Introduction
Colorectal cancer is one of the most common tumors, but also one of the most responsive to treatment when detected early. Surgery is the main treatment and, in many cases, curative.
This guide will help you understand what to expect before, during, and after the procedure, and what your recovery will be like.
The colon and rectum
The colon (large intestine) and rectum form the final part of the digestive system:
- Colon: Measures approximately 1.5 meters and is divided into ascending, transverse, descending colon, and sigmoid
- Rectum: The last 15-20 cm before the anus, where stool is stored
Their main function is to absorb water and salts and to store waste until it is eliminated.
Symptoms of colorectal cancer
Symptoms may vary depending on tumor location:
- Changes in bowel habits (constipation or diarrhea)
- Blood in stool (red or dark)
- Persistent abdominal pain
- Feeling of incomplete bowel movement
- Unexplained weight loss
- Tiredness and weakness (from anemia)
Important: Many of these symptoms may have other causes, but should always be discussed with a specialist.
Treatment of colorectal cancer
Treatment depends on tumor location and stage:
Colon cancer
- Surgery is usually the first treatment
- Depending on stage, chemotherapy may be needed afterward (adjuvant)
Rectal cancer
- Often starts with chemoradiation (neoadjuvant)
- Surgery is performed after this prior treatment
- May be completed with later chemotherapy
Types of surgery
Colon cancer surgery
- Right hemicolectomy: Removal of the right colon (ascending and part of transverse)
- Left hemicolectomy: Removal of the left colon (descending)
- Sigmoidectomy: Removal of the sigmoid
- Total colectomy: In specific cases, removal of the entire colon
Rectal cancer surgery
- Anterior resection: Removal of the rectum with sphincter preservation
- Low/ultra-low anterior resection: For lower tumors
- Abdominoperineal resection: When the tumor is very close to the anus
Most of these procedures can be performed laparoscopically (minimally invasive surgery), which allows for faster recovery.
The stoma: what it is and when it is needed
A stoma is an opening in the abdomen where the intestine comes out, so that stool can empty into a bag.
Types of stoma
- Colostomy: When the colon is brought out
- Ileostomy: When the small intestine is brought out
Temporary or permanent?
- Temporary: Created to protect a suture. Closed months later with another procedure
- Permanent: When sphincter preservation is not possible
If you will have a stoma, a specialized nurse (stoma therapist) will teach you how to care for it. Over time, most patients learn to manage it as a normal part of life.
Preparation for surgery
- Bowel preparation: In some cases, colon cleansing with laxatives
- Fasting: According to team instructions
- Nutrition: Optimization of nutritional status beforehand
- Stop smoking: At least 4 weeks before
- Physical activity: Maintain mobility
- Stoma marking: If planned, the nurse will mark the best location
Postoperative period
First days
- Pain control with analgesia
- Early start of fluids and diet
- Mobilization from the first day
- Recovery of bowel transit (gas, bowel movements)
Hospitalization
- Laparoscopic surgery: Usually 3-5 days
- Open surgery: 5-7 days
- May vary depending on complexity and progress
Possible complications
Anastomotic leak
Leak at the junction between the two ends of the intestine:
- More common in rectal surgery
- May require reoperation or drainage
- In some cases, temporary stoma
Paralytic ileus
Delayed recovery of intestinal movement:
- Causes abdominal distension and nausea
- Usually resolves spontaneously
- Early mobilization helps prevent it
Other complications
- Postoperative bleeding
- Wound infection
- Urinary retention
Recovery at home
Once home, recovery continues:
- Diet: Progressive diet, avoiding gas-producing foods initially
- Physical activity: Walk from the beginning, gradually increase
- Wound: Basic care according to instructions
- Stoma (if you have one): Follow-up with stoma therapist
Changes in bowel habits
It is normal to experience changes after surgery:
- Increased frequency of bowel movements
- Softer stools
- Urgency to defecate (especially after rectal surgery)
These symptoms usually improve over time.
Oncological follow-up
Follow-up after surgery includes:
- Periodic check-ups with your medical team
- Blood tests including tumor markers (CEA)
- Surveillance colonoscopy
- Imaging tests (CT) according to stage
- Evaluation of adjuvant chemotherapy if indicated
Quality of life
Most patients return to a normal life after colorectal surgery:
- Can eat everything (with some initial adaptations)
- Can exercise
- Can work and perform usual activities
- With a stoma, can lead a completely active life
A message of hope
When treated properly, colorectal cancer has high cure rates. Laparoscopy allows a faster recovery with fewer after-effects, and most patients return to their normal lives after treatment.
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