Your physician will develop a colon cancer treatment plan to fit your needs based on the location of the tumor and the stage of the disease. The three main types of treatment for colon cancer and rectal cancer are surgery, radiation therapy, and chemotherapy. Newer, targeted therapies known as monoclonal antibodies are just beginning to be used to treat colon cancer. Depending on the stage of the colon cancer, two or more of these types of treatment may be combined concurrently or used consecutively. ¹¹

See a diagram of minimally invasive surgery and open surgery for colon cancer.

Watch an animation of what happens during minimally invasive surgery and open surgery for colon cancer.

During surgery, the cancer, along with a small length of normal colon on either side of the cancer, is removed through an incision in the abdomen. Sometimes, the nearby lymph nodes are also removed. In addition, your surgeon will check your intestine and liver to see if the cancer has spread. The two ends of the colon are then sewn back together.

Sometimes, the surgeon cannot reconnect the colon. In this case, a new opening, or stoma, leading to the outside of the abdomen is created. The intestine is then connected to the stoma, where a bag is attached to collect body waste. This is called a colostomy, and, in most cases, a colostomy is only temporary.

Advancing technology and research have transformed surgery for the treatment of colon cancer in recent years. In the past, most patients underwent “open” surgery for colon cancer. However, patients now have a second surgery option: laparoscopic surgery, also known as a Minimally Invasive Colon Surgery.

During traditional, or open, surgery the surgeon makes an incision up to 12 inches long from the upper abdomen to the lower abdomen in order to view the colon and remove the diseased portions. Because of the nature of this procedure, patients often face a healing process that results in a hospital stay of at least a week, with recovery time ranging from six to eight weeks.

During minimally invasive colon surgery, the surgeon makes a series of small incisions, from one quarter of an inch to four inches, in the patient’s abdomen. A small video camera, or “scope,” is placed in one of the incisions, providing the surgeon with a magnified view of the patient’s internal organs on a television monitor. Surgical instruments are placed in the other incisions, allowing the surgeon to work inside and remove portions of the colon.

Minimally invasive colon surgery, has been shown to be as effective as open surgery, while offering many benefits over the open procedure. These benefits include:

• Less pain and scarring

• Quicker recovery time

• Shorter hospital stay

• Better cosmetic results

If you’re considering minimally invasive colon surgery, you should consult a surgeon who has already performed at least 20 colon resections using this procedure.⁸ Get a list of qualified surgeons in your area who specialize in minimally invasive colon surgery.

Radiation is used to kill cancer cells that the surgeon cannot be sure of removing. Radiation might be used, for example, if the cancer has also attached to an internal organ or the lining of the abdomen. In cases of rectal cancer, radiation therapy is given to prevent the cancer from recurring in the pelvis where the tumor started.

Radiation may be given either before or after surgery, and recently oncologists have begun to favor radiation treatment before an operation, along with chemotherapy. Radiation therapy is given to treat local recurrences in rectal cancers that are causing symptoms such as pain. ¹²

Chemotherapy after surgery can increase the survival rate for patients with some stages of colon cancer and rectal cancer. Chemotherapy can also help shrink tumors and relieve symptoms of advanced cancer. For cancers that have spread beyond the colon, systemic chemotherapy (anticancer drugs injected into a vein or given by mouth) is used to reach all areas of the body.

For all but stage IV disease, surgery to remove the colon tumor is the primary or first treatment. Radiation and chemotherapy may also be used. 

Stage 0: Surgery to take out the cancer is all that is needed.

Stage I: Surgical resection to remove the cancer is the standard treatment.

Stage II: Surgical resection is usually the only treatment needed. If the cancer is likely to come back, radiation therapy or chemotherapy may be used.

Stage III: Surgical resection is the first treatment, followed by chemotherapy. Radiation therapy may be needed if the cancer has grown into adjacent tissues.

Stage IV: Surgery in this stage is done to relieve blockages and prevent complications, not with the expectation of curing the colon cancer. Chemotherapy and radiation may follow surgery in this stage.

Recurrent colon cancer: Surgery to remove local recurrences can sometimes help and, along with chemotherapy, can still be curative.

In a small number of patients, minimally invasive colon surgery does not work effectively. Factors that may increase the possibility of choosing open surgery or converting to an open procedure may include:

• Obesity

• History of prior abdominal surgery causing dense scar tissue

• Inability to visualize organs

• Bleeding problems during the operation

The decision to perform minimally invasive colon surgery or an open procedure is a judgment made by your surgeon either before or during the actual operation. The decision to convert to an open, or conventional, procedure is based strictly on your safety.

As with any surgical procedure, there are some risks that accompany both open and minimally invasive colon surgery. You should consult your physician to see if minimally invasive colon surgery is right for you.

With both open surgery and minimally invasive colon surgery, you will need time to heal. You will be on intravenous fluids and pain medication, and you will not be able to eat for the first couple of days after surgery. You probably will feel tired and weak, and possibly have some constipation for some time. Your healthcare team will monitor your progress and work to get you back to normal as quickly as possible.

Find a surgeon in your area who specializes in minimally invasive colon surgery.

Find a list of questions to ask   your surgeon about minimally invasive colon surgery.

See a comparison diagram for “open” surgery and minimally invasive colon surgery.