Colorectal Cancer

WHAT YOU SHOULD KNOW:

• Colorectal cancer starts as a tumor (lump) in the colon and rectum. The colon and rectum are also called the large bowel. These are parts of the digestive system where stools are formed. Having a family history of colorectal cancer puts you at a higher risk of having the disease. Having certain diseases, such as polyps and ulcerative colitis, and eating a diet high in fat and low in fiber also puts you at a higher risk.
  
  
• At first you may have no signs and symptoms of the disease. Later, you may have bloody, black, or pencil-thin stools. You may also notice some changes in your bowel habits, such as diarrhea and constipation. You may have a colonoscopy, barium enema, and abdominal ultrasound to learn if you have colorectal cancer. Treatment may include anticancer medicines, radiation, and surgery. The chances of surviving colorectal cancer are better when it is found and treated as soon as possible.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Some treatments for colorectal cancer cause unpleasant side effects. You could get an infection or bleed too much if the cancer is removed with surgery. Your chance of stopping cancer from spreading is better if you are treated. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• If the cancer is not treated, it can spread to other parts of your body. Once cancer spreads, it becomes more difficult to treat and you can have other serious medical problems. Call your caregiver if you are worried or have questions about your disease, medicines, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity:

You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

Diet:

It is important that you get good nutrition when you have cancer. Eat a variety of healthy foods. Eating healthy foods may help you feel better and have more energy. If you have trouble swallowing, you may be given foods that are soft or in liquid form. Ask your caregiver about any extra nutrition you may need, such as nutrition shakes or vitamins. Tell your caregiver if you have problems eating, or if you are getting sick to your stomach.

Drinking liquids:

Men 19 years old and older should drink about three Liters of liquid each day (about 13 eight-ounce cups). Women 19 years old and older should drink about two Liters of liquid each day (about 9 eight-ounce cups). It is especially important to drink enough liquids if you are vomiting (throwing up) from chemotherapy. Follow your caregiver's advice if you must change the amount of liquids you drink. For most people, healthy liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty. It may be helpful to drink liquids between your meals instead of with your meals.

Medicines:

You may need one or more of the following medicines:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Tests:

Your caregiver will do tests to learn what stage the cancer is in. Staging includes measuring the lump and also having tests to see if the cancer has spread. Test results will help your caregiver decide on a treatment plan. You may need one or more of the following tests:

• Abdominal ultrasound: This test is done so caregivers can see the tissues and organs of your abdomen. Gel will be put on your abdomen and a small sensor will be moved across your abdomen. The sensor uses sound waves to send pictures of your abdomen to a TV-like screen.
  
  
• Barium enema: A barium enema is an x-ray of the colon. A tube is put into your anus, and a liquid called barium is put through the tube. Barium is used so that caregivers can see your colon better on the x-ray film.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
  • You may need a test that looks for a chemical in the blood called carcinoembryonic antigen (CEA). CEA is a "tumor marker" which may be found in people with colorectal cancer.
    
    
  
  
• Bone scan: This test uses a special x-ray machine with a computer to take pictures of your bones. Caregivers look at the pictures to see if the cancer has spread to your bones. This test may be done if you have bone pain.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Colonoscopy: A colonoscopy is a test that is done to look at your colon. A tube with a light on the end will be put into your anus, and then moved forward into your colon.
  
  
• CT scan: This test is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your abdomen (stomach). Caregivers look at the pictures to see if there is colon cancer and if it has spread to the liver. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps the cancer show up better in the pictures. Tell your caregiver if you are allergic to shellfish (lobster, crab, or shrimp) as you may be allergic to this dye.

Treatment options:

Your treatment may change if the cancer continues to grow. You may have one or more of the following treatments:

• Biologic therapy for cancer: Biologic therapy is medicine given to help your body fight growing cancer cells. It may also make cancer cells weaker and easier to kill. You may need this medicine more than once. You may feel like you have the flu during this therapy.
  
  
• Chemotherapy:
  
  
  • This medicine, often called chemo, is used to treat cancer. It works by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them. Once the tumor is smaller, you may need surgery to cut out the rest of the cancer.
    
    
  • Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy can cure some cancers. Even if the chemotherapy does not cure your cancer, it may help you feel better or live longer.
  
  
• Radiation: Radiation shrinks tumors and kills cancer cells with x-rays or gamma rays. Radiation may be given after surgery to kill cancer cells that were not removed. It may also be given alone or with chemotherapy to treat cancer.
  
  
• Surgery: Your need for surgery depends on the stage of the colon cancer. All or part of your colon or rectum may be removed. You may also need to have some lymph nodes removed. This may keep the cancer from spreading to other parts of your body. Surgery is often the only treatment needed if the cancer is found early. After the diseased bowel is removed, the surgeon may be able to connect the healthy parts of the colon and rectum together.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Colorectal Cancer (Inpatient Care)