Mount Elizabeth Medical Centre, Singapore 228510
Colorectal cancer treatment depends on the location and stage of the tumour as well as the patient’s overall health and treatment needs. Surgery plays an important role in the treatment of many localised colorectal cancers, although the overall treatment sequence differs between colon and rectal cancer and may also involve chemotherapy or radiotherapy. There is no single operation that is suitable for every patient.
Understanding how colorectal surgeons choose between different procedures can help patients make sense of their treatment recommendations.
What Surgical Options Are Available for Colorectal Cancer?
Several surgical procedures are available for colorectal cancer, but the most appropriate option depends on the tumour's location, stage and your overall health. The aim is to remove the cancer completely while preserving as much healthy bowel function as possible whenever it is safe to do so.
Local or Endoscopic Treatment for Selected Early Cancers
Some carefully selected early colorectal cancers can be removed without a major bowel resection. Certain early lesions can be removed endoscopically, while local excision may be an option for selected early rectal cancers. Suitability depends on factors such as tumour depth, location and the risk of lymph node involvement.
Colon Resection
A colon resection (colectomy) is the most common operation for colon cancer. The surgeon removes the affected section of the colon along with nearby lymph nodes. In most cases, the remaining healthy ends of the bowel can be reconnected to restore bowel continuity.
Rectal Cancer Surgery
Rectal cancer surgery is planned according to the tumour’s location and its relationship to the anal sphincter and surrounding structures. Depending on these factors, surgery may involve removing part or all of the rectum, with the bowel reconnected where this can be done safely. Some patients may require a temporary or permanent stoma.
Laparoscopic and Robotic-Assisted Surgery
Depending on the tumour’s location, stage and complexity, colorectal cancer surgery may be performed using open, laparoscopic or robotic-assisted techniques. Laparoscopic and robotic-assisted surgery use smaller incisions than open surgery and may be associated with less post-operative pain and a shorter recovery for appropriately selected patients. However, open surgery may still be recommended when it provides safer access or better supports complete cancer removal.
How Does a Colorectal Cancer Specialist Choose the Right Operation?
Choosing the most appropriate operation involves more than identifying where the cancer is located. A colorectal cancer specialist considers several clinical factors to select a procedure that offers the best chance of removing the cancer completely while supporting recovery and preserving bowel function where possible.
Cancer Stage and Extent of Disease
The stage of the cancer is one of the most important factors in surgical planning. Colonoscopy, biopsy and imaging provide different information needed for treatment planning. Biopsy confirms the cancer diagnosis, while imaging helps assess the tumour’s extent and whether there are signs of spread to lymph nodes or other organs. These findings influence the type and extent of surgery required.
Tumour Location Within the Bowel
Whether the cancer is in the colon or rectum, and its exact position, affects which operation is most suitable. For rectal cancers, the distance from the anal sphincter is particularly important, as it may influence whether the bowel can be safely reconnected after surgery.
Overall Health and Surgical Fitness
A patient's general health also plays a role in treatment planning. Factors such as existing medical conditions, nutritional status, physical fitness and suitability for anaesthesia influence surgical planning and recovery.
Preserving Bowel Function Where Possible
The goal of surgery is to remove the cancer completely while preserving bowel function whenever it is medically appropriate. A colorectal cancer specialist will discuss the expected benefits, potential risks and whether a temporary or permanent stoma may be necessary so patients can make informed treatment decisions.
The Overall Cancer Treatment Plan
Surgical planning also needs to fit within the wider cancer treatment pathway. Depending on the cancer stage and location, colorectal surgeons may work with medical oncologists, radiation oncologists, radiologists and other specialists to determine whether treatments such as chemotherapy or radiotherapy are needed before or after surgery.
What Can You Expect Before and After Colorectal Cancer Surgery?
Understanding the treatment journey can help you prepare for surgery and recovery. While every patient's experience differs depending on the type of operation performed and their overall health, colorectal cancer treatment generally follows a structured pathway from preoperative assessment to ongoing follow-up care.
Treatment Before Surgery
Some patients, particularly those with certain rectal cancers, may receive chemotherapy, radiotherapy or a combination of treatments before surgery. This may be recommended to reduce or control the tumour before an operation and forms part of the overall treatment plan determined by the multidisciplinary team.
Preparing for Surgery
Before surgery, your colorectal cancer specialist will arrange investigations such as blood tests, imaging scans and, where needed, additional assessments to confirm the extent of the cancer and evaluate your fitness for surgery. You will also have an opportunity to discuss the planned procedure, expected recovery and any potential risks.
Recovery After the Operation
After surgery, you will be monitored closely while your bowel function gradually returns. Pain relief, early mobilisation and a gradual return to eating all play an important role in recovery. The length of your hospital stay depends on the type of surgery performed and how well you recover.
Determining Whether Further Treatment Is Needed
The tissue removed during surgery is examined to confirm the cancer stage and whether it has spread to nearby lymph nodes. These findings help determine the final pathological stage and whether additional treatments, such as chemotherapy, are recommended after surgery.
Follow-Up Care and Surveillance
Regular follow-up appointments allow your specialist to monitor your recovery, manage any ongoing concerns and check for signs of recurrence. Follow-up care may include physical examinations, blood tests, imaging scans and colonoscopies at intervals based on your individual treatment plan.
Personalised Colorectal Cancer Care at Colorectal Practice
Colorectal cancer treatment may involve surgery alone or surgery combined with other treatments depending on the location and stage of the cancer. Surgical planning considers both cancer removal and the preservation of bowel function where medically appropriate.
At Colorectal Practice, we are committed to delivering personalised care through the expertise of our experienced surgeons. Our clinical team is led by our medical director and senior consultant colorectal surgeon, Dr Dennis Koh, alongside Dr Sharon Koh and Dr Pauleon Tan, our other senior consultant colorectal surgeons, who work closely with relevant healthcare professionals to ensure treatment recommendations remain patient-centred and evidence-based. Schedule a consultation and take the next step towards appropriate colorectal care.
Frequently Asked Questions (FAQs) About Colorectal Cancer Surgery
Can colorectal cancer always be treated with surgery alone?
Not always. Surgery is an important treatment for many localised colorectal cancers, but chemotherapy may also be recommended depending on the cancer stage and other pathological features. Radiotherapy is used primarily in selected rectal cancers and may be given together with chemotherapy before or after surgery depending on the treatment plan.
Will I need a stoma after colorectal cancer surgery?
Not everyone requires a stoma. Whether a temporary or permanent stoma is needed depends on the location of the tumour, the type of operation performed and whether it is safe to reconnect the bowel. Your colorectal cancer specialist will discuss this with you before surgery whenever possible.
How long does it take to recover from colorectal cancer surgery?
Recovery continues after discharge and varies according to the operation, surgical approach, complications and the patient’s overall health. Your surgical team will advise when it is appropriate to increase activity, return to work and resume exercise.
Can minimally invasive surgery be used for all colorectal cancers?
No. Laparoscopic or robotic-assisted surgery may be suitable for many patients, but not every tumour can be safely treated using these techniques. Your colorectal cancer specialist will recommend the approach that offers the safest and most effective cancer removal based on your individual circumstances.
Should I seek a second opinion before deciding on surgery?
Seeking a second opinion is a reasonable option if you would like more information about your diagnosis or treatment plan. Another colorectal cancer specialist can review your test results, explain the available surgical options and help you feel more confident about your treatment decision.
Meet Our Colorectal Specialists in Singapore
