Tumour Board Evaluation
All cancer patients who come to DHRC start their treatment only after they have been discussed in the Tumor Board and given a Tumor Board Number. In the tumor board all our specialists (Surgical Oncologists, Medical Oncologists, Radiation Oncologists, Urologists, Oncopathologists, Radiologists and Microbiologists) evaluate and discuss the findings, and chart out the optimal plan of treatment for each patient based on established national and international guidelines and protocols.
Oncologists at DHRC see several thousand patients who have colorectal cancer each year. That experience helps them to guide patients toward the most appropriate treatment approach. We take great care to ensure patients understand the benefits and risks associated with each treatment option.
DHRC offers all treatment options for Colorectal Cancer, including Surgery, External Beam Radiation Therapy, Brachytherapy, Chemotherapy and Targeted therapy.
Surgery
Surgery is the mainstay of treatment and involves in block removal of diseased segment with adequate margins, surrounding tissue and lymph nodes. The names given to such resections are right hemicolectomy, transverse colectomy, left hemicolectomy, sigmoid colectomy, and subtotal colectomy.
- Polypectomy: If the cancer is found in a polyp (a small piece of bulging tissue), the polyp is often removed during a colonoscopy.
- Local excision: If the cancer is found on the inside surface of the rectum and has not spread into the wall of the rectum, the cancer and a small amount of surrounding healthy tissue is removed.
- Resection: If the cancer has spread into the wall of the rectum, the section of the rectum with cancer and nearby healthy tissue is removed. Sometimes the tissue between the rectum and the abdominal wall is also removed. The lymph nodes near the rectum are removed and checked under a microscope for signs of cancer.
- Pelvic exenteration: If the cancer has spread to other organs near the rectum, the lower colon, rectum, and bladder are removed. In women, the cervix, vagina, ovaries, and nearby lymph nodes may be removed. In men, the prostate may be removed. Artificial openings (stoma) are made for urine and stool to flow from the body to a collection bag.
Radiation therapy or chemotherapy may be given before surgery to shrink the tumor, make it easier to remove the cancer, and lessen problems with bowel control after surgery. Treatment given before surgery is called neoadjuvant therapy. Even if all the cancer that can be seen at the time of the operation is removed, some patients may be given radiation therapy or chemotherapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy beams or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses linear accelerators outside the body to send radiation toward the cancer. Internal radiation therapy (Brachytherapy) uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
OTHER TYPES OF TREATMENT
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibody therapy is a type of targeted therapy being studied in the treatment of rectal cancer.
Monoclonal antibody therapy uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. At DHRC, Colorectal cancers are routinely tested for men targets to be able to select specific targeted therapy for the patient.
FOLLOW-UP TESTS MAY BE NEEDED
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if patient's condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
After treatment for rectal cancer, a blood test to measure amounts of carcinoembryonic antigen (a substance in the blood that may be increased when cancer is present) may be done to see if the cancer has come back.
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