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Finding out You Have Colorectal Cancer: What You Can Expect from Treatment

separator Thanks to the Today Show’s Katie Couric, more Americans than ever know that having a colonoscopy is the best way to detect colorectal cancer early. But there’s no television personality who can tell you what to do if in fact you do have colorectal cancer.

As with just about all cancers, you and your doctor will base your treatment decisions on the stage of your cancer. Colon cancer is classified in stages—0 through IV.

Most colorectal cancers that have a 0 stage are detected and removed during a colonoscopy. At stage 1, the cancer usually has to be removed surgically. In almost all cases, at stages 0 or 1 patients will not need further treatment, such as radiation or chemotherapy, after the tumor is removed.

Tumors get classified as 2 or 3 based on the amount of surrounding tissue and lymph nodes that are affected. Surgery is almost always necessary. Sometimes, your doctor might recommend chemotherapy or radiation treatment to shrink the tumor before you have the operation. Chemotherapy and radiation may also be part of your treatment after the surgery.

Typically, at stage 4, the tumor is too large and too involved with surrounding tissue to be removed successfully. At this point, chemotherapy is the most likely treatment.

The surgery
Surgery for colorectal cancer involves removing the tumor and any lymph nodes or tissue that have been affected, usually in the colon or rectum. Pain and tenderness in the area of the operation are common after surgery. People often experience constipation or diarrhea after the surgery as well, but that usually goes away after a little while.

In rare cases, colorectal surgery creates a need for a colostomy. This is a surgical opening, also called a stoma, in the abdomen that provides a pathway for waste to leave your body and collect in a bag that you wear near your body. Often, the colostomy is temporary. If you do have to have this procedure, make sure you understand exactly how to care for your colostomy. Your doctor or nurse can teach you how to clean it, how to prevent infection, how often to empty it and any other things you have questions about.

Chemotherapy and radiation for colorectal cancer
Common side effects of chemotherapy for colorectal cancer typically can include vomiting, nausea, diarrhea or mouth sores. It’s also very common for chemotherapy to make you extremely tired. Tingling in your hands and feet may also occur. But hair loss is not common with colorectal chemotherapy drugs.

Talk with your doctor if you experience these side effects. There are medications that can help manage them, and that can make such a big difference in your quality of life. It’s also possible sometimes to postpone a treatment or to lower your chemotherapy dosage. Whatever you do, don’t suffer with your side effects in silence.

Radiation therapy can be used in combination with chemotherapy or on its own. It’s most commonly used when the cancer is in the rectum. In this treatment, high-energy x-rays are targeted in the area of the cancer. These rays can kill cancer cells. Many patients have radiation treatments five days a week for several weeks. Radiation can damage healthy cells as well as cancerous ones. Side effects include fatigue, skin irritation and damage at the treatment site, loss of appetite, nausea and diarrhea. Some people also experience bloody stools when they’re getting radiation treatments.

Questions to ask your doctor about your treatment
Be sure to ask your doctor lots of questions about your colorectal cancer treatment. In fact, your doctor will probably give you a lot of information, but it’s hard to take it all in the first time. You may need to ask the same thing more than once, and that’s okay. Here are the kinds of things you need to make sure you know, and the kinds of questions you should ask:

  • What can you tell me about my cancer right now?
  • What exactly will you be doing during the surgery—what will you be taking out?
  • Will I have to have a colostomy? If so, will it be permanent or temporary?
  • How should I prepare for the surgery and how long can I expect to be in the hospital?
  • How much experience do you have performing this type of surgery?
  • When will I be able to go back to work after the surgery?
  • If I need chemotherapy or radiation, when should I start them?
  • How will my treatment affect my ability to work?
  • What is my prognosis?

The American Cancer Society; The American Society of Clinical Oncology; The National Cancer Institute.
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