Introduction
When it comes to cancer care, various medical specialties frequently work together to develop a patient's comprehensive treatment plan, which typically consists of or combines a variety of procedures. This is called a multidisciplinary team. This usually includes a surgeon, gastroenterologist, medical oncologist, and radiation oncologist for colorectal cancer. A physician who focuses on the health and diseases of the gastrointestinal system is known as a gastroenterologist. Numerous other medical specialists are involved in cancer care teams, including physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dieticians, and other professionals.
What Are the Treatment Options for Colorectal Cancer?
The type and stage of the cancer, potential side effects, the patient's preferences, and their general health are some variables that affect treatment options and recommendations. Make sure to ask questions about any unclear things and spend some time learning about all of the possibilities for treatment. Discuss the objectives of each treatment and what to anticipate from the procedure with the physician. These discussions are called ‘shared decision-making’. This is known as shared decision-making when the patient and the healthcare provider collaborate to select treatments that meet the patient's care goals. Collaborative decision-making can be particularly vital because there are various treatment options for colorectal cancer.
The most popular treatment for colorectal cancer is surgery, which can be as minimally invasive as excising a polyp during a colonoscopy or, in extreme circumstances, removing the entire colon. Tumors, surrounding normal tissue, adjacent lymph nodes, and the colonic segment in which the tumor was discovered are all removed during many colorectal cancer surgeries. For colon cancer, patients may get radiation therapy along with chemotherapy before, during, or following surgery. These adjuvant medicines target cancer cells that may linger after surgery and help decrease tumors before they are physically removed.
The cancer stage may have an impact on the kind of colorectal surgery performed. Treatment options for early-stage malignancies include local procedures that avoid abdominal incisions by the surgeon. More complicated procedures, such as the removal of the entire or partial colon or rectum, may be necessary for advanced-stage malignancies. The course of treatment for colorectal cancer may include surgery to remove tumors in distant parts of the body, such as the liver, if the cancer has spread there.
How Can Treatment for Colorectal Cancer Be Personalized?
Research has indicated that the advantages of these diverse therapy modalities are comparable for patients of all ages. However, elderly patients could face particular difficulties concerning the treatment they receive. Every decision about therapy should take into account the following to customize care for each patient:
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Other health issues of the patient.
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The overall health of the patient.
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The possible adverse effects of the treatment plan.
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Additional drugs currently used by the patient.
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The patient's level of nutrition and social support.
How Are the Treatment Options Modified for the Elderly?
Before choosing and beginning surgical treatment, it is important to consider the variety of comorbid medical and psychological conditions that elderly individuals frequently present with. Therefore, to provide a more customized approach to assure optimal treatment among many possibilities for therapy, the importance of a holistic evaluation, a multidisciplinary approach, and careful preoperative screening are highlighted as essential first steps.
How Is Surgery for Colorectal Cancer Personalized for the Elderly?
It is frequently accepted that older people have more excellent rates of morbidity and mortality due to their increased comorbidities. According to a study, older patients had higher rates of comorbidities, were more likely to require emergency surgery, and were less likely to receive curative care. The same research showed that cancer-specific survival did not decrease despite a reduction in the overall survival rate.
A common sign of advanced disease, particularly in the older population, is bowel blockage. Right colon cancer exhibits obstructive symptoms very rarely, and when it does, surgical intervention is nearly always required. On the contrary, care for left colon cancer has been controversial because it is more often the cause of intestinal obstruction on onset.
How Is Surgery Personalized for the Advanced Stages of Colorectal Cancer?
When compared to the treatment of primary colorectal cancer without local problems, therapy regimens for advanced stages of the disease are noticeably more complex and call for a distinct approach. Hepatic metastasis, lung metastasis, and peritoneal carcinosis are the three primary types of metastatic spread caused by colorectal cancer. It is necessary to distinguish between distinctive forms of occurrence. Firstly, metastases can develop in a synchronous or metachronous fashion based on the original diagnosis; secondly, the disease can manifest in a diffuse or oligometastatic pattern, and it can be treatable, treatable following pretreatment, or incurable. One of the key therapy pillars that has a significant impact on the prognosis of patients with hepatic metastatic colorectal cancer is surgical resection.
In most cases of primary as well as secondary colorectal cancer, aggressive surgical techniques aimed at total removal of the malignancy are associated with better disease-free and overall survival. The influence on quality of life must be considered while weighing the radicality of surgery. In many cases, multidisciplinary therapy techniques are advised to attain a high quality of life and healing. Oncologic surgery has demonstrated the value of new technological advancements, like minimally invasive surgery, which aim to improve patient comfort and quality of life.
How Is Surgery Personalized for the Pulmonary Metastasis of Colorectal Cancer?
Numerous surgical modifications have been proposed since Blalock's 1946 publication on the first pulmonary metastasectomy (removal of pulmonary metastasis) for colorectal cancer. To improve the patient's chances of survival and recovery, the primary objective of the surgical resection has historically been to obtain histological confirmation of metastatic disease while carrying out a thorough excision of all detected lesions. Pulmonary metastases can vary widely in size, local growth qualities, histological features, and origin. Additionally, the surgeon must determine how to modify the surgical approach and resection procedure to suit the specific form of Pulmonary metastases. Additionally, novel methods for achieving resection with an appropriate safety margin are provided by contemporary surgical procedures, such as laser resection and the Video-Assisted Thoracoscopic Surgery (VATS) approach.
For pulmonary metastasectomy, VATS in conjunction with pre-operative thin slice CT imaging is becoming increasingly popular. Reduced post-operative pain, smaller incisions, improved pleural cavity visualization, lower surgical morbidity, shorter hospital stays, fewer adhesions in cases of repeat metastasectomy, and a shorter time between surgery and adjuvant therapy with improved treatment compliance are some benefits of the VATS approach.
Conclusion
Different treatments may be recommended for each stage of colorectal cancer. Colorectal cancer is among the most prevalent cancers in the world. Many methods are now available to identify colorectal cancer as precursor lesions or in its early stages, avoiding the need for harsh treatment. Depending on the stage, age of the patient, or presentation of the colorectal cancer, several treatments could be advised.
