Rectal Cancer Surgery
Most people who have rectal cancer require surgery. Your surgery will be done by a surgeon who is specially trained and certified in gastro-intestinal surgery, colorectal surgery, or both. SCCA patients have surgery at University of Washington Medical Center by surgeons who provide care at both UWMC and SCCA. Your surgeon will work very closely with the other doctors on your medical team.
The type of surgery you have will depend on a number of things, such as the stage of your cancer, your surgeon’s area of expertise, your health and weight, and what you prefer. You and your team will discuss your options and decide what is best for you.
Local excision/polypectomy
If your rectal cancer is found at a very early stage, your surgeon may remove the tumor without cutting into the abdomen. If the cancer is found in a polyp (a growth that protrudes from the rectal mucous membrane), the operation is called a polypectomy.
Total mesorectal excision
“Total mesorectal excision is one of the most exciting surgical, technical developments of the 20th Century,” says Dr. Karen Horvath, associate professor of surgery at University of Washington Medical Center, and director of the UW Surgery Residency Program. Developed by Dr. R.J. Heald in Basingstoke, England, this is the most advanced treatment for rectal cancer treatment and is available to SCCA patients.
If your cancer is too large to treat with a local excision, your surgeon will perform a resection of the rectum to remove the cancer and a small amount of healthy tissue around it. This is called a total mesorectal excision. The surgeon will then perform an anastomosis (sewing the healthy parts of the rectum together). Then he or she will sew the remaining rectum to the colon or sew the colon to the anus.
A patient who has this procedure may not need to use a colostomy bag after surgery. The doctor also takes out lymph nodes near the rectum and examines them under a microscope to see if they contain cancer. “This procedure influences how much tissue we need to remove and it has a significant impact on reducing local recurrence of rectal cancer,” explains Dr. Horvath.
Resection and colostomy
If your surgeon is not able to sew the rectum back together, a stoma (an opening) is made on the outside of the body for waste to pass through into a colostomy bag. This procedure is called a colostomy. Sometimes the colostomy is needed only until the rectum has healed and then it can be reversed. If the doctor needs to remove the entire rectum, however, the colostomy may be permanent.
Colonal surgery
When the patient has rectal tumors close to the anus, doctors can sometimes connect the colon directly with the anus, avoiding the need for a colostomy bag.
Further treatment/Adjuvant therapy
Even if your doctor removes all the cancer that can be seen at the time of surgery, some patients may be offered chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after surgery to increase the chances of a cure is called adjuvant therapy.
The type of surgery you have will depend on a number of things, such as the stage of your cancer, your surgeon’s area of expertise, your health and weight, and what you prefer. You and your team will discuss your options and decide what is best for you.
Local excision/polypectomy
If your rectal cancer is found at a very early stage, your surgeon may remove the tumor without cutting into the abdomen. If the cancer is found in a polyp (a growth that protrudes from the rectal mucous membrane), the operation is called a polypectomy.
Total mesorectal excision
“Total mesorectal excision is one of the most exciting surgical, technical developments of the 20th Century,” says Dr. Karen Horvath, associate professor of surgery at University of Washington Medical Center, and director of the UW Surgery Residency Program. Developed by Dr. R.J. Heald in Basingstoke, England, this is the most advanced treatment for rectal cancer treatment and is available to SCCA patients.
If your cancer is too large to treat with a local excision, your surgeon will perform a resection of the rectum to remove the cancer and a small amount of healthy tissue around it. This is called a total mesorectal excision. The surgeon will then perform an anastomosis (sewing the healthy parts of the rectum together). Then he or she will sew the remaining rectum to the colon or sew the colon to the anus.
A patient who has this procedure may not need to use a colostomy bag after surgery. The doctor also takes out lymph nodes near the rectum and examines them under a microscope to see if they contain cancer. “This procedure influences how much tissue we need to remove and it has a significant impact on reducing local recurrence of rectal cancer,” explains Dr. Horvath.
Resection and colostomy
If your surgeon is not able to sew the rectum back together, a stoma (an opening) is made on the outside of the body for waste to pass through into a colostomy bag. This procedure is called a colostomy. Sometimes the colostomy is needed only until the rectum has healed and then it can be reversed. If the doctor needs to remove the entire rectum, however, the colostomy may be permanent.
Colonal surgery
When the patient has rectal tumors close to the anus, doctors can sometimes connect the colon directly with the anus, avoiding the need for a colostomy bag.
Further treatment/Adjuvant therapy
Even if your doctor removes all the cancer that can be seen at the time of surgery, some patients may be offered chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after surgery to increase the chances of a cure is called adjuvant therapy.