Advanced, comprehensive treatment options
Massey offers the full spectrum of advanced treatment options only available at large academic medical centers such as VCU Health. At Massey, one doctor does not decide your care. Instead, your personalized treatment plan is recommended by the region’s largest and most comprehensive multidisciplinary gastrointestinal cancer treatment team. A dedicated nurse navigator will guide you and your family through the treatment process to help reduce stress associated with coordinating care.
Most colorectal cancer patients require surgery to remove the tumor and may also receive chemotherapy and/or radiation therapy before and/or after surgery. Specific treatment plans and the sequence of care are recommended by your team based on a variety of health factors and personal preference.
Treatments may include any of the following:
Surgery
The aim of surgery is to remove the tumor. The extent of surgery will depend on whether the cancer has spread. When cancer develops from a polyp, the entire polyp is removed in a procedure called a polypectomy , which can often be performed at the same time as a colonoscopy. A colon resection is an operation that involves removing the cancer and a section of normal tissue on either side. Nearby lymph nodes are also removed during a colon resection.
Usually, the healthy ends of the bowel are surgically reconnected at the time of the initial surgery. However, in some patients the doctor may need to create a temporary connection between the bowel and the wall of the abdomen. This is called a stoma or ostomy. A stoma can be fashioned from the small intestine, called an ileostomy, or the colon, called a colostomy. The stoma is typically temporary but in some patients, it may be permanent.
Massey is also a leading expert in robotic-assisted surgery using the da Vinci Surgical System, which may allow for smaller incisions leading to a faster recovery. For some patients, laparoscopic surgery may also be an option. In laparoscopic surgery, several tiny incisions are made and a camera is used to guide the surgeon as they control the da Vinci Surgical System.
At Massey, we follow an Enhanced Recovery After Surgery (ERAS) protocol in our care of patients before, during and after surgery. Through ERAS, our patients are actively involved in their own recovery process. Components of the program are:
Pain management. Each patient has a personalized pain management plan designed to limit the use of opioids (narcotics)
Early mobility and feeding. We help our patients begin to move and eat as soon after surgery as possible
-Fluid management. We provide our patients with only as much IV fluid as they need to prevent fluid overload and bloating after surgery
Following ERAS helps our patients recover faster, leave the hospital sooner and have fewer complications following surgery.
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Chemotherapy
Chemotherapy uses drugs to treat cancerous cells, most often by interfering with their ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Studies have shown that chemotherapy after surgery can increase survival for some patients. Chemotherapy also can help relieve symptoms of advanced cancer.
External radiation
A precise beam of radiation is directed at the cancer cells from outside of the body using a linear accelerator. In order to protect the surrounding healthy tissue, special shields may be used. Radiation treatments are painless and usually last a few minutes. Side effects are typically mild but may include sensitivity and redness similar to a sunburn at the treatment site.
Heated intraperitoneal chemotherapy (HIPEC)
Massey is one of few cancer care providers in Virginia to offer HIPEC. HIPEC is a complex procedure reserved for patients with advanced abdominal cancers. It involves surgery to remove as much of the tumor or tumors as possible, followed by the circulation of a heated chemotherapy solution throughout the abdominal cavity. The chemotherapy solution helps kill any remaining cancer cells and reduces the risk of cancer recurrence. There is substantial evidence showing HIPEC is an effective treatment for several cancers affecting the abdominal region.
Radiation therapy
Radiation therapy uses high-energy radiation to kill cancer cells and to shrink tumors. Radiation therapy may be used alone or in combination with chemotherapy. There are two ways to deliver radiation therapy to the site of the cancer:
Brachytherapy is a form of internal radiation therapy delivered inside the body as close to the cancer as possible. Substances that produce radiation, called radioisotopes, are positioned close to or implanted directly in the tumor. Brachytherapy often allows doctors to deliver higher doses of radiation while limiting radiation exposure to other organs. In some cases, brachytherapy is used to supplement or “boost” external radiation therapy.
Immunotherapies stimulate the patient’s own immune system to attack cancer in various ways. This is a new and promising type of cancer treatment, and because of this many therapies are only available through participation in clinical trials.
Targeted therapies
Also known as “precision cancer care,” new drugs are being developed that target specific genetic mutations known to cause cancer. Massey was the first cancer care provider in Virginia to perform DNA sequencing for the treatment of cancer, and we continue to stay at the forefront of precision cancer care.
Clinical trials
Clinical trials are research studies that evaluate new medical treatments and devices and increase scientific understanding of a wide variety of diseases. Massey has one of the largest clinical trial portfolios in Virginia, which means our patients have access to new and promising treatments before they are made available to community providers.
