Colon cancer refers to the growth of abnormal cells in the large intestine or rectum. It is often referred to as a malignant or cancerous tumor. The bowel is made up of the:

• Small intestine (where most of the nutrients are absorbed).
• Large intestine or colon (where most of the water is reabsorbed and stool is stored).
• Rectum (where stool is stored until it is eliminated from the body).

Colon cancers and rectal cancers come from similar tissues, so they are often grouped together. However, this care path focuses on colon cancer. It does not contain information about rectal cancer.

Cancer usually begins with the formation of a polyp, a noncancerous piece of tissue that grows out from the lining of the colon.

• From its initial location in the bowel, colon cancer can spread or metastasize to lymph nodes and other organs or tissues.
• Tumor markers are blood tests that can show evidence of a cancer growing, even before it is large enough to see.
• Tumor markers allow your healthcare provider to monitor your status before, during and after treatment. These tests are called carcinoembryonic antigen (CEA) and CA 19-9.

Healthcare providers will look for spread of the colon cancer to other areas of the body. This process is called “staging.” Metastatic colon cancer is cancer that started in the colon and has spread to other organs. Your healthcare provider will need the following clinical information to decide what type of treatment is right for you.

• What does the cancer look like under the microscope?
• How large is the primary cancer in the colon?
• Has the cancer spread outside the large intestines?
• Has the cancer spread to lymph glands or anywhere else in the body?

A colectomy is the surgical removal of varying amounts of the large intestine through an incision in the abdomen. How much of the large intestine that is removed depends on your specific circumstances. The factors that will determine the right procedure for you include:

• The size of the tumor and where it is located
• Your family history
• Your age and general health

In some cases, removal of the colon can be done using small medical instruments and a camera inserted into three or four small cuts in the abdomen. This is called a laparoscopic, or minimally invasive, surgery.

• Laparoscopic surgery allows for a quicker recovery with less pain and scarring.
• After the surgery, you will need to stay in the hospital for three to seven days.
• A couple of days after surgery, you will start with clear liquids and then slowly increase your diet as your bowel function returns toward normal.

Many factors can increase your chance of getting colon cancer. Some of the risks factors for colon cancer include:

• Age – You have a higher risk as you age.
• Family history – A close family member has had cancer of the colon or a condition that causes many polyps to grow in the colon. Some of the polyps can become malignant, or cancerous.
• Medical history – You have a history of breast cancer, polyps in your colon or inflammatory bowel disease.
• Race – You are African American or from Eastern Europe.
• Diet – You eat red meat or meat that is processed. High-fat and low-fiber diets may also play a role in the development of colon cancer. However, the link between colon cancer and low-fiber diets is not clear.
• Alcohol use – You drink excessive amounts of alcohol.
• Smoking – You smoke.

There are frequently no symptoms in the early stages of colon cancer, which is why appropriate screenings are important. Some of the symptoms that can develop as the cancer grows include:

• Pain or discomfort in the lower part of the abdomen
• Blood in the stool, or stools that are long and narrow
• Changes in the bowel habits, such as constipation or diarrhea
• Unexplained weight loss

As the cancer advances, other symptoms can develop.

Contact your healthcare provider if you have symptoms of colon cancer. He or she will ask you questions and perform a physical examination. They may also recommend one of the following tests:

• Colonoscopy and removal of tissue for examination under a microscope (biopsy)
• Lab tests, such as a complete blood count (CBC), liver panel, CEA or CA 19-9
• Imaging studies (i.e., CT, MRI, PET scan) to determine if a diagnosed cancer has spread

The treatment for colon cancer is based on many factors, including:

• Your age and overall health
• The type and stage of the cancer
• Other tests that determine the specific characteristics of the cancer

Treatments are either local (only affects the area of the cancer) or systemic (affects all areas of the body). Local treatments include:

• Surgery to remove the cancer
• Radiation to kill the cancer cells

Systemic treatments include:

• Chemotherapy to kill the cancer cells
• Targeted or biologic therapy to interfere with the changes in cells that help the cancer grow

Treatment for colon cancer usually involves a combination of local and systemic treatments. You may have more than one type of treatment at a time. Depending on your situation, you may alternate between chemotherapy and radiation before or after surgery.

To get a full range of opinions and perspectives, you may want to consider input from a variety of doctors. This group may include:

• Your primary care physician
• A medical oncologist (a doctor who specializes in the treatment of cancer)
• A surgeon with experience in colon cancer
• A radiation oncologist (a doctor who specializes in treating cancer with radiation therapy)

If your healthcare provider recommends a colectomy, prior to the surgery you should tell them about any medications you are taking (including over-the-counter medications and supplements). You should also ask about specific instructions you should follow before and after the surgery. These include:

• Medications you should not take before the surgery, such as blood thinners
• Regular medications you should continue to take on the day of your surgery
• What diet should follow the weeks before surgery
• What medicine or prep you will take to clean out your colon for surgery
• How many hours you should stop eating and drinking before the surgery

If you are a smoker, you should quit smoking, as it can interfere with your recovery.

During your surgery, you will receive anesthesia to keep you comfortable and pain free. General anesthesia is the most common type of anesthesia for a colectomy. With this type of anesthesia, you are put into a deep sleep and are unable to see, hear, or feel anything.

• Recovery from a colectomy typically takes 4 to 6 weeks.
• You may need pain medication and help at home while you recover.

It is important to remember that the total cost of this care path does not include all possible medications, lab work or imaging studies. Those charges can add up. If your healthcare provider recommends any lab work or imaging studies, you may need to search for their costs separately.

Contact your healthcare provider if you have symptoms of colon cancer. Be prepared to discuss your symptoms and how long you have had them.

• Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
• Make a list of your medications (including over-the-counter).
• Write down any questions, symptoms or concerns you want to talk about.
• If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

What should I ask my healthcare provider before having a colectomy?

• What is my diagnosis? What type of colon cancer do I have?
• What is the reason for the surgery? Are there any alternatives to surgery?
• What tests are you recommending and why? Will the test results change my treatment plan? If not, then why do I need them?
• How will I feel after the surgery? Will I have to modify my activity?
• What are the possible complications for this surgery?
• What happens if I do not go through with the surgery?
• What is your experience in doing this type of surgery? What is your complication rate?
• Is there any special preparation for the surgery? (If so, get clear instructions on what you need to do.)
• Will I be receiving other treatments before or after my surgery?
• Will my diet change after surgery?
• Will my bowel habits change after surgery?

Do not forget to arrange for transportation to and from the facility and for help at home.

Before you go home, make sure you understand all home care instructions (including medications and side effects), what symptoms you should report to your healthcare provider after discharge and follow-up plans. Your surgeon should also communicate with your primary care physician.

Source UHC.com

Also known as:

Removal of Colon

Partial Removal of Colon

Partial Colon Removal

Partial Colectomy

Intestine Cancer

Colon Removal

Colon Biopsy

Colectomy

Cancer of Colon

Cancer

Bowel Cancer

Biopsy Colon