Nobody loves having surgery, but it’s a promising option for colorectal cancer patients. The goal of surgery is to remove cancer from your body. Sometimes surgery can remove all your cancer; sometimes it can only remove some of it. Colorectal cancer surgery can be an effective and efficient step in your treatment plan.

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If you’ve been diagnosed with colon cancer, your first treatment step may be surgery to remove the primary tumor, especially if it is a small or early tumor that can be entirely removed with the portion of affected colon.

Surgery and the subsequent examination of the removed colon and tumor will also allow doctors to assign a pathological stage to your cancer, which offers a better picture of the cancer’s extent and helps guide further treatment options.

A polypectomy, or local excision, removes a cancerous polyp from the body via colonoscopy without an abdominal incision, may take place for pre-cancerous polyps or in people who cannot tolerate abdominal surgery.

All other cancers (clinical stages I, II, III and IV) may require open or minimally invasive abdominal surgeries.

If you have been diagnosed with rectal cancer, you will likely be treated with radiation and chemotherapy before surgery. For females of child-bearing age with rectal cancer, an ovarian transposition may be recommended for fertility preservation prior to radiation therapy. Egg freezing in women or sperm banking in men is also an option prior to rectal cancer treatment because of the rectum’s close proximity to pelvic nerves and sex organs.

In some rectal cancer patients, neoadjuvant treatment (treatment given before surgery) is sufficient for treating the cancer, and patients don’t need surgery. In these cases, patients may be offered the “watch and wait” approach as an alternative to surgery. These patients will be continually reassessed and monitored via physical exam and colonoscopy or sigmoidoscopy in the weeks and months following treatment to see if the cancer grows and/or returns and warrants surgery.

There are several surgical techniques that doctors use on colorectal cancer patients depending on the case.

Surgery methods include:

Open surgery is a type of surgery where a doctor makes a long cut (incision) down the middle of the abdomen to access the area where the surgery needs to be done. This type of surgery is usually done when the area being operated on is hard to reach, or when the surgery requires a larger opening to see and work in the area.

After surgery, the incision will be closed. The abdominal muscles are closed with sutures, and the skin will be closed with stitches or staples. Open surgery usually requires a longer recovery time and can be more painful than minimally invasive surgery. However, sometimes open surgery is the best option for certain situations.

Laparoscopic surgery uses multiple small incisions instead of one long cut. The doctor inserts a tiny camera and small tools into the incisions to remove the cancer. This can make recovery time shorter and less painful.

There are several types of colorectal surgery. You’ll need to talk with your doctor about their recommendations depending on your diagnosis and your other health conditions.

In cases of colorectal cancer metastasis, additional surgeries on the liver, lungs, abdomen, uterus/ovaries, bladder, and brain may also be needed. It’s important to speak with your doctor about your treatment plan and course of action, and which surgeries need to come first. Your treatment plan will be unique to your case.

Many patients who will undergo intravenous treatment will also have a port-a-cath placed (also called a port). The port will be placed during a relatively quick procedure while you are under sedation.

Before surgery, you’ll need several tests. Some of these tests may have been what led you into surgery. Some will inform your doctors on the extent of your cancer and guide your next steps:

Different methods of surgery have varied recovery times. You need to be prepared. Following your surgery, you will likely want to lay low, but movement is key. Get up and walk as much as you’re able.

Your diet will progress as you recover. You will be on NPO (nothing by mouth) immediately following surgery, but you’ll progress to ice chips and clear liquids. From there, you’ll move on to full liquids, and if you tolerate those well, you’ll likely have more food choices. You’ll want to choose soft foods, and foods without fiber.

In some cases, patients choose to undergo prophylactic surgery, which is surgery to remove an organ or gland to try to stop cancer before it starts. Often, patients with a family history and/or a genetic syndrome consider prophylactic surgery.

If you’re considering this preventive surgery, work closely with your medical team to determine the risks versus rewards of having surgery, and create a plan that best fits your needs.

Some patients are inoperable either because of the size/location of their tumors, it’s metastatic, and/or their health does not permit it. In this case, there are still treatment options like chemotherapy, targeted therapy, immunotherapy, and radiation therapy.

Let your doctor know your thoughts about how to proceed with treatment if surgery is not an option for you, and always consider getting a second opinion and searching for clinical trials.

Also, even if you do not undergo surgery, you’ll want to ask your doctor to perform tumor testing on a biopsy of your tumor so you can identify your biomarkers.

After your surgery, you will receive information that will guide your next steps. This can include:

You will see your surgeon (or someone on their team, like their physician assistant or nurse practitioner) every day while you’re in the hospital. It’s important to attend all your follow-up visits once you’re released.

If you have colorectal cancer, it’s important to make sure you’ve set up follow-up visits not only with your surgeon, but also your oncology team.