Treatment of colon cancer

Colon neoplasms can be both benign and malignant. They arise from the cover of the large intestine and are localized in its various regions. The cells of the mucous layer in the intestine renew themselves regularly. Sometimes they can undergo regenerative changes unevenly, giving birth to colon cancer.

Content

1. Colon cancer symptoms
2. Causes
3. Cancer treatment with surgery
4. Radiation therapy and chemotherapy
5. The onset of the disease
6. First stage colon cancer
7. Second stage colon cancer
8. Third stage colon cancer
9. Fourth stage colon cancer
10. Treatment for metastatic colon cancer
11. Where to undergo colon cancer treatment abroad?
12. Why undergo treatment of colon cancer in Germany?
13. Prices for treatment abroad
14. How to undergo treatment abroad?

Colon cancer symptoms

Benign colon tumors are often asymptomatic and found by chance. Sometimes people experience abdominal discomfort, unstable stools, or blood in the stool.

Colon cancer (ICD C18) develops rather slowly and may not manifest itself clinically at the very beginning; it can only be diagnosed through screening.. Some of the first symptoms of the disease are bleeding and anemia. In addition to bleeding, patients with a colon cancer diagnosis may experience abdominal pain, tenesmus, and problems with stool. Constipation occurs at the advanced stages of the process, as the intestinal obstruction develops. People with cancer diagnosis feel incomplete emptying, i.e. tenesmus. Men and women complain of general weakness, loss of appetite, and a sharp weight loss. At the advanced stage of the disease, the liver enlarges, and signs of ascites appear.

Causes

The causes that lead to the development of colon cancer have been studied for a long time, but scientists and clinicians have not come to a consensus. All agree that this medical group of diseases is polyetiological.

The risk of pathology development increases with age. A diet rich in animal protein, fat and poor in fiber is a trigger. Such a diet leads to frequent constipation and imbalance of the intestinal microbiome. Intestinal contents with a high amount of bile acids and phenols, which have carcinogenic properties, stay in contact with the intestinal walls for a longer time. This increases the risk of developing colon cancer. Carcinogens in industrial preservatives and processed products also trigger the diagnosis.

Inflammatory diseases are of great importance in the development of tumors of the large intestine, both malignant and benign ones. With a long course (five years or more), benign neoplasms can transform to a malignant diagnosis.

Cancer treatment with surgery

Colon cancer treatment options include surgical methods of cancer care, chemotherapy, and radiation therapy.

There are few main factors that influence the choice of the surgical intervention, including:

• Ensuring the maximum radicalism of the operation, that is, the removal of the cancerous tumor together with the zones and pathways of regional metastasizing
• Ensuring the maximum adjustment of the operation to human physiology

Also, the choice of the type and volume of colon cancer surgery (primarily the organ-preserving one) depends on the local spread of the tumor process and the tumor localization in the colon.

The conventional surgery for colon cancer treatment involves a large incision that is required to view the entire abdominal cavity and perform the planned surgery. Despite the availability of modern high-tech minimally invasive colon cancer treatments (laparoscopic and robotic ones), traditional operations remain relevant, especially when it comes to the need to perform an extensive combined operation.

Laparoscopic and robotic colon cancer treatments are high-tech. Their peculiarity is that the operation is performed with the help of special instruments that are inserted into the abdominal cavity through small punctures in the anterior abdominal wall. The same volume of operation is performed as if it were performed traditionally, only without damaging healthy tissues extensively.

The fundamental difference between laparoscopic and robotic colon cancer treatments is that in the case of laparoscopic surgery, the instruments are in the hands of the surgeon, while in the case of robotic surgery, the instruments are in the manipulators of the robot, which is controlled by the surgeon.

The main advantages of minimally invasive colon cancer treatments are minimal trauma, minimal blood loss, reduction or absence of pain syndrome, reduced length of hospital stay, faster restoration of digestive function and intestinal motility, and a better cosmetic effect.

The listed types and methods of operations are available in the best European hospitals.

Radiation therapy and chemotherapy

In oncology hospitals, chemotherapy is used primarily for metastatic colon cancer. Most often, in patients with the advanced stage colon cancer different organs are affected.

Radiotherapy is performed before surgery, if all three layers of the intestinal wall are involved in the process. Radiotherapy is performed prior to surgery as preparation for the surgical colon cancer treatment.

In colon cancer treatment, radiation therapy is used mainly if internal organs (including bones and brain) or the peritoneum are affected.

For colon cancer treatment, radiation treatment options including external beam radiation therapy, intracavitary radiotherapy, and embolization are applied.

The body's response to radiation therapy is individual. Radiation therapy, like any type of colon cancer treatment, may be accompanied by long term side effects. Side effects of radiation therapy arise in tissues and organs that were exposed to radiation. Side effects developing after colon cancer treatment are relatively mild and are responsive to medications or proper nutrition. They usually disappear in 2-3 weeks after the radiation therapy completion. Sometimes side effects after colon cancer treatment do not occur at all.

The specific scheme of colon cancer treatment is determined according to the results of clinical, histological, and instrumental studies. Colon cancer treatment must be comprehensive. It includes supporting the body during chemotherapy and radiation exposure, and high-quality postoperative cancer care.

The onset of the disease

Preinvasive stage colon cancer is the onset of the disease.

At this stage colon cancer cells do not penetrate the intestinal mucosa, and all that is needed is the removal of these cells.

As a rule, early stage colon cancer is detected by chance, since the patient does not have any complaints. Symptoms are poor and specific manifestations are absent. Patients may experience constipation or a feeling of heaviness in the rectum.

Most often, the disease progresses without any symptoms. If an early stage colon cancer is detected, a good prognosis can be guaranteed.

Treatment options for early stage colon cancer include either endoscopic polypectomy or short-term chemotherapy. No further measures of cancer care are required for early stage colon cancer.

First stage colon cancer

First stage colon cancer is a tumor smaller than 2 cm; regional metastases are absent.

Intra-abdominal resection of the tumor and all affected tissues in the colon is one of the main treatment options for first stage colon cancer.

As a rule, no further postoperative treatment is required. If the examination of the excised tissue reveals an extensive cancer spreading, then the patient undergoes postoperative irradiation and/or chemotherapy.

Second stage colon cancer

Second stage colon cancer penetrates all intestinal wall layers.

Surgery and preoperative chemotherapy are main treatment options for second stage colon cancer.

In the postoperative period, cancer care consists of radiation therapy or chemotherapy.

Third stage colon cancer

Third stage colon cancer implies the presence of metastases in the regional lymph nodes. At this stage of the disease, colon cancer treatment always includes few therapeutic options.

Preoperative chemotherapy and radiotherapy are treatment options for this stage. They reduce the volume of neoplasm, transform it from inoperable into operable one, and decrease the risk of third stage colon cancer relapse.

The next step of colon cancer treatment is surgery. In the case of large neoplasms penetrating the neighboring organs, pelvic exenteration is performed.

In the postoperative period, a half-a-year course of adjuvant (postoperative) chemoradiation therapy is mandatory for third stage colon cancer.

Fourth stage colon cancer

Fourth stage colon cancer affects distant organs and tissues.

Colon cancer treatment options depend on the spreading of the fourth stage colon cancer.

If there’s a possibility of complete removal of both the primary tumor and its metastases, then the following treatment options are used:

1. Extensive combined surgery with tumor resection and removal of metastases in any organ, followed by chemotherapy or radiation therapy
2. Preoperative chemotherapy followed by surgery
3. Preoperative radiation therapy, then surgery, and then even more intensive postoperative chemotherapy

These treatment options can significantly prolong life of patients with fourth stage colon cancer. If the fourth stage colon cancer cannot be excised surgically, chemotherapy and radiotherapy become main treatment options.

Treatment for metastatic colon cancer

In 95% of cases, metastases are observed in the liver which increases in size and becomes denser. This causes discomfort and heaviness in the right hypochondrium.

Doctors in oncology hospitals use preoperative chemotherapy for metastatic colon cancer in order to slow its growth and destroy metastases. This increases success rates of surgery. Specialists in oncology hospitals also use chemotherapy for metastatic colon cancer when it is impossible to destroy the tumor radically.

Postoperative chemotherapy for metastatic colon cancer is performed after surgery in order to prevent relapses, and destroy distant metastases.

The effectiveness of the treatment for metastatic colon cancer is influenced largely by the equipment and techniques available in hospitals. So, before starting treatment for metastatic colon cancer, it's recommended to research hospitals of choice.

Where to undergo colon cancer treatment abroad?

Choosing the best hospital for treatment is an important and difficult step. An independent search and study of information will take a lot of time and effort.

We recommend the following hospitals for quality colon cancer treatment abroad:

• University Hospital Duesseldorf, Germany
• University Hospital of Ludwig Maximilian University of Munich, Germany
• University Hospital Ulm, Germany
• University Hospital Frankfurt am Main, Germany
• University Hospital Heidelberg, Germany
• University Hospital Bonn, Germany

Why undergo treatment of colon cancer in Germany?

Colon cancer treatment programs are elaborated individually for each patient. In German hospitals, doctors prefer to combine several therapeutic approaches that give the best results of cancer care. Mentioned hospitals are very prestigious and reputable oncology hospitals in the country. The colon cancer treatment programs in these medical institutions are very successful.

Prices for treatment abroad

The prices for colon cancer treatment abroad differ:

• The cost of da Vinci surgery for colon cancer ranges between 20,400 EUR and 40,700 EUR.
• The cost of chemotherapy for colon cancer ranges between 6,950 EUR and 12,100 EUR.
• The cost of cytoreductive surgery and HIPEC for colon cancer ranges between 51,900 EUR and 92,400 EUR.

More prices are on the Booking Health website.

How to undergo treatment abroad?

To undergo cancer treatment abroad, you need to prepare medical reports, select a clinic and a doctor, submit a request, receive a cost estimate and make an advance payment.

If you want to save money and save yourself from unnecessary stress and worries, use the services of Booking Health. This is the medical tourism company with extensive experience in organizing treatment abroad.

Booking Health works with hospitals directly, so you will not have to wait a long time for a clinic to accept your treatment request. Besides, Booking Health provides the services of booking tickets and transfers, translation of your medical reports and services of a personal interpreter, stable cost of treatment and much more. Most importantly, Booking Health will provide support during the entire period of your stay abroad.

To start your treatment abroad, please leave a request on the Booking Health website, and a medical advisor will contact you shortly.

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

Sources:

National Center for Biotechnology

American Cancer Society

Sience Direct