Surgery Tumors of the colon should be removed whenever practical, even if there are metastases,
because complications—blockage of the bowel or bleeding—frequently will develop.
The standard operation is designed to remove the portion of the bowel with the tumor along with the entire lymph node drainage. This requires removing the vessels that supply blood to a considerable portion of the bowel, so most of the time about one-third to one-half of the colon is removed even if the tumor itself is relatively small. This procedure is easier, safer and more likely to provide surgical margins—areas around the tumor—that are free of cancer. The bowel is then reconnected (anastomosis).
Sometimes, in patients who have tumors in the left side of the colon and who have a partial or complete obstruction, reconnecting the bowel is not possible because there is too much stool or contamination in the area. These patients receive a temporary colostomy , which is removed 6 to 10 weeks later. ( see Living with an Ostomy )
Local excision may be used for small lesions or the removal of polyps, with a wedge resection for larger tumors.
Radiation Therapy In selected cases of invasive cecal tumors (where the small bowel joins the
colon), radiotherapy may help reduce local recurrences. Palliative radiation is primarily used for localized metastatic tumors and painful liver metastases.
