KNOW YOUR OPTIONS
Different treatment options are available to patients depending on the size, location and stage of colorectal cancer.
Local therapies consist of surgery, radiation therapy and interventional radiology. These therapies can remove or destroy cancer in a particular area such as the colon, rectum, liver, lungs, peritoneum and more, without affecting other parts of the body.
Systemic therapies consist of chemotherapy and biological therapy whereby drugs enter the bloodstream and destroy or control cancer throughout the body.
It is important to understand your options in managing the disease which is why Colorectal Cancer Canada has developed a comprehensive guide to understanding colorectal cancer treatments. The treatments have been organized according to the following sections:
- Surgical Therapies
- Drug Therapies
- Radiation Therapies
- Interventional Radiology
Surgical removal of a malignant tumour is the most common treatment for colorectal cancer. The diseased portion of the colon and/or rectum is removed, and in most cases, the healthy portions are reattached (often referred to as anastomosis). Sometimes this procedure is not possible because of the extent of the disease or its location. In this case, a surgical opening is made through the abdomen to provide a new pathway for waste elimination. This is what is commonly referred to as an ostomy. The ostomy can be permanent, when an organ must be removed, or it can be temporary, when the organ needs time to heal.
For colorectal cancer, there are two types of ostomy:
- Ileostomy (1) – the bottom of the small intestine (ileum) is attached to the stoma (opening). This bypasses the colon, rectum and anus.
- Colostomy (2) – the left side of the colon is attached to the stoma. This bypasses the rectum and the anus.
A stoma (opening) is a portion of your small or large intestine that has been brought through the surface of the abdomen (belly) which provides an alternative path for fecal waste to leave the body. A surgeon forms a stoma by bringing out a piece of bowel onto the abdomen, turning it back like a turtleneck, and then suturing it to the abdominal wall. An ostomy flange and pouch with an adhesive backing is then attached over the stoma and worn on the abdomen to collect waste. It will require emptying throughout the day and being completely changed at least once a week.
DID YOU KNOW?
An ostomy need not be permanent. It may be reversed 9 months after your colorectal surgery. Speak with your colorectal surgical oncologist.
However, people living with a permanent ostomy can lead a perfectly fulfilling and enriching life!
Since a percentage of the colorectal cancer population may require an ostomy, it is with this in mind that Colorectal Cancer Canada has developed a guide to helping patients understand the different types of ostomies and the care required to properly manage them.
This guide will help you better understand ostomies — what they are, why they are required, how they affect the normal digestive process and what changes they can bring to a person’s life.
THE FUTURE OF COLORECTAL CANCER DRUGS
Chemotherapeutics, small molecules, biologics and biosimilars all play a role in the management of colorectal cancer.
DID YOU KNOW?
Chemotherapeutic drugs affect "younger" tumours more effectively as mechanisms regulating cell growth are usually still preserved.
Newer anti-cancer drugs act directly against abnormal proteins in cancer cells; this is termed “targeted therapy” and the drugs which commonly target cancer cells are called “biologics”.
Clinical trials are research studies designed to evaluate new cancer treatment options. They test the safety and effectiveness of treatments. Clinical trials may evaluate:
- A new anti-cancer drug
- Unique approaches to surgery and radiation therapy
- New combinations of treatments
- A drug being studied in a clinical trial is called an “investigational drug”. There are 4 phases to clinical trials and they answer the following questions:
- Phase I: Is the treatment safe?
- Phase II: Does the therapy work?
- Phase III: Is the therapy better than what is currently available?
- Phase IV: What else do we need to know?
It is important to note that all new cancer drugs that are currently available for the treatment of colorectal cancer were, at one point, only available through clinical trials. While the decision to enroll in a clinical trial of a novel cancer treatment is ultimately very personal, a clear understanding of the nature of clinical trials can help patients make the choice that is appropriate for them.
DID YOU KNOW?
A clinical trial is performed only when there is good reason to believe that the treatment being studied may be better than the one currently used.
All new cancer drugs currently available for the treatment of colorectal cancer were, at one point, only available through clinical trials.
The treatment of colorectal cancer may consist of one or a combination of the following: chemotherapy, biological or targeted therapy, radiation therapy or surgery. These therapies are designed to kill or eradicate cancer cells throughout the body. Not surprisingly, these therapies may also damage normal, healthy cells that are not affected by the cancer which results in an adverse side effect of the treatment. When cancer therapies cannot distinguish between cancer cells and normal, healthy cells, the result is an unwanted side effect.
Treatment-induced side effects may cause inconvenience, discomfort, pain and occasionally, fatality. One of the more disturbing facts associated with unwanted side effects is the interruption or discontinuation of the treatment as well as a possible dosage reduction. This can clearly limit a patient’s ability to achieve the best outcome from treatment by preventing the delivery of therapy at its optimal dose and time.
Many side effects of treatment are normal and pose no danger to you other than minor inconveniences. What is important to remember is that most side effects are merely temporary and will subside once the body adjusts to therapy or once therapy is completed.
Do not become discouraged about the side effects induced by colorectal cancer therapies; remedies are readily available and symptoms are often short-lived.
Naturopathic medicine is a system using natural remedies to help the body heal itself. Naturopathic doctors work to help treat the root cause of the problem by using tools like dietary support, fitness modules, botanicals, supplements, acupuncture, lifestyle counseling and education. Looking at the mind, body and spirit of a person while using medical diagnostics allows for a thorough and complete plan of action to optimize health and prevent disease.
Naturopathic medicine is an important part of colorectal cancer care and offers therapies that:
- Reduce the risk of initially developing colorectal cancer
- Are supportive during chemotherapy, radiation and/or surgery and help to improve both the tolerance and success of conventional therapies
- Help prevent recurrence once cancer has been successfully treated
RESEARCH AND PRACTICE UPDATES
Colorectal Cancer Canada provides up-to-date information on clinical research and treatments. These monthly updates furnish information relating to:
- Surgical therapies
- Radiation therapies
- Interventional therapies
- Psychosocial oncology