|
你现在的位置: 首页 > 癌症医典(结直肠癌) > 结肠癌治疗
中文版 / English
结肠癌治疗(PDQ®)

结肠癌的基本信息

结肠癌是结肠组织中出现恶性（癌）细胞的疾病。

结肠是人体消化系统的一部分。消化系统吸收并处理食物中的营养物质（维生素、矿物质，碳水化合物、脂肪、蛋白质和水），并促进废物排出体外。消化系统由食管、胃、大肠和小肠组成。结肠（大肠）是大肠的第一部分，大约1.5米长。大肠的最后一部分由直肠与肛管组成，约15-20厘米长。肛管尽头为肛门，肛门是大肠通向体外的开口处）。

下消化系统解剖图，显示结肠和其他器官。

胃肠道间质瘤可发生在结肠。欲了解更多信息，请参见PDQ总结，查阅更多有关胃肠道间质瘤治疗（成人)的信息。

想了解更多有关儿童结直肠癌的信息，请参见PDQ有关儿童少见癌症治疗方案的概述。

健康史会影响结肠癌的发病风险。

任何增加患病几率的因素都被称为风险因素。有风险因素并不意味着您就会得癌症；没有风险因素也并不意味着您不会得癌症。如果您认为自己有患结直肠癌的风险，请咨询您的医生。

结直肠癌的风险因素包括以下几点：

  • 一级亲属（父母、兄弟姐妹或子女）有结肠癌或直肠癌家族史。
  • 有结肠癌、直肠癌或卵巢癌的个人史。
  • 有高风险腺瘤的个人史（1厘米或更大的结直肠息肉或在显微镜下发现有看似异常的细胞）。
  • 某些基因的遗传变化增加了家族性腺瘤性息肉病（FAP）或林奇综合征（遗传性非息肉性结直肠癌）的风险。
  • 有8年以上慢性溃疡性结肠炎或克罗恩病病史。
  • 每天饮酒三杯或三杯以上。
  • 吸烟。
  • 黑人。
  • 肥胖。

    • 年龄较大是大多数癌症的主要风险因素。随着年龄的增长，癌症的患病几率会增加。

    结肠息肉。有些息肉有蒂，有些则没有。插图显示了一个有蒂息肉的照片。

    患结肠癌的迹象包括粪便中带血或者排便习惯的改变。

    这些迹象和其他症状可能是由结肠癌或其他疾病导致的。如果你有以下任何症状，请咨询医生。

  • 排便习惯的改变。
  • 粪便中带血（鲜红或深红色）。
  • 腹泻、便秘，或者感觉肠道并未清空。
  • 粪便比平时更细。
  • 经常性的胀气痛、胃胀、饱胀感、胃痉挛。
  • 无原由的体重减轻。
  • 感到非常疲倦。
  • 呕吐。

    • 结肠和直肠检查用于检测（发现）并诊断结肠癌。

    可能会用到以下检查和程序：

  • 体检以及病史：体检用以检查一般健康状况，包括检查疾病的迹象，比如肿块或其它任何异常体征。还将采集患者的健康习惯史以及既往疾病和治疗史。
  • 直肠指检：直肠检查。医生或护士将润滑、带有手套的手指插入直肠中检查有无肿块或其他任何异常。
  • 粪便潜血试验（FOBT）：一种通过显微镜检查粪便（固体废物）中是否有血的检查方法。将少量粪便样本置于一张特殊的卡片上或一个特殊的容器中，然后交给医生或实验室进行检测。粪便中有血可能是息肉、癌症或其他疾病的迹象。

    • 有两种类型的粪便潜血试验（FOBT）：

  • 愈创木脂法粪便潜血试验：将粪便样本置于特殊的卡片上，采用化学物质进行检测。如果粪便中有血，这个特殊的卡片就会发生颜色变化。
    • 愈创木脂法粪便潜血试验（FOBT）检查粪便中是否有潜在的（隐藏的）血。将少量粪便样本置于一张特殊的卡片上，然后交给医生或实验室进行检测。
  • 免疫化学法粪便潜血试验（FOBT）:在粪便样本中加入液体。将混合物注射到含有抗体的机器中，可以检测粪便中的血迹。如果粪便中带血，机器的窗口中就会出现一条线。该试验也被称为粪便免疫化学试验或FIT。
    • 粪便免疫化学试验（FIT）检查粪便中潜在（隐藏的）血迹。将少量粪便样本置于一个特殊的收集管或特殊卡片上，然后交给医生或实验室进行检测。
  • 钡剂灌肠：下消化道的一系列X光检查。将一种含有钡（一种银白色金属化合物）的液体灌入直肠。钡覆盖了下消化道，然后拍摄X光相片。这个程序也被称为下GI系列检查。
    • 钡剂灌肠程序。病人躺在x光检查台上。钡剂进入直肠并流经结肠。用X光查看异常区域。
  • 乙状结肠镜检查：这个程序用来观察直肠和乙状（下段）结肠中的息肉（小块的突起组织）、其他异常部分或癌症。通过直肠将乙状结肠镜插入乙状结肠。乙状结肠镜是一种薄薄的管状仪器，配有用于观察的灯和镜头。它可能还配有用来切除息肉或组织样本的工具，这些样本用于在显微镜下发现癌症的迹象。
    • 乙状结肠镜检查。通过肛门和直肠将一个明亮的细管插入结肠下部，以查看异常区域。
  • 结肠镜检查：这个程序用来观察直肠和结肠中的息肉、异常区域或癌症。结肠镜是一种薄薄的管状仪器，配有用于观察的灯和镜头。它可能还配有用来切除息肉或组织样本的工具，这些样本用于在显微镜下发现癌症的迹象。
    • 结肠镜检查。通过肛门和直肠将一个明亮的细管插入结肠，以查看异常区域。
  • 虚拟结肠镜检查：这个程序使用称为计算机断层扫描的一系列X光来拍摄一系列结肠图像。电脑将这些图片合成为细节图，这些细节图可能会显示结肠内表面上的息肉以及其它任何异常情况。该检查也称为结肠成像或CT结肠成像。
  • 活检：切除细胞或组织，这样病理医生就能在显微镜下检查癌症的迹象。

    • 影响预后（恢复几率）和治疗方法的一些因素。

    预后（恢复几率）和治疗方法取决于以下几点：

  • 癌症的分期（无论癌细胞是否局限在结肠肠壁内或已通过结肠壁扩散，或者已扩散至淋巴结或身体其他部位）。
  • 肠道肿瘤是否已堵塞肠腔或发生穿孔。
  • 手术后是否有癌细胞残留。
  • 癌症是否复发。
  • 患者的总体健康状况。

    • 预后也取决于治疗开始前血液中的癌胚抗原（CEA）浓度。CEA是血液中的一种物质，它可能在有肿瘤时增加。

    Colon Cancer Treatment (PDQ®)

    General Information About Colon Cancer

    Colon cancer is a disease in which malignant (cancer) cells form in the tissues of the colon.

    The colon is part of the body’s digestive system. The digestive system removes and processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps pass waste material out of the body. The digestive system is made up of the esophagus, stomach, and the small and large intestines. The colon (large bowel) is the first part of the large intestine and is about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine and are about 6-8 inches long. The anal canal ends at the anus (the opening of the large intestine to the outside of the body).

    Anatomy of the lower digestive system, showing the colon and other organs.

    Gastrointestinal stromal tumors can occur in the colon. See the PDQ summary on Gastrointestinal Stromal Tumors Treatment (Adult) for more information.

    See the PDQ summary about Unusual Cancers of Childhood Treatment for information about colorectal cancer in children.

    Health history affects the risk of developing colon cancer.

    Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk to your doctor if you think you may be at risk for colorectal cancer.

    Risk factors for colorectal cancer include the following:

  • Having a family history of colon or rectal cancer in a first-degree relative (parent, sibling, or child).
  • Having a personal history of cancer of the colon, rectum, or ovary.
  • Having a personal history of high-risk adenomas (colorectal polyps that are 1 centimeter or larger in size or that have cells that look abnormal under a microscope).
  • Having inherited changes in certain genes that increase the risk of familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary nonpolyposis colorectal cancer).
  • Having a personal history of chronic ulcerative colitis or Crohn disease for 8 years or more.
  • Having three or more alcoholic drinks per day.
  • Smoking cigarettes.
  • Being black.
  • Being obese.

    • Older age is a main risk factor for most cancers. The chance of getting cancer increases as you get older.

    Polyps in the colon. Some polyps have a stalk and others do not. Inset shows a photo of a polyp with a stalk.

    Signs of colon cancer include blood in the stool or a change in bowel habits.

    These and other signs and symptoms may be caused by colon cancer or by other conditions. Check with your doctor if you have any of the following:

  • A change in bowel habits.
  • Blood (either bright red or very dark) in the stool.
  • Diarrhea, constipation, or feeling that the bowel does not empty all the way.
  • Stools that are narrower than usual.
  • Frequent gas pains, bloating, fullness, or cramps.
  • Weight loss for no known reason.
  • Feeling very tired.
  • Vomiting.

    • Tests that examine the colon and rectum are used to detect (find) and diagnose colon cancer.

    The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Digital rectal exam: An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum to feel for lumps or anything else that seems unusual.
  • Fecal occult blood test (FOBT): A test to check stool (solid waste) for blood that can only be seen with a microscope. A small sample of stool is placed on a special card or in a special container and returned to the doctor or laboratory for testing. Blood in the stool may be a sign of polyps, cancer, or other conditions.

    • There are two types of FOBTs:

  • Guaiac FOBT: The sample of stool on the special card is tested with a chemical. If there is blood in the stool, the special card changes color.
    • A guaiac fecal occult blood test (FOBT) checks for occult (hidden) blood in the stool. Small samples of stool are placed on a special card and returned to a doctor or laboratory for testing.
  • Immunochemical FOBT: A liquid is added to the stool sample. This mixture is injected into a machine that contains antibodies that can detect blood in the stool. If there is blood in the stool, a line appears in a window in the machine. This test is also called fecal immunochemical test or FIT.
    • A fecal immunochemical test (FIT) checks for occult (hidden) blood in the stool. A small sample of stool is placed in a special collection tube or on special cards and returned to a doctor or laboratory for testing.
  • Barium enema: A series of x-rays of the lower gastrointestinal tract. A liquid that contains barium (a silver-white metallic compound) is put into the rectum. The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series.
    • Barium enema procedure. The patient lies on an x-ray table. Barium liquid is put into the rectum and flows through the colon. X-rays are taken to look for abnormal areas.
  • Sigmoidoscopy: A procedure to look inside the rectum and sigmoid (lower) colon for polyps (small areas of bulging tissue), other abnormal areas, or cancer. A sigmoidoscope is inserted through the rectum into the sigmoid colon. A sigmoidoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.
    • Sigmoidoscopy. A thin, lighted tube is inserted through the anus and rectum and into the lower part of the colon to look for abnormal areas.
  • Colonoscopy: A procedure to look inside the rectum and colon for polyps, abnormal areas, or cancer. A colonoscope is inserted through the rectum into the colon. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.
    • Colonoscopy. A thin, lighted tube is inserted through the anus and rectum and into the colon to look for abnormal areas.
  • Virtual colonoscopy: A procedure that uses a series of x-rays called computed tomography to make a series of pictures of the colon. A computer puts the pictures together to create detailed images that may show polyps and anything else that seems unusual on the inside surface of the colon. This test is also called colonography or CT colonography.
  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.

    • Certain factors affect prognosis (chance of recovery) and treatment options.

    The prognosis (chance of recovery) and treatment options depend on the following:

  • The stage of the cancer (whether the cancer is in the inner lining of the colon only or has spread through the colon wall, or has spread to lymph nodes or other places in the body).
  • Whether the cancer has blocked or made a hole in the colon.
  • Whether there are any cancer cells left after surgery.
  • Whether the cancer has recurred.
  • The patient’s general health.

    • The prognosis also depends on the blood levels of carcinoembryonic antigen (CEA) before treatment begins. CEA is a substance in the blood that may be increased when cancer is present.

    结肠癌治疗(PDQ®)

    结肠癌的分期

    结肠癌确诊后，进行检查以确定癌细胞是否在结肠内扩散或扩散至身体其它部位。

    检查癌细胞是否在结肠内扩散或已扩散至身体其它部位的程序叫做分期。在分期过程中获得的信息决定了疾病的分期。要想制订治疗计划，了解分期很重要。

    以下检查和程序可能会在分期过程中使用：

  • CT扫描（CAT扫描）：从不同的角度对身体内部，比如腹部、骨盆和胸部，进行一系列详细图片采集的程序。通过连接至x光机的计算机生成图片。可将染料注入静脉或吞服，用来帮助器官或组织更清楚的显示。这个程序可能被称为计算机断层扫描，计算机化断层显像，或计算机轴向断层扫描。
  • MRI（磁共振成像）：这个程序使用磁铁、无线电波以及计算机对结肠内部拍摄一系列详细图片的程序。通过静脉将一种叫做钆的物质注入患者体内。钆在癌细胞周围聚集，使它们在图片上显得更亮。这个程序也被称为核磁共振成像（NMRI）。
  • PET扫描（正电子发射断层扫描）：用以发现体内肿瘤细胞的程序。将少量放射性葡萄糖（糖）注入静脉。PET扫描仪环绕身体拍摄葡萄糖在体内的使用位置。恶性肿瘤细胞在图片中更亮，因为它们比普通细胞更活跃，吸收了更多的葡萄糖。
  • X线胸片：针对胸内器官和骨骼的X光摄像。X射线是一种能量束，它能穿过身体射到底片上，形成身体内部的图像。
  • 手术：这是切除肿瘤并观察它在结肠中扩散情况的程序。
  • 淋巴结活检：切除全部或部分淋巴结。病理医生在显微镜下观察淋巴结组织，检查是否有癌细胞。这可以在手术中进行，也可以在超声内镜引导下进行细针穿刺活检。
  • 全血细胞计数（CBC）：采集血样并检查以下参数的程序：
  • 红细胞、白细胞和血小板的数量。
  • 红细胞中血红蛋白（携带氧气的蛋白质）的数量。
  • 血样中由红细胞组成的那部分血样。
  • 癌胚抗原（CEA）测定：测量血液中CEA水平的试验。CEA从癌细胞和正常细胞中释放到血液中。当CEA高于正常量时，这可能是结肠癌或其它疾病的征兆。

    • 癌细胞通过三种方式在体内扩散。

    癌细胞可通过组织，淋巴系统和血液扩散：

  • 组织：癌细胞从开始生长的部位向邻近部位生长来扩散。
  • 淋巴系统：癌细胞从进入淋巴系统开始扩散。癌细胞通过淋巴管转移至身体其他部位。
  • 血液：癌细胞从进入血液开始扩散。癌细胞通过血管行至身体其他部位。

    • 癌细胞可能会从其起始处扩散到身体其他部位。

    当癌细胞扩散到身体的另一部位时，称为转移。癌细胞从其起始处（原发性肿瘤）脱离并穿过淋巴系统或血液。

  • 淋巴系统：癌细胞进入淋巴系统，通过淋巴管转移，并在身体其它地方形成肿瘤（转移瘤）。
  • 血液：癌细胞进入血液，通过血管转移，并在身体其它部位形成肿瘤（转移瘤）。

    • 转移瘤与原发性肿瘤种类相同。比如，如果结肠癌扩散至肺部，肺部的癌细胞实际上是结肠癌细胞。该疾病为转移性结肠癌，而非肺癌。

    许多癌症患者死亡是由于癌细胞从原来的肿瘤转移、扩散到其他组织和器官。这被称为转移性癌症。这个动画展示了癌细胞是如何从体内最初形成的部位迁移到身体的其他部位的。

    结肠癌分期如下：

    0期（原位癌）

    0期（原位结肠癌）。异常细胞位于结肠壁黏膜。

    在0期，结肠壁黏膜（最内层）发现异常细胞。这些异常细胞可能变成癌细胞并扩散到附近的正常组织。0期又称原位癌。

    I期

    I期结肠癌。癌细胞已从结肠壁的黏膜扩散到黏膜下层或肌层。

    在I期结肠癌中，癌细胞已在结肠壁的黏膜层（最内层）形成，并已扩散到黏膜下层（粘膜旁的组织层）或结肠壁的肌层。

    II期

    II期结肠癌。在IIA期，癌细胞已经通过结肠壁的肌层扩散到浆膜。在IIB期，癌细胞已通过浆膜扩散，但未扩散到邻近器官。在IIC期，肿瘤已经通过浆膜扩散到附近的器官。

    II期结肠癌分为IIA期、IIB期和IIC期。

  • IIA期：癌细胞已通过结肠壁的肌层扩散至结肠壁的浆膜（最外层）。
  • IIB期：癌细胞已通过结肠壁的浆膜（最外层）扩散到腹部器官周围的组织（内脏腹膜）。
  • IIC期：癌细胞已通过结肠壁的浆膜（最外层）并扩散至附近器官。

    • III期

    III期结肠癌分为IIIA期、IIIB期和IIIC期。

    IIIA期结肠癌。癌细胞已透过结肠壁黏膜扩散至黏膜下层，可能已扩散至肌层，并已扩散至附近1至3个淋巴结或淋巴结附近的组织。或者，癌细胞已经通过黏膜层扩散到黏膜下层和附近的4至6个淋巴结。

    在IIIA期，癌细胞已经扩散：

  • 通过结肠壁的黏膜层（最内层）到黏膜下层(黏膜旁边的组织层）或到结肠壁的肌层。癌细胞已扩散至附近1至3个淋巴结，或已在淋巴结附近的组织中形成癌细胞;或
  • 通过结肠壁的黏膜层（最内层）到黏膜下层(黏膜附近的组织层）。癌症已经扩散到附近的4到6个淋巴结。
    • IIIB期结肠癌。癌细胞已透过结肠壁的肌层扩散至浆膜，或已透过浆膜但未扩散至邻近的器官;癌细胞已经扩散到附近的1到3个淋巴结或淋巴结附近的组织。或者，癌细胞已经扩散到肌层或浆膜，以及附近的4到6个淋巴结。或者，癌细胞已通过黏膜层扩散到黏膜下层，并可能已扩散到肌层；癌细胞已经扩散到附近的7个或更多的淋巴结。

    在IIIB期，癌细胞已经扩散：

  • 通过结肠壁的肌层到达结肠壁的浆膜（最外层）或通过浆膜到达腹部器官的组织（内脏腹膜）。癌细胞已扩散至附近1至3个淋巴结，或已在淋巴结附近的组织中形成癌细胞；或
  • 到结肠壁的肌层或浆膜（最外层）。癌细胞已经扩散到附近的4到6个淋巴结；或
  • 通过结肠壁的粘膜层（最内层）到粘膜下层（粘膜旁边的组织层）或到结肠壁的肌层。癌细胞已经扩散到附近的7个或更多的淋巴结。
    • IIIC期结肠癌。癌细胞已通过结肠壁浆膜扩散，但未扩散到附近的器官；癌细胞已经扩散到附近的4到6个淋巴结。或者，癌细胞已通过肌层扩散到浆膜，或已通过浆膜扩散但未扩散到附近的器官；癌细胞已经扩散到附近的7个或更多的淋巴结。或者，癌细胞已经通过浆膜扩散到附近的器官和附近的1个或多个淋巴结或淋巴结附近的组织。

    在IIIC期，癌细胞已经扩散：

  • 通过结肠壁的浆膜（最外层）到达腹部器官的组织（内脏腹膜）。癌细胞已经扩散到附近的4到6个淋巴结;或
  • 通过结肠壁的肌层到达结肠壁的浆膜（最外层）或通过浆膜到达腹部器官的组织（内脏腹膜）。癌细胞已经扩散到附近的7个或更多的淋巴结；或
  • 通过结肠壁的浆膜（最外层）到达附近的器官。癌细胞已扩散至附近的1个或多个淋巴结，或已在淋巴结附近的组织中形成癌细胞。

    • IV期

    IV期结肠癌。癌细胞已经通过血液和淋巴结扩散到身体的其他部位，如肺、肝、腹壁或卵巢。

    IV期结肠癌分为IVA期、IVB期和IVC期。

  • IVA期：癌细胞已经扩散到非结肠附近的一个区域或器官，如肝、肺、卵巢或远处的淋巴结。
  • IVB期：癌细胞已经扩散到非结肠附近的多个区域或器官，如肝、肺、卵巢或远处的淋巴结。
  • IVC期：癌细胞已扩散到腹壁周围的组织，并可能已扩散到其他区域或器官。
    • Colon Cancer Treatment (PDQ®)

    Stages of Colon Cancer

    After colon cancer has been diagnosed, tests are done to find out if cancer cells have spread within the colon or to other parts of the body.

    The process used to find out if cancer has spread within the colon or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.

    The following tests and procedures may be used in the staging process:

  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen, pelvis, or chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the colon. A substance called gadolinium is injected into the patient through a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • Surgery: A procedure to remove the tumor and see how far it has spread through the colon.
  • Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the lymph node tissue under a microscope to check for cancer cells. This may be done during surgery or by endoscopic ultrasound-guided fine needle aspiration biopsy.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
  • The number of red blood cells, white blood cells, and platelets.
  • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
  • The portion of the blood sample made up of red blood cells.
  • Carcinoembryonic antigen (CEA) assay: A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of colon cancer or other conditions.

    • There are three ways that cancer spreads in the body.

    Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

    • Cancer may spread from where it began to other parts of the body.

    When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

  • Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.

    • The metastatic tumor is the same type of cancer as the primary tumor. For example, if colon cancer spreads to the lung, the cancer cells in the lung are actually colon cancer cells. The disease is metastatic colon cancer, not lung cancer.

    Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.

    The following stages are used for colon cancer:

    Stage 0 (Carcinoma in Situ)

    Stage 0 (colon carcinoma in situ). Abnormal cells are shown in the mucosa of the colon wall.

    In stage 0, abnormal cells are found in the mucosa (innermost layer) of the colon wall. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

    Stage I

    Stage I colon cancer. Cancer has spread from the mucosa of the colon wall to the submucosa or to the muscle layer.

    In stage I colon cancer, cancer has formed in the mucosa (innermost layer) of the colon wall and has spread to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the colon wall.

    Stage II

    Stage II colon cancer. In stage IIA, cancer has spread through the muscle layer of the colon wall to the serosa. In stage IIB, cancer has spread through the serosa but has not spread to nearby organs. In stage IIC, cancer has spread through the serosa to nearby organs.

    Stage II colon cancer is divided into stages IIA, IIB, and IIC.

  • Stage IIA: Cancer has spread through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall.
  • Stage IIB: Cancer has spread through the serosa (outermost layer) of the colon wall to the tissue that lines the organs in the abdomen (visceral peritoneum).
  • Stage IIC: Cancer has spread through the serosa (outermost layer) of the colon wall to nearby organs.

    • Stage III

    Stage III colon cancer is divided into stages IIIA, IIIB, and IIIC.

    Stage IIIA colon cancer. Cancer has spread through the mucosa of the colon wall to the submucosa and may have spread to the muscle layer, and has spread to one to three nearby lymph nodes or tissues near the lymph nodes. OR, cancer has spread through the mucosa to the submucosa and four to six nearby lymph nodes.

    In stage IIIA, cancer has spread:

  • through the mucosa (innermost layer) of the colon wall to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the colon wall. Cancer has spread to one to three nearby lymph nodes or cancer cells have formed in tissue near the lymph nodes; or
  • through the mucosa (innermost layer) of the colon wall to the submucosa (layer of tissue next to the mucosa). Cancer has spread to four to six nearby lymph nodes.
    • Stage IIIB colon cancer. Cancer has spread through the muscle layer of the colon wall to the serosa or has spread through the serosa but not to nearby organs; cancer has spread to one to three nearby lymph nodes or to tissues near the lymph nodes. OR, cancer has spread to the muscle layer or to the serosa, and to four to six nearby lymph nodes. OR, cancer has spread through the mucosa to the submucosa and may have spread to the muscle layer; cancer has spread to seven or more nearby lymph nodes.

    In stage IIIB, cancer has spread:

  • through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall or has spread through the serosa to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to one to three nearby lymph nodes or cancer cells have formed in tissue near the lymph nodes; or
  • to the muscle layer or to the serosa (outermost layer) of the colon wall. Cancer has spread to four to six nearby lymph nodes; or
  • through the mucosa (innermost layer) of the colon wall to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the colon wall. Cancer has spread to seven or more nearby lymph nodes.
    • Stage IIIC colon cancer. Cancer has spread through the serosa of the colon wall but not to nearby organs; cancer has spread to four to six nearby lymph nodes. OR, cancer has spread through the muscle layer to the serosa or has spread through the serosa but not to nearby organs; cancer has spread to seven or more nearby lymph nodes. OR, cancer has spread through the serosa to nearby organs and to one or more nearby lymph nodes or to tissues near the lymph nodes.

    In stage IIIC, cancer has spread:

  • through the serosa (outermost layer) of the colon wall to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to four to six nearby lymph nodes; or
  • through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall or has spread through the serosa to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to seven or more nearby lymph nodes; or
  • through the serosa (outermost layer) of the colon wall to nearby organs. Cancer has spread to one or more nearby lymph nodes or cancer cells have formed in tissue near the lymph nodes.

    • Stage IV

    Stage IV colon cancer. The cancer has spread through the blood and lymph nodes to other parts of the body, such as the lung, liver, abdominal wall, or ovary.

    Stage IV colon cancer is divided into stages IVA, IVB, and IVC.

  • Stage IVA: Cancer has spread to one area or organ that is not near the colon, such as the liver, lung, ovary, or a distant lymph node.
  • Stage IVB: Cancer has spread to more than one area or organ that is not near the colon, such as the liver, lung, ovary, or a distant lymph node.
  • Stage IVC: Cancer has spread to the tissue that lines the wall of the abdomen and may have spread to other areas or organs.
    • 结肠癌治疗(PDQ®)

    复发性结肠癌

    复发性结肠癌是指结肠癌治疗后复发的癌症。可能在结肠或身体其他部位复发，如肝、肺或二者兼有。

    Colon Cancer Treatment (PDQ®)

    Recurrent Colon Cancer

    Recurrent colon cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the colon or in other parts of the body, such as the liver, lungs, or both.

    结肠癌治疗(PDQ®)

    治疗方案概述

    针对结肠癌患者有不同类型的治疗方法。

    结肠癌患者有不同类型的治疗方法。一些治疗为标准治疗（当前使用的治疗），一些正在临床试验中检测。治疗方案临床试验是为改善现行治疗方案或为癌症患者的新治疗方案获取信息的研究。当临床试验显示新的治疗方案比标准治疗方案更好时，新的治疗方案就有可能成为标准治疗方案。患者可能会想要考虑参与临床试验。一些临床试验只对没有开始治疗的患者开放。

    采用7种标准治疗方法：

    手术

    手术（通过手术切除肿瘤）是对所有分期的结肠癌最常见的治疗方案。医生可能会用以下手术中的一种来切除肿瘤：

  • 局部切除：如果在早期发现癌症，医生可能不用切开腹壁就能将其切除。取而代之的是，医生可能通过直肠放入结肠一个带有剪切工具的管，然后将肿瘤切除。这被称为局部切除。如果肿瘤发现于息肉中（组织上小的突起区域），此手术就被称为息肉切除术。
  • 结肠切除吻合术：如果肿瘤更大，医生可能会使用结肠部分切除术（切除肿瘤以及它周围的少量健康组织）。然后医生可能会执行吻合术（将结肠健康的部分缝合在一起）。医生也通常会切除结肠附近的淋巴结并在显微镜下检查，以确定淋巴结中是否含有癌细胞。
    • 结肠切除吻合术。部分带有肿瘤的结肠和附近的健康组织被切除，然后将结肠的切缘缝合起来。
  • 结肠切除造口术：如果医生无法将结肠的两端缝合在一起，则可在身体外部做一个用来通过粪便的造口（开口）。这个程序叫做结肠造口术。在造口周围放置一个袋子来收集废物。有时只有在下部结肠痊愈之前需要结肠造口术，然后就可以逆转。
    • 结肠癌结肠造口术。部分带有癌细胞的结肠和附近的健康组织被切除，创建一个造口，然后将结肠造瘘袋与造口连接。

    在医生切除手术时所能看到的所有肿瘤后，一些病人可能会在手术后接受化疗或放疗，以杀死任何残余的癌细胞。手术后给予治疗，以降低癌症复发的风险，被称为辅助治疗。

    射频消融

    射频消融是使用特殊的探针，它带有可以杀死癌细胞的小电极。有时探针直接插入皮肤，并且仅需要局部麻醉。在其他情况下，探针通过切口插入腹部。这需要在医院中通过全身麻醉来进行。

    冷冻手术

    冷冻手术是一种使用仪器来冷冻并摧毁异常组织的治疗方法。这种治疗方法也被称为冷冻疗法。

    化疗

    化疗是使用药物来抑制癌细胞生长的癌症治疗方法，药物可以杀死细胞或阻止细胞分裂。当通过口服药物或静脉或肌肉注射进行化疗时，药物进入血流并到达全身的癌细胞（全身化疗）。当化疗药物直接置于脑脊髓液、器官或体腔（比如腹部），药物就主要影响那些区域的癌细胞（局部化疗）。

    肝动脉栓塞化疗可能会用来治疗扩散到肝脏的癌症。这包括堵塞肝动脉（为肝脏提供血液的主要动脉）并在堵塞物与肝脏之间注射抗癌药物。然后肝脏的动脉就会将药物传送给整个肝脏。只有少量的药物会到达身体的其他部位。堵塞可能是暂时性的或永久性的，这取决于用什么来堵塞动脉。肝脏会继续接收来自于肝门静脉的一些血液，这些血液是从胃和肠输送来的血液。

    化疗采用的方法取决于要治疗的癌症类别与分期。

    更多信息请见获批用于治疗结肠癌和直肠癌的药物。

    放射治疗

    放射疗法是一种癌症治疗方法，使用高能x射线或其他类型的辐射杀死癌细胞或阻止癌细胞生长。有两种类型的放射治疗方法：

  • 体外放射疗法是利用体外的机器将射线发送到肿瘤部位。
  • 体内放射疗法是将放射性物质密封在针、放射性粒子、导丝或导管中，然后直接放置到肿瘤或附近。

    • 采用的放射治疗方式取决于癌症的类型和分期。体外放射疗法用作姑息治疗，以缓解症状和改善生活质量。

    靶向治疗

    靶向治疗是使用药物或其他物质来识别并攻击特定的癌细胞同时不伤害正常细胞的一种疗法。

    治疗结肠癌所使用的靶向治疗包括以下几种：

  • 单克隆抗体：单克隆抗体是在实验室中从单一种类免疫系统细胞制成的。这些抗体能识别癌细胞上的物质或可能会帮助癌细胞生长的正常物质。抗体附着于这些物质并杀死癌细胞，抑制癌细胞生长，或阻止癌细胞扩散。单克隆抗体通过输注给药。它们可以单独使用，也可以直接携带药物、毒素或放射性物质到癌细胞。

    • 单克隆抗体治疗有不同的类型:

  • 血管内皮生长因子（VEGF）抑制剂治疗:癌细胞产生一种叫做VEGF的物质，这种物质能导致新血管的形成（血管生成），并促进癌细胞生长。VEGF抑制剂可阻断VEGF，并抑制新血管的形成。这可能会杀死癌细胞，因为它们的生长需要新的血管。贝伐珠单抗和雷莫芦单抗是VEGF抑制剂和血管生成抑制剂。
  • 表皮生长因子受体（EGFR）抑制剂治疗：EGFR是在某些细胞表面发现的蛋白质，包括癌细胞。表皮生长因子附着在细胞表面的表皮生长因子受体上，使细胞生长和分裂。EGFR抑制剂阻断受体，阻止表皮生长因子附着在癌细胞上。这抑制了癌细胞的生长和分裂。西妥昔单抗和帕尼单抗是EGFR抑制剂。
  • 血管生成抑制剂：血管生成抑制剂抑制肿瘤生长所需的新血管的生长。
  • 阿柏西普是一种血管内皮生长因子捕获因子，可阻断肿瘤中新生血管生长所需的一种酶。
  • 瑞戈非尼用于治疗已扩散至身体其他部位且通过其他治疗未好转的结直肠癌。阻断某些蛋白质的作用，包括血管内皮生长因子。这可能有助于阻止癌细胞生长，并可能杀死它们。它还可能抑制肿瘤所需的新血管的生长。

    • 更多信息请见批准的治疗结肠癌和直肠癌的药物。

    免疫治疗

    免疫疗法是一种利用病人的免疫系统对抗癌症的治疗方法。采用体内生成的物质或实验室生产的物质增强、引导或恢复人体对于癌症的天然防御力。这种癌症治疗方法也被称为生物疗法或生物治疗。

    免疫检查点抑制剂治疗是一种免疫疗法：

  • 免疫检查点抑制剂疗法：PD-1是T细胞表面的一种蛋白质，有助于控制人体的免疫反应。当PD-1附着在癌细胞上另一种称做PDL-1的蛋白质上时，它会阻止T细胞杀死癌细胞。PD-1抑制剂附着在PDL-1上，使T细胞能够杀死癌细胞。帕博利珠单抗是一种免疫检查点抑制剂。
    • 免疫检查点抑制剂。检查点蛋白，例如肿瘤细胞上的PD-L1和T细胞上的PD-1，有助于控制免疫反应。PD-L1与PD-1的结合使T细胞无法杀死体内的肿瘤细胞（左图）。用免疫检查点抑制剂（抗PD-L1或抗PD-1）阻断PD-L1与PD-1的结合，使T细胞能够杀死肿瘤细胞（右图）。
    免疫疗法利用人体的免疫系统对抗癌症。这个动画解释了一种使用免疫检查点抑制剂来治疗癌症的免疫疗法。

    更多信息请见批准的治疗结肠癌和直肠癌的药物。

    新的治疗方案正在临床试验中检验。

    NCI网站上有临床试验的信息。

    结肠癌的治疗可能产生副作用。

    如想了解癌症治疗的副作用的信息，请参阅我们的副作用页面。

    患者可能会考虑参与临床试验。

    对于一些患者来说，参与临床试验可能是最好的治疗选择。临床试验是癌症研究过程的一部分。临床试验用以了解新的癌症治疗方法是否安全有效或优于标准治疗。

    如今很多癌症的标准治疗方法都基于早期的临床试验。参与临床试验的患者可能会接受标准治疗方案，或者称为首先接受新治疗方法的人之一。

    参与临床试验的患者也能帮助改善未来癌症的治疗方法。即使临床试验没有形成有效的治疗方法，它们通常也能回答重要的问题并帮助推动研究。

    患者可以在开始进行癌症治疗之前、之中或之后参与临床试验。

    一些临床试验仅纳入未接受过治疗的患者。另一些试验是为癌症未转好的患者测试治疗方案。也有一些临床试验测试防止癌症复发（回来）或减小癌症治疗副作用的新方法。

    临床试验正在全国许多地方进行。有关NCI支持的临床试验的信息，可在NCI的临床试验搜索网页上找到。其他组织支持的临床试验可以在ClinicalTrials.gov网站上找到。

    可能需要后续检查。

    一些用来诊断癌症或发现癌症分期的试验可能要重复进行。一些用来发现治疗方案效果的试验要重复进行。是否要继续、改变或停止治疗的决定有可能会基于这些试验的结果。

    一些试验在治疗结束之后要继续时不时的进行。这些检查结果能显示你的状况是否改变，或者癌症是否复发。这些试验有时被称为后续测试或检查。

    Colon Cancer Treatment (PDQ®)

    Treatment Option Overview

    There are different types of treatment for patients with colon cancer.

    Different types of treatment are available for patients with colon cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Seven types of standard treatment are used:

    Surgery

    Surgery (removing the cancer in an operation) is the most common treatment for all stages of colon cancer. A doctor may remove the cancer using one of the following types of surgery:

  • Local excision: If the cancer is found at a very early stage, the doctor may remove it without cutting through the abdominal wall. Instead, the doctor may put a tube with a cutting tool through the rectum into the colon and cut the cancer out. This is called a local excision. If the cancer is found in a polyp (a small bulging area of tissue), the operation is called a polypectomy.
  • Resection of the colon with anastomosis: If the cancer is larger, the doctor will perform a partial colectomy (removing the cancer and a small amount of healthy tissue around it). The doctor may then perform an anastomosis (sewing the healthy parts of the colon together). The doctor will also usually remove lymph nodes near the colon and examine them under a microscope to see whether they contain cancer.
    • Resection of the colon with anastomosis. Part of the colon containing the cancer and nearby healthy tissue is removed, and then the cut ends of the colon are joined.
  • Resection of the colon with colostomy: If the doctor is not able to sew the 2 ends of the colon back together, a stoma (an opening) is made on the outside of the body for waste to pass through. This procedure is called a colostomy. A bag is placed around the stoma to collect the waste. Sometimes the colostomy is needed only until the lower colon has healed, and then it can be reversed. If the doctor needs to remove the entire lower colon, however, the colostomy may be permanent.
    • Colon cancer surgery with colostomy. Part of the colon containing the cancer and nearby healthy tissue is removed, a stoma is created, and a colostomy bag is attached to the stoma.

    After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.

    Radiofrequency ablation

    Radiofrequency ablation is the use of a special probe with tiny electrodes that kill cancer cells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in the hospital with general anesthesia.

    Cryosurgery

    Cryosurgery is a treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy.

    Chemotherapy

    Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

    Chemoembolization of the hepatic artery may be used to treat cancer that has spread to the liver. This involves blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The liver’s arteries then deliver the drugs throughout the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine.

    The way the chemotherapy is given depends on the type and stage of the cancer being treated.

    See Drugs Approved for Colon and Rectal Cancer for more information.

    Radiation therapy

    Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:

  • External radiation therapy uses a machine outside the body to send radiation toward the cancer.
  • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

    • The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used as palliative therapy to relieve symptoms and improve quality of life.

    Targeted therapy

    Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.

    Types of targeted therapies used in the treatment of colon cancer include the following:

  • Monoclonal antibodies: Monoclonal antibodies are made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.

    • There are different types of monoclonal antibody therapy:

  • Vascular endothelial growth factor (VEGF) inhibitor therapy: Cancer cells make a substance called VEGF, which causes new blood vessels to form (angiogenesis) and helps the cancer grow. VEGF inhibitors block VEGF and stop new blood vessels from forming. This may kill cancer cells because they need new blood vessels to grow. Bevacizumab and ramucirumab are VEGF inhibitors and angiogenesis inhibitors.
  • Epidermal growth factor receptor (EGFR) inhibitor therapy: EGFRs are proteins found on the surface of certain cells, including cancer cells. Epidermal growth factor attaches to the EGFR on the surface of the cell and causes the cells to grow and divide. EGFR inhibitors block the receptor and stop the epidermal growth factor from attaching to the cancer cell. This stops the cancer cell from growing and dividing. Cetuximab and panitumumab are EGFR inhibitors.
  • Angiogenesis inhibitors: Angiogenesis inhibitors stop the growth of new blood vessels that tumors need to grow.
  • Ziv-aflibercept is a vascular endothelial growth factor trap that blocks an enzyme needed for the growth of new blood vessels in tumors.
  • Regorafenib is used to treat colorectal cancer that has spread to other parts of the body and has not gotten better with other treatment. It blocks the action of certain proteins, including vascular endothelial growth factor. This may help keep cancer cells from growing and may kill them. It may also prevent the growth of new blood vessels that tumors need to grow.

    • See Drugs Approved for Colon and Rectal Cancer for more information.

    Immunotherapy

    Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or biologic therapy.

    Immune checkpoint inhibitor therapy is a type of immunotherapy:

  • Immune checkpoint inhibitor therapy: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. When PD-1 attaches to another protein called PDL-1 on a cancer cell, it stops the T cell from killing the cancer cell. PD-1 inhibitors attach to PDL-1 and allow the T cells to kill cancer cells. Pembrolizumab is a type of immune checkpoint inhibitor.
    • Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).
    Immunotherapy uses the body’s immune system to fight cancer. This animation explains one type of immunotherapy that uses immune checkpoint inhibitors to treat cancer.

    See Drugs Approved for Colon and Rectal Cancer for more information.

    New types of treatment are being tested in clinical trials.

    Information about clinical trials is available from the NCI website.

    Treatment for colon cancer may cause side effects.

    For information about side effects caused by treatment for cancer, see our Side Effects page.

    Patients may want to think about taking part in a clinical trial.

    For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

    Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

    Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

    Patients can enter clinical trials before, during, or after starting their cancer treatment.

    Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

    Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

    Follow-up tests may be needed.

    Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

    Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

    结肠癌治疗(PDQ®)

    结肠癌的治疗方案

    如想了解下列治疗方案的信息，请见治疗方案概述部分。

    0期（原位癌）

    0期（原位癌）的治疗方案可能包括以下几种手术：

  • 局部切除或简单的息肉切除术。
  • 切除术和吻合术。这在肿瘤过大，无法局部切除时进行。

    • 使用我们的临床试验搜索，您可以查找在NCI支持癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的一般信息。

    I期结肠癌

    I期结肠癌的治疗方案通常包括以下几种：

  • 切除术与吻合术。

    • 使用我们的临床试验搜索，您可以查找在NCI支持癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的一般信息。

    II期结肠癌

    III期结肠癌的治疗方案可能包括以下几种：

  • 切除术与吻合术。

    • 使用我们的临床试验搜索，您可以查找在NCI支持癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的一般信息。

    III期结肠癌

    III期结肠癌的治疗方案可能包括以下几种：

  • 可能伴随有化疗的切除术与吻合术。
  • 手术后新的化疗方案临床试验。

    • 使用我们的临床试验搜索，您可以查找在NCI支持癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的一般信息。

    IV期与复发性结肠癌

    IV期与复发性结肠癌的治疗方案可能包括以下几种：

  • 局部切除复发的肿瘤。
  • 伴有或不伴有吻合术的切除术。
  • 用手术来切除癌症已复发或癌细胞已扩散到的其他器官的部分，比如肝脏、肺和卵巢。已扩散至肝脏的癌症治疗方案可能包括以下几种：
  • 在术前、术后或术前后均给予化疗，以缩小肿瘤。
  • 射频消融术或冷冻手术，适用于不能进行手术的患者。
  • 肝动脉栓塞化疗
  • 部分患者可采用放疗或化疗作为姑息治疗，以缓解症状并提高生活质量。
  • 单克隆抗体或血管生成抑制剂的化疗和/或靶向治疗。
  • 免疫疗法
  • 化疗和／或靶向治疗临床试验。

    • 使用我们的临床试验搜索，您可以查找在NCI支持癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的一般信息。

    Colon Cancer Treatment (PDQ®)

    Treatment Options for Colon Cancer

    For information about the treatments listed below, see the Treatment Option Overview section.

    Stage 0 (Carcinoma in Situ)

    Treatment of stage 0 (carcinoma in situ) may include the following types of surgery:

  • Local excision or simple polypectomy.
  • Resection and anastomosis. This is done when the tumor is too large to remove by local excision.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage I Colon Cancer

    Treatment of stage I colon cancer usually includes the following:

  • Resection and anastomosis.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage II Colon Cancer

    Treatment of stage II colon cancer may include the following:

  • Resection and anastomosis.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage III Colon Cancer

    Treatment of stage III colon cancer may include the following:

  • Resection and anastomosis which may be followed by chemotherapy.
  • Clinical trials of new chemotherapy regimens after surgery.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage IV and Recurrent Colon Cancer

    Treatment of stage IV and recurrent colon cancer may include the following:

  • Local excision for tumors that have recurred.
  • Resection with or without anastomosis.
  • Surgery to remove parts of other organs, such as the liver, lungs, and ovaries, where the cancer may have recurred or spread. Treatment of cancer that has spread to the liver may also include the following:
  • Chemotherapy given before surgery to shrink the tumor, after surgery, or both before and after.
  • Radiofrequency ablation or cryosurgery, for patients who cannot have surgery.
  • Chemoembolization of the hepatic artery.
  • Radiation therapy or chemotherapy may be offered to some patients as palliative therapy to relieve symptoms and improve quality of life.
  • Chemotherapy and/or targeted therapy with a monoclonal antibody or an angiogenesis inhibitor.
  • Immunotherapy.
  • Clinical trials of chemotherapy and/or targeted therapy.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    结肠癌治疗(PDQ®)

    了解更多有关结肠癌的信息

    更多来自国家癌症研究所的结肠癌信息，请见以下：

  • 结直肠癌主页
  • 结直肠癌的预防
  • 结直肠癌的筛查
  • 检测结直肠癌和息肉的检查
  • 少见癌症的儿童治疗方案
  • 冷冻手术治疗癌症
  • 经批准的结肠与直肠癌药物
  • 癌症靶向治疗
  • 遗传性癌症易感性综合征的基因检测

    • 想了解来自国家癌症研究所的癌症基本信息和其他资源，请见以下：

  • 关于癌症
  • 分期
  • 化疗与你：对癌症患者的支持
  • 放射治疗与你：对癌症患者的支持
  • 战胜癌症
  • 需要问医生的癌症有关问题
  • 幸存者与护理者
    • Colon Cancer Treatment (PDQ®)

    To Learn More About Colon Cancer

    For more information from the National Cancer Institute about colon cancer, see the following:

  • Colorectal Cancer Home Page
  • Colorectal Cancer Prevention
  • Colorectal Cancer Screening
  • Tests to Detect Colorectal Cancer and Polyps
  • Unusual Cancers of Childhood Treatment
  • Cryosurgery in Cancer Treatment
  • Drugs Approved for Colon and Rectal Cancer
  • Targeted Cancer Therapies
  • Genetic Testing for Inherited Cancer Susceptibility Syndromes

    • For general cancer information and other resources from the National Cancer Institute, see the following:

  • About Cancer
  • Staging
  • Chemotherapy and You: Support for People With Cancer
  • Radiation Therapy and You: Support for People With Cancer
  • Coping with Cancer
  • Questions to Ask Your Doctor about Cancer
  • For Survivors and Caregivers
    • 结肠癌治疗(PDQ®)

    About This PDQ Summary

    About PDQ

    Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

    PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

    Purpose of This Summary

    This PDQ cancer information summary has current information about the treatment of colon cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

    Reviewers and Updates

    Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

    The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

    Clinical Trial Information

    A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

    Permission to Use This Summary

    PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

    The best way to cite this PDQ summary is:

    PDQ® Adult Treatment Editorial Board. PDQ Colon Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated . Available at: https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq. Accessed . [PMID: 26389319]

    Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

    Disclaimer

    The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

    Contact Us

    More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

    Colon Cancer Treatment (PDQ®)

    About This PDQ Summary

    About PDQ

    Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

    PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

    Purpose of This Summary

    This PDQ cancer information summary has current information about the treatment of colon cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

    Reviewers and Updates

    Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

    The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

    Clinical Trial Information

    A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

    Permission to Use This Summary

    PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

    The best way to cite this PDQ summary is:

    PDQ® Adult Treatment Editorial Board. PDQ Colon Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated . Available at: https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq. Accessed . [PMID: 26389319]

    Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

    Disclaimer

    The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

    Contact Us

    More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

    < 1 2 3 4 5 6 7 >
    目录
    章 节
    结肠癌的基本信息 结肠癌的分期 复发性结肠癌 治疗方案概述 结肠癌的治疗方案 了解更多有关结肠癌的信息 About This PDQ Summary
    地址：北京市朝阳区潘家园南里17号中国医学科学院肿瘤医院科研楼216、217室  邮编：100021  电话：010-87788070、010-87788069  邮箱：bjzlxh8746@163.com

    Copyright by 北京肿瘤学会 All rights reserved. 京ICP .备案：18036179号﹣1号