People who have colorectal cancer may require surgery to remove the tumor. Surgical procedures can be minimally invasive, but they can also be major, involving the removal of a large portion of the colon.
This article reviews common terms associated with colorectal cancer surgery, what the different procedures involve, and how much they may cost. It also answers some frequently asked questions.
When speaking with a doctor or researching colorectal cancer surgery, a person will likely come across a variety of terms related to the procedure.
In the table below, we explain the meaning of terminology related to colorectal cancer.
|Abdomen||This is the part of the body between the chest and the pelvis. Colorectal surgery may involve cutting into the abdomen.|
|Anal cancer||Anal cancer forms in the anus, which is the end of the large intestine.|
|Biopsy||This refers to the removal of a small piece of tissue that doctors use to check for cancer.|
|Catheter||Doctors use this small tube to either take fluids from or put them into the body.|
|Colectomy surgery||During this procedure, a doctor removes a part or all of the colon.|
|Colonoscope||A colonoscope is a long, flexible tube that doctors insert into the anus to examine the inside of the colon.|
|Colonoscopy||A colonoscopy is a procedure where a doctor inserts a colonoscope into the anus to examine the colon.|
|Colostomy||In this procedure, a surgeon makes a small incision in the abdomen and places one end of the colon through to allow for the passing and collection of feces.|
|Endoscopy||An endoscopy is any procedure in which a doctor inserts a long, flexible tube into the body. If they examine the colon, they typically call it a colonoscopy.|
|Enema||Healthcare professionals usually use this in preparation for a colonoscopy or other procedure. It involves inserting a medicated fluid into the rectum to induce a bowel movement.|
|General anesthesia||This is a medication-induced state where a person does not feel anything and is unaware of what is going on during a procedure.|
|Histologic grade||Healthcare professionals use this system to determine the aggressiveness of tumors.|
|Immunomodulator||Doctors use this medication to suppress, enhance, or otherwise alter how the immune system works.|
|Inoperable||When a doctor refers to a tumor as inoperable, it means that they are unable to use a surgical procedure to remove it. In some cases, they may try chemotherapy, radiation, or other therapy to help reduce the size of the tumor so they can operate on it.|
|Local anesthesia||Doctors use local anesthesia to temporarily remove sensation from a small portion of the body.|
|Open surgical procedure||This refers to surgery that doctors perform through a large incision in the abdomen.|
|Pelvic exenteration||In this procedure, a surgeon removes all the organs of the pelvis, including the rectum.|
|Polyp||A polyp is a small growth that can develop into cancer. Polyps can grow in organs such as the colon and rectum.|
|Polypectomy||This is the surgical removal of a polyp.|
|Resection, or colectomy||This procedure involves the removal of cancerous tissue, as well as some healthy tissue and local lymph nodes.|
|Sedation||Sedation is the process of making someone feel sleepy or calm and often precedes a colonoscopy.|
|Sigmoidoscope||A sigmoidoscope is a long, flexible instrument that doctors use to perform a sigmoidoscopy.|
|Sigmoidoscopy||A sigmoidoscopy is an examination where a doctor examines the sigmoid colon, which is the part of the colon that empties into the rectum.|
|Stoma||A stoma is an opening that a surgeon makes between a cavity or canal, such as the large intestine, and the skin.|
|Ultrasound||An ultrasound uses sound waves to create an image of a part of the body.|
|Virtual colonoscopy||A virtual colonoscopy uses a combination of X-rays and computers to create an image of the inside of the colon.|
|Wide surgical resection||This involves removing the cancerous part of the colon, as well as healthy tissue and local lymph nodes.|
A polypectomy is a minimally invasive procedure that doctors carry out during a colonoscopy.
It involves inserting a wire into the colonoscope and wrapping around the base of a cancerous polyp. Once the wire is in place, a doctor uses an electric current to cut out the polyp.
A local excision is another minimally invasive procedure that doctors conduct during a colonoscopy. However, it is a bit
During a local excision, a surgeon inserts instruments into the colon to remove cancerous growths inside the colon. To guide the procedure, the surgeon uses a colonoscope.
Doctors may perform a local excision for stage 0 or stage 1 tumors.
A colectomy involves partial or full removal of the colon and surrounding lymph nodes.
A surgeon may perform the procedure in more advanced cases of colon cancer where the cancer has started to spread within the colon.
A segmental resection, also known as a partial colectomy or hemicolectomy, involves removing a part of the colon. During the procedure, a surgeon will remove about one-quarter to one-third of the colon, including the cancerous portion and some healthy tissue on either side. They will also remove a minimum of 12 lymph nodes to check for cancer.
A total colectomy involves the removal of the entire colon from a person’s body. A surgeon will likely not suggest a total colectomy unless another condition makes it necessary, such as the presence of hundreds of polyps, or another underlying health condition, including inflammatory bowel disease, is present.
The American College of Surgeons states that a surgeon can perform both types of colectomy in two different ways — an open colectomy or a laparoscopic colectomy.
During an open surgery, a surgeon makes an incision in the abdomen and performs the procedure through that incision.
A laparoscopic procedure involves making several smaller incisions and inserting instruments through the openings to remove all or part of the colon. This type of procedure
A person should speak with a doctor about what procedure is best for them. Laparoscopic procedures require additional expertise that not all doctors have, so they may not be available to everyone.
A surgeon may perform a colostomy or ileostomy to
Both procedures involve redirecting either the large or small intestine to a stoma in the skin of the abdomen. The stoma will allow stool to pass until the doctor has treated the blockage or the damage that has resulted from the cancer.
A colostomy will redirect the large intestine, and an ileostomy will redirect the small intestine.
Once a person is healthy enough, the surgeon will perform a reversal of the original procedure to put the ends of the colon together.
Learn more about a colostomy and an ileostomy here:
A diverting colostomy involves cutting the colon above the cancerous part. A surgeon then places the healthy colon through a stoma so that stool can pass out of the body.
The cost of colorectal cancer surgery will vary depending on several factors, including:
- type of procedure
- insurance coverage
- any extra treatments a person may need
A 2019 study analyzed the cost of various colon cancer treatments among people who received care from the United States Military Health System. The study authors found that the average cost of surgery alone was $19,944. In addition, the average cost of surgery combined with chemotherapy was $100,404.
According to the Centers for Disease Control and Prevention (CDC), colorectal cancer accounts for
People with insurance can expect to pay less. How much less will depend on their deductible and what their plan offers.
A person should contact their insurance provider for details about the cost of their recommended procedure.
For people without insurance
A person can speak with a doctor or the hospital about paying a reduced cost. They may be able to help directly, provide information on where to apply for aid, or help with setting up a payment plan.
Individuals may also wish to contact a hospital social worker, who will help them determine whether they qualify for government-based healthcare programs.
A person may be able to find financial help using the following sources:
A person can often get a referral for colorectal cancer surgery from a doctor or medical team. Some insurance companies require a specialist referral before they will accept charges for a surgery, while others may not.
A person should work with a healthcare team to determine whether surgery is the best treatment option for them. A healthcare team will likely provide a referral if they collectively believe surgery is the most suitable option for an individual.
According to the
The recovery time will differ depending on the procedure.
After surgery, a person can expect to feel pain, and they will need to take medications for a few days. In addition, it may not be possible to eat, or a healthcare professional will suggest limited liquids, as the colon needs time to recover.
In some cases, the bowel may take some time to begin working again, and a person will have difficulty passing stool. This may be due to the medication or the surgery itself.
Leaking can also occur. If the ends of the colon leak, a person can experience pain and fever, and the abdomen may become hard. Smaller leaks can result in a person losing their appetite and having difficulty passing stool.
It is advisable to discuss any questions an individual has about the recovery time, side effects, and risks with a healthcare professional.
When a person receives a colorectal cancer diagnosis or when a doctor recommends they undergo surgery, they may have several questions they want or need to ask.
The following questions may help guide a person’s conversation with a doctor:
- Is laparoscopic surgery an option?
- What are the risks and side effects to be aware of?
- Is there any other procedure or treatment that may work better?
- Whom can I talk to about financial aid for the procedure?
- How long can I expect recovery to take?
- Will the procedure remove all the cancer?
- What do I need to do to prepare for the procedure?
- Do I need to stop taking any medications beforehand?
Surgeries for colorectal cancer include polypectomy, local excision, colostomy, and ileostomy.
The costs can vary greatly depending on a person’s insurance status and the type of procedure a doctor recommends.
People who need help paying for the procedure should consult a healthcare professional about financial aid options.