Colon Cancer Treatment

About Colon Cancer

At Penn Medicine's Abramson Cancer Center, patients with colon cancer receive their care from a multidisciplinary team of nationally recognized experts in the diagnosis, treatment and research of gastrointestinal cancer.

The colon is the largest part of the large intestine, also known as the large bowel. After food is chewed and swallowed, it travels through the stomach and small intestine where it is broken down and most of the nutrients absorbed. It then passes to the large intestine where water and nutrients are absorbed from the food and waste matter is stored. The colon's function is to change liquid waste into solid waste and prepare it to be expelled from the body through the anus.

Colon cancer is the third most common type of cancer in both men and women, and is the second leading cause of death from cancer in the United States. Colon cancer is cancer that forms in the lining tissues of the colon. Most colon tumors begin when normal tissue forms a polyp, or pre-cancerous growth projecting from the wall of the colon. As the polyp grows, a tumor forms. Because the tumor grows slowly, early detection is possible through screening and tests.

Colon cancer is often combined with rectal cancer and can be referred to as “colorectal cancer.”

Penn Medicine's multidisciplinary approach to cancer diagnosis and treatment provides better outcomes and gives patients access to the most advanced treatment, surgical techniques and clinical trials.

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Read more About Colon Cancer

Diagnosing Colon Cancer

An accurate cancer diagnosis from trusted cancer specialists is the first step in getting personalized treatment options to treat colon cancer.

Patients who choose Penn’s Abramson Cancer Center benefit from a multidisciplinary team of cancer specialists including gastroenterologists, radiologists, pathologists and surgeons who work together to provide a diagnosis and joined by radiation oncologists and medical oncologists to develop an appropriate treatment plan customized for each patient with colon cancer.

Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing colon cancer and are actively researching better and more precise ways to detect colon cancer.

Navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right person. Penn Medicine’s contact center has experienced cancer nurses available and ready to guide patients in finding the cancer specialist right for them.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Read more Diagnosing Colon Cancer

Colon Cancer Treatment

Following the diagnosis and staging of colon cancer, cancer specialists at Penn Medicine’s Abramson Cancer Center develop a personalized treatment plan. Penn’s treatment options for colon cancer include:

  • Surgery
    • Segmented colon resection
    • Local excision
    • Resection of limited metastatic disease
  • Radiation therapy
    • 3-D conformal radiation
    • Intensity-modulated radiation therapy (IMRT)
    • Volumetric-modulated arc therapy (VMAT)
    • Proton therapy
  • Chemotherapy and biologic therapies
    • Chemotherapy (alone or combined with monoclonal antibody therapy)
    • Liver-directed therapies
    • Monoclonal antibody therapy
  • Clinical trials
  • Other treatments
    • Integrative medicine and wellness
    • Palliative care
    • Penn Home Care and Hospice

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right person.

To connect with a cancer nurse at Penn Medicine, patients should call 1-800-789-PENN (7366).


Surgery for Colon Cancer

Surgery is the most common treatment for all stages of colon cancer. After the cancer is removed, the surgeon may sew together healthy tissue to reattach organs, or make an opening in the abdomen where stool can pass into a collection bag. 

Segmented Colon Resection

If the cancer has spread into the wall of the colon, the section of the colon with the cancer and nearby healthy tissue is removed. This is called a colectomy. The surgeon may sew together the healthy parts of the colon. Lymph nodes near the colon are usually removed and checked under a microscope for signs of cancer.

Local Excision

Typically used for early stage colon cancers, where the cancer has not spread into the wall of the colon. The cancer and some surrounding healthy tissue are removed.

Resection of Limited Metastatic Disease

Surgical experts at Penn may perform surgical resection of metastatic disease in liver or lung, and try to cure some patients who may have limited (less) metastatic disease in liver or lung after they have responded to chemotherapy (with or without monoclonal antibodies).

Radiation Therapy for Colon Cancer

Radiation therapy for colon cancer is rarely used. If it is, it is used only in selective instances.

Radiation oncologists at Penn Medicine are recognized for techniques that target radiation precisely to the disease site while sparing nearby tissue.

Proton therapy at Penn Medicine is now being used to treat upper gastrointestinal cancers and recurrent tumors in the digestive tract. Penn Medicine is one of the only facilities in the country treating gastrointestinal cancers in this way.

Radiation therapy uses high-energy radiation to kill cancer cells. A radiation therapy schedule usually consists of a specific number of treatments given over an extended period of time. In many cases, radiation therapy is capable of killing all of the cancer cells.

3-D Conformal Radiation Therapy

The imaging technology used by radiation oncologists at Penn Medicine helps shape the radiation treatment beam to the shape of the tumor. Conformal radiation therapy gives doctors more control when treating tumors.

Special computers use CT imaging scans to create 3-D maps of the location of the cancer in the body. The system permits the delivery of radiation from several directions, and the beams can then be shaped, or conformed, to match the shape of the cancer. Conformal radiation therapy limits radiation exposure to nearby healthy tissue as well as the tissue in the beam's path.

Intensity-Modulated Radiation Therapy

This advanced type of radiation therapy uses a computer-controlled device, called a linear accelerator, to deliver precise doses of radiation to tumors or specific areas within the tumors. Radiation therapy, including IMRT, stops cancer cells from dividing and growing, thus slowing or stopping tumor growth. In many cases, radiation therapy is capable of killing all of the cancer cells, including those that may have been missed during surgery.

Using 4-D computed tomography (CT) images along with computerized dose calculations, IMRT allows for the radiation dose to conform more precisely to the shape of the tumor by controlling, or modulating, the intensity of the radiation beam while tracking any movement of the tumor. The therapy allows higher radiation doses to be delivered to areas within the tumor while minimizing the dose to the surrounding area.

Volumetric-Modulated Arc Therapy (VMAT)

Volumetric modulated arc therapy (VMAT) is a type of specialized intensity modulated radiation therapy. VMAT delivers radiation by rotating the linear accelerator through one or more arcs while radiation is continuously delivered.

VMAT allows Penn radiation oncologists to treat complex cancers while minimizing exposure to surrounding healthy tissue. VMAT shortens radiation delivery time, and offers patient more comfort because it does not require patients to lie completely still for long periods of time.

Penn radiation oncologists use RapidArc™ radiotherapy technology to treat hard to reach tumors.

Proton Therapy

Penn Medicine is the only health care facility in the country that is using proton therapy to treat recurrent gastrointestinal tumors in clinical trials.

Penn Medicine's Roberts Proton Therapy Center is the largest and most advanced facility in the world for this precise form of cancer radiation. Patients have access to one of the most sophisticated weapons against cancer, seamlessly integrated with the full range of oncology services available at Penn Medicine. Proton therapy is external beam radiotherapy in which protons are directed at a tumor.

The radiation dose that is given through protons is very precise, and limits the exposure of normal tissues. This allows the radiation dose delivered to the tumor to be increased beyond conventional radiation. The result is a better chance for curing cancer with fewer harmful side effects.

Proton therapy, like all forms of radiation therapy, works by aiming the energized particles, in this case protons, onto the target tumor. The particles damage the DNA of cells, ultimately causing their death. Unlike X-rays, protons can be manipulated to release most of their energy only when they reach their target. With more energy reaching the cancerous cells, more damage is administered by each burst of radiation.

Chemotherapy and Biologic Therapies for Colon Cancer

Penn Medicine specializes in a team approach to treatment with interdisciplinary care and innovative approaches that use chemotherapy to target tumors prior to and after surgery.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It is delivered through the bloodstream, targeting cancer cells throughout the body. Chemotherapy is usually delivered intravenously through a catheter, or orally by pill.

Biologic (Targeted) Therapy
Biologic therapy, also called targeted therapy, uses the patients' own immune system to target cancer cells. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer, and are delivered orally by pill or intravenously, such as EGFR-inhibitor therapy.  This type of cancer treatment is also called immunotherapy.

Liver-Directed Therapies

Colon cancer can spread to other organs, most often the liver. Cancer treatments are available to treat colon cancer that has spread to the liver.

Chemoembolization of the Hepatic Artery
Injecting an anticancer drug into the hepatic artery, which supplies blood to the liver, blocks blood flow to the liver and disrupts the blood supply to the tumor. This starves the tumor of blood and other nutrients.

Radiofrequency Ablation

A special probe is inserted into the colon, and uses tiny electrodes to kill cancer cells. This can be done through the skin, or through an incision in the abdomen. This is done under local or general anesthesia.

Clinical Trials for Colon Cancer

Today, more and more people are surviving cancer. Clinical trials benefit patients with access to breakthrough therapies and treatments. These new advances in cancer treatment are occurring every day at Penn Medicine, giving patients hope that even greater discoveries lie ahead. Through clinical trials:

  • Diagnosing cancer has become more precise.
  • Radiation and surgical techniques have advanced.
  • Medications are more successful.
  • Combinations of medical, surgical and radiation therapy are improving treatment effectiveness and enhancing outcomes.
  • Strategies to address the late effects of cancer and its treatment are improving quality of life.

Penn Medicine is the only health care facility in the country that is using proton therapy to treat recurrent gastrointestinal tumors in clinical trials. Also, radiation oncologists at Penn Medicine will soon use proton therapy to treat gastrointestinal cancers in the upper digestive tract.

Other Treatments for Colon Cancer

In addition to standard treatments and clinical trials, patients at Penn Medicine may wish to add additional therapies and treatments such as massage therapy, acupuncture and art therapy. These therapies do not have curative intent, and are designed to complement standard treatments – not take their place.

Integrative Medicine and Wellness Programs

At Penn Medicine, integrative medicine and wellness services can supplement traditional cancer treatments such as chemotherapy, surgery and radiation therapy. While conventional medicine plays a critical role in eradicating cancer, integrative medicine and wellness programs offer patients and their families ways to enhance the quality of their lives, minimize or reduce the side effects of cancer and cancer treatment, and promote healing and recovery.

Cancer specialists at Penn Medicine are knowledgeable and supportive of complementary cancer treatments. The cancer team works with patients and families to integrate these supportive programs into the overall care plan, while ensuring the safety and health of patients.

The Abramson Cancer Center’s range of integrative supportive services is designed to help patients cope with the cancer experience and improve their overall sense of well-being. Services include:

The Abramson Cancer Center at Pennsylvania Hospital at Pennsylvania Hospital offers a variety of supportive care programs for patients and families, from diagnosis through survivorship. These programs are available at no cost to the patients treated at Pennsylvania Hospital, and some are open to patients treated elsewhere. These services include social work counseling, nutrition counseling, psychological counseling and spiritual counseling.

The Cancer Appetite and Rehabilitation Clinic focuses on patients with loss of appetite and weight.

The Supportive Care Clinic helps to manage cancer related symptoms. Integrative support programs include:

Support groups and educational programs are available at Pennsylvania Hospital throughout the year.

Palliative Care

Palliative care provides medical and non-medical interventions to ease the symptoms of cancer and its treatment. Palliative care includes physical, emotional and spiritual care that can enhance the quality of life for cancer patients.

Palliative care can be used to complement traditional cancer therapies, or can be used to improve quality of life when curative therapies are no longer an option.

Palliative care is an approach to patient care that can be integrated with curative therapies at any point from diagnosis to survivorship or end of life care.

Palliative care services include palliative chemotherapy, radiation therapy and surgery as well as psychological counseling, art therapy and support groups for patients and families. The goals of palliative care are to enhance the quality of life for cancer patients and their families, and provide emotional and spiritual support to enhance personal growth.

Palliative care services are offered at Pennsylvania Hospital, and at the Hospital of the University of Pennsylvania.  

Penn Home Care and Hospice Services

Penn Home Care and Hospice Services offer a full range of home health care needs by partnering three top-level home health care services under one roof:

Penn Home Care and Hospice Services offer an array of specialized therapies and medications for patients with cancer and cancer-related conditions.

Oncology Navigation Specialists

Every step of cancer treatment – from cancer diagnosis, to surgery and treatment to forming a survivorship plan – comes with different needs and issues that should be addressed.

Oncology Navigation Specialists at the Abramson Cancer Center are available to make a patient’s experience as seamless as possible. As experts in navigating complex health care situations, patient support specialists serve as a consistent point of contact and a reliable source for advice, support and direction for patients and families. They can help in a variety of ways including; provide emotional support, identify resources, and ensure access to information, support services, educational programs and community resources.

Learn more about Patient Navigation specialists at the Abramson Cancer Center.

Colon Cancer Survivorship

Survivorship programs at Penn Medicine are a distinct phase of colon cancer care and are designed to help patients' transition from their cancer treatment routine to a post-cancer care lifestyle. There are more than 12 million cancer survivors living and thriving today as a result of advances in cancer treatment. However, cancer treatments can result in physical, emotional and financial complications long after the therapy is complete.

Read more Colon Cancer Survivorship


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