Houston Colon and Rectal Surgery

Treating stage II re**al cancer

Many stage II re**al cancers have grown through the wall of the re**um and might extend into nearby tissues. They have not spread to the lymph nodes.

Most people with stage II re**al cancer will be treated with chemotherapy, radiation therapy, and surgery, although the order of these treatments might be different for some people. For example, here’s a common approach to treating these cancers:

Many people get both chemo and radiation therapy (called chemoradiation) as their first treatment. The chemo given with radiation is usually either 5-FU or capecitabine (Xeloda).

This is usually followed by surgery, such as a low anterior resection (LAR), proctectomy with colo-a**l anastomosis, or abdominoperineal resection (APR), depending on where the cancer is in the re**um. If the chemo and radiation therapy shrink the tumor enough, sometimes a transa**l resection can be done instead of a more invasive LAR or APR. This might help you avoid having a colostomy. But not all doctors agree with this method, because it doesn’t let the surgeon check the nearby lymph nodes for cancer. Also the radiated re**um does not heal well predisposing you higher rates of wound breakdown

Additional chemo is then given after surgery, usually for a total of about 6 months. The chemo may be the FOLFOX regimen (oxaliplatin, 5-FU, and leucovorin), 5-FU and leucovorin, CAPEOX (capecitabine plus oxaliplatin) or capecitabine alone, based on what’s best suited to your health needs.

Another option might be to get chemotherapy alone first, followed by chemo plus radiation therapy, then followed by surgery.
**alsurgeon

reating stage I re**al cancer

Stage I re**al cancers have grown into deeper layers of the re**al wall but have not spread outside the re**um itself.

This stage includes cancers that were part of a polyp. If the polyp is removed completely during colonoscopy, with no cancer in the edges, no other treatment may be needed. If the cancer in the polyp was high grade (see Colore**al Cancer Stages), or if there were cancer cells at the edges of the polyp, you might be advised to have more surgery. More surgery may also be advised if the polyp couldn’t be removed completely or if it had to be removed in many pieces, making it hard to see if there were cancer cells at the edges (margins).

For other stage I cancers, surgery is usually the main treatment. Some small stage I cancers can be removed through the a**s without cutting the abdomen (belly), using transa**l resection or transa**l endoscopic microsurgery (TEM). For other cancers, a bigger surgery is required to remove the cancer bearing part of the re**um. This usually entails a low anterior resection (LAR), proctectomy with colo-a**l anastomosis, or an abdominoperineal resection (APR) may be done, depending on exactly where the cancer is located within the re**um.

Additional treatment typically isn't needed after these operations, unless the surgeon finds the cancer is more advanced than was thought before surgery. If it is more advanced, a combination of chemo and radiation therapy is usually given. 5-FU and capecitabine are the chemo drugs most often used.

If you're not healthy enough to have surgery, you may be treated with chemotherapy given with radiation therapy.

Once again most of these cancers are curable with appropriate treatment.

**alsurgeon

Hemorrhoids are enlarged, bulging blood veins in and about the re**um. There are two types of Hemorrhoids: external and internal, which refer to their location.

External (outside) hemorrhoids develop near the a**s. These are usually painless. However, if a blood clot develops in an external hemorrhoid, it becomes a painful, hard lump. The external hemorrhoid may bleed if it ruptures.

Internal (inside) hemorrhoids develop within the re**um. Painless bleeding and protrusion during bowel movements are the most common symptoms. However, an internal hemorrhoid can cause severe pain if they protrude from the a**l opening and cannot be pushed back inside

What are the symptoms?

If you notice any of the following, you could have hemorrhoids:
• Bleeding during bowel movements
• Protrusion during bowel movements
• Itching in the a**l area
• Pain
• Sensitive lump(s)

How are hemorrhoids treated?

Mild symptoms can be relieved frequently by increasing the amount of fiber (e.g., fruits, vegetables, breads and cereals) and fluids in the diet. Eliminating excessive straining reduces the pressure on hemorrhoids and helps prevent them from protruding. A sitz bath - sitting in plain warm water for about 10 minutes - can also provide some relief.

Contrary to popular belief, surgery for hemorrhoids is not very pain full. In many cases hemorrhoids can be ligated using rubber bands or sutures. A small rubber band is placed over the hemorrhoid, cutting off its blood supply. The hemorrhoid shrinks and falls off in a few days. This procedure sometimes produces mild discomfort.

Do hemorrhoids lead to cancer?

No. There is no relationship between hemorrhoids and cancer. However, the symptoms of hemorrhoids, particularly bleeding, are similar to those of colore**al cancer. It is therefore very important not to ignore any of these symptoms.