Colorectal Cancer Diagnosis, Treatment & Surgery

Colorectal cancer, depending on where it begins, is often called either colon or rectal cancer. Colorectal cancer starts in the colon or the rectum as a growth or polyps, which can further develop into cancer. However, it must be noted polyps usually do not show symptoms, and for this reason, doctors typically ask for several testing procedures such as biopsy, colonoscopy, etc. Once the doctors have the findings, they will discuss the treatment with the patient – the treatment goals and expectations.

How is Colorectal Cancer Diagnosed?

Colorectal cancer diagnosis takes place depending on the age and by considering some other factors such as the type of cancer, signs and symptoms, results of previous medical results, family and medical history of the patient, and many others. 

Here are some of the tests used to diagnose colorectal cancer, but not all tests are used for all the patients –

• Colonoscopy – A colonoscopy helps the doctor examine the colon and rectum while the patient is sedated. If the cancer is found, the doctors will perform further tests to diagnose the condition properly until the tumour is surgically removed. 
• Biopsy – If traces of cancer or polyps are found, the doctors perform a biopsy. During a biopsy, a small amount of tissue is removed from the colon and rectum and examined under the microscope. This diagnostic test specifies the type of cancer in the colon. Sometimes, a biopsy is performed during a colonoscopy or is done during any surgery. Also, doctors might use a CT scan or ultrasound to perform a needle biopsy – it is a process of removing tissue through the skin with a needle guided into the tumour. 
• Blood Tests – Patients are more likely to become anaemic as colorectal cancer often bleeds into the large intestine. CBC (Complete Blood Count) can help the doctor understand if there is any bleeding. Another blood test that might determine the level of protein is Carcinoembryonic Antigen (CEA), in which higher levels of CEA indicate that the cancer has spread to other parts of the body. However, it is not considered reliable because the CEA might also increase due to some medications. This test usually helps in monitoring the cancer for people who are already receiving the treatment. 
• Computed Tomography – A CT Scan uses X-rays to take a picture of the inside of the human body, which are combined to form a detailed, 3-dimensional image that shows any sign of a tumour. It is also used to measure the size of the tumour and check if the cancer has spread to the liver, lungs, or other body parts. 
• Magnetic Resonance Imaging – An MRI produces a detailed image of the body using a magnetic field and is also used to determine the tumour size. It is best to find out the exact location of the tumour. 
• Ultrasound – An ultrasound creates a picture of internal organs to find where the cancer has spread, using sound waves. Doctors perform endorectal ultrasound to find how deep the rectal cancer is, which helps in charting out treatment plans. 
• Chest X-rays – Chest X-rays use a small amount of radiation to form images of the inside of the human body. This is done to see if the cancer has spread to the liver or lungs.
• Positron Emission Tomography (PET) – PET is usually done with a CT scan. This diagnostic test creates images of the organs and tissues and is usually only done for some of the patients once specified by the doctor.

In addition to the above tests mentioned, the doctors may ask the patient to get some other tests, such as biomarker testing to be done to identify specific genes, repair proteins, etc.

How is Colorectal Cancer Treated?

Treatment options for colorectal surgery depend on several factors, such as type and stage of the cancer, side effects, patient preference, and health condition. Hence, the patient needs to talk about all the possible factors before jumping to the conclusion of the treatment. 

Here are some of the most preferred treatments for colorectal cancer –

Radiation Therapy 

Radiation therapy utilises high-energy X-rays to eliminate cancer cells and is most commonly used to kill rectal cancer cells. The procedure is carried out by a specialist known as a Radiation Oncologist. 

There are two types of radiation therapy –

• External Beam Radiation Therapy – This therapy uses a machine to deliver X-rays where cancer is located. This treatment goes for 5 times a week (up to a particular period, as suggested by the doctor).
• Stereotactic Radiation Therapy – This radiation therapy is used if the cancer has spread to the liver or lungs. Stereotactic radiation therapy delivers a large, precise radiation dose to a smaller area. This usually saves parts of the lungs and liver tissue which might have to be removed during the surgery. 
• Intraoperative Radiation Therapy – This uses a high dose of radiation therapy during the surgery. 
• Brachytherapy – During Brachytherapy, a radioactive seed is placed in the body, and a tiny amount of radioactive substance called Yttrium-90 is injected into the liver to treat cancer that has spread to that part of the body.

Chemotherapy 

During chemotherapy, the doctor uses drugs to destroy cancer cells by keeping them from multiplying and growing. This cancer treatment is usually done after the surgery to kill the remaining cancer cells. Sometimes, the doctor might give chemotherapy and radiation therapy before the surgery to shrink the size of the cancer. 

Targeted Therapy

Before proceeding with the targeted therapy, the doctors usually perform several tests to identify the protein levels, genes, and the tissue environment that contribute to the growth of the cancer cells. Targeted therapy blocks the development of the cancer cells. Thus stopping them from spreading to other parts of the body. Also, this treatment limits damage to the healthy cells. 

Immunotherapy

Immunotherapy uses the body’s natural defence to fight cancer by boosting immunity and its ability to fight cancer cells. 

Does Surgery Help in Treating Colorectal Cancer?

Colorectal cancer surgery is one of the common treatments, as it completely removes the cancer cells. During surgery, the tumour is removed along with some healthy surrounding tissues. Here are some of the surgical options for colorectal cancer –

• Laparoscopic Surgery – During a laparoscopic surgery, the surgeon makes a few small incisions, not more than half an inch long. Then, a tube is inserted through each opening, and the surgery is done. As it involves minimal invasion, it is considered best as compared to traditional surgery. The surgery helps to treat minor problems, such as removing growths or blockages. 
• Colostomy – Patients with rectal cancer might need a colostomy to remove the colorectal cancer. It helps change the trajectory of food waste through your bowels. 
• Radiofrequency Ablation – RFA is done to remove the cancer that has spread to the lungs or liver. During RFA, the cancer cells are frozen through a process called Cryoablation. 

Conclusion

Colorectal cancer is treatable if diagnosed early. With so much technological advancement, it is now quite possible to treat cancer. If a patient has colorectal cancer, we advise you to go see a healthcare provider at Wockhardt Hospitals as soon as possible. The doctor will diagnose and chart out a treatment plan depending on the findings, and will also inform the patient of colorectal cancer treatment cost.