pancreatic cancer

pancreatic cancer

What is pancreas?

The pancreas is a 6-inch long organ located behind the stomach in the back of the abdomen. It is spongy and shaped somewhat like a fish, extended horizontally across the abdomen. The head of the pancreas is on the right side of the abdomen where the stomach is attached to the first part of the small intestine (the duodenum). The tail of the pancreas - its narrowest part - extends to the left side of the abdomen next to the spleen.

The pancreas contains exocrine and endocrine glands that create pancreatic juices, hormones, and insulin. Pancreatic juices, or enzymes, made by the exocrine glands are released into the intestines by way of a series of ducts in order to help digest fat, proteins, and carbohydrates. Over 95% of the pancreas is made up of exocrine glands and ducts. The endocrine cells are arranged in small clusters called islets of Langerhans, which release insulin and glucagon into the bloodstream. These two hormones manage levels of sugar in the blood. When they are not working properly, the result is often diabetes.

What Is Pancreatic Cancer?

Rather than developing into healthy, normal pancreas tissue, these abnormal cells continue dividing and form lumps or masses of tissue called tumors. Tumors then interfere with the main functions of the pancreas. If a tumor stays in one spot and demonstrates limited growth, it is generally considered to be benign.

More dangerous, or malignant, tumors form when the cancer cells migrate to other parts of the body through the blood or lymph systems. When a tumor successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a more serious condition that is very difficult to treat.

In the United States each year, over 30,000 people are diagnosed with pancreatic cancer. Europe sees more than 60,000 diagnoses each year. Because pancreatic cancer is usually diagnosed late into its development, the five-year survival rate after diagnosis is less than 5%.

How Is Pancreatic Cancer Classified?

Pancreatic cancer is categorized depending on whether it affects the exocrine or endocrine functions of the pancreas. There is an important distinction between the two broad types of pancreatic cancer because they have different risk factors, causes, symptoms, diagnostic tests, treatments, and prognoses.

Tumors that affect the exocrine functions are the most common type of pancreatic cancer. Sometimes these tumors or cysts are benign, called cystadenomas. However, it is more likely to find malignant tumors called adenocarcinomas, which account for 95% of exocrine pancreatic cancers. Adenocarcinomas typically start in gland cells in the ducts of the pancreas, but they can also arise from pancreatic enzyme cells (acinar cell carcinoma).

Other types of pancreatic cancers that are associated with exocrine functions include adenosquamous carcinomas, squamous cell carcinomas, and giant cell carcinomas, named for their appearances underneath a microscope. There is also a disease called ampullary cancer (carcinoma of the ampulla of Vater) that starts where the bile duct and pancreatic duct meet the duodenum of the small intestine.

Tumors that affect the endocrine functions of the pancreas are called neuroendocrine or islet cell tumors, but these are fairly uncommon. These tumors are named for the type of hormone-producing cell that is initially affected. For example: insulinomas (insulin), glucagonomas (glucagon), gastrinomas (gastrin), somatostatinomas (somatostatin), and  VIPomas (vasoactive intestinal peptide or VIP). Functioning islet cell tumors still make hormones, while non-functioning ones do not. Most of these tumors are benign, but non-functioning tumors are more likely to be malignant, islet cell carcinomas.

What Causes Pancreatic Cancer?

Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer results. Pancreatic cancer cells do not experience programmatic death, but instead continue to grow and divide. Although scientists do not know exactly what causes these cells to behave this way, they have identified several potential risk factors.

Cells can experience uncontrolled growth if there is damage or mutations in the DNA, and therefore, damage to the genes involved in cell division. Four key types of genes are responsible for the cell division process: oncogenes tell cells when to divide, tumor suppressor genes tell cells when not to divide, suicide genes control apoptosis and tell cells to kill themselves if something goes wrong, and DNA-repair genes instruct cells to repair damaged DNA.

Cancer occurs when a cell's gene mutations make the cell unable to correct DNA damage and unable to commit suicide. Similarly, cancer is a result of mutations that inhibit oncogene and tumor suppressor gene functions, leading to uncontrollable cell growth. If you have DNA mutations of oncogenes or tumor suppressor genes that lead to pancreatic cancer, it is likely that the mutation was a result of factors that affected DNA after you were born rather than a result of inheritance from parents.

Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life. About 10% of pancreatic cancers are though to be caused by inherited gene mutations. Genetic syndromes that are associated with pancreatic cancer include hereditary breast and ovarian cancer syndrome, melanoma, pancreatitis, and non-polyposis colorectal cancer (Lynch syndrome).

Carcinogens

Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Certain pesticides, dyes, and chemicals used in metal refining are thought to be carcinogenic, increasing the risk of developing pancreatic cancer. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. Theses free radicals damage cells, affecting their ability to function normally, and the result can be cancerous growths.

As we age, there is an increase in the number of possible cancer-causing mutations in our DNA. This makes age an important risk factor for pancreatic cancer, especially for those over the age of 60. There are several other diseases that have been associated with an increased risk of cancer of the pancreas. These include cirrhosis or scarring of the liver, helicobacter pylori infection (infection of the stomach with the ulcer-causing bacteria H. pylori), diabetes mellitus, chronic pancreatitis (inflammation of the pancreas), and gingivitis or periodontal disease.

Pancreatic cancers are more likely to exist in men than in women, and among African-Americans than among whites. Smoking cigarettes increases one's risk of pancreatic cancer by a factor of 2 or 3. Even smokeless tobacco has been noted as a risk factor.

Diet and obesity have also been linked to cancers of the pancreas. People who do not exercise much and who are obese are more likely to develop pancreatic cancer. In addition, those who eat diets low in vegetables and fruits and high in red meat and fat are more likely to be diagnosed with the disease. Alcohol consumption is also considered a risk factor for pancreatic cancer. Long term, heavy drinking leads to chronic pancreatitis, which is a known risk factor for pancreatic cancer.

What Are The Symptoms Of Pancreatic Cancer?

Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. Pancreatic cancer is often called a "silent" disease because it rarely shows early symptoms and presents non-specific later symptoms. Tumors of the pancreas cancers are usually too small to cause symptoms. However, when the cancer grows, symptoms include:

    Pain in the upper abdomen from the tumor pushing against nerves

    A painless yellowing of the skin and eyes and darkening of the urine called jaundice, created when the cancer interferes with the bile duct and the liver.

    Loss of appetite, nausea, and vomiting

    Significant weight loss and weakness

    Acholic stool (pale or grey stool) and steatorrhea (excess fat in stool)

These symptoms of pancreatic cancer have numerous other causes, making it difficult to diagnose the disease before it is in an advanced stage.

Cancers of the pancreas are also associated with Trousseau's sign - spontaneous blood clots formed in the portal blood vessels, deep veins of the arms and legs, or other superficial veins. Clinical depression is another symptom that is sometimes reported before the cancer is diagnosed.

If the cancer spreads, or metastasizes, additional symptoms can present themselves in the newly affected area. Symptoms of metastasis ultimately depend on the location to which the cancer has spread.

Islet cell or neuroendocrine cancers of the pancreas may cause the organ to produce too much insulin or hormones. This may lead to weak or dizzy feelings, chills, muscle spasms, or diarrhea.

How Is Pancreatic Cancer Diagnosed?

In order to diagnose pancreatic cancer, physicians will request a complete physical exam as well as personal and family medical histories. The way in which the cancer presents itself will differ depending on whether the tumor is in the head or the tail of the pancreas. Tail tumors present with pain and weight loss while head tumors present with steatorrhea, weight loss, and jaundice. Doctors also look for recent onset of atypical diabetes mellitus, Trousseau's sign, and recent pancreatitis.

In general, when making a pancreatic cancer diagnosis, physicians pay special attention to common symptoms such as abdominal or back pain, weight loss, poor appetite, tiredness, irritability, digestive problems, gallbladder enlargement, blood clots (deep venous thrombosis (DVT) or pulmonary embolism), fatty tissue abnormalities, diabetes, swelling of lymph nodes, diarrhea, steatorrhea, and jaundice.

It is also common for doctors to administer blood, urine, and stool tests. Blood tests can detect a chemical called carcinoembryonic antigen (CEA) as well as CA 19-9 - a chemical released into the blood by pancreatic cancer cells. Liver function tests check for bile duct blockage.

Several imaging techniques are employed in order to see if cancer exists and to find out how far it has spread. Common imaging tests include:

    Ultrasound - to visualize tumor

    Endoscopic ultrasound (EUS) - thin tube with a camera and light on one end

    Abdominal computerized tomography (CT) scans - to visualize tumor

    Endoscopic retrograde cholangiopancreatography (ERCP) - to x-ray the common bile duct

    Angiogram - to x-ray blood vessels

    Barium swallows to x-ray the upper gastrointestinal tract

    Magnetic resonance imaging (MRI) - to visualize tumor

    Positron emission tomography (PET) scans - useful to detect if disease has spread

The only absolute way to make a cancer diagnosis is to remove a small sample of the tumor and look at it under the microscope in a procedure called a biopsy. A fine needle aspiration (FNA) biopsy is the most commonly used method. A thin needle is inserted into the pancreas through the skin, and the pathologist uses CT scan or ultrasound images as a guide. Another type is the brush biopsy performed during ERCP to gather cells. A laparotomy is sometimes ordered to determine the stage, or extent, of the disease because it provides access to a large part of the abdominal cavity.

What Are The Stages Of Pancreatic Cancer?

After a diagnosis is made, doctors find out how far the cancer has spread to determine the stage of the cancer. The stage determines which choices will be available for treatment and informs prognoses. The standard pancreatic cancer staging method is called the TNM (Tumor - Node - Metastasis) system. T indicates the size and direct extent of the primary tumor, N indicates the degree to which the cancer has spread to nearby lymph nodes, and M indicates whether the cancer has metastasized to other organs in the body. A small tumor that has not spread to lymph nodes or distant organs may be staged as (T1, N0, M0), for example.

Group staging, from 0 to IV, for pancreatic cancer follows from TNM categories. Stage 0 is written as (Tis, N0, M0) where Tis stands for carcinoma in situ. This is when the tumor is confined to the top layers of pancreatic duct cells and has not invaded deeper tissues nor spread outside of the pancreas. Stage IV is written as (Any T, Any N, M1) and describes cancer that has spread to distant sites throughout the body.

Physicians also use a simpler staging system that classifies tumors based on the likelihood that they can be surgically removed. Resectable cancers are isolated to the pancreas and can be entirely removed. Locally advanced (unresectable) tumors have not spread to distant organs but cannot be completely removed surgically. Metastatic tumors have spread to distant organs, and surgery would only be used to relieve pain or unblock ducts.

What Are The Pancreatic Cancer Treatment Options?

Cancer treatment depends on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. There is no single treatment for cancer, and pancreatic cancer is usually only curable when found in its earliest stages. Surgery, radiation, and chemotherapy are the most common treatment types. Treatments seek to remove the cancer and/or relieve painful symptoms that the cancer is causing.

Surgery may be used to remove all or part of the pancreas. If a cancer has not metastasized, it is possible to completely cure a patient by surgically removing the cancer from the body. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells. There are three main surgical procedures that are used when it seems possible to remove all of the cancer:

    Whipple procedure (most common in cancers of the head of the pancreas): the pancreas head, and sometimes the entire organ, is removed along with a portion of the stomach, duodenum, lymph nodes, and other tissue. The procedure is complex and risky with complications such as leaking, infections, bleeding, and stomach problems.

    Distal pancreatectomy: the pancreas tail is removed, and sometimes part of the body, along with the spleen. This procedure is usually used to treat islet cell or neuroendocrine tumors.

    Total pancreatectomy: The entire pancreas and spleen are removed. Although you can live without a pancreas, diabetes often results because your body no longer produces insulin cells.

Palliative surgery is also an option when the cancer in the pancreas cannot be removed. Often, a surgeon will create a bypass around the common bile duct or the duodenum if either is blocked so that bile can still flow from the liver and pain or digestive problems can be kept at a minimum. Bile duct blockage can also be relieved by inserting a small stent in the duct to keep it open, a less invasive procedure using an endoscope.

Chemotherapy

Chemotherapy utilizes chemicals that interfere with the cell division process - damaging proteins or DNA - so that cancer cells will commit suicide. These treatments target any rapidly dividing cells (not necessarily just cancer cells), but normal cells can usually recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is generally used to treat cancer that has spread or metastasized because the medicines travel throughout the entire body. Treatment occurs in cycles so the body has time to heal between doses. However, there are still common side effects such as hair loss, nausea, fatigue, and vomiting. Combination therapies often include multiple types of chemotherapy or chemotherapy combined with other treatment options.

Gemcitabine (Gemzar) is the chemotherapy drug used most often to treat pancreatic cancer, and it is usually administered intravenously on a weekly basis. Another commonly used drug is 5-fluorouracil (5-FU). Chemotherapy is not always administered with the intent to cure the cancer. Some patients receive treatments after surgery (adjuvant therapy) to kill any cancer cells that were missed, and others receive it as palliative chemotherapy to improve their quality of life if the cancer cannot be cured.

Newer drugs that target specific parts of cancer cells are now being studied. These drugs work differently from standard chemotherapy drugs, and they often have fewer side effects.  One such drug, erlotinib (Tarceva), has helped some patients with advanced pancreatic cancer and is taken orally in pill form. This drug has been used in combination with gemcitabine to show modest benefits.

Radiation

radiotherapy

Radiation treatment, also known as radiotherapy, destroys cancer by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilizes high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Radiotherapy can be used as a standalone treatment to shrink a tumor or destroy cancer cells, and it is also used in combination with other cancer treatments.

Radiation treatments for pancreatic cancer are usually given 5 days a week for 5 to 6 weeks.  Patients may receive radiation treatment in addition to surgery, chemotherapy, or other treatments. In addition, radiation therapy can be palliative, serving to relieve pain or digestive problems when the common bile duct or duodenum is blocked.

Side effects of radiation therapy may include mild skin changes resembling sunburn or suntan, nausea, vomiting, diarrhea, and fatigue. Patients also tend to lose their appetites and have trouble maintaining weight, but most side effects subside a few weeks after completing treatment.

How Can Pancreatic Cancer Be Prevented?

There are no established guidelines or recommendations for preventing pancreatic cancer, according to the American Cancer Society. However, it is advisable to quit smoking because cigarette use is thought to be a main factor in 20-30% of pancreatic cancers. In general, physicians recommend standard preventive measures such as keeping a healthy weight, exercising, and increasing consumption of fruits, vegetables, and whole grains while decreasing red meat intake. There is no evidence, however, that following these dietary guidelines will prevent or reduce pancreatic cancer.

Some studies suggest that certain vitamins can reduce the risk of pancreatic cancer. Vitamin D has been associated with reducing the risk of several types of cancer, including pancreatic cancer. B vitamins such as B12, B6, and folate that are consumed in food (not in pill or tablet form) have also been suggested to reduce pancreatic cancer risk.

cancer facts

cancer facts

Lung cancer facts

    Lung cancer is the number-one cause of cancer deaths in both men and women in the U.S. and worldwide.
    Cigarette smoking is the principal risk factor for development of lung cancer.
    Passive exposure to tobacco smoke also can cause lung cancer.
    The two types of lung cancer, which grow and spread differently, are the small cell lung cancers (SCLC) and non-small cell lung cancers (NSCLC).
    The stage of lung cancer refers to the extent to which the cancer has spread in the body.
    Treatment of lung cancer can involve a combination of surgery, chemotherapy, and radiation therapy as well as newer experimental methods.
    The general prognosis of lung cancer is poor, with overall survival rates of about 16% at five years.
    Smoking cessation is the most important measure that can prevent the development of lung cancer.

Colon cancer facts

    Colorectal cancer is a malignant tumor arising from the inner wall of the large intestine.

    Colorectal cancer is the third leading cause of cancer in males and fourth in females in the U.S.

    Risk factors for colorectal cancer include heredity, colon polyps, and long-standing ulcerative colitis.

    Most colorectal cancers develop from polyps. Removal of colon polyps can prevent colorectal cancer.

    Colon polyps and early cancer can have no symptoms. Therefore regular screening is important.

    Diagnosis of colorectal cancer can be made by barium enema or by colonoscopy with biopsy confirmation of cancer tissue.

    Treatment of colorectal cancer depends on the location, size, and extent of cancer spread, as well as the health of the patient.
    Surgery is the most common treatment for colorectal cancer.

    Chemotherapy can extend life and improve quality of life for those living with colorectal cancer.

cancer pictures

cancer pictures

What is cancer?

Every day within our bodies, a massive process of destruction and repair occurs. The human body is comprised of about fifteen trillion cells, and every day billions of cells wear out or are destroyed. In most cases, each time a cell is destroyed the body makes a new cell to replace it, trying to make a cell that is a perfect copy of the cell that was destroyed because the replacement cell must be capable of performing the same function as the destroyed cell. During the complex process of replacing cells, many errors occur. Despite remarkably elegant systems in place to prevent errors , the body still makes tens of thousands of mistakes daily while replacing cells either because of random errors or because there are outside pressures placed on the replacement process that promote errors. Most of these mistakes are corrected by additional elegant systems or the mistake leads to the death of the newly made cell, and another normal new cell is produced. Sometimes a mistake is made, however, and is not corrected. Many of the uncorrected mistakes have little effect on health, but if the mistake allows the newly made cell to divide independent of the checks and balances that control normal cell growth, that cell can begin to multiply in an uncontrolled manner. When this happens a tumor (essentially a mass of abnormal cells) can develop.

Tumors fall into two categories; there are benign tumors and malignant (cancerous) tumors. So what is the difference? The answer is that a benign tumor grows only in the tissue from which it arises. Benign tumors sometimes can grow quite large or rapidly and cause severe symptoms, even death, although most do not. For example, a fibroid tumor in a woman's uterus can cause bleeding or pain, but it will never travel outside the uterus and grow as a new tumor elsewhere. Fibroids, like all benign tumors, lack the capacity to shed cells into the blood and lymphatic system, so they are unable to travel to other places in the body and grow. A cancer, on the other hand, can shed cells that can float like dandelion seeds in the wind through the blood or lymphatic system, landing in tissues distant from the primary tumor and growing into new tumors in these distant tissues. This process of spreading to distant tissues, called metastasis, is the defining characteristic of a cancerous tumor.

Cancer often is referred to as a single entity, but in fact, it is a group of more than 100 different diseases, much like infectious diseases. Cancers are named by the tissues from which the first tumor arises. Hence, a lung cancer that travels to the liver is not a liver cancer but is described as lung cancer metastatic to the liver, and a breast cancer that spreads to the brain is not described as a brain tumor but rather as breast cancer metastatic to the brain. Each cancer is a different disease with different treatment options and varying prognoses (likely outcomes). In fact, each individual with cancer has a unique disease, and the relative success or lack thereof of treatment among patients with the same diagnosis may be very different. As a result, it is important to treat each person with a diagnosis of cancer as an individual regardless of the type of cancer.

cancer stages

cancer stages

Colon Cancer Signs

When colorectal cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that people should watch for. Common signs and symptoms of colorectal cancer include:

•     a change in the frequency of bowel movements
•     diarrhea, constipation, or feeling that the bowel does not empty completely
•     either bright red or very dark blood in the stool
•     stools that are narrower than usual
•     general abdominal discomfort such as frequent gas pains, bloating, fullness, and/or cramps
•     weight loss with no known reason
•     constant tiredness
•     vomiting

These symptoms may be caused by colorectal cancer or by other conditions. It is important to check with a doctor if you have symptoms because only a doctor can make a diagnosis. Don't wait to feel pain. Early cancer usually doesn't cause pain.

Colon cancer facts

    Colorectal cancer is a malignant tumor arising from the inner wall of the large intestine.

    Colorectal cancer is the third leading cause of cancer in males and fourth in females in the U.S.

    Risk factors for colorectal cancer include heredity, colon polyps, and long-standing ulcerative colitis.

    Most colorectal cancers develop from polyps. Removal of colon polyps can prevent colorectal cancer.

    Colon polyps and early cancer can have no symptoms. Therefore regular screening is important.

    Diagnosis of colorectal cancer can be made by barium enema or by colonoscopy with biopsy confirmation of cancer tissue.

    Treatment of colorectal cancer depends on the location, size, and extent of cancer spread, as well as the health of the patient.
    Surgery is the most common treatment for colorectal cancer.

    Chemotherapy can extend life and improve quality of life for those living with colorectal cancer.

What is cancer?

Every day within our bodies, a massive process of destruction and repair occurs. The human body is comprised of about fifteen trillion cells, and every day billions of cells wear out or are destroyed. In most cases, each time a cell is destroyed the body makes a new cell to replace it, trying to make a cell that is a perfect copy of the cell that was destroyed because the replacement cell must be capable of performing the same function as the destroyed cell. During the complex process of replacing cells, many errors occur. Despite remarkably elegant systems in place to prevent errors , the body still makes tens of thousands of mistakes daily while replacing cells either because of random errors or because there are outside pressures placed on the replacement process that promote errors. Most of these mistakes are corrected by additional elegant systems or the mistake leads to the death of the newly made cell, and another normal new cell is produced. Sometimes a mistake is made, however, and is not corrected. Many of the uncorrected mistakes have little effect on health, but if the mistake allows the newly made cell to divide independent of the checks and balances that control normal cell growth, that cell can begin to multiply in an uncontrolled manner. When this happens a tumor (essentially a mass of abnormal cells) can develop.

Tumors fall into two categories; there are benign tumors and malignant (cancerous) tumors. So what is the difference? The answer is that a benign tumor grows only in the tissue from which it arises. Benign tumors sometimes can grow quite large or rapidly and cause severe symptoms, even death, although most do not. For example, a fibroid tumor in a woman's uterus can cause bleeding or pain, but it will never travel outside the uterus and grow as a new tumor elsewhere. Fibroids, like all benign tumors, lack the capacity to shed cells into the blood and lymphatic system, so they are unable to travel to other places in the body and grow. A cancer, on the other hand, can shed cells that can float like dandelion seeds in the wind through the blood or lymphatic system, landing in tissues distant from the primary tumor and growing into new tumors in these distant tissues. This process of spreading to distant tissues, called metastasis, is the defining characteristic of a cancerous tumor.

Cancer often is referred to as a single entity, but in fact, it is a group of more than 100 different diseases, much like infectious diseases. Cancers are named by the tissues from which the first tumor arises. Hence, a lung cancer that travels to the liver is not a liver cancer but is described as lung cancer metastatic to the liver, and a breast cancer that spreads to the brain is not described as a brain tumor but rather as breast cancer metastatic to the brain. Each cancer is a different disease with different treatment options and varying prognoses (likely outcomes). In fact, each individual with cancer has a unique disease, and the relative success or lack thereof of treatment among patients with the same diagnosis may be very different. As a result, it is important to treat each person with a diagnosis of cancer as an individual regardless of the type of cancer.

What is cancer of the colon and rectum?

The colon and the rectum are the final portions of the tube that extends from the mouth to the anus. Food enters the mouth where it is chewed and then swallowed. It then travels through the esophagus and into the stomach. In the stomach, the food is ground into smaller particles and then enters the small intestine in a carefully controlled manner. In the small intestine, final digestion of food and absorption of the nutrients contained in the food occurs. The food that is not digested and absorbed enters the large intestine or colon and finally the rectum. The large intestine is about six feet long and acts primarily as a storage facility for waste; however, additional water, salts, and some vitamins are further removed. In addition, some of the undigested food, for example, fiber, is digested by colonic bacteria and some of the products of digestion are absorbed from the colon and into the body. (It is estimated that 10% of the energy derived from food comes from these products of bacterial digestion in the colon.) The remaining undigested food, dying cells from the lining of the intestines, and large numbers of bacteria are stored in the colon and then periodically passed into the rectum. Their arrival into the rectum initiates a bowel movement that empties the colonic contents from the body as stool.

Most of the large intestine rests inside a cavity in the abdomen called the peritoneal cavity. Parts of the colon are able to move quite freely within the peritoneal cavity as the undigested food is passing through it. As the colon heads towards the rectum, it becomes fixed to the tissues behind the peritoneal cavity, an area called the retroperitoneum. The end portion of the large intestine, the part that resides in the retroperitoneum, is the rectum. Unlike much of the rest of the colon, the rectum is fixed in place by the tissues that surround it. Because of its location, treatment for rectal cancer often is different than treatment for cancer of the rest of the colon, as we'll explain later.



Treatment & Care

Many colon cancer treatment options are available for colorectal cancer, including surgery, chemotherapy, and radiation. Here’s what to expect from each type of treatment and tips for recovery.

Treatment

Colon Polyp Removal and Other Precancerous Conditions

Learn how colon polyps are removed and why it’s so important to stay on top of these and other precancerous conditions.
Colorectal Cancer Treatment

Here’s a quick rundown of the options available for colorectal cancer treatment from surgery to cutting-edge biologic therapy.
Colon Cancer: Treatment by Stage

Here you’ll find detailed information on how the various stages of colon cancer are treated -- from stage 0 to stage IV and also recurrent colon cancer.
Rectal Cancer Treatment by Stage

Here you’ll find detailed information on how the various stages of rectal cancer are treated -- from stage 0 to stage IV and also recurrent rectal cancer.
Colon Cancer Chemotherapy

Learn about the different ways chemotherapy is used to treat colon cancer and rectal cancer and the side effects of commonly used chemotherapy drugs.
New Colon Cancer Drugs: Avastin and Erbitux

New medications called monocolonal antibodies are the latest options for treating colon cancer and rectal cancer. Learn more here.
Understanding Colostomy and Colon Cancer

Some people require a colostomy -- an opening between the surface of the skin and the colon -- after colon cancer surgery. It can be permanent or temporary. Learn when it may be necessary.
Surgery to Treat Colorectal Cancer

Learn more about surgery to treat colorectal cancer here.
Care
Colon Cancer Specialists: What to Look for

People with colorectal cancer often encounter several types of doctors when going through treatment. Learn about the different specialists and find out how to build your cancer team.
Questions to Ask Your Doctor About Colon Cancer

Be your own best advocate. Know which questions to ask your doctor about your type of colorectal cancer.
Your Doctor: Your Cancer Partner

Partnering with your doctor helps give you a sense of control and may lead to better treatment. Here’s how to get started.
Related Guide: Managing Colon Cancer Pain

Getting control of pain that you may have is vitally important. Find out what causes cancer pain and which treatments may be right for you.
Video: New Approach to Colorectal Cancer Pain

Learn about a new way some doctors are using to gauge a patient’s level of pain -- and determine if more -- or less -- pain treatment is needed in this WebMD video.
Video: Cupping: Alternative Medicine for Cancer Pain

Learn about cupping, an alternative medicine treatment for cancer pain, in this WebMD video.
Colon Cancer and Nausea

Thanks to new drugs and other treatments, you can control nausea from chemotherapy. Find out how.
Chemotherapy and Colon Cancer Side Effects

Learn simple ways to cope with the “terrible triad” of nausea, hair loss, and fatigue from chemotherapy.
Tool: Anemia in Colon Cancer

Tired and worn out? Check out WebMD’s animated guide on chemotherapy-related anemia to see if anemia may be the cause.
Am I Cured? Understanding Your Colon Cancer Prognosis

What does the future hold? Learn more about the outlook for colorectal cancer and what happens if the cancer comes back.
Follow-Up Care for Colon Cancer

Regular checkups help ensure that any changes in your health are noticed; and if the cancer returns, it can be treated as soon as possible.
Clinical Trials
Colorectal Cancer Clinical Trials

Learn about colorectal cancer clinical trials. Then, check out sites chosen by WebMD doctors that offer information and services to help you determine if a clinical trial may be right for you.

cancer treatment

cancer treatment

Standard treatments for localized basal cell and squamous cell carcinomas are safe and effective. Small tumors can be surgically excised, removed with a scraping tool (curette) and then cauterized, frozen with liquid nitrogen, or killed with low-dose radiation. Applying an ointment containing a chemotherapeutic agent called 5-fluorouracil -- or an immune response modifier called imiquimod -- to a superficial tumor for several weeks may also work. Larger localized tumors are removed surgically.

In rare cases where basal cell or squamous cell carcinoma has begun to spread beyond the skin, tumors are removed surgically and patients are treated with chemotherapy and radiation.

Melanoma tumors must be removed surgically, preferably before they spread beyond the skin into other organs. The surgeon removes the tumor fully, along with a safe margin of surrounding tissue. There is controversy whether removing nearby lymph nodes is valuable in certain cases. Neither radiation nor chemotherapy will cure advanced melanoma, but either treatment may slow the disease and relieve symptoms. Chemotherapy, sometimes in combination with immunotherapy -- using drugs like interferon -- is generally preferred. If melanoma spreads to the brain, radiation is used to slow the growth and control symptoms.

Immunotherapy is a relatively new field of cancer treatment that attempts to target and kill cancer cells by manipulating the body's immune system. Some of the most promising developments in the field of immunotherapy have sprung from efforts to cure advanced melanoma. Some researchers are treating advanced cases with vaccines, while others have used drugs such as interferon, interleukin-2, or Yervoy (ipilimumab) in an effort to stimulate immune cells into attacking melanoma cells more aggressively. Genetic manipulation of melanoma tumors may make them more vulnerable to attack by the immune system. Each of these experimental treatment approaches aims to immunize a patient's body against its own cancer -- something the body cannot do naturally.

The drug Zelboraf (vemurafenib), is FDA-approved for inoperable or late-stage melanoma that tests positive for the BRAF mutation, a genetic change that appears responsible for some cancers, including melanoma.

Yervoy (ipilimumab) has recently been approved by the FDA to treat advanced melanoma, with or without dacarbazine.

Chemotherapy

    Chemotherapy and You: Support for People With Cancer
 
 Information about what to expect during chemotherapy and what patients can do to take care of themselves during and after treatment.
 
 Chemotherapy Side Effects Sheets
 
 Chemotherapy fact sheets with clear medical advice from doctors and nurses, and practical tips from patients to help you manage side effects.

Radiation Therapy

    Radiation Therapy for Cancer
 
 A fact sheet that defines the different types of radiation therapy and discusses scientific advances that improve the effectiveness of this treatment.
 
 Radiation Therapy and You: Support for People With Cancer
  
Information about what to expect during radiation therapy, including the general effects of treatment and how to deal with specific side effects.
 
 What To Know About Brachytherapy (A Type of Internal Radiation Therapy)
 
 Practical information and tips to help radiation therapy patients understand brachytherapy, a type of internal radiation therapy.
  
What To Know About External Beam Radiation Therapy
  
Practical information and tips for radiation therapy patients about external beam radiation therapy.
 
 Radiation Therapy Side Effects Sheets
 
  Radiation therapy fact sheets that help patients understand their treatment and manage side effects. The fact sheets (also available in audio) have tips from patients and healthcare providers, and questions to ask providers.
 
  Radiation Therapy and Side Effects - Audio Files
 
 A list of a series of audio interviews on topics related to side effects of radiation therapy.

Surgery

    Cryosurgery in Cancer Treatment: Questions and Answers
  
A fact sheet that describes cryosurgery, the technique of using extreme cold to treat tumors. Lists the indications, risks, benefits, and side effects of cryotherapy.

Transplantation

    Childhood Hematopoietic Cell Transplantation (PDQ®)
    [ health professional ]

  Expert-reviewed information summary about the use of hematopoietic cell transplantation in treating childhood cancer.
 
 Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation
 
 A fact sheet that explains the step-by-step procedures of two types of transplantations used with high-dose chemotherapy, including their risks and benefits.

Other Treatment Methods

    Angiogenesis Inhibitors
 
 A fact sheet that describes the process of eliminating the blood supply to tumors. Lists the cancers in which this approach is being tested.
 
 Biological Therapies for Cancer
 
 A fact sheet that provides an overview of how the immune system functions and describes the actions of biological therapies.
 
 Biological Therapy
  
An introduction to biological therapy to help patients prepare to receive it for cancer treatment or managing side effects.
 
  Cancer Vaccines
 
 A fact sheet that discusses cancer vaccines. Explains how they work, how they are made, and describes research related to their use.
 
 Gene Therapy for Cancer: Questions and Answers
 
 A fact sheet that discusses research with genetic material in developing cancer therapies, including risks, benefits, and ethical issues.
 
 Hyperthermia in Cancer Treatment

   A fact sheet that defines hyperthermia (treating tumors with heat) and its side effects.

  Lasers in Cancer Treatment

    A fact sheet that describes use of high-intensity light in cancer treatment, its advantages and disadvantages, and types of procedures that use it.

    Photodynamic Therapy for Cancer

    A fact sheet that explains photodynamic therapy, how it is administered, and indications and side effects of treatment.

    Targeted Cancer Therapies

    A fact sheet that describes targeted cancer therapies, which are drugs that block the growth and spread of cancer by interfering with specific molecules involved in carcinogenesis (the process by which normal cells are transformed into cancer cells) and tumor growth.