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Most people with colon cancer begin treatment by having surgery to remove their cancer. If colon cancer has spread beyond your colon, you might have chemotherapy first. This can help treat cancer wherever it is. After chemotherapy, your care team may recommend surgery if:
- The tumors responded to the medicine.
- They can be surgically removed.
People with advanced colon cancer might not have surgery. That’s because chances are low that surgery will cure the disease. But sometimes surgery to remove tumors may help a person live longer or manage symptoms.
Colon Cancer Care Tailored to You
You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services.
Types of Surgery to Treat Colon Cancer
There is a range of surgeries for colon cancer — from removing a single small polyp to taking out a large section of the colon. At Fred Hutch Cancer Center, our experienced surgeons offer all types of colon cancer surgeries.
Your exact procedure will depend on many factors. Your care team will take into account things like the site, size and stage of your cancer and your health, weight and wishes. You and your team will talk about your options and decide together what is best for you.
Polypectomy
If your cancer is only in one or more polyps, your physician may have taken it all out during your colonoscopy. Taking out a polyp is called polypectomy.
Colectomy
Sometimes a polypectomy is not enough, or it’s not possible. In this case, your surgeon will remove the segment of your colon that contains cancer. This is called resection of the colon or colectomy. Your surgeon will also remove a small amount of healthy tissue around the cancer. Then the surgeon will join the ends of the healthy segments above and below the part that was removed (anastomosis).
They will also check if cancer has spread to other organs. This will include taking out nearby lymph nodes to look for cancer cells.
Colostomy or Ileostomy
If the surgeon can’t join the ends of the healthy intestine, they do a colostomy or ileostomy. The surgeon makes an opening (stoma) in your belly. Then they attach the top end of your colon or ileum (part of the small intestine) to the opening on the inside. A bag is attached on the outside to collect waste.
You may need a colostomy or ileostomy only for a short time. After the lower part of your intestine heals, the surgeon may be able to reconnect the two ends. Sometimes a colostomy or ileostomy is permanent.
Understanding Stomas
A stoma is an opening created surgically on the abdomen to allow waste to exit the body. Your Fred Hutch team will help you learn how to care for your stoma and adjust so you can go on with your usual activities in comfort. We have a specially certified wound ostomy nurse. They understand the physical and emotional impact of ostomies. The nurse will work closely with you, your family and the rest of your care team. Our Survivorship Clinic also plays a key part in your ongoing care.
Why Choose Fred Hutch for Colon Cancer Surgery
As a patient at Fred Hutch, you’ll have surgery done by a UW Medicine surgical oncologist. Your surgeon will be specially trained and board certified in colorectal surgery. They know the most advanced surgical options for treating your disease. Your surgeon will design a personalized treatment plan to fit your needs.
Whenever possible, our surgeons use minimally invasive techniques. Knowing when to do an open or minimally invasive procedure is important. This is part of the expertise offered by our surgeons. They are among the country’s leading experts in both techniques. To help you recover, Fred Hutch care teams follow evidence-based guidelines (“early-recovery after surgery” protocols).
There are three main techniques for surgery to remove colon tumors.
- Endoscopic surgery: Done with small tools that go through one of the body’s natural openings, like the anus.
- Robotic/laparoscopic surgery: Done through small “keyhole” incisions. Endoscopic and robotic/laparoscopic methods are also called minimally invasive surgery.
- Open surgery: Done through a longer cut (incision) in the belly.
At Fred Hutch, we do colectomies through keyhole incisions when possible. Most of the time, this method means a shorter hospital stay and less need for pain medicine. In some complex cases, open surgery is a better choice. Other times, it is simply not possible to use a minimally invasive approach — due to the size of a tumor or where it is, for example.
Learn more about minimally invasive and open surgical techniques.
Like with any surgery, you will probably have some pain after your operation. Your care team will give you pain medicines to help with this. You may not be able to have solid food for the first few days. Other issues could include a delay in your intestines starting to work again, a problem (like a leak) where the two ends of the colon were joined or scarring that causes discomfort.
Your Fred Hutch care team will talk with you about common side effects and signs to watch for. We’ll make sure you know what to do and how to reach us if any concerns come up.
- Endoscopic surgery: This is typically done as an outpatient procedure. You may go home the same day. In some cases, your care team may ask you to stay at the hospital for about a day for observation.
- Robotic/laparoscopic surgery: People often stay in the hospital for two to four days after surgery. After this, you can expect it to take about three to four weeks to fully recover.
- Open surgery: A typical hospital stay is three to five days. Most people need about four to six weeks at home to recover fully from their operation.