Patients with colon cancer may develop a condition called a bowel obstruction. According to the American Society of Clinical Oncology, the tumor prevents food and liquids from continuing through the intestinal tract. The intestines continue to try to work and force the food through with contractions; these contractions--called peristalsis--can cause significant amounts of pain. Patients with colon cancer who develop bowel obstructions are generally very ill and unable to tolerate surgery so physicians employ several other techniques to manage this condition.
Nasogastric Tube
One method for treating a bowel obstruction associated with colon cancer is the placement of a nasogastric tube, according to the American Society of Clinical Oncology. A nasogastric tube is placed through the nose into the stomach and a suction device is attached; this removes the contents from the stomach and relieves some of the pain and discomfort. Using a nasogastric tube does not cure the problem but is a temporary or supportive measure.
Octreotide
The medication octreotide can also be used to treat a bowel obstruction caused by cancer. According to Drs. Carla Ripamonti and Sebastiano Mercadante in a 2004 article in the "Journal of Supportive Oncology," this medication can decrease the secretion of substances into the gastrointestinal tract, which decreases the amount of abdominal bloating and distention. Octreotide also stops the contractions, which relieves the pain. This treatment is also only a supportive and temporary measure; other forms of therapy may need to be included to manage the situation.
Stent Placement
For some patients, a more permanent solution is the placement of a stent in the area of the obstruction, according to the Cancer Research UK website. The surgeon uses an endoscope--a lighted flexible tube--to place the stent. The physician inserts the endoscope through the rectum up to the level of obstruction and pushes the stent through the area of obstruction. This creates an opening for waste products to travel through the intestine. Stent placement procedures are often performed in patients who would not tolerate open surgery. The success of the placement of a stent also depends on the location of the obstruction in the colon; the obstruction may be in a location that the endoscope can't reach.
Gastrostomy Tube
Another treatment for a bowel obstruction is the placement of a gastrostomy tube directly through the wall of the abdomen into the stomach, according to the National Cancer Institute. The tube can relieve any pressure or air in the stomach as well as allow any food in the stomach to be drained out. Food and medicines can be placed into the stomach through the tube as well. Patients may also be able to consume some types of food by mouth with this type of tube in place; the food can be removed from the stomach through the tube and the patient may be allowed to enjoy the taste of food.
Surgery
Another way to treat a bowel obstruction is through open surgery. According to the Cancer Research UK website, the goal of this surgery is to remove the area of the obstruction. In some cases, the surgeon can simply connect the ends of the colon together after the operation; however, for other patients, the surgeon may need to attach the end of the colon to an opening in the abdomen. This procedure is called a colostomy and a bag is placed over the opening for the waste products to collect into. A colostomy procedure is a major surgical procedure with a significant recovery time; some patients are not healthy enough to survive this procedure and may benefit from some of the other treatments for this condition.
References
- American Cancer Society: Managing Symptoms of Advanced Cancer
- Cancer Research UK: Surgery for Advanced Bowel Cancer
- American Society of Clinical Oncology: Blocked Intestine or Gastrointestinal Obstruction
- "Journal of Supportive Oncology;" How to Use Octreotide for Malignant Bowel Obstruction; Drs. Carla Ripamonti and Sebastiano Mercadante; 2004.
- Cancer Research UK: If You Need a Colostomy for Bowel Cancer
