- Treatment Zero Phase of Colon Cancer
- Treatment First Phase of Colon Cancer
- Treatment Second Phase of Colon Cancer
- Treatment Third Phase of Colon Cancer
- Treatment Fourth Phase of Colon Cancer
- Treatment Recidivating Colon Cancer
Colon cancer therapy depends on the phase of the cancer. However, there are some extra significant factors. Patients with localized colon cancer undergo surgery, as it is the key treatment. Adjuvant chemotherapy can also be placed on. It can last for about 6 months.
Treatment Zero Phase of Colon Cancer
As the zero phase does not lead to growing beyond mucous membrane of the colon, surgery is the only treatment required. The optimal surgery is produced through a flexible endoscope. Thus, a polyp can be removed (colonoscopic polypectomy). If a tumor is rather big to be removed locally, excision of a part of the colon can be required (partial colectomy).
Treatment First Phase of Colon Cancer
The first phase of colon cancer leads to invasion of the layers of the colon walls, but it is not spread outside the colon wall or contiguous globate glands.
The first phase of colon cancer is characterized by polyps. In case if the polyp is excised and there are no more oncogenous cells at the borders of the excised sample, another treatment is not required.
In case of the high malignized polyp or if there are oncogenous cells at the borders of the polyp, more surgery can be recommended. The same treatment can be suggested, if the entire polyp cannot be removed or it was excised in many little segments and it is not possible to detect if there are any oncogenous cells at the borders.
In case of cancers not in polyps, partial colectomy is required. It is an excision of colon segment, which is affected by cancer, and related lymph nodes. It is the only treatment in the case.
Treatment Second Phase of Colon Cancer
Usually, colon cancers of the second phase have intergrowths through the colon walls or into nearby tissue; and there is no expansion to globate glands.
Excision of colon cancer section together with globate glands close to it can be the only treatment required. However, the doctor can suggest chemical therapy. It is usually prescribed if there is a high risk of colon cancer return.
There is a number of activating factors:
- Cancer cells look abnormal if viewed under the microscope.
- Cancer cells have intruded into blood vessels and globate glands close to the tumor.
- Less than 12 globate glands were removed by surgery.
- Cancer cells were revealed in or near the border of the surgical specimen, which means that some oncogenous cells were left.
- The tumor obstructed the colon.
- The tumor lead to a bursting in the colon wall.
There is no consensus of doctors` opinion concerning the necessity of chemical therapy in case of the second phase treatment. Therefore, you should discuss all pro and contra of this type of therapy, especially, the way it can reduce the risk of cancer return in your case.
The main treatment options used in case of chemical therapy consist of 5-FU, leucovorin or capecitabine. However, treatment schemes can be different.
Beam-therapy can be required if the surgery did not remove all cancer cells, as it grew into nearby tissues. This type of therapy should kill leftover cancer cells in the area of abdomen.
Treatment Third Phase of Colon Cancer
The third phase of colon cancer is characterized by invading of close globate glands, but cancer cells have not yet extended to other areas of the body.
The routine treatment for this phase includes the surgery in order to excise the segment of the colon affected with cancer and the following adjuvant chemical therapy.
Two main schemes of chemical therapy are used here: FOLFOX (5-FU, leucovorin, and oxaliplatin) or CapeOx (capecitabine and oxaliplatin). However, there are patients, who get 5-FU with only leucovorin or capecitabine considering their age and health state.
Specialist can also recommend beam-therapy if there is a strong suspicion that some malignant cells might have been left over after surgical attack.
Patients, whose state of health is unconducive for a surgical attack, can get beam-therapy or chemical therapy as the only possible treatment.
Treatment Fourth Phase of Colon Cancer
The fourth phase of cancer comes through invasion of this type of cancer to remote organs and tissues. It often invades liver, sometimes it also spreads to the lungs, peritoneum (the lining of the abdominal cavity) or to remote globate glands.
In the majority of cases of the fourth phase, surgical attack can be useless. Nevertheless, if the areas of the cancer invasion in liver or in lungs are small enough, they can be excised during the one and the same surgery together with close lymph nodes. It can help you live a long life and even cure you. Chemical therapy should also be used before and/or after the surgical attack. Hepatic artery infusion is likely to be used if colon cancer has invaded liver.
In case of multiple or big metastases, which cannot be excised, chemical therapy can be offered before a surgical attack. Then, if tumors are diminished, the surgery is used to remove them. And chemical therapy is given again after this surgical attack. If the liver is affected, ablation or embolization can be used.
If the cancer invasion is significant, any surgical attack is useless. Then, chemical therapy is the only treatment available. However, if the tumor blocks the colon, a surgical attack may be still required. It can be replaced by inserting a stent (a hollow metal or plastic tube) into the colon in order to keep it open. Such stent can be inserted during a colonoscopy. In other cases, colectomy or diverting colostomy can be applied.
In case of the fourth phase of colon cancer, doctors usually recommend a surgical attack. You should have a clear idea of the surgery in the case. Its purpose can be either to cure the colon cancer or just to reduce the disease symptomatology.
The majority of people with the fourth phase of cancer should get chemical therapy and/or targeted therapy in order to control the tumor.
There are the following widespread schemes of therapy:
- FOLFOX: leucovorin, 5-FU, and oxaliplatin (Eloxatin);
- FOLFIRI: leucovorin, 5-FU, and irinotecan (Camptosar);
- CapeOX: capecitabine (Xeloda) and oxaliplatin;
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan;
- One of the above combinations plus either a medication that targets VEGF (bevacizumab [Avastin], ziv-aflibercept [Zaltrap], or ramucirumab [Cyramza]), or a drug that targets EGFR (cetuximab [Erbitux] or panitumumab [Vectibix]);
- 5-FU and leucovorin, with or without a targeted drug;
- Capecitabine, with or without a targeted drug;
- Irinotecan, with or without a targeted drug;
- Cetuximab alone;
- Panitumumab alone;
- Regorafenib (Stivarga) alone;
- Trifluridine and tipiracil (Lonsurf).
The selection of schemes is reliant on a number of factors. They involve your former treatment and the general state of your health. As soon as one scheme turns out to be inefficient, another one can be applied.
It is recommended to reduce such symptom as pain in case of advanced cancer. The tumor can be diminished for some time. However, it can`t be cured. You should have a clear idea of the radiological therapy, if it is strongly recommended by your doctor.
Treatment Recidivating Colon Cancer
Recidivating cancer can be local (in the same place) or in distant tissues and organs.
Focal Recidivating Cancer
If the cancerous growth appears on the same place as before, one more surgical attack with possible followed chemical therapy can help you live longer and even cure you. If the tumor can`t be excised, chemical therapy can be used first. If the tumor is diminished, surgery followed by chemical therapy may be used.
Distant Recidivating Cancer
Usually distant recidivating cancer appears in the liver. Here, a surgical attack can be helpful. If it is not, chemical therapy can be used to diminish the tumor. Consequently, a surgical attack can help to remove the tumor. Such options as ablation or embolization techniques can also be used for treatment in the case.
If the cancer invasion is too big and it can`t be treated with surgical attacks, chemical and/or targeted therapies can be applied. Available treatment options are the same as for the fourth phase of cancer. Everything depends here on medication you had taken before the cancer came back, on the period of medication intake, on your state of health. Surgical attacks can also be required, especially to reduce or prevent the colon blockage or some other complications. Beam-therapy can also be a treatment to reduce symptoms in the case.
Recidivating cancer is often hard to be cured. Therefore, you can ask your doctor if there are any new treatments to be used in your case.