“Ask Dr. HKSH” – Surgical Treatment of Colon Cancer

Dr. LI Ka Wah, Michael

Specialist in General Surgery

Q1. Are colorectal cancer, colon cancer, and rectal cancer the same?

The large intestine, rectum, and colon are all organs within the abdomen, but they are located in different spots. Colon cancers mostly are located within the abdominal cavity, whereas rectal cancer occurs below the pelvis.

Q2. Why is colon cancer often diagnosed at an advanced stage?

The symptoms of colon cancer are often subtle, usually involving just blood in the stool or general abdominal discomfort. Patients often overlook these changes or altered bowel habits, leading to diagnosis at an advanced stage. Because of this, the government recommends that people aged over 50 undergo regular screening to detect cancer at an early-stage cancer.

Q3. What treatment options are available for patients with colon cancer?

The main treatment is surgical removal. However, if the colon cancer is at an advanced stage, with cancer cells already spread throughout the body, and the patient is elderly, surgery may not be the first-line option. That said, even when the cancer has spread, patients can often undergo comprehensive chemotherapy first to control the progression and shrink the tumour, making surgical removal possible at a later stage.

Q4. What are the differences among various surgical procedures?

Nowadays, minimally invasive surgery is the primary method for colorectal cancer removal. This technology, which has been in use for over 30 years, greatly reduces patients’ postoperative pain. While traditional open surgery might need 7-10 days for recovery, patients undergoing minimally invasive surgery can often recover and be discharged in just 3-4 days.

A small number of patients still require open surgery, especially in emergency situations. For example, if a patient has a bowel obstruction, minimally invasive surgery may no longer be appropriate.

Q5. Does colon cancer require a colostomy?

Currently, surgery for colon cancer usually does not require a stoma. However, for lower rectal cancers, a temporary protective stoma may be necessary after tumour removal. This can typically be reversed after 4-6 weeks.