Surgery is by far the treatment most likely to result in cure of bowel cancer
if the tumour is localised. When bowel cancer is diagnosed at a very early
stage, it can be often cured by removing the abnormal tissue at the time of colonoscopy. When this is done, the doctor does not need to cut into the
abdomen. More advanced cancers usually require surgical removal of the
affected area of the bowel leaving sufficient margins to reduce likelihood of
recurrence. Your doctor will discuss the most appropriate type of surgery,
depending on the stage of your cancer and its position in the bowel.
Cancer of the bowel can be removed by using one of the following types of surgery:
- Colectomy - surgery used to remove either the whole
(total colectomy) or part
of the colon (partial colectomy). After a part of the colon has been removed, the open healthy ends
are then joined together. This is known as anastomosis. The
surrounding lymph nodes are usually also removed as this is the most
probably the first place the cancer spreads to. Laparoscopic colectomy is a surgery done through
four or five small incisions through which a laparoscope (a thin medical
instrument containing a light and a camera) is inserted into your bowel. It is
less invasive than the standard colectomy done through one larger incision,
the recovery is usually quicker as well. However, this is not commonly
performed yet as it is currently being researched to find its risks and
benefits.
- Colostomy, ileostomy - if for some
reason the bowel ends cannot be rejoined, the upper end is brought out onto
the abdominal wall - this surgery is called colostomy (large bowel)
or ileostomy (small bowel). The opening of the bowel is called stoma.
Stools are collected in a bag worn over the stoma. Often these are only
temporary and later operation to rejoin the bowel is performed and
consequently the stoma is removed.
- Low anterior resection - usually used for
cancer present in the upper part of rectum (a part of the bowel near to the
colon). After this operation the colon is reattached to the anus and waste
is eliminated in the usual way.
- Abdomino-perineal resection - usually
performed on patients with tumour in the lower end of the rectum. The
patient will have permanent colostomy because the whole rectum and anus are
removed.
- Total mesorectal excision (TME) - an
operation used to remove the whole rectum as well as the surrounding tissue
with the lymph nodes.
- Pelvic exenteration - a more extensive
type of surgery used on patients with the rectal cancer growing into
surrounding organs. The surgeon removes the rectum as well as the bladder,
prostate, or uterus if the cancer has spread to these organs. After this
operation a colostomy is needed. If the bladder is removed, a urostomy
(opening in the abdomen through which urine exits the body) is
needed to collect the urine.
- Radiofrequency ablation - a special
probe with tiny electrodes is used to heat and destroy the cancer cells. The
probe can be inserted either directly through the skin or through an
incision in the abdomen. In the latter case, general anesthesia is used.
- Cryosurgery - a treatment that uses an
instrument to freeze and destroy abnormal tissue, such as carcinoma in situ.
It is sometimes referred to as cryotherapy.
Potential side effects of surgery include
the following:
- bleeding from the surgery
- blood clots in the legs
- possible damage to the surrounding organs during the operation
- leakage in the place where the ends of the intestine were connected
during the surgery
- possible occurrence of infection
- later after the surgery, blockage of the bowel (called adhesion)
can occur
Further general information Your doctors and specialist nurses are in an ideal position to
give you relevant information on your disease and treatment as they know your
individual circumstances. Cancerbackup
has a help line (0808 800 1234) and a prize
winning video available in English, Italian, Urdu, Bengali, Gujarati
& Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk
has over 500 pages describing cancer, its management, practical tips and tool
which patients, their carers and their doctors have found helpful during the
cancer journey.
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