Surgery for Colon Cancer
Overview
Surgery is the most common treatment for colon cancer.
Your surgeon will talk with you about which surgery is best for you, based on:
- How far the cancer has spread.
- The stage.
- Your family history and genetic risk.
- Your personal preferences.
MSK surgeons may be able to use minimally invasive methods that do less harm to the body. You may recover faster, with fewer side effects. Surgery may sometimes be used along with other therapies.
Our colon cancer surgeons are experts in the latest surgery methods. Connect with our Care Advisors to start planning your care.
Types of surgery for colon cancer
There are a few types of colon surgeries to remove colon polyps or tumors. Your surgeon will talk with you about which type you’ll have. We explain some surgeries in this section.
Words you may hear about colon cancer surgery
- Ostomy
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An ostomy (OS-toh-mee) is an opening created during surgery. An ostomy can be made out of the small intestine (ileostomy) or colon (colostomy). An ostomy can be temporary, for just a few months or weeks. Or it can be permanent, for all of your life.
- Ileostomy
-
An ileostomy (IL-ee-OS-toh-mee) is when your surgeon brings a piece of your intestine to the outside of your abdomen (belly).
An ileostomy changes the way stool (poop) comes out of your body. It will now come through the ostomy. An ileostomy can be temporary, for just a few months or weeks. Or it can be permanent, for all of your life.
- Colostomy
-
A colostomy (koh-LOS-toh-mee) is when your surgeon brings a piece of your colon to the outside of your abdomen (belly). A colostomy changes the way stool (poop) comes out of your body.
Some people have a colostomy for a few weeks or months while their body heals. Others need one for life, called a permanent colostomy.
These types of colostomies connect parts of your colon to the wall of your belly.
- A sigmoid colostomy connects the sigmoid colon and is the most common type.
- A descending colostomy connects the left colon.
- A transverse colostomy connects the transverse colon and often is temporary.
- Stoma
-
A stoma is the part of your intestine or colon that’s on the outside of your body. It will look red and moist, like the inside of your mouth. Your stoma will be swollen right after surgery, but it will get smaller in 6 to 8 weeks.
- Colostomy or ostomy pouching system (bags)
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Pouching (bag) systems are worn over an ostomy. These bags are also called colostomy bags or ostomy bags. They’re waterproof pouches made up of a skin barrier (wafer) and a collection pouch.
Instead of pooping like you did before, your poop collects in a bag on the outside of your body. This pouch attaches to your abdomen (belly). It fits over and around your stoma to collect stool.
At MSK, almost everyone with colon cancer can avoid a permanent colostomy because we use the latest surgery methods. People who need a permanent colostomy will use a bag to collect stool for the rest of their lives.
A stoma after a colostomy.
Polypectomy during a colonoscopy
When colon cancer is found early, it’s often just an abnormal (not normal) growth on the inside lining of the colon. This is called a polyp. The cancer may be in the polyp.
Removing polyps during a colonoscopy is called a polypectomy (PAH-lee-PEK-toh-mee). It may be the only treatment you’ll need.
Your doctor places a flexible tube, called a colonoscope, into your rectum and into your colon. The scope lets them see inside your anus, rectum, and colon. The scope is connected to a video monitor. Watch our video to learn what happens during a colonoscopy.
What happens during a polypectomy:
Your doctor passes a wire loop through the colonoscope. The loop has an electric current that can cut the polyp from the colon wall.
Colon cancer may have spread through the colon. If so, treatment is a type of surgery called a colectomy.
Endoscopic submucosal dissection (ESD) during a colonoscopy
An endoscopic submucosal dissection (en-doh-SKAH-pik sub-myoo-KOH-sul dy-SEK-shun) is a procedure to remove tumors from the colon using the colonoscope.
An ESD treats tumors and lesions in the submucosa. It can remove colon polyps and early-stage tumors. It can also remove colon tumors that have not yet spread deep into the colon wall.
Sometimes your doctor cannot do an ESD during a colonoscopy or sigmoidoscopy.
Colon resection surgery
In a colon resection, your surgeon removes the part of your colon with the cancer. Then they connect the healthy ends of your colon back together.
Colon anatomy: Your surgeon will explain which part of your colon they’ll remove
Colectomy
A colectomy (koh-LEK-toh-mee) is a procedure to remove part or all of the colon. Your surgeon also removes nearby lymph nodes. There are a few kinds of colectomies.
During a segmental (seg-MEN-tul) colectomy, your surgeon removes a few inches of your colon that has the polyps or tumors. In most cases, your surgeon reconnects your colon.
Most people recover from a segmental colectomy very well. In just a few months, they can go to the bathroom the same as before surgery.
- Right hemicolectomy: Removes the ascending colon and the cecum.
- Left hemicolectomy: Removes the descending colon.
- Total colectomy: Removes all of the colon.
The healthy parts of the colon are reconnected.
Most people with colon cancer do not need a colostomy. It depends on the stage and location of the colon cancer.
If you need a colostomy, most often it’s reversed (changed back) after a short time. Your surgeon will reconnect the 2 ends of the colon. You can go back to how you used the bathroom before surgery.
For a few people, the colostomy may be permanent. You’ll wear a pouching (bag) system over your ostomy to collect stool.
It’s natural to feel anxious about this big change. An MSK wound, ostomy, and continence (WOC) nurse will support you as you have a colostomy or colostomy bag.
Open surgery for colon cancer
Traditional surgery is often called open surgery. Your surgeon does a single incision (cut) large enough to operate using their tools by hand.
You’ll be in the hospital for 5 to 7 days to recover from this type of surgery.
In general, people who have open surgery or minimally invasive surgery have similar long-term results.
Minimally invasive colon cancer surgery
MSK surgeons are experts in surgery methods that do less harm to your body. Minimally invasive surgery does less harm to your body because it’s done with small incisions (cuts).
Minimally invasive surgery methods are laparoscopy and robot-assisted surgery.
At MSK, we use minimally invasive surgery methods for some colon cancer operations. We may use this method if the tumor is smaller and in a certain part of the colon.
Benefits of minimally invasive surgery for colon cancer include:
- Less loss of blood.
- A shorter hospital stay.
- A faster recovery.
- Less scarring.
- Less pain.
- Less risk of infection.
- Fewer complications (problems) during and after surgery.
- Less risk than regular surgery for people with other health conditions.
MSK does hundreds of minimally invasive surgeries each year. It’s one of the busiest cancer centers for these procedures.
Laparoscopic (LA-puh-ruh-SKAH-pik) surgery is called a laparoscopy. Your surgeon uses a thin tube with a light and video camera at its tip.
This tool is called a laparoscope. It’s inserted (put) through a small cut in the wall of the abdomen (belly). It lets your surgeon see the images from the laparoscope on a television monitor.
Laparoscopy uses special instruments to remove the colon cancer tumors and body parts with colon cancer.
With robotic-assisted surgery, your surgeon uses the da Vinci® Surgical System. They sit at a console and control a robot that moves the surgical tools. There are hand, finger, and foot controls.
The console has a special monitor where they can see very clear 3D images from a special flexible tool inside your colon. Your surgeon can see and remove a tumor. MSK’s operating rooms have the latest technology, including 11 robotic platforms.
Robotic-assisted surgery uses special instruments to remove the colon cancer tumors and areas with cancer.
MSK leads the nation in doing the most colorectal robotic surgeries. Our surgical skills with this technology come from many years of experience. MSK surgeons do more than 700 robot-assisted colorectal surgeries each year. Almost half of our surgeries for colorectal cancer are done robotically.
Tools for predicting colon cancer survival and cancer coming back
MSK’s online prediction tools (nomograms) predict colon cancer 5-year survival rates and the chance of recurrence after colon cancer surgery.
One nomogram calculates the chance of colon cancer recurrence (cancer coming back) 3 or 5 years after your surgery.
The other nomogram predicts the chance you’ll survive colon cancer at least 5 years after your surgery.
Learn more about our colon cancer clinical calculators.
Common questions
You may have many questions if your care team recommends surgery for colon cancer. Here are some examples.
- What surgery do you recommend for me and why?
- Will I need other treatments before or after surgery?
- How long will I be in the hospital?
- When will I know the results of my surgery?
- What are the risks and side effects? Will any of them be long-term?
- Are there any special diets or foods I should have or avoid?
- Will I be able to go back to normal activities?
- Can I get follow-up care at MSK’s locations in New Jersey, on Long Island, or in Westchester?
Colon cancer that has metastasized (spread) to other organs may need a few types of treatments. Metastatic colon cancer is also called advanced or stage 4 colon cancer.
Your treatment options depend on a few things, such as tumor size and which organs cancer has spread to.
Colon cancer most often spreads to the liver. It can also spread to the lungs, lining of the abdomen, ovaries, brain, or other organs.
When the cancer is in the liver, surgery often can remove tumors in both the colon and the liver. MSK surgeons operate on hundreds of people with liver metastasis each year.
To help your colon heal, you’ll change how you eat for the first few weeks after surgery.
- Eat small meals often. Try to have 6 small meals throughout the day instead of 3 large ones.
- Eat slowly and chew your food well.
- Drink 8 to 10 (8-ounce) glasses (about 2 liters) of liquids every day.
- Eat mostly bland, low-fiber foods.
If you had a colostomy, you can follow these diet guidelines.
When part of your colon is removed, the part that’s left adapts to the change. Your colon will start to adapt shortly after your surgery. During this time, you may have gas, cramps, or changes in your bowel habits. This can include diarrhea (loose stool). These changes may take weeks or months to go away.
If you’re having problems with changes in how your bowel works, talk with your healthcare provider.