At Stony Brook Cancer Center, the Colorectal Oncology Management Team provides comprehensive services for colon, rectal, small intestine and anal cancers. These cancers usually respond well to treatment. Often, these cancers can be treated with surgery alone, depending on the type and stage of the cancer. The latest protocols and treatments are delivered by a multidisciplinary team.
The types of surgical options available for colon, rectal, small intestine and anal cancers are listed under each heading. The type of procedure depends on how advanced the disease is, where it is located, your overall health and other factors. For some patients, surgery on more than one body part is performed at the same time.
Surgical Treatment Options
Colon cancer is usually treated with surgery, which is made easier because the colon is located in the belly. When only part of the colon is removed, it’s called a partial colectomy. Your surgeon may recommend one of these treatment options:
Traditional surgery is often called open surgery. It usually involves
a single incision (cut) that is large enough so that your surgeon can operate
using their hands.
Why your surgeon would recommend open surgery:
- The tissue that needs to be removed will not come out without a larger incision.
- If you have had many other abdominal surgeries and scar tissue is expected.
- If the cancer has spread (metastasized) beyond the colon to other organs, open surgery may be the most efficient way to remove tumors from the colon and other organs at the same time.
Minimally Invasive Surgery
Your surgeon may be able to use minimally invasive approaches. These include:
Laparoscopy
During a laparoscopy your surgeon uses a thin, lighted tube with a video camera at its tip. This tool is called a laparoscope. Multiple small holes are made in the abdominal wall to insert camera and instruments into the abdomen. Once the goals of the operation are accomplished, a small incision is made to remove the tissue of concern.Robotic-assisted surgery
In robotic-assisted surgery, a camera and instruments are inserted through keyhole-size cuts in the abdominal wall, just like laparoscopy. Then robotic arms are attached to the instruments and your surgeon sits at a computer and uses controls to move the robotic arms. A high-definition visual system helps your surgeon see more clearly by magnifying the operation.
Why your surgeon would recommend one of these minimally invasive procedures:
- Surgeons can use smaller incisions than in open surgery.
- These techniques can help minimize damage to nearby organs and tissues.
- A lower risk of infection and less blood loss.
- Patients often recover faster.
Cytoreductive Surgery (CRS) and Heated Intra-Peritoneal Chemotherapy (HIPEC)
Occasionally, the CRS-HIPEC procedure is used in advanced cases. For patients who have colon cancer that has spread to the peritoneum, the CRS-HIPEC procedure is an aggressive combination of surgery and chemotherapy to eradicate abdominal tumors. The goal is to perform radical surgery to remove all disease, but also enable you to return to regular daily activities.
In CRS, your surgeon removes all visible cancer in the abdominal cavity. With HIPEC, your surgeon administers heated chemotherapy solution into the abdominal cavity while they’re in the operating room during the CRS procedure. The heated chemotherapy can be delivered using either the open or closed techniques when the skin is either sewn closed or left open during the chemotherapy procedure. CRS and HIPEC work together to eradicate and kill all cancer cells. With CRS, all visible cancer cells are removed. With HIPEC, the remaining microscopic cancer cells are treated. The heat and chemotherapy work in combination to eradicate and kill cancer cells.
Why your surgeon would recommend the CRS-HIPEC procedure:
- In select patients, HIPEC may significantly increase survival time.
- HIPEC allows direct contact between the chemotherapy drugs and microscopic cells that remain in the peritoneal cavity.