Doctors at Johns Hopkins are leading the way in research for treating sporadic (nonhereditary) colorectal cancer and other colorectal conditions. We believe in staying active in current studies to further our understanding of these diseases. Through our continuous efforts to offer the latest treatment strategies, our gastroenterologists continue to provide excellent patient care. Many patients choose to be part of our patient registry, which helps us gather information and learn how to take care of our patients even better in the future.
Your specific course of treatment will depend on the exact location of the cancer and how early it was found.
Treatment for sporadic colorectal cancer includes:
Often, polyps are safely removed during a colonoscopy. If the polyps were large, your doctor may mark the polypectomy (polyp removal) site with a special ink. Localizing the area can help during subsequent surveillance colonoscopies.
Patients with small polyps do not generally have an increased risk of developing colorectal cancer and should follow regular screening guidelines. For patients with larger polyps, follow-up colonoscopies should be performed every year.
The treatment of choice for colorectal cancer is surgical resection, removing the cancer through surgery. Surgery is performed in order to remove the cancer completely and reconstruct the bowel, if possible, so your postoperative bowel function is normal or near normal.
The type of resection you have depends on many factors, including:
Rectal cancer presents a challenge, depending on the location of the tumor. There are a number of surgical procedures available to treat patients with rectal cancer. Your doctor will want to determine the precise location and depth of the tumor in order to plan a successful treatment.
The options include:
Local excision . Your surgeon removes the tumor surgically. This is an option when the tumor is confined to the rectal wall.
Restorative anterior/low anterior resection . Your surgeon removes the cancerous tumor without affecting the anus. The colon is attached to the anus, allowing waste to leave the body in a normal manner.
Abdominal perineal resection with permanent colostomy. Your surgeon removes the anus, rectum and part of the colon. The remaining colon becomes an opening, called a colostomy, on the surface of the abdomen. A bag is attached to the opening to collect waste.
In more advanced cancers, you may need a course of chemotherapy following your surgery. The chemotherapy is generally administered on an outpatient basis. You come to the treatment center, receive your chemotherapy and go home when the session is over.
Chemotherapy combined with radiation therapy, sometimes called chemoradiation, may also be used after surgery. In some cases, if you have rectal cancer, you may have chemoradiation therapy before surgery, in order to shrink the tumor.
If you had colorectal cancer surgery, a critical part of your care is vigilant monitoring. There is a risk of recurrence, especially if the cancer involved the lymph nodes. Following your surgery, your doctor will see you:
You will undergo colonoscopy after one year, and then every one to three years after to detect new polyps or cancer.
Routine evaluation, physical exam and blood tests are important for your post-surgical evaluation and are the best ways to monitor recurrent disease.