Colon cancer: advice on treatment options

Being diagnosed with colon cancer is an extremely stressful experience for the patient and their family. Leading colon cancer specialist Prof. Dr. Schmidt shares his medical expertise to help you get a better understanding of the treatment process for this disease.
As with all cancer diagnoses, learning you have colon cancer is certain to be a stressful experience. Eminent expert Prof. Dr Schmidt, of the leading private Swiss hospital group Hirslanden, discusses diagnosis and treatment in order to help you better understand your options.

Prof. Dr. Schmidt, you are known as a leading expert in the field of visceral surgery. Colon cancer is one of the most frequent cancer diseases in both women and men. Could you outline the options for colon cancer therapy?

There are many new treatment options for colon cancer which together are contributing to excellent survival in most patients.

However, surgery remains the mainstay of curative treatment in colon cancer, both in localised and even in many metastatic patients.

Removal of the affected part of the colon and/or rectum with adequate surgical techniques is essential. This is especially true for cancer of the rectum.

Very few patients need a temporary ileostomy (artificial bowel opening) and if needed mostly only for 3 months. Most patients can be treated without it.

The number of lymph nodes removed is essential for improved curative treatment and precise nerve sparing anatomical preparation avoids many cases of local recurrence and postoperative bladder or sexual dysfunction in cancer of the rectum.

Sometimes, there is a necessity for preoperative radiotherapy to downsize the tumour to obtain best results.

For this, it is important to discuss every single case before and after the operation with an interdisciplinary team of experts (surgery, oncology, radiotherapy etc.). We have founded such a team at the Hirslanden Clinics in Zurich.

There are many new techniques and treatment possibilities from various medical fields that help to improve outcome in bowel cancer.

Prof. Dr. Schmidt

What are the most recent developments in successfully treating bowel cancer?

Most innovations in the treatment of bowel cancer have come from the field of oncology in recent years. At the same time surgery standards have also been improved and new options have been introduced.

For example, there are now many possibilities for successful resection of liver metastases, even if it is located in multiple areas and both lobes of the liver.

Modern technologies to treat metastases in the abdominal area (peritoneal carcinomatosis) by hyperthermic perfusion of the abdomen with special drugs at 42 degrees Celsius are other examples of new treatment types.

Oncologists have now much better options to kill tumour cells by chemotherapy and specific antibodies that recognize receptors of the cell surface of the cancer cells.

Also today it is possible to identify individual tumour receptors and surface targets in single patients by analysing the patient’s tumour profile.

Taken together, there are many new techniques and treatment possibilities from various medical fields that help to improve outcome in bowel cancer.

We know that it is difficult to give definite numbers on prognosis of colon cancer; however, what do the healing chances of bowel cancer depend on?

The healing chances of colon cancer depend mainly on the fact when the tumour diagnosis is made. Early signs such as blood in the stools or sometimes anaemia should trigger immediate colonoscopy.

Everybody above the age of 50 should undergo a colonoscopy at least once and then every 5 years. Once the diagnosis is made chances of cure depend on the presence or absence of metastases.

If there are now metastases the chances of cure are more than 90 %. If local lymph node metastases are found this comes down to approximately 70%. If distant metastases are present the chances are further reduced to less than 50%.

On the other hand these figures mean that even in seemingly desperate cases there is still some chance for cure and at least substantial prolongation of life time.

To achieve the best possible results in a given situation, it is of utmost importance to put the treatment in the hands of experts that are connected to an interdisciplinary team, such as the gastrointestinal tumour centre in Zurich.

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