22 mars 2023
Colorectal cancer can involve either the colon, the longest part of the large intestine, or the rectum. Its treatment depends on its location and its stage of development. Update on the different options during this time of Blue March, the month dedicated to the prevention of colorectal cancer.
Regardless of the location of the tumour, “Surgery is the main treatment for colorectal cancer”, indicates the center for the fight once morest cancer Gustave-Roussy. The intervention then consists of “to remove the affected colon segment. If it is rectal cancer, the surgeon removes the rectum, preserving the anal sphincter if possible.. The act can be performed by laparotomy (opening of the abdominal wall) or by laparoscopy, which consists of introducing into the abdomen “a micro-camera and the instruments through several small incisions”.
In the case of rectal cancer, surgery usually follows radiation therapy, which is itself often “accompanied by chemotherapy to reduce the size of the tumor and make cancer cells more sensitive to ionizing radiation”underlines the medical dictionary Vidal.
Chemotherapy
Chemotherapy can be prescribed at all stages of the disease, completes the Foundation for Cancer Research. “For more advanced tumours, it is recommended following surgery in order to reduce the risk of recurrence: we speak of adjuvant chemotherapy”. And for metastasized colorectal cancers, “chemotherapy is systematically prescribed, whether before a first surgical operation in order to facilitate it or instead of surgery when this is not possible”. Targeted therapies can be associated with it.
There are also cases where the digestive stoma is necessary: these are“an opening created in the colon or small intestine to pass stools when they can no longer be passed through the natural channels”, says the National Cancer Institute. They are then collected in a pocket located outside the body. The stoma can be temporary, the time of healing when the surgeon has removed the tumor and was able to “connect” the two portions of the affected organ. It can also be permanent.
To note : About a third of the patients treated present postoperative complications, linked to poor healing of the intestinal barrier. In Canada, a research team has found, on mice, that modifying the intestinal flora before surgery might reduce postoperative complications in patients with colorectal cancer. The results of this experiment, which remain to be confirmed in humans, have been published in the journal Gut.
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Source : Gustave-Roussy Cancer Center – Cancer Research Foundation – Vidal – InCa – Gut – March 2023
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Written by : Charlotte David – Edited by: Emmanuel Ducreuzet