operation. After removing the piece of intestine containing the tumor, the ends of the intestine are attached to each other again. There is a small chance that it is decided to temporarily or permanently create a stoma.

If the tumor has closed the gut, sometimes only a stoma is applied or a tube (stent) is placed in the tumor. This allows the stool to pass again. In the second instance, the removal of the tumor may be decided afterwards.

In the case of a stoma, the end of the intestine is brought out through the abdominal wall and inserted into the skin of the abdomen. However, a stoma does not have a sphincter, and therefore there is no control over the stool. That is why a bag is stuck over the stoma to collect the stool. With a temporary stoma, after a few months it can be decided to remove the stoma and restore the large intestine.

The AMC also performs operations for advanced colon cancer, where there may be in growth in surrounding organs such as the abdominal wall, small intestine, bladder or stomach.

Systemic therapy

Systemic therapy consists of chemotherapy and so-called "targeted" or targeted therapy. There are different types of chemotherapy and targeted therapy, each with its own effect. Chemotherapy is a treatment with cancer-inhibiting drugs, cytostatic. "Targeted" therapy consists of drugs that directly have an inhibitory effect on growth signals of cancer cells. Systemic therapy can be given both curatively and palliative. Systemic therapy as palliative treatment focuses mainly on short-term inhibition of the condition, which reduces the symptoms.

An intentionally curative systemic therapy is used before or after an operation. For surgery (neo-adjuvant) the goal of the treatment is to make the tumor smaller, so that it can then be removed more easily during the operation. If chemotherapy is used after surgery, this is usually to kill any non-observable metastases.

There are different types of cytostatic that each have their own effect. Some cytostatic inhibit cell division, causing the tumor to grow less rapidly. Other cytostatic kill cancer cells. Combinations of medicines are often given. The chemotherapy is administered via injections, tablets or infusion. Through the blood the medicines can move quickly through the body and reach the cancer cells. The cytostatic are often administered once a week for several weeks. Then follows a rest period.

The cytostatic and "targeted" medicines often affect healthy cells in addition to cancer cells. This may cause unpleasant side effects. Common side effects are hair loss, nausea, bowel disorders, fatigue and an increased risk of infections. The side effects vary per type and amount of cytostatic and per person. Drugs are also available for some side effects. Your doctor will discuss the consequences of systemic therapy with you.

Treatment of hereditary colorectal cancer

The team of gastrointestinal liver doctors and surgeons at the AMC has specific experience in treating patients with Lynch syndrome, familial adenomatous polyposis (FAP) and rarer diseases with an increased risk of colon cancer. This treatment is strongly tailored to the individual patient and depends on the stage and appearance of the disease. Part of the treatment is preventive and requires good coordination between the treatment team and the patient. In doing so, we look for the right balance between the chance of developing cancer, determining the interplay of therapy and quality of life.

Treatment of colon cancer with metastases

Even if colon cancer has already spread to other organs, such as the liver, there are possibilities for curative treatment in approximately 20-30% of patients. Various techniques are then used to treat the metastases locally, such as surgical removal of part of the liver or local heating (RFA) of the metastasis. The treatment of the intestinal tumor and the metastases can take place in the same (viewing) operation or in multiple operations, possibly in combination with prior chemotherapy. The AMC has expertise in this area and any treatment options are carefully considered, in good balance with the risk of side effects and quality of life.

Psychosocial help

From the moment you are told that you may have cancer, you are faced with major uncertainties. Dealing with this is not self-evident. The period of examinations and treatments are very heavy, but after the treatment you have to learn to live with your new situation. This applies not only to you as a patient, but also to your family, friends and any partner and children. There are organizations that can support you and your environment in learning how to live with cancer, both inside and outside the hospital.

Do you want more information?

Here you will find more information about colon cancer.

 

You also visit our page about the necessary tests that are performed for the diagnosis of colon cancer.

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What is high blood pressure?

Your blood pressure can be increased and that is not good. So far the story is clear. But what does blood actually mean and what is the difference between lower and upper pressure?

By blood pressure we mean the pressure that comes on the walls of blood vessels every time the heart contracts. The heart pumps 60 to 80 times per minute. Here blood is pumped through arteries and veins. For example, nutrients and oxygen are transported through the body and waste products are removed.

Press on vessel walls

The upper pressure or systolic pressure is the pressure on the vessel walls when a lot of blood flows through the veins. So when the heart contracts or strikes. When the heart then relaxes, the pressure on the vessel walls decreases. This is called the negative pressure or diastolic pressure. We note this pressure in millimeters of mercury (mmHg).

Hypertension

What is normal blood pressure? For a healthy person, a blood pressure of 120 over 80 (120/80) is optimal. This is an upper pressure of 120 mmHg and a negative pressure of 80 mmHg. The limit values ​​increase slightly as you get older. For example, an over-80s may have an upper pressure of 150-160.

Blood pressure is not always as high. In some activities your body requires more nutrients and oxygen. The blood pressure can then temporarily be higher. For example in sports, stress or fright. This does not mean that you have high blood pressure.

When your resting blood pressure is higher or equal to 140 above 90, you suffer from hypertension or high blood pressure. In this case, there is a constant pressure on the vessel walls and your heart needs more effort to pump blood around. This is not a healthy situation for your heart and vessels.

Lifestyle

In some people, high blood pressure is more common. Older people are more likely to suffer from it. It can also be in the family and in black people it is more common.

An unhealthy lifestyle, for example too much salt, alcohol, smoking and too little potassium and exercise, can increase the risk. A healthy lifestyle can therefore help to prevent high blood pressure.

How do you know if you have high blood pressure? You cannot control this yourself, because you do not notice anything. The doctor can measure your blood pressure, prescribe medication and give you advice to adjust your lifestyle.

Decrease your blood pressure yourself

High blood pressure is not good for your heart and blood vessels. Sometimes medicines are necessary, but often you can also do something about it by adjusting your lifestyle.

There is not one specific cause for high blood pressure. It is often a combination of heredity and lifestyle. Adjustments in your daily habits can thus help to lower blood pressure.

Lose weight and exercise

Overweight is the cause of one in five people with high blood pressure. According to government agency RIVM, weight loss of one kilo already leads to a decrease of the top pressure of 1.6 mmHg and a decrease of 1.3 mmHg to the under pressure.

Sufficient exercise can also help lower blood pressure. This does not mean that you immediately have to go to the gym. More often a block around and shopping on the bike can make a lot of difference.

According to the Exercise Standard, we should move for 30 minutes five days a week. Those accustomed to this can increase the movement a bit and occasionally make some more effort on, for example, the tennis court or in the swimming pool.

Less alcohol

Moderate drinking can have benefits, but if you consume more than three alcoholic drinks per day, you increase your blood pressure and the risk of a heart attack. So look critically at what you drink exactly per day and make sure it stays within limits.

Quit smoking

Smoking causes an increase in blood pressure and a less flexible blood wall. Stopping smoking is always good for your health, but if you suffer from high blood pressure, you still have an extra reason. There are countless methods to stop. Choose a method that suits you well.

Less salt

Salt has good qualities and is indispensable for your body. But too much salt leads to too much sodium in the body. Unfortunately, our diet often contains too much salt.

The average salt intake in the Netherlands is around 10 to 12 grams. According to the Health Council, a salt intake of 6 grams (about 1 teaspoon) per day is the maximum.

Now that seems easy to turn back, just sprinkle less salt. But unfortunately three-quarters of the salt that you get in comes straight from bread, soup, sauces, ready-made meals, and liquor ice and meat products. Choose more often for low-salt products and leave the salt shaker in the cupboard. A little less salt can already provide a lot of health benefits.

More potassium

Make sure you get enough potassium. Potassium is a substance found in many foods and helps your body to excrete excess sodium. This way it restores the natural balance in the body. Potassium is in different vegetables, fruit and dairy products.

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Cancer cells can become addicted and you can exploit that

Cancer cells can become addicted to the drugs that are meant to eradicate them. Researchers at Antoni van Leeuwenhoek have found out how this addiction occurs and how this can be exploited.

With the knowledge gained, the fight against cancer can be improved somewhat. The research results this week published in the scientific journal Nature.

It is a well-known problem for the medical world: cancer cells that become resistant to drugs, so that treatments are no longer effective.

"Tumor cells are very flexible," says research leader Daniel Peeper. "They have multiple 'electronic circuits' where they can switch between, and when a drug fights one circuit, they switch to another circuit and they continue to grow."

Achilles heel

For that resistance, tumors pay a high price. Some cancer cells become addicted to medicine and dig their own grave. "Such a resistant cancer cell is, as it were, a motor that has to work very hard to counter the medicine."

Suddenly completely stopping medication (cold turkey) disrupts this process. Consequence: the cell blows itself up, as it were. "It's like two teams that are tugging in. When one team releases, the other group falls over," Peeper explains. "That tumors can become addicted was already known, but nobody knew exactly how it worked. Mechanism we have now clarified. "

Neck stroke

However, this does not mean that tumors with resistant cells can be eradicated by suddenly stopping treatment. "Cancer is far too complicated for that: compare a tumor with a container full of colored gumballs, and if you can give 99 percent of the colors a cure, one color can survive."

His team recommends that cold-turkey stopping medication should be followed immediately by a second treatment. "In this way we can also try to administer the last surviving cells."

Discovered Achilles Heel of Cancer

British scientists think they have the Achilles heel of cancer. That is the crucial conclusion of their years of research into the control of the disease.

The immune system of the human body can be used to successfully combat cancer, even when the disease has reached an advanced stage, according to the researchers at the prestigious University College London yesterday in a statement.

Identifying a tumor

Rapidly mutating tumors such as lung cancer can also be controlled in the future. The immune system can basically recognize every cancer cell in a tumor and then destroy it, the researchers are convinced of that.

This so-called immunotherapy will eventually replace the fight against cancer with medicines. Cancer cells differ enormously from each other. By vaccinating the immune system, it can recognize and destroy all malignant cells. The first tests with patients will be held in two years.

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