Frankford Hospitals - Surgery for Cancer of the Colon or Rectum

Section on Colorectal Surgery, Frankford Hospitals

Treatment for cancer of the colon or rectum has improved significantly in recent years. Laparoscopic procedures, for example, have minimized the invasiveness of colorectal surgery for many patients. These operations are a newer, advanced, minimally invasive form of surgery, that allows surgeons to remove a colon tumor or colon segment without a large surgical opening. The team makes small incisions at several locations in the lower abdomen and uses these to access the colon with endoscopic equipment. These tools are slender tubes, including a scope with a self-lit lens at the end, that permit the surgeon to see and manipulate the colon during the operation.

Using laparoscopy, the colorectal surgeon can perform surgery while watching a video monitor of the endoscopic images and of the instruments used to resect and suture the intestine. The skilled surgeon can take advantage of these techniques to resect tumors and repair the colon safely – providing for an easier procedure for patients to undergo. The laparoscopic approach means less blood loss, a shorter hospital stay, quicker healing, less pain, faster recovery (including of bowel function), and more prompt return to activities, when compared to open colon resection.

For some patients (often those with more involved disease) conventional, open surgery will be necessary. The surgical team makes a longer incision in the lower abdomen. This gives the surgeon direct visual and manual access to the colon to remove a cancerous section or a length of the colon.

Surgery Specific to Each Patient

In either form of colorectal surgery for cancer treatment, the surgeon will remove the tumor and a margin of surrounding healthy tissue, and as well as adjacent lymph nodes. Some patients will need a smaller section or longer segment of the colon removed. In still other cases, the entire colon will be resected, sometimes including the rectum, sometimes including the anus. But in many colon resections, the surgeon can remove the cancerous tissue and rejoin the ends or margins of the tract, without loss of normal digestion and the function of elimination (continence).

Often the surgeon can completely remove the cancer. The survival rate is highest for these “complete, curative resections.” The type of surgery used for each patient, will depend on the location and stage of the cancer.

In some cases, especially to treat more advanced cancers, the surgery may include a colostomy, in which the surgeon creates an artificial opening (stoma) through which waste can pass to in an external bag. This arrangement is usually temporary and permits the resected portion of the bowel to heal. Permanent colostomies are rare today.

Some patients with cancer of the colon or rectum will require only surgery, while some will also undergo chemotherapy or radiation therapy before or after surgery. Recent progress in treating cancer is partly a result of such combined treatments.

Retaining Bowel Function

When undergoing surgery for cancer of the rectum, patients are understandably concerned about the possible loss of continence. Today, though, even for cancer in the lower rectum, the skilled surgical team can often remove the cancerous tissue and preserve the nerves and muscles of the anal sphincter, permitting the patient to retain bowel control. Preoperative radiation therapy, combined with precise surgical techniques to remove early-stage cancer, helps to preserve the natural functions that control bowel movement.

Surgery to Relieve Symptoms

Sometimes when curative surgery is not possible, surgical treatment can still be beneficial in addressing and reducing symptoms. Colorectal cancers can cause pain or result in obstruction of the digestive tract. Surgery to debulk, or reduce the size of, tumors can help to alleviate some of these situations. This type of surgery, called palliative surgery, is meant to improve quality of life for the patient.

Another type of palliative surgery is colon resection for patients whose cancer has already spread to other parts of the body at the time of initial diagnosis. The step can help reduce later bleeding, blockages, and symptoms caused by colon masses and by tumor invasion of nearby organs.

Surgical treatment for colorectal cancer may also be directed at sites to which the cancer has spread (or metastasized). Common sites for metastatic colon cancer include the liver and lung. Today, it is possible to remove sections or large segments of the liver when this organ becomes cancerous. After hepatic resection, healthy liver tissue can partly regenerate. Our team can refer patients for both hepatic and pulmonary procedures.

Research & Clinical Trials: As part of The Cancer Center at Frankford Hospitals – a comprehensive cancer program – the gastrointestinal, colorectal surgical, and surgical oncology services at Frankford use a complete team approach, through which patients can also benefit from the latest innovations, trials, and experimental forms of care, in collaboration with radiation oncologists and medical oncologists. These are techniques that include new combinations of treatments, available primarily or exclusively at medical centers that participate in research. For multicenter trials, the Cancer Center participates in the Eastern Cooperative Oncology Group and the Radiation Therapy Oncology Group, as well as in trials coordinated by the National Cancer Institute. The Frankford cancer program also participates in the Jefferson Oncology Group and is a part of the Jefferson Cancer Network.