Treatment of Stage I Colorectal Cancer

This content has been reviewed and approved by

Howard Burris, MD
Director, Drug Development
Sarah Cannon Cancer Center
Tennessee Oncology

Stage I colorectal cancer is typically treated with surgery (either resection or laparoscopic surgery) to remove the cancer.

• Resection - Your doctor will remove the cancer and a small amount of the healthy tissue surrounding the cancer. The doctor will usually sew the healthy parts of the colon together so that your bowel can continue to function normally. This procedure is known as anastomosis. In anastomosis, the doctor often removes lymph nodes near the colon and examines them under a microscope to find out if they have any cancer cells.
• Laparoscopic surgery (also known as keyhole surgery) - In some cases, Stage I colorectal cancer can be treated with laparoscopic surgery. In laparoscopic surgery, the surgeon uses a laparoscope, or tiny telescope connected to a video camera. The laparoscope is put into a narrow tubelike instrument called a cannula, which has been inserted into the abdomen. The laparoscope shows a magnified view of the colon on a monitor. The surgeon inserts several other cannulas to work inside and take out part of the colon. The cuts needed to insert the cannulas are usually small and heal quickly.

If you have rectal cancer and you are too sick to handle surgery, you might be treated only with radiation therapy.

• Endocavity radiation therapy - This radiation is also given by a machine outside the body. A hand-held device is put into your anus. The device delivers high-intensity radiation for a few minutes. This is done three more times every 2 weeks or so. This procedure lets the radiation reach your rectum without going through the skin or other tissues in the abdomen. It might let you avoid major surgery and colostomy, but it is usually only used for small tumors. Sometimes, it is given in combination with external beam radiation.
• Internal radiation therapy - Internal radiation therapy is also called brachytherapy. In this type of treatment, small pellets that contain radioactive materials are placed in your body near the tumor. Brachytherapy lets the doctor use a higher dose of radiation, but it can only be used if the doctor can reach the tumor to place the pellets. Brachytherapy is sometimes used for people with rectal cancer, especially if they are too sick or weak to have curative surgery. This type of treatment is a one-time procedure.