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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