Colorectal cancer is cancer of the colon or rectum, located at the lower end of the digestive tract.

At ProHealth Care, a multidisciplinary team of professionals works together to provide individualized cancer care. It includes the involvement of physicians from surgery, radiology, pathology, radiation, interventional radiology and medical oncology as well as other health professionals such as oncology nurses, social workers, research staff and dietitians.

ProHealth Care also has an active research support team that helps align patients with available clinical trials.

 

Diagnostics

Colonoscopy: This test allows the physician to look at the inner lining of the large intestine (colon) and rectum.  Its purpose is to look for polyps that are precancerous and to evaluate a patient for cancer. It usually is done under sedation.

CT scan: A computed tomography test enables physicians to see cross-sections of the body with a great deal of speed and precision.  It is used to evaluate whether the colorectal cancer has spread (metastasized).

Endorectal ultrasound: This specialized ultrasound looks at how deep the tumor is and if it has spread to any lymph nodes. It also helps determine the rectal cancer’s stage.

Flexible sigmoidoscopy: This procedure allows the physician to examine the inside of the rectum and lower colon (or sigmoid).  Involving a flexible tube, the procedure can be done with or without sedation.

MRI: Magnetic resonance imaging uses a combination of a large magnet, radio frequencies and a computer to produce detailed images.  This will help determine the rectal cancer’s stage before surgery.

PET scan: This nuclear medicine (positron emission tomography) scan measures metabolic activity of cancer in the body.

Proctoscopy: In this procedure an instrument called a proctoscope is used to evaluate the last part of the colon and rectum to look at rectal cancer and provide an evaluation for surgical options. The procedure is done in the doctor’s office.

 

Treatments

Surgery: Surgical procedures can be done using the traditional open approach, laparoscopically or robotically.   Robotic surgery offers more minimally invasive options.  Benefits include less blood loss, smaller incisions, less scarring and pain, reduced infection and shorter hospital stays. Other procedures include:

TAMIS or transanal minimally invasive surgery is a technique used in the excision of rectal tumors using a laparoscope or in conjunction with the robot.

TAE or transanal excision is an even less-invasive approach that is an option for patients with small, early stage rectal cancer that is near the anus.

Proctectomy with coloanal anastomosis is the removal of the entire rectum and the connection of the colon to the anus.  This allows the person to still move their bowels in the usual way.

Low anterior resection refers to the removal of the sigmoid colon (closest to the rectum and anus) and part of the rectum that is done in the case of rectal cancer. This surgery spares the sphincter and may not require an ostomy. 

Colectomy is an operation that removes part or all of the large intestine (colon).  It is used for both cancerous and non-cancerous conditions.

APR, or abdominoperineal resection, is a type of surgery in which the anus, rectum and sigmoid colon are removed.  This procedure most often is used to treat cancer located very low in the rectum or anus.  Once the anus and the rectum are removed, a colostomy is created.

Tumor ablation of metastasis includes radiofrequency ablation, microwave ablation and Y-90 labeled TheraSpheres. “Ablation” means to remove or destroy.

  • With radiofrequency ablation, a needle device is directed through the skin and into the target lesion, using CT or MRI imaging, ultrasound or fluoroscopy.  When the needle is in the lesion, a controlled electrical current that heats the needle tip is applied, thereby destroying the adjacent target tissues. This procedure sometimes is referred to as RFA.
  • Microwave ablation is a procedure in which a tumor is localized using image guidance and then either a single antenna or several microwave antennae are inserted through the skin into the tumor.  The antennae destroy the tumors by directing a blast of microwave energy that generates intense heat. This sometimes is referred to as MWA.
  • Y-90 TheraSpheres is a treatment, sometimes referred to as selective internal radiation or SIRT, that delivers millions of tiny radioactive beads directly to the liver tumors via the blood supply.

 

Chemotherapy:

Chemotherapy uses a group of drugs that, when combined, destroy or slow the growth of cancer cells.  It can be administered into a vein or as a pill or pills.  It also can be used to radiosensitize tumor cells, making them more sensitive to radiation treatments and resulting in a more effective treatment.

Chemoembolization is a delivery method that directs the chemotherapy drugs directly into a tumor while minimizing exposure to healthy tissue.  This is used in cases where the cancer has spread (or metastasized) in the liver. 

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Why is a colonoscopy so important?

Colorectal cancer is the second leading cause of cancer death in the U.S., but during a colonoscopy, polyps can be found and removed before they become cancerous.

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http://www.prohealthcare.org/cancer-care-colorectal-cancer