Colon Cancer

General Information

• Colon cancer is a new uncontrolled growth in the area of the colon (large bowel). It is very common and occurs mostly in older men and women. The cause of this type of cancer is not known.

Common Signs and Symptoms

• In the early stage, there are usually no symptoms. If the stool is tested, it may show the presence of blood.
• The blood in the stool may vary in color from bright red to maroon, or even black.
• If the cancer begins to block the colon, there may be a sense of fullness, cramping, constipation, or narrowing of the stool.
• As the colon pushes stool through the narrowing passage, all the stool and the liquid above it come out as a mixed solid and liquid diarrhea.
• There may be anemia because of slow bleeding from the tumor.

Diagnosis

Usually, the diagnosis begins by taking a detailed history and doing a thorough physical examination. It is necessary to have either a barium enema or a colonoscopy.

• Barium enema: This is done by placing liquid barium into the rectum and colon (just like a regular enema) and taking x-ray pictures. The results help to determine the cause of the symptoms.
• Colonoscopy: This is done with an optical instrument with a light at its tip. It is smooth, flexible, and as big around as your little finger. During the procedure you will be given medicine that will make you feel drowsy. The tip of the instrument will be lubricated and then gently inserted into your anus. It can be used to inspect your entire colon. If suspicious tissue is seen, a small piece of it can be taken (a biopsy) for laboratory examination.
• CT scan (computed tomography scan): These special x-rays are taken by a machine that is shaped like a huge doughnut. You will lie on a table inside the hole in the ''doughnut.'' The x-rays are taken as very thin slices through the area of the abdomen. This makes it possible to see the fine details in the abdomen.

Treatment

The treatment is an operation to remove the part of the colon with the cancer and then to reconnect the colon so that the contents of the colon can travel in a normal manner.

Preparing for Surgery

• During the day before the operation, drink only liquids. In the afternoon before the operation, you will need to drink two 1½ ounce bottles of Fleets Phospho-soda. It is best to drink it in stages. Every ten minutes for the first half hour, drink one half ounce with eight to twelve ounces of a soft drink, (first bottle). Then wait two hours before repeating the whole sequence (second bottle).
• Have only a clear liquid (e.g., jello, broth) for supper.
• Do not eat or drink anything for 8 hours before your operation.
• Shower (and shave) as usual on the morning of the operation.
• You may be given medicine that will make you feel drowsy before you are brought to the operating room.

The Operation

• You will be asleep during this operation.
• Very infrequently, a temporary colostomy (bowel opening on the side of your body) has to be done for safety reasons. If you have a colostomy, it will be closed a few weeks later.
• Some patients have a cancer in the rectum so close to the anus that the anus also must be removed. These patients must have a permanent colostomy.
• You will not receive a blood transfusion unless it is absolutely necessary.
• The operation usually takes 2 hours.

Following Surgery 

• You will wake up in a recovery room. When your blood pressure, pulse, and breathing are stable, you will be taken to a regular hospital room.
• You may have a thin plastic tube in your nose. It goes down to your stomach to suck up the air you swallow. It will be removed when your bowels start working.
• That evening you will be helped to sit up in bed and on the next day to get out of bed.
• Pain can be controlled with medicine.
• After the tube in your nose is removed you will be started on a liquid diet; this will be advanced to solid food as you tolerate it.
• As with any operation, complications are always possible. With this type of operation, they can include peritonitis, bleeding, bowel obstruction, and pneumonia, among others.
• The hospital stay ranges from five to ten days.
• Arrangements will be made for your medicine, follow-up office visit, and stitch removal.

At Home After Surgery

• Continue with the program started while you were in the hospital.
• You may walk about as you wish, even climb stairs.
• You may eat as you did before the operation but include plenty of roughage and liquids in your diet to help prevent constipation.
• Unless instructed otherwise, you may shower if you wish and with any dressings on or off. There may be narrow strips of tape across the incision. It's all right if they get wet; they will be removed in the doctor's office if they don't fall off by themselves. After you dry yourself, replace any dressings with clean, dry ones.
• Don't lift anything heavier than ten pounds for six weeks after the date of surgery.
• Driving a car with an automatic shift is not too demanding. But if you suddenly have to slam on the brakes or twist to turn a wheel, you may strain the sutures or tear something. We recommend that you resume driving when you are completely pain free and you are confident you can handle an automobile under all driving circumstances.
• You may resume sexual activity whenever you choose.
• You may return to work when you feel up to it. It is a good idea to wait a month after surgery and then go back part time for a week or two.

Call our office if...

• You develop any unusual signs or symptoms.
• You develop cramps or become bloated.
• You do not have a bowel movement for 2 to 3 days.
• You develop a temperature higher than 100.7 ºF.
• The incision becomes red or swollen, or there is drainage from it.
• You have any questions.