Colorectal cancer treatment:
Surgical treatment is currently the primary treatment modality. Surgeons should choose the appropriate surgical approach based on the different locations of the tumor, tumor size, and tumor biology.
(1)Curative surgery for colon cancer.
Curative surgery for colon cancer involves the extensive resection of the site of the colon cancer and the lymphatic drainage area as a whole. Common surgical methods include: right hemicolectomy; transverse colectomy; left hemicolectomy; sigmoid colectomy.
(2)Curative surgery for rectal cancer.
There are five different surgical approaches: abdominoperineal resection (APR); anterior resection with coloanal anastomosis; pull-through resection with colostomy and colonic J-pouch anastomosis; local full-thickness excision of rectal cancer; total mesorectal excision with colonic reconstruction.
In principle, patients with early-stage cancer and no lymph node metastasis may not require adjuvant therapy after surgery. Many patients undergo comprehensive treatment, including chemotherapy and radiation therapy before or after surgery, depending on the condition. For advanced-stage cancer, preoperative radiation therapy or chemotherapy can improve local tumor invasion, shrink the tumor, induce regression or disappearance of cancer cells, and enhance treatment efficacy. Preoperative arterial infusion chemotherapy is preferred over systemic chemotherapy, as it has fewer side effects and similar effectiveness to preoperative radiation therapy. Postoperative radiation therapy and chemotherapy should be determined based on the individual’s condition.
For a few patients who are unable to undergo surgery due to their overall health or tumor conditions, radiation therapy and chemotherapy are also used. The majority of patients experience significant symptom relief and pain alleviation. Most patients require appropriate comprehensive treatment, where the best treatment outcome for the patient’s quality of life and survival should be considered first to prolong their survival.
After surgical treatment for colon cancer, dietary adjustments are important. On one hand, it is crucial to consume easily digestible foods, and on the other hand, maintaining a balanced nutrition is essential. It is advisable to include fresh vegetables, fruits, legumes, dairy products, and high-quality proteins such as fish and seafood in the diet. Avoid smoking and excessive alcohol consumption, and drinking tea is acceptable. Regular follow-up visits to the treatment hospital for check-ups are recommended.
For some rectal cancer patients who have undergone surgery and received a colostomy (artificial anus), post-operative care is crucial. After the stoma is created, a colostomy bag is worn to collect feces. In case of fecal leakage contaminating clothing, it should be promptly replaced, and caregivers and family members should not show disgust or delay in attending to it.
Once the patient can control bowel movements independently, a soft cloth can be placed over the stoma and secured with a cloth belt. It is important to keep the stoma area clean and dry regularly, and after the surgical incision has healed, the surface can be cleaned with soapy water. If the surrounding skin is eroded, zinc oxide ointment can be applied for protection. Keeping the colostomy bag clean, training the patient to empty it regularly, and maintaining good dietary hygiene to prevent diarrhea are essential.
