Surgery for colon cancer

The treatment that a patient and doctor choose to pursue will be based on the extent, or stage, of the cancer. For removing tumors due to colon cancer, resection surgery (sometimes called a partial or hemicolectomy) is the most common treatment.

A resection is major surgery where the surgeon enters the abdomen through a large incision in the abdominal wall. The diseased section of the colon or rectum is removed along with lymph nodes and part of the healthy colon. Next, the two healthy ends are reattached.

The surgeon’s goal will be for the patient to return to the most normal bowel function possible.

Some of the tissue removed from the lymph nodes is taken to a pathology lab and examined under a microscope. Lymph nodes conduct a fluid called “lymph” to cells in the body. Cancer cells tend to gather in the lymph nodes, so they are a good indicator for determining how far the cancer has spread. The removal of lymph nodes also reduces the risk of cancer reoccurring.

In some cases where a significant amount of the colon or rectum is diseased, a reconnection (also called anastomosis) may not be possible. In these cases, a colostomy may be necessary. A colostomy is created when part of the large intestine is inserted through an opening in the abdominal wall. The part of the colon that is on the outside of the body is called a stoma (Greek for ‘mouth’). The stoma is pink, like gum tissue, and does not feel pain. An external bag which is worn on the abdomen is then necessary to collect waste. The bag is emptied several times a day and changed on a regular basis.

Most colostomies are temporary and are only necessary to allow the colon to heal properly after surgery. During a second surgery the colon is reattached together and the stoma is removed. A permanent colostomy is only necessary about 15 percent of the time. Other treatments such as chemotherapy or radiation may be used in conjunction with surgery. After surgery regular check ups will be necessary to ensure that the cancer has not reoccurred.

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