Colorectal Cancer Treatment Options in Central New York
The recommended treatment options primarily depend on the location and stage of the colon or rectal tumor. Your risk group and overall health also is considered when choosing the appropriate treatments. Treatment for colorectal cancer may involve surgery, chemotherapy, targeted therapy, immunotherapy, or radiation therapy.
Surgery for Colon and Rectal Cancers
Surgery is the most common treatment for all stages of colorectal cancer, usually followed by other treatments. The type of surgery will depend largely on where the cancer is found and how large it is, including whether it is grown into or through the colon wall.
Colon and Rectal Cancer Surgeries Performed During a Colonoscopy
Polypectomy
This procedure removes a small malignant polyp from the colon or upper rectum using a colonoscope. Some small tumors in the lower rectum can be removed through the anus without a colonoscope. If the polyp is completely removed, no further treatment may be necessary. However, a follow-up colonoscopy might be recommended to check for any other polyps.
Local excision
If small tumors are found on the colon or rectum lining during a colonoscopy, the surgeon can remove the cancer and a small amount of surrounding healthy tissue.
Colon Cancer Surgeries
Colectomy: This surgery removes all or part of the colon. There are two main approaches for this procedure, with the minimally invasive version preferred whenever possible.
Laparoscopy
Early-stage colon cancer may be removed using a laparoscope, a thin, lighted tube. The surgeon sees inside the abdomen through three or four tiny cuts. The tumor and part of the healthy colon are removed. Nearby lymph nodes may also be removed, and your intestine and liver will be checked to see if the cancer has spread.
Open surgery
The surgeon makes a large incision in the abdomen to remove the tumor, part of the healthy colon or rectum, and some nearby lymph nodes. They also check the rest of the intestine and the liver for any signs of cancer spread.
Rectal Cancer Surgeries
Transanal endoscopic surgery (TEM)
This type of surgery removes larger tumors higher in the rectum that are harder to access through local transanal resection. A special magnifying scope is inserted through the anus and into the rectum.
Low anterior resection
For some stage I, II, and III cancers in the upper rectum, the surgeon removes the tumor and part of the rectum, then reattaches the colon to the remaining rectum. This surgery requires abdominal incisions, but a permanent colostomy is not necessary.
Proctectomy
For some stage I and many stage II and III cancers in the middle and lower rectum, this surgery removes the entire rectum and nearby lymph nodes. The colon is then attached to the anus (called a colo-anal anastomosis) so you can have normal bowel movements.
Abdominoperineal resection (APR)
This procedure is usually performed for stage II and stage III cancers in the lower to middle rectum. It removes the rectum through abdominal incisions, along with the anus and sphincter muscles through incisions around the anus. This surgery is often required if the cancer has spread to the sphincter muscle (which controls the anus) or nearby muscles that assist in controlling urine flow.
Pelvic exenteration
This major operation may be recommended if the rectal cancer has spread to nearby organs. The surgeon removes the rectum and any nearby organs affected by the cancer, such as the bladder, prostate (in men), or uterus (in women).
Is a Colostomy Bag After Colon or Rectal Surgery Always Necessary?
When a section of the colon or rectum is removed, the surgeon usually reconnects the healthy parts. However, in some cases, reconnection is not immediately possible. In situations like this, the surgeon creates a new path for waste to exit your body by an opening (stoma) in the wall of the abdomen, connecting the upper end of the intestine to the stoma, and closing the other end. This procedure is known as a colostomy. A flat bag fits over the stoma to collect waste and is secured in place with a special adhesive.
For many patients, the stoma is temporary and is only necessary until the colon or rectum heals from surgery. Once you have healed completely, the surgeon can reconnect the sections of the intestine and close the stoma. Some people, particularly those with a tumor in the lower rectum, may require a permanent stoma.
Chemotherapy for Colorectal Cancers
Chemotherapy uses anticancer drugs to kill cancer cells. The drugs circulate in the bloodstream, allowing them to reach cancer cells all through the body. Chemotherapy is typically administered through a vein, but some drugs can also be taken by mouth.
Significant advances have been made in chemotherapy options for colorectal cancer. One common chemo regimen called FOLFOX, combining several drug therapies given over 24 hours to treat colorectal cancer. Other combination chemotherapy regimens include FOLFIRI and CAPOX. Depending on the stage of the cancer, chemotherapy may be used before surgery to shrink tumors and/or after surgery to help kill any remaining cancer cells that may be circulating in the lymphatic system. The highly skilled, certified oncology nurses at HOA will show you and a family member what you need to know about
Targeted Therapy for Colorectal Cancer
Targeted therapy for colorectal cancer focuses on targeting specific genes, proteins, or tissues contributing to the cancer’s growth. This approach blocks cancer growth while allowing healthy cells to continue growing with very little impact.
At HOA, we take pride in offering advanced targeted therapies, including bispecific antibody therapy. This innovative treatment uses engineered proteins to attach cancer cells to immune cells, boosting the immune system's ability to identify and destroy cancer cells.
Unlike other cancer centers in the region that require an overnight hospital stay, bispecific antibody therapy at HOA is administered in an outpatient setting for patients in and around Central and Upstate New York.
Patients with colorectal cancer should undergo testing to find the most effective targeted therapy. The tests can identify the genes, proteins, and other factors in the tumor. Based on the results, one of the following types of targeted therapy may be included in your colorectal cancer treatment program.
Anti-angiogenesis therapy
These unique cancer-fighting agents, called angiogenesis inhibitors, block the growth of blood vessels that support tumor growth, rather than directly killing tumor cells. Some of these agents are monoclonal antibodies that specifically target and bind to VEGF (vascular endothelial growth factor), a substance that cells produce that promotes new blood vessel formation. Because of how they work, angiogenesis inhibitors are administered over an extended period and may be most effective when combined with other therapies.
Epidermal growth factor receptor (EGFR) inhibitors
EGFR is a protein that helps cancer cells grow. Cancerous cells tend to have an abundance of this protein. By slowing the growth of EGFR, the colorectal cancer cells reproduce more slowly.
Immunotherapy for Colorectal Cancers
Immunotherapy uses the body's immune system to fight cancer. This treatment uses substances produced by the body or created in a laboratory to mimic natural processes.
Immune checkpoint inhibitors are a relatively new form of immunotherapy drugs that block proteins called checkpoints, which are found on certain immune system cells, called T cells, and some cancer cells. These checkpoints keep the immune system from responding properly and sometimes can keep T cells from killing cancer cells. By blocking these proteins, immune checkpoint inhibitors enhance the body’s ability to fight cancer.
Some patients with metastatic colorectal cancer receive a monoclonal antibody that binds to colorectal cancer cells. This binding interrupts cancer cell growth and spread. Monoclonal antibody therapy is given through an infusion at the cancer center and may be used along with chemotherapy.
Radiation Therapy for Colon and Rectal Cancers
Radiation therapy (also known as radiotherapy) uses high-energy radiation to kill cancer cells. This treatment primarily affects cancer cells in the treated area and is often used for colorectal cancer patients because the cancer tends to recur in the same place it was previously found.
Your HOA cancer care team will include a radiation oncologist, who specializes in determining the right type and amount of radiation therapy that may be needed based on the stage of cancer and its location in the body.
Types of radiation therapy used to treat colon and rectal cancer include:
External radiation
This type of radiation comes from a machine called a linear accelerator. Patients typically visit the HOA cancer center for treatment, usually five days a week for several weeks.
Internal radiation
Used primarily for rectal cancer, radioactive material is placed in thin tubes that are inserted in the rectum, near the tumor. Because of the high doses of radiation, the seeds are only inserted for a few minutes at a time before being removed. Treatments occur around every two weeks for a total of about four treatments.
Intraoperative radiation therapy (IORT)
In some cases, radiation is given during surgery.
Hematology-Oncology Associates of Central New York has been treating colorectal cancer using the latest therapies for several decades, allowing patients to receive the most advanced medical and supportive care close to home.
Clinical Research Trials Available for Colorectal Cancer in Central New York
In recent years, several new colorectal cancer treatments have been approved and used in combination with long-standing treatments. HOA has been participating over the years in these studies and offers clinical trials to patients with colorectal cancer. Your oncologist will discuss possible clinical trial participation if you meet the study's criteria for participation.
Learn more about clinical trials available at Hematology-Oncology Associates of CNY.
Supportive Care for Colorectal Cancer Patients
In addition to cancer treatments, HOA offers supportive care that focuses on relieving cancer symptoms and side effects, as well as enhancing the patient's quality of life. This may involve nutritional support, emotional counseling, pain management, and guidance on how to address practical challenges related to the disease and its treatment.
If you need assistance and support in managing life with cancer, please reach out to a member of your colorectal cancer care team.
Find a Colorectal Cancer Specialist in the Syracuse Area
At Hematology-Oncology Associates of CNY, we are committed to providing expert, patient-centered colon and rectal cancer care. Our multidisciplinary team of specialists ensures that each patient receives a personalized treatment plan based on the latest advancements in colorectal cancer care. With comprehensive diagnostic imaging, an in-house pharmacy and laboratory, leading-edge treatment options, access to clinical research trials, a survivorship program for support after treatment ends, and a dedicated team, HOA provides expert colon and rectal cancer care in Central New York.
Our cancer centers offer care for patients in Central New York, in the Syracuse area, including Camillus and all of Onondaga County; Auburn, and the rest of Cayuga County; Jefferson County, including Watertown; Madison County, including Oneida; Oneida County, including Utica and Verona; and throughout Oswego County, including Oswego and Fulton.
Source: American Cancer Society, National Cancer Institute.
