Once colon surgery has taken place, the patient will be checked to make sure that the cancer has been treated correctly, and further treatments may be ordered to make sure that it does not return. However, these really depend on the stage of the cancer when it was: (a) diagnosed, and (b) operated on.
The following may apply after surgery:
Stage 0 – Tests will need to be taken to assess the surrounding lymph nodes, liver, and lungs to see if they are free from cancerous cells. This is usually a precautionary measure, as with stage 0 colon cancer; it has not metastasized (spread) through the lining of the colon and usually requires only one operation to remove it.
Stage I – This is where the cancerous cells have grown through several layers of the colon, but has not yet spread outside the colon wall. A colectomy (surgery performed to remove part or all of a patient’s colon) is usually sufficient without any further treatment necessary for the patient.
Stage II – The cancer has metastasized into nearby tissues, although not to the lymph nodes. A colectomy is usually used to treat this stage of cancer; however, if the cancer is found near the margins of the exercised tumor, or has blocked the colon, then chemotherapy may be used to help treat it.
Chemotherapy will usually include: 5-FU (Fluorouracil, Adrucil and 5-Fluorouracil), capecitabine, leucovorin, or oxaliplatin that may be used alone or combined. Radiation therapy may also be applied to the area of the abdomen where the cancer was removed.
Stage III – The cancer has now metastasized to the lymph nodes around the area of the abdomen; however, it shows no further metastasis to other parts of the body. Once again colectomy will be the order of the day, followed by chemotherapy (5-FU, capecitabine, leucovorin, or oxaliplatin) for a period of up to 6-weeks.
Radiation therapy may also be used to rid the body of any cancerous cells that may have been left-behind. Chemotherapy and radiation therapy may also be ordered (without surgery) if the patient is considered not to be strong enough to support surgery.
Stage IV – The cancer has metastasized through the colon, to the lymph nodes, and to distant body tissues and organs, including: the peritoneum (the continuous thin sheet of tissue that lines the abdominal and pelvic cavities), the liver, the lungs, and the ovaries (in the case of female patients). Usually at this stage surgery on its own will not be sufficient.
Chemotherapy may be used to help shrink the tumor before surgery, and radiation therapy given after surgery to rid the body of cancerous cells. However, after stage IV surgery the prognosis (life expectancy) of a patient is not particularly good with less than 5% surviving past 5-years, opposed to earlier stage colon cancer diagnosis survival rates being 90% or more.