Colon Cancer--Continue

TAKING CONTROL

• Stay positive. A diagnosis of cancer is often overwhelming. Marshal your energies to gather information and resources. A close network of family and friends is vital. Support groups, including counselling, may improve coping skills.
• De-stress before surgery, if possible. Music and relaxation tapes used before, sometimes during and after surgery often help allay anxiety. Meditation, exercise, yoga, biofeedback, massage and breathing exercises may also be useful.
• Try ginger if nausea is a problem because of chemotherapy. A cup of ginger tea or the powdered herb (100 to 200 mg) every four hours may quell symptoms; take it with food to avoid stomach irritation. But do let your doctor know if you are trying ginger or other remedies. Some vitamins, herbs and nutritional supplements can interfere with surgery or medications.
• Get regular follow-up tests. Blood and stools should be tested on a regular schedule to help detect any recurrence. After surgery and every few years, a colonoscopy (see on next) will be necessary. During this procedure, the doctor can remove pre-cancerous growths called polyps and very early-stage cancers. If colon cancer is discovered a second time, it can often be completely cured with another round of treatment.

Treatments
Cancer of the colon and rectum is one of the most curable of all cancers. The choice of treatments usually depends on the stage of the disease, and patients of all ages can benefit. For most people surgery to remove the tumour is the first step. Depending on the degree of spread and the tumour's location, cancer-fighting chemotherapy drugs as well as radiation therapy may also be used to increase your chances of complete cure. Doctors who specialise in cancer care (oncologists) refer to the use of  drugs after surgery to kill off any remaining cancer cells as 'adjuvant chemotherapy'. Specifically, your treatment will be keyed to the stage of your cancer.
Stage A colon or rectal cancer: both can usually be cured by surgery alone. You probably will not need additional treatments. 
Stage B colon cancer: this may be treated with surgery alone. If your cancer has spread to the outermost colon wall, some doctors recommend chemotherapy to kill of microscopic cancer cells that may remain after surgery (a regimen now under debate).
Stage B rectal cancer: radiation and chemotherapy is standard.
Stage C colon cancer: chemotherapy after surgery is standard. 
Stage C rectal cancer: doctors prescribe chemotherapy after surgery. Radiation before or after surgery is often recommended.
Stage D colon or rectal cancer: surgery may remove tumours in the intestine or in distant organs, such as the liver or lungs. This can produce good results if there aren't too many metastases. Chemotherapy and/or radiation may also help shrink the tumours. 
  Procedures

Most people with colon cancer can benefit from surgical resection, the medical term for removal of their tumour (see illustration below). The operation, called a partial colectomy, involves cutting away a piece of the colon along with some surrounding normal tissue and nearby lymph nodes in case the cancer has spread. The colon is then reconnected. The procedure may take several hours and requires a general anaesthetic. Your doctor will probably do various blood tests and scans beforehand to help determine the degree of spread and prepare you for the operation. If cancer occurs in the rectum, the surgery may be more complicated because many muscles and nerves that control sexual, bowel and urinary functions cross through this area. Aftereffects may include poor bowel or bladder control and sexual problems, although these are often reverisble.

                  In this common procedure the surgeon cuts out the cancerous part of the colon (at right above), then staples together the remaining segments. About 75% of colon cancers occur in the sigmoid colon or rectum.
 
   Radiation therapy may be performed after rectal surgery to help kill any tumour cells left behind and to decrease the risk of another occurrence. You'll probably need to have regular radiation procedure, doctors aim high doses of X-rays at  the tumour, often from different directions. The best results are obtained when a chemotherapy drug such as 5-FU is given by IV infusion or orally during the radiation. Increasingly, doctors perform radiation therapy before surgery for rectal cancers to help shrink larger tumour's and make the operation easier. It may also eliminate the need for a colostomy. Radiation can be given alone to relieve pain and other symptoms when the tumour cannot be surgically removed or in cases of a bowel obstruction.