Colon/Rectal cancer is a disease in which malignant (cancer) cells form in the tissues of the colon.

The colon is part of the body’s digestive system. The digestive system removes and processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps pass waste material out of the body. The digestive system is made up of the esophagus, stomach, and the small and large intestines. The first 6 feet of the large intestine are called the large bowel or colon. The last 6 inches are the rectum and the anal canal. The anal canal ends at the anus (the opening of the large intestine to the outside of the body).

Stages of Colon/Rectal Cancer

After colon cancer has been diagnosed, tests are done to find out if cancer cells have spread within the colon or to other parts of the body.

The process used to find out if cancer has spread within the colon or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.

As colon cancer progresses from Stage 0 to Stage IV, the cancer cells grow through the layers of the colon wall and spread to lymph nodes and other organs.

Stage 0 (Carcinoma in Situ): In stage 0, the cancer is found only in the innermost lining of the colon. Stage 0 cancer is also called carcinoma in situ.

Stage 1: In stage I, the cancer has spread beyond the innermost tissue layer of the colon wall to the middle layers. Stage I colon cancer is sometimes called Dukes’ A colon cancer.

Stage II: In stage II, the cancer has spread beyond the middle tissue layers of the colon wall, or has spread to nearby tissues around the colon or rectum, or has spread beyond the colon wall into nearby organs and/or through into the abdominal cavity. Stage II colon cancer is sometimes called Dukes’ B colon cancer.

Stage III: In stage III, the cancer has spread from the innermost tissue layer of the colon wall to the middle layers and has spread to as many as 3 lymph nodes. Stage III colon cancer is sometimes called Dukes’ C colon cancer.

Stage IV: In stage IV, cancer may have spread to nearby lymph nodes and has spread to other parts of the body, such as the liver or lungs. Stage IV colon cancer is sometimes called Dukes’ D colon cancer.

Colon/Rectal Cancer Treatment Options

Laparoscopic Colon Surgery

Surgery (removing the cancer in an operation) is the most common treatment for all stages of colon cancer. Most of the time surgery can be performed laparoscopically (through small incisions).

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. External radiation therapy uses a machine outside the body to send radiation toward the cancer.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is administered, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Chemotherapy is generally given after surgery for stage III and above colon cancers.

Colon/Rectal Cancer Treatment by Stage

Stage 0 Colon/Rectal Cancer is generally removed during colonoscopy. If the tumor is too large cannot be removed during colonoscopy surgery may be required.

Stage I Colon/Rectal Cancer is generally treated by laparoscopic surgical removal of the cancer.

Stage II Colon Cancer is generally treated by laparoscopic surgical removal of the cancer. Stage II Rectal Cancer is generally treated by laparoscopic surgical removal of the cancer followed by chemotherapy.

Stage III Colon Cancer is generally treated by laparoscopic surgical removal of the cancer followed by chemotherapy. Stage II Rectal Cancer is generally treated by radiation therapy and chemotherapy initially, followed by laparoscopic surgical removal of the cancer, followed by more chemotherapy.

Stage IV Colon or Rectal Cancer treatment is highly variable but generally consists of a combination of surgery, chemotherapy, and radiation therapy

Laparoscopic Colon Resection

Each year, more than 600,000 surgical procedures are performed in the United States to treat a number of colon diseases. Although surgery is not always a cure, it is often the best way to stop the spread of disease and alleviate pain and discomfort.

In most laparoscopic colon surgeries or resections, surgeons operate through 2 or 3 small openings (each about a quarter inch) while watching an enlarged image of the patient’s internal organs on a television monitor. In some cases, one of the small openings may be lengthened to 2 or 3 inches to complete the procedure.