DIGESTIVE CANCERS

Cancer that begins in the colon is called colon cancer, and cancer that begins in the rectum is called rectal cancer. Cancer that starts in either of these organs may also be called colorectal cancer.

In 2011, more than 141,000 people in the United States were expected to be diagnosed with colorectal cancer. It is the fourth most common cancer in men, after skin, prostate, and lung cancer. It is also the fourth most common cancer in women, after skin, breast, and lung cancer.

Treatment Methods 

The choice of treatment depends mainly on the location of the tumor in the colon or rectum and the stage of the disease. Treatment for colorectal cancer may involve surgery, chemotherapy, biological therapy or radiation therapy. Some people have a combination of treatments.

Surgery is the most common treatment for colorectal cancer.

• Colonoscopy: A small malignant polyp may be removed from your colon or upper rectum with a colonoscope. Some small tumors in the lower rectum can be removed through your anus without a colonoscope.
• Laparoscopy: Early colon cancer may be removed with the aid of a thin, lighted tube (laparoscope). Three or four tiny cuts are made into your abdomen. The surgeon sees inside your abdomen with the laparoscope. The tumor and part of the healthy colon are removed. Nearby lymph nodes also may be removed. The surgeon checks the rest of your intestine and your liver to see if the cancer has spread.
• Open surgery: The surgeon makes a large cut into your abdomen to remove the tumor and part of the healthy colon or rectum. Some nearby lymph nodes are also removed. The surgeon checks the rest of your intestine and your liver to see if the cancer has spread.

When a section of your colon or rectum is removed, the surgeon can usually reconnect the healthy parts. However, sometimes reconnection is not possible. In this case, the surgeon creates a new path for waste to leave your body. The surgeon makes an opening (stoma) in the wall of the abdomen, connects the upper end of the intestine to the stoma, and closes the other end. The operation to create the stoma is called a colostomy. A flat bag fits over the stoma to collect waste, and a special adhesive holds it in place.

For most people, the stoma is temporary. It is needed only until the colon or rectum heals from surgery. After healing takes place, the surgeon reconnects the parts of the intestine and closes the stoma. Some people, especially those with a tumor in the lower rectum, need a permanent stoma.

New treatment methods may be under study in clinical trials. For up to date Information about clinical trials visit http://cancer.gov/clinicaltrials.

For more information about cancer of the colon and rectum, download this booklet from the National Cancer Institute.

In 2011, about 52,000 men and 17,000 women were expected to be diagnosed with bladder cancer in the United States. Most are over 70 years old.

There are three types of bladder cancer that begin in cells in the lining of the bladder. These cancers are named for the type of cells that become malignant (cancerous):

• Transitional cell carcinoma: Cancer that begins in cells in the innermost tissue layer of the bladder. These cells are able to stretch when the bladder is full and shrink when it is emptied. Most bladder cancers begin in the transitional cells.
• Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells that may form in the bladder after long-term infection or irritation.
• Adenocarcinoma: Cancer that begins in glandular (secretory) cells that may form in the bladder after long-term irritation and inflammation.

Cancer that is confined to the lining of the bladder is called superficial bladder cancer. Cancer that begins in the transitional cells may spread through the lining of the bladder and invade the muscle wall of the bladder or spread to nearby organs and lymph nodes; this is called invasive bladder cancer.

Treatment Methods 

There are different types of treatment for patients with bladder cancer. Treatment methods include surgery, radiation therapy, chemotherapy, and biologic therapy.

If surgery is needed, one of the following types of surgery may be done:

• Transurethral resection (TUR) with fulguration: Surgery in which a cystoscope (a thin lighted tube) is inserted into the bladder through the urethra. A tool with a small wire loop on the end is then used to remove the cancer or to burn the tumor away with high-energy electricity. This is known as fulguration.
• Radical cystectomy: Surgery to remove the bladder and any lymph nodes and nearby organs that contain cancer. This surgery may be done when the bladder cancer invades the muscle wall, or when superficial cancer involves a large part of the bladder. In men, the nearby organs that are removed are the prostate and the seminal vesicles. In women, the uterus, the ovaries, and part of the vagina are removed. Sometimes, when the cancer has spread outside the bladder and cannot be completely removed, surgery to remove only the bladder may be done to reduce urinary symptoms caused by the cancer. When the bladder must be removed, the surgeon creates another way for urine to leave the body.
• Segmental cystectomy: Surgery to remove part of the bladder. This surgery may be done for patients who have a low-grade tumor that has invaded the wall of the bladder but is limited to one area of the bladder. Because only a part of the bladder is removed, patients are able to urinate normally after recovering from this surgery.
• Urinary diversion: Surgery to make a new way for the body to store and pass urine.

Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy after surgery to kill any cancer cells that are left.

New treatment methods are being studied in clinical trials. For up to date Information about clinical trials visit http://cancer.gov/clinicaltrials.

For more information about bladder cancer, you can download this booklet from the National Cancer Institute.

Ovarian cancer is cancer that forms in tissues of the ovary. Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells). The most common type of ovarian cancer is ovarian epithelial cancer.

In 2011 an estimated 21,990 cases of ovarian cancer were expected to be diagnosed.

Women who have one first-degree relative (mother, daughter, or sister) with ovarian cancer are at an increased risk of developing ovarian cancer. This risk is higher in women who have one first-degree relative and one second-degree relative (grandmother or aunt) with ovarian cancer. This risk is even higher in women who have two or more first-degree relatives with ovarian cancer.

Some women who have an increased risk of ovarian cancer may choose to have a prophylactic oophorectomy - the removal of healthy ovaries so that cancer cannot grow in them. In high-risk women, this procedure has been shown to greatly decrease the risk of developing ovarian cancer.

Early ovarian cancer may not cause any symptoms. When symptoms do appear, ovarian cancer is often advanced.

Treatment Methods 

Different types of treatment are available for patients with ovarian epithelial cancer. Standard treatments include surgery, radiation therapy, and chemotherapy.

Most patients have surgery to remove as much of the tumor as possible. Different types of surgery may include:

• Total hysterectomy: A surgical procedure to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision (cut) in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
• Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube.
• Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes.
• Omentectomy: A surgical procedure to remove the omentum (a piece of the tissue lining the abdominal wall).
• Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells.

New types of treatment are being tested in clinical trials. For up to date Information about clinical trials visit http://cancer.gov/clinicaltrials.

For more information about ovarian cancer, you can download this booklet from the National Cancer Institute.

Cervical cancer is cancer that forms in tissues of the cervix. It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap tests. Cervical cancer is almost always caused by human papillomavirus (HPV) infection.

The disease begins on the surface of the cervix. If not treated, the cancer invades more deeply into the cervix. This is called invasive cervical cancer. In 2011, more than 12,000 women in the United States were expected to be diagnosed with invasive cervical cancer. Most of these women are younger than 55.

Three types of standard treatment are used, including surgery, radiation therapy, and chemotherapy.

The following surgical procedures may be used:

• Conization: A procedure to remove a cone-shaped piece of tissue from the cervix and cervical canal. A pathologist views the tissue under a microscope to look for cancer cells. Conization may be used to diagnose or treat a cervical condition. This procedure is also called a cone biopsy.
• Total hysterectomy: Surgery to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.

New types of treatment are being tested in clinical trials. For up to date Information about clinical trials visit http://cancer.gov/clinicaltrials.

For more information about cervical cancer, you can download this booklet from the National Cancer Institute.