When is which method used?
The choice of treatment method depends mainly on the stage of the disease. However, other factors also play a role, such as the patient’s age, any secondary diseases, as well as the patient’s ideas and wishes. In early stages without metastasis to the lymph nodes or other organs, surgery alone may be sufficient to treat the disease. If the tumor has already grown into deeper layers of the intestinal wall or has metastasized to lymph nodes or other organs, subsequent chemotherapy is recommended 4 to 6 weeks after surgery. Chemotherapy can also be used to delay the growth of tumors that have already become inoperable.
Therapy of metastases
Colorectal cancer is one of the few tumor diseases for which a curative therapy is still possible even if metastases in the liver and lungs are present, provided that the metastasis has not yet progressed too far. The number, size and localization of the liver or lung metastases are important in this context. If there are too many, too large or even inoperable metastases, curative treatment is no longer possible.
In addition, the lung or liver must be in a sufficiently good condition to compensate for the loss of the healthy organ parts removed by the metastases. The method of choice here is surgical removal of the metastasis(s), but other procedures are also used. One example is radiofrequency ablation, in which liver metastases can be destroyed by heat with the help of high-frequency current pulses through a probe. In any case, adjuvant chemotherapy should also be administered after successful surgery to reduce the risk of further metastases.Likewise, regular follow-up examinations should be taken very seriously in order to be able to take therapeutic measures early on if metastases occur.
How can pain be treated?
For tumor-related pain, a permanent pain therapy consisting of one or more drugs is recommended nowadays. The therapy is individually tailored to the patient and aims to achieve permanent freedom from pain for the patient. Therefore, it is important to take the medication at regular intervals to achieve an even level of effectiveness.
This so-called basic medication is supplemented by an analgesic taken as needed, which can be taken acutely in case of suddenly occurring severe pain, the so-called tumor breakthrough pain. Pain therapy is initially started with light painkillers according to the WHO (World Health Organization) step-by-step scheme. If these are not sufficient to relieve the pain, stronger analgesics are used until a combination and dose has been found with which the pain can be successfully kept under control.
In addition to the classic painkillers, other medications can be used as a support, such as antidepressants (support the effect of the painkillers) or antispasmodic drugs (anticonvulsants), which also have analgesic properties. Furthermore, with some drugs, possible side effects must be taken into account. For example, especially when taking morphine preparations, constipation often occurs, which must be treated with laxative measures.
