The Colon is the large intestine located around the small intestine. Colon cancer is the formation of cancer cells in the large intestine. Most colon cancer begins as benign cell piles (polyps). Over time, some of these cell masses turn into colon cancer. Polyps can cause some symptoms and, when identified, they are recommended to be taken to prevent colon cancer.

What methods are used in colon cancer surgery? What should be done after colon cancer surgery, learn the details, get informed!

Robotik Kolon ve Rektum Kanseri Cerrahisi

What are Colon Cancer Symptoms?

Symptoms of colon cancer may not be seen in the early stages of the disease. The symptoms may vary depending on the location and size of the cancer in the intestine. Some signs of colon cancer:
  • Constipation or diarrhea lasting more than 4 weeks
  • Blood in the stool
  • Permanent cramp or abdominal pain
  • The feeling that the gut is not completely emptied
  • Weakness or fatigue
  • Unexplained weight loss.

What are the causes of colon cancer?

In most cases, it is not known what causes colon cancer. Cancer cells are formed by abnormal division of a cell after its DNA has been damaged.

Abnormally dividing cells accumulate and form the tumor. These gene mutations that damage the DNA of the cells can be inherited (from the family) to the patient.

Hereditary gene mutations do not necessarily cause cancer, but significantly increase an individual's risk of developing cancer.

What are the Most Known Hereditary Colon Cancer Syndromes?

HNPCC (Lynch Syndrome): Increases the risk of developing colon cancer and other cancers. People with Lynch syndrome have a high risk of developing colon cancer before the age of 50.

FAP: It is a rare disease that causes thousands of polyps to develop in the lining of the colon and rectum. People with this disease without treatment have a high risk of developing colon cancer before the age of 40.

Hereditary Colon Cancer Syndromes Can Be Detected by Genetic Testing. What are the other factors that increase the risk of colon cancer?

  • Nutrition
  • Age
  • Colon cancer treatment
  • Chronic intestinal inflammation
  • Family history of colon cancer
  • Lack of physical activity
  • Diabetes
  • Obesity
  • Smoking and alcohol use
  • To have had radiation therapy before.

What are the methods used in the diagnosis of colon cancer?

Since colon cancer is a non-symptomatic type of cancer in the early stages, screening tests are recommended at regular intervals. Early diagnosis of colon cancer greatly increases the chances of treatment. Tests used for the diagnosis of colon cancer:

Colonoscopy: Imaging of the entire colon and rectum through a camera connected to a long, flexible, cylindrical tube. Tissue samples can be taken from the area suspected of having cancer cells during imaging (biopsy).

Blood test: It can be used to measure the chemicals produced by colon cancer cells. The change in the levels of chemicals in the blood also helps to see if cancer treatment is effective.

Imaging tests: Can be used to monitor the presence and spread of cancer.

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What are Colon Cancer Stages?

It is important to know the stage of cancer to determine the course of treatment after colon cancer is diagnosed. Imaging tests such as computed tomography (CT) scans of the abdomen and chest can be used to determine the stage of the cancer.

Stages of colon cancer:
  • Phase 1: The cancer cells are in the lining of the colon and have not advanced to the colon wall.
  • Phase 2: Cancer cells spread to the colon wall but did not progress to the lymph nodes.
  • Phase 3: The cancer may have spread to the lymph nodes near the colon, but has not spread to other organs.
  • Phase 4: Cancer cells have spread to other organs.

What are the Methods Used in Colon Cancer Treatment?

The course of treatment for colon cancer is determined by considering the patient's general health, stage of cancer, and the site of the cancer. Treatment methods used in colon cancer; surgical methods, chemotherapy and radiation therapy.

; It is a form of treatment used to destroy cancer cells. In colon cancer, chemotherapy is usually performed after the surgery for cancer diagnosed at the stage spread to the lymph nodes. Thus, chemotherapy can reduce the risk of cancer recurrence. Chemotherapy can also be used to reduce preoperative cancer, or to alleviate the symptoms of cancer where surgery is not possible.

Radiation Therapy; Radiotherapy is a treatment that uses high energy rays to kill cancer cells. It can be used to shrink the preoperative tumor, to kill the remaining cancer cells after surgery, or to alleviate the symptoms of cancer diagnosed in the advanced stage.

Targeted Drug Therapy; It is a treatment method that uses drugs that target mutations that promote the growth of cancer cells in advanced for colon cancer patients. It can be administered together with chemotherapy or alone.

Supportive (palliative) care; Palliative care is specialized medical care that focuses on relieving pain and other serious illness symptoms. Palliative care professionals work with the patient, the patient's family, and doctors to make an additional contribution to complementing the ongoing treatment.

Surgical treatments for colon cancer diagnosed at an early stage; Removal of polyps during colonoscopy: In the treatment of early stage colon cancer, where tumor cells are limited to small polyps, polyps are completely removed from the body during colonoscopy.

Endoscopic mucosal resection; In this procedure, polyps that cannot be removed by colonoscopy are removed from the body. A portion of the column liner may need to be removed with the polyps.

Partial Colectomy; It is a surgical treatment that can be applied in cases where cancer is limited to colon. During the procedure, a portion of the cancerous portion of the colon, along with some healthy tissue on both sides of the cancer, is removed from the body. The amount of lymph nodes in the cancer area is removed and tested for the presence of cancer cells. If a cancer cell is found in the lymph nodes, it is removed with the colon. The healthy parts of the colon or rectum are reconnected and the operation is terminated. Operation is called left colectomy when performed on the left side of the colon, right colectomy when performed on the right side, and sigmoid colectomy when performed on the sigmoid colon.

In cases where it is not possible to reconnect the healthy parts of the colon or rectum, a new way out of the stool should be established. In this case, the stool is discharged from the intestine into a bag through an opening in the abdomen.

Total Colectomy; It is the operation where the entire colon is removed. It requires the creation of a new way for the feces to leave the body.

Robotic Surgery (Robot Assisted Minimally Invasive Surgery):

The operation is performed by a few small incisions in the abdominal region of the patient and is performed by the surgeon within 3-4 meters of the patient. During the entire operation, another surgeon standing at the patient's head assists the surgeon in the console. The surgeon transmits his hand movements through the console to robotic instruments that have more mobility than the human hand, and disconnects the cancerous part of the colon from the remaining parts after disconnecting it from the surrounding tissues. By combining the separated parts of the column to provide a new way out to the feces, the operation is terminated by closing the small incisions. After colectomy, permanent or temporary stool may need to be emptied into a bag. The small incisions after the operation accelerate the healing time of the patient.

Open Surgery

In the open surgical method, a large incision is made on the cancerous side of the colon, and after the cancerous part of the colon is removed, the healthy part of the colon or rectum is joined. If the healthy parts of the colon or rectum are not suitable for stool to leave the body, the stool is discharged directly from the intestine into the bag through a hole in the stomach of the patient. The biggest advantage of open surgery is to perform the operation by feeling the tissues of the surgeon. However, a large incision in the patient increases the recovery time of the patient after surgery.

Laparoscopic Surgery (Minimally Invasive Surgery):

As with robotic surgery, operations are performed with small incisions. Under the guidance of 2-dimensional image transmitted from the screen to the operating room, the surgeon performs the operation using long straight laparoscopic instruments. The cancerous colon or a portion of the colon is removed and the operation is terminated after a new exit path is created in the feces.