Stage 0
Since these diseases have not become past the internal covering of the colon, surgery to take out the malignancy is all that is required. This may be done as a rule by polypectomy (evacuating the polyp) or neighborhood extraction through a colonoscope. Colon resection (colectomy) might every so often be required if a tumor is too enormous to be uprooted by nearby extraction.
Stage I
These malignancies have become through a few layers of the colon, yet they have not spread outside the colon divider itself (or into the adjacent lymph hubs). Stage I incorporates tumors that were a piece of a polyp. On the off chance that the polyp is evacuated totally, with no tumor cells in the (edges), no other treatment may be required. In the event that the malignancy in the polyp was high review (see "How is colorectal growth arranged?") or there were disease cells at the edges of the polyp, more surgery may be prompted. You might likewise be encouraged to have more surgery if the polyp couldn't be uprooted totally or in the event that it must be evacuated in numerous pieces, making it difficult to check whether tumor cells were at the edges.
For tumors not in a polyp, fractional colectomy ─ surgery to evacuate the segment of colon that has growth and adjacent lymph hubs ─ is the standard treatment. You needn't bother with any extra treatment.
Stage II
A number of these tumors have become through the mass of the colon and they may stretch out into adjacent tissue. They have not yet spread to the lymph hubs.
Surgery to evacuate the area of the colon containing the disease alongside close-by lymph hubs (fractional colectomy) may be the main treatment required. Be that as it may, your specialist may suggest chemotherapy (chemo) after surgery (adjuvant chemo) if your disease has a higher danger of returning in view of specific variables, for example,
- The disease looks exceptionally anomalous (is high review) when seen under a magnifying instrument.
- The disease has developed into adjacent organs.
- The specialist did not uproot no less than 12 lymph hubs.
- Growth was found in or close to the (edge) of the surgical example, implying that some tumor may have been deserted.
- The growth had closed off (blocked) the colon.
- The growth created a puncturing (gap) in the mass of the colon.
Not all specialists concede to when chemo ought to be utilized for stage II colon growths. It is essential to talk about the upsides and downsides of chemo with your specialist, including the amount it may lessen your danger of repeat and what the possible reactions will be.
The fundamental choices for chemo for this stage incorporate 5-FU and leucovorin (alone) or capecitabine, yet different mixes might likewise be utilized.
On the off chance that your specialist is not certain the greater part of the growth was uprooted on the grounds that it was developing into different tissues, he or she may encourage radiation treatment to attempt to slaughter any staying malignancy cells. Radiation treatment can be given to the zone of your guts where the tumor was developing.
Stage III
In this stage, the tumor has spread to adjacent lymph hubs, however it has not yet spread to different parts of the body.
Surgery to evacuate the area of the colon containing the disease alongside adjacent lymph hubs (fractional colectomy) trailed by adjuvant chemo is the standard treatment for this stage. Either the FOLFOX (5-FU, leucovorin, and oxaliplatin) or CapeOx (capecitabine and oxaliplatin) regimens are utilized frequently, yet a few patients may get 5-FU with leucovorin or capecitabine alone taking into account their age and wellbeing needs.
Your specialists might likewise prompt utilizing radiation treatment if your specialist thinks some growth cells may have been deserted after surgery.
In individuals who aren't sufficiently sound for surgery, radiation treatment and/or chemo may be choices.
Stage IV
The growth has spread from the colon to inaccessible organs and tissues. Colon malignancy regularly spreads to the liver, however it can likewise spread to different places, for example, the lungs, peritoneum (the coating of the stomach hole), or far off lymph hubs.
By and large surgery is unrealistic to cure these growths. Be that as it may, if a couple of little regions of tumor spread (metastases) are available in the liver or lungs and they can be totally evacuated alongside the colon disease, surgery may help you live more and may even cure you. This would mean a fractional colectomy to evacuate the segment of the colon containing the malignancy alongside adjacent lymph hubs, in addition to surgery to uproot the territories of tumor spread. Chemo is normally given too, before and/or after surgery. Sometimes, hepatic conduit mixture may be utilized if the disease has spread to the liver.
In the event that the metastases can't be surgically uprooted in light of the fact that they are too vast or there are an excess of them, chemo may be given before any surgery. At that point, if the tumors shrink, surgery may be attempted. Chemo would then be given again after surgery. Another choice may be to crush tumors in the liver with removal or embolization.
On the off chance that the tumor is excessively boundless, making it impossible to attempt to cure it with surgery, chemo is the primary treatment. Surgery is here and there required if the tumor is hindering the colon (or is liable to do as such). In some cases, such surgery can be kept away from by embeddings a stent (an empty metal or plastic tube) into the colon amid colonoscopy to keep it open. Something else, operations, for example, a colectomy or redirecting colostomy (cutting the colon over the level of the tumor and appending the end to an opening in the skin on the belly to permit waste out) may be utilized.
On the off chance that you have stage IV malignancy and your specialist prescribes surgery, it is critical to comprehend the objective of the surgery ─ whether it is to attempt to cure the tumor or to counteract or diminish indications of the ailment.
Most patients with stage IV malignancy will get chemo and/or focused on treatments to control the growth. The most regularly utilized regimens include:
- FOLFOX: leucovorin, 5-FU, and oxaliplatin (Eloxatin)
- FOLFIRI: leucovorin, 5-FU, and irinotecan (Camptosar)
- CapeOX: capecitabine (Xeloda) and oxaliplatin
- Any of the above mixes in addition to either bevacizumab (Avastin) or cetuximab (Erbitux) (however not both)
- 5-FU and leucovorin, with or without bevacizumab
- Capecitabine, with or without bevacizumab
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan
- Irinotecan, with or without cetuximab
- Cetuximab alone
- Panitumumab (Vectibix) alone
- Regorafenib (Stivarga)
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