Most people with colon cancer have surgery to remove their cancer. Usually this is the first step of treatment that patients have. After surgery, they typically have chemotherapy to reduce the risk that their cancer will come back (recur).
Colon cancer surgery for Seattle Cancer Care Alliance patients is performed by surgeons at University of Washington Medical Center. If you need surgery, it will be done by a surgeon who is specially trained and certified in gastrointestinal surgery, colorectal surgery, or both. Your surgeon will work closely with the other members of your healthcare team.
The exact procedure you have will depend on many factors, such as the stage of your cancer, your surgeon’s expertise, and your health, weight, and preferences. You and your team will discuss your options and decide together what is best for you.
If your cancer is limited to one or more polyps, the cancer may have been completely removed at the time of the colonoscopy. This procedure is called a polypectomy.
If your cancer cannot be removed with polypectomy, your surgeon will perform a colectomy. This means removing (also called resecting) the segment of your colon that contains cancer as well as removing some lymph nodes. Then the surgeon sews the healthy parts of the colon together to form a complete tube (a procedure called anastomosis). Because the colon is reconnected, bowel function returns to normal or near normal.
Instead of anastomosis, some people need a colostomy. This means the surgeon creates an opening (stoma) in your abdomen and attaches the open end of your colon to it on the inside. A colostomy bag is attached on the outside to collect waste. Usually the colostomy is only temporary, and it’s reversed after the colon heals.
Open vs. Laparoscopic Surgery
A colectomy may be done using a single, longer incision to open the abdomen, or it may be done laparoscopically, using several smaller incisions. The smaller incisions typically mean spending less time in the hospital and being on pain medication for a shorter period of time. Either way, during your operation your surgeon will check to see if your cancer has spread to any other organs (including removing some nearby lymph nodes), which will help determine the rest of your treatment.