Sunday, January 13, 2008

Treatment

Treatment depends mainly on the size, location, and extent of the tumour, and on the patient's general health. Patients are often treated by a team of specialists, which may include a gastroenterologist, surgeon, medical oncologist, and radiation oncologist. Several different types of treatment are used to treat colorectal cancer. Sometimes different treatments are combined.

Surgery to remove the tumour is the most common treatment for colorectal cancer. Generally, the surgeon removes the tumour along with part of the healthy colon or rectum and nearby lymph nodes. In most cases, the doctor is able to reconnect the healthy portions of the colon or rectum. When the surgeon cannot reconnect the healthy portions, a temporary or permanent colostomy is necessary. Colostomy, a surgical opening (stoma) through the wall of the abdomen into the colon, provides a new path for waste material to leave the body. After a colostomy, the patient wears a special bag to collect body waste. Some patients need a temporary colostomy to allow the lower colon or rectum to heal after surgery. About 15 percent of colorectal cancer patients require a permanent colostomy.

Chemotherapy is the use of anticancer drugs to kill cancer cells. Chemotherapy may be given to destroy any cancerous cells that may remain in the body after surgery, to control tumour growth, or to relieve symptoms of the disease. Chemotherapy is a systemic therapy, meaning that the drugs enter the bloodstream and travel through the body. Most anticancer drugs are given by injection directly into a vein (IV) or by means of a catheter, a thin tube that is placed into a large vein and remains there as long as it is needed. Some anticancer drugs are given in the form of a pill.

Radiation therapy, also called radiotherapy, involves the use of high-energy x-rays to kill cancer cells. Radiation therapy is a local therapy, meaning that it affects the cancer cells only in the treated area. Most often it is used in patients whose cancer is in the rectum. Doctors may use radiation therapy before surgery (to shrink a tumour so that it is easier to remove) or after surgery (to destroy any cancer cells that remain in the treated area). Radiation therapy is also used to relieve symptoms. The radiation may come from a machine (external radiation) or from an implant (a small container of radioactive material) placed directly into or near the tumour (internal radiation). Some patients have both kinds of radiation therapy.

Biological therapy, also called immunotherapy, uses the body's immune system to fight cancer. The immune system finds cancer cells in the body and works to destroy them. Biological therapies are used to repair, stimulate, or enhance the immune system's natural anticancer function. Biological therapy may be given after surgery, either alone or in combination with chemotherapy or radiation treatment. Most biological treatments are given by injection into a vein (IV).

Clinical trials (research studies) to evaluate new ways to treat cancer are an appropriate option for many patients with colorectal cancer. In some studies, all patients receive the new treatment. In others, doctors compare different therapies by giving the promising new treatment to one group of patients and the usual (standard) therapy to another group.

Cancer Glossary Terms

abdomen (AB-do-men)
The area of the body that contains the pancreas, stomach, intestine, liver, gallbladder, and other organs.

barium enema
procedure in which a liquid with barium in it is put into the rectum and colon by way of the anus. Barium is a silver-white metallic compound that helps to show the image of the lower gastrointestinal tract on an x-ray.

benign (beh-NINE)
Not cancerous; does not invade nearby tissue or spread to other parts of the body.

biological therapy (by-o-LAHJ-i-kul)
Treatment to stimulate or restore the ability of the immune system to fight infections and other diseases. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy.

biopsy (BY-op-see)
The removal of cells or tissues for examination under a microscope. When only a sample of tissue is removed, the procedure is called an incisional biopsy or core biopsy. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. When a sample of tissue or fluid is removed with a needle, the procedure is called a needle biopsy or fine-needle aspiration.

cancer
term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread through the bloodstream and lymphatic system to other parts of the body.

catheter (KATH-i-ter)
A flexible tube used to deliver fluids into or withdraw fluids from the body.

chemotherapy (kee-mo-THER-a-pee)
Treatment with anticancer drugs.

clinical trial
A type of research study that tests how well new medical treatments or other interventions work in people. Such studies test new methods of screening, prevention, diagnosis, or treatment of a disease. The study may be carried out in a clinic or other medical facility. Also called a clinical study.

colonoscope (ko-LAHN-o-skope)
A thin, lighted tube used to examine the inside of the colon.

colonoscopy (ko-lun-AHS-ko-pee)
An examination of the inside of the colon using a thin, lighted tube (called a colonoscope) inserted into the rectum. If abnormal areas are seen, tissue can be removed and examined under a microscope to determine whether disease is present.

colorectal (ko-lo-REK-tul)
Having to do with the colon or the rectum.

colostomy (ko-LAHS-toe-mee)
An opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed.

digital rectal examination (DRE)
An examination, in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities.

enterostomal therapist (en-ter-o-STO-mul)
A health professional trained in the care of persons with urostomies and other stomas.

external radiation (ray-dee-AY-shun)
Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external-beam radiation.

familial polyposis (pah-li-PO-sis)
An inherited condition in which numerous polyps (growths that protrude from mucous membranes) form on the inside walls of the colon and rectum. It increases the risk for colon cancer. Also called familial adenomatous polyposis or FAP.

faecal occult blood test (FEE-kul o-KULT)
A test to check for blood in stool. (Fecal refers to stool; occult means hidden.)

gastroenterologist (GAS-tro-en-ter-AHL-o-jist)
A doctor who specializes in diagnosing and treating disorders of the digestive system.

internal radiation (ray-dee-AY-shun)
A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy.

IVIntravenous (in-tra-VEE-nus).
Injected into a blood vessel.

local therapy
Treatment that affects cells in the tumour and the area close to it.

lymph node (limf node)
A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called a lymph gland.

lymphatic system (lim-FAT-ik SIS-tem)
The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes, and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.

malignant (ma-LIG-nant)
Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body.

medical oncologist (on-KOL-o-jist)
A doctor who specializes in diagnosing and treating cancer using chemotherapy, hormonal therapy, and biological therapy. A medical oncologist often is the main caretaker of someone who has cancer and coordinates treatment provided by other specialists.

metastasis (meh-TAS-ta-sis)
The spread of cancer from one part of the body to another. A tumour formed from cells that have spread is called a secondary tumour, a metastatic tumour, or a metastasis. The secondary tumour contains cells that are like those in the original (primary) tumour. The plural form of metastasis is metastases (meh-TAS-ta-seez).

polyp (POL-ip)
A growth that protrudes from a mucous membrane.

radiation oncologist (ray-dee-AY-shun on-KOL-o-jist)
A doctor who specializes in using radiation to treat cancer.

radiation therapy (ray-dee-AY-shun)
The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumours. Radiation may come from a machine outside the body (external-beam radiation therapy), or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumour or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy, irradiation, and x-ray therapy.

recurrent cancer
Cancer that has returned after it had disappeared. It may return at the same site as the original (primary) tumour or in another location.

risk factor
Anything that increases a person's chance of developing a disease. Some examples of risk factors for cancer include a family history of cancer, use of tobacco products, certain foods, being exposed to radiation or other cancer-causing agents, and certain genetic changes.

side effects
Problems that occur when treatment affects tissues or organs other than the ones meant to be affected by the treatment. Common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.

sigmoidoscope (sig-MOY-da-skope)
A thin, lighted tube used to view the inside of the colon.

sigmoidoscopy (sig-moid-OSS-ko-pee)
Inspection of the lower colon using a thin, lighted tube called a sigmoidoscope. Samples of tissue or cells may be collected for examination under a microscope. Also called proctosigmoidoscopy.
stageThe extent of a cancer within the body, especially whether the disease has spread from the original site to other parts of the body.

staging (STAY-jing)
Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.

stoma (STO-ma)
A surgically created opening from an area inside the body to the outside.

systemic therapy (sis-TEM-ik THER-a-pee)
Treatment using substances that travel through the bloodstream, reaching and affecting cells all over the body.

tumour (TOO-mer)
An abnormal mass of tissue that results from excessive cell division. Tumours perform no useful body function. They may be benign (not cancerous) or malignant (cancerous).

ulcerative colitis
Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel.

x-ray
A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.

Source: National Cancer Society Malaysia