Surgery is a common part of colon cancer treatment. Just about every patient diagnosed with stage I-III colon cancer will have surgery at some point. The type of surgery you’ll need depends on the stage of the cancer.
We spoke with colon and rectal cancer surgeon Yi-Qian Nancy You, M.D., about what colon cancer patients should know about surgery.
What types of surgery are used to treat colon cancer?
Typically, we treat colon cancer with one of two types of surgery. These include:
Polypectomy: This type of surgery is performed through a colonoscope, typically by a gastroenterologist with specialized training. It is used when the cancer is located entirely within the polyps. The entire polyp is removed by passing a wire loop and cutting it off from the colon's wall with an electric current.
Large bowel resection/colectomy: A colectomy is another word for a large bowel resection. During this procedure, a surgeon removes part of the large intestine, which is another name for the colon. While a bowel resection can be done through open, traditional surgery, it is most commonly performed through minimally invasive surgery today. The surgeon makes a short incision, then inserts a few ports. The surgeon inserts a camera and uses either laparoscopic instruments or robotic surgical arms to remove the impacted part of the colon. This minimally invasive approach typically offers faster recovery for the patient.
What is recovery from colon cancer surgery like? What can patients expect?
Recovery from colon cancer surgery often isn’t as difficult as patients anticipate, particularly if the surgery is minimally invasive. The pain is the worst for the first 48 hours, and after that, it generally subsides.
As part of our enhanced recovery system at MD Anderson, we use a long-lasting local anesthetic that helps limit the need for additional pain medication. Patients are usually up and walking around about 24 hours after surgery. Typically, their bowel functions will return about 2 to 3 days following surgery. Most patients stay in the hospital anywhere from 2 to 5 days. An MD Anderson-spearheaded clinical trial showed that it was safe for select patients to stay in the hospital after surgery for as little as 24 hours in combination with a telemedicine-based recovery program out of the hospital.
Recovery from rectal cancer surgery can take longer.
What is life like after colon cancer surgery? Are there any long-term side effects?
Patients can return to their normal diet. They often don’t experience any long-term side effects in terms of bowel patterns from a colectomy.
A common myth surrounding colon cancer is that patients will require an ostomy bag after surgery. But this is only true for patients who had a surgery called a colostomy. During a colostomy procedure, a surgeon will connect the healthy end of the colon to the skin which is surrounded by a plastic bag that collects waste from the digestive tract and needs to be emptied throughout the day. Most colon cancer patients do not need a colostomy; the procedure is more commonly used to treat rectal cancer.
What other methods are used to treat colon cancer?
Historically, the type of treatment a colon cancer patient received was determined by the stage of the cancer. Patients with stage II or III colon cancer usually underwent chemotherapy following surgery. But not all such colon cancer patients need chemotherapy.
MD Anderson has launched several clinical trials through our Intercept program. As a part of this program, following surgery patients undergo a liquid biopsy that shows if any of the cancer cells remain in the blood and helps their care team determine what type of additional treatment might be best for them. This is a unique additional tool that we offer at MD Anderson.
In addition, patients with stage IV colon cancer that has spread to other parts of the body may not have colon surgery. These patients often have chemotherapy or another targeted therapy.
What should patients know when preparing for colon cancer surgery?
Find a hospital that treats all the issues you may face. Across the nation, nearly 1 in 10 new colon cancer patients are diagnosed before age 50. At MD Anderson, about one-third of our new colorectal cancer patients are age 50 or younger. These relatively young patients face a unique set of challenges that impact multiple dimensions of their lives. MD Anderson addresses these through our Young-Onset Colorectal Cancer Program, which connects patients with the services they may need in addition to cancer treatment, including genetic testing and counseling, fertility services, supportive services, and connection to our Adolescent and Young Adult Oncology Program.
In addition, while it’s understandable that most colon cancer patients want their tumors removed as quickly as possible, it’s worth taking the time to find the most experienced surgical team. Find someone who truly specializes in colon cancer, so they understand what unique challenges colon cancer patients face. It also helps to select a hospital like MD Anderson that specializes in multidisciplinary care and will coordinate with your medical oncologist, so you don’t have to find a separate surgeon and oncologist. This will ensure you receive the best possible care and have the best chance for successful treatment.