After Colon Surgery

In most cases, it is surgery that marks your first treatment for colon cancer. In rare situations, doctors will do chemotherapy or radiation to shrink a tumor before colon surgery is done.

After colon surgery, you and your doctor have a lot of talking to do. Decisions need to be discussed about what needs to be done in order to make sure the cancer is treated properly.

Stage 0

The next thing doctors need to do is stage the cancer. After colon surgery, doctors do tests of the cancer, the surrounding lymph nodes and assess the liver and lungs for colon cancer. If the cancer is in stage 0, it has not gone past the lining of the colon and all the doctor needs to do is to do surgery to remove the tumor.

Stage I

In stage I cancer, the cancer cells have grown through several colon layers but the cancer hasn’t spread outside of the colon wall. Doctors do a colectomy to get rid of any cancer cells growing in and around the colon. You don’t need any other treatment after colon surgery.

Stage II

In Stage II cancer, the cancer may extend into nearby tissues and may require a colectomy. The cancer will not have been transferred to lymph nodes. If the cancer is high grade, chemotherapy is indicated for stage II cancer or if cancer was found near the margins of the excised tumor.

If the doctor didn’t remove at least 12 lymph nodes or if the cancer blocked the colon, then chemotherapy is indicated. Discuss the pros and cons of chemotherapy with your doctor before going ahead with it.

The chemotherapy used after colon surgery includes 5-FU, leucovorin, oxaliplatin or capecitabine. They can be used alone or in combination. If local treatment is advised, then radiation to the abdomen where the cancer was removed is recommended. You’ll need to talk to a radiation oncologist after colon surgery to be able to tell whether or not you need radiation therapy.

Stage III

If you are found to have Stage III cancer of the colon, it means you have had spread to the lymph nodes of the abdominal area but no spread to other body areas. Colectomy is the initial treatment of choice along with several treatments done after colon surgery. These include chemotherapy with the above medications that lasts up to six weeks.

The doctor may also recommend radiation therapy to get rid of any cancer that has been left behind following cancer surgery. Many people with Stage III cancer do both chemotherapy and localized radiation. Radiation and chemotherapy alone are done in cases where a person isn’t healthy enough for cancer surgery.

Stage IV

In stage IV cancer of the colon, the cancer is found to have spread to distant body tissues and organs, including the peritoneum, lungs, liver and ovaries. Surgery generally won’t cure these kinds of cancers and more treatment is needed after colon surgery.

Some small metastases can be treated with surgery or local radiation to the tumors. If there are many tumors, chemotherapy is recommended to attempt to shrink the tumors. Chemotherapy can be given before or after metastases removal in order to shrink the tumors to their smallest possible size.

If the metastases are too big, even for radiation, then chemotherapy is recommended as the only other recourse to try and shrink the tumor. After colon surgery in cases of stage IV cancer of the colon, the prognosis is not good. The prognosis of stage IV colon cancer is less than five percent who survive past 5 years. This is why it is important to have colon cancer screening so that surgery alone can correct any colon cancer found. Then the colon cancer survival rate is greater than 90 percent.

Written by Christine Traxler

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