In the United States, more than 600,000 surgical procedures are performed each year to treat various colon diseases, including colon cancer, polyps, and inflammatory bowel diseases. For all stages of colon cancer, surgery is actually the most commonly used treatment.
Depending on the extent of cancer and its location, the type of colon surgery may vary. For example, early colon cancers and most polyps may be removed during colonoscopy, where polyps are cut off the wall of the colon with an electric current or a local excision is made to remove small cancer cells located on the internal lining of the colon.
In cases where there are some cancer cells left behind or the tumor is found to possibly spread to adjacent areas, partial or total colectomy may be required. In partial colectomy, the surgeon removes the section of the colon with cancer and reattaches the remaining part to the normal section of the colon. Total colectomy or removal of the colon is performed when other problems like the presence of hundreds of polyps or inflammatory bowel disease exist.
After the removal of all cancer cells or tumor visible at the time of the surgery, some patients may further undergo other types of standard treatments like radiation therapy and chemotherapy to ensure that possible leftover cancer is also removed.
To learn more about colon cancer stages and their treatment options, check out Battling Colon Cancer: Treatment Options by Stage.
Possible side effects of colon cancer surgery
The side effects experienced after a colon cancer procedure depend upon the extent of the surgery and the patient’s general health before the procedure.
During or immediately after the operation, patients commonly experience infection, bleeding, leak at the point where colon sections are reattached, injury to adjacent organs, and leg blood clots that may travel to the lungs. Occasionally, the bowel system may take time to work again properly. This condition called ileus may be caused by excessive anesthesia or the handling of the bowel itself during the operation. Also, rarely, the reattached sections of the colon during colectomy may possibly not hold together and leak, causing severe pain, fever, stool that cannot pass, or infection.
Just like any surgical procedure, scar tissue may develop in the abdominal part where the incision was made. This process called adhesion causes organs or tissues to stick together and the bowel to twist up. Further surgery may be required to fix this.
Post-colon cancer surgery recovery
Colon cancer surgical patients may be required to stay at the hospital for several days following the procedure. The length of hospital stay depends on the recovery progress of the patient. The average hospital stay requirement for those who have undergone partial colectomy is from three to six days.
To promote quicker recovery and avoid the risk of complications, Enhanced Recovery After Surgery (ERAS) protocols are followed by the surgical care team during hospitalization. The protocols include avoiding narcotic medications to manage pain, providing the best nutrition, and encouraging mobility as soon as patients can already get off the bed.
At home, patients are also encouraged to observe the following to continuously achieve full recovery:
- Increase activity levels
If the body allows it, a patient may go for walks, climb stairs, take a shower, and even drive during the home recovery period. These little exercises help in general recovery by strengthening the muscles, maintaining clear lungs, and keeping blood circulation in the right flow to avoid blood clots.
For patients who have been doing regular exercise before surgery, other physical activities may be resumed if their body is comfortable with it and if the doctor approves. However, strenuous activities like lifting more than 20 pounds and abdominal exercises must be avoided until six weeks following the surgery. Other activities like swimming and using hot tubs are also prohibited until the full healing of the incisions.
As a general rule, any activity that hurts must be avoided.
- Eat healthy foods and drinks
Within the first two days after the surgical procedure, a patient cannot eat or drink, so fluid drips (also called an intravenous or IV infusion) are normally administered to help maintain nutrition. The drip comes as a tube inserted into the small bowel through the nose or into the vein.
The reason for the disruption in eating or drinking habits is that surgical procedures in the colon or rectum can temporarily change bowel functions. After surgery, the bowel becomes swollen, and peristalsis (the wave-like movement of food along the intestinal tract) may be reduced. These result in slow passing of food through the colon, where one may feel bloated, or inefficient absorbance of water by the food, which is the common cause of loose stools.
Most people are able to eat small amounts of food a few days after the operation, but the type and amount must be gradually built up. For example, experts recommend a soft diet or a reduced amount of fiber in the diet after the operation, as fiber can cause loose stools. Rich fiber sources like green leafy vegetables, raw fruits, pulses, and nuts must be avoided. The same is recommended for foods that are a source of caffeine (ex. soda, energy drinks, and coffee), sorbitol (ex. sugar-free sweets and chewing gum), and alcohol (ex. beer, lager, and cider) because they increase bowel activity and loose stools.
A registered dietitian can provide a diet plan and guidelines, which the patient should follow until the next follow-up visit with the doctor. Smaller meals are often advised in the first two to three weeks to prevent discomfort. The amount is then increased slowly and bowels are observed on how they cope with the changes. If a patient finds a particular food causing stomach upsets, the food must be cut down and reintroduced later on. This continues until a regular diet is once again achieved.
- Go to follow-up appointments
To avoid cancer recurrence, manage any treatment side effects, and monitor patients’ overall health, follow-up appointments with the doctor and health care team are necessary. They are the ones responsible for keeping track of patients’ recovery in the following months and years.
These appointments, which may include medical tests and physical examinations, are especially important in the first five years following the surgical treatment because recurrence is at its highest during this stage.
