Bowel cancer treatments

Staging bowel cancer

The tests described in the Diagnosis article help determine whether you have bowel cancer. Some tests also show if the cancer has spread to other parts of the body. This is called staging. It helps your doctors work out the best treatment for you.
 

Treatment

The main treatment for bowel cancer is surgery. You may also have chemotherapy or radiotherapy. You may only need one type of treatment, but sometimes you may have a combination.

Surgery

There are different types of surgery for bowel cancer. Which one you have depends on where the cancer is in the bowel, the type and size of the cancer and whether it has begun to spread. The doctor will also consider your age and general health.

Minimally invasive surgery

The term minimally invasive surgery, also called keyhole or laparoscopic surgery, means a surgical technique that involves several small cuts (incisions) instead of one large cut on the abdomen.
The surgeon passes a thin, flexible tube called a laparoscope through one of the cuts. The laparoscope is fitted with a light and camera so the surgeon can see into the abdomen and remove the cancer. This technique usually means less pain and scarring, a lower risk of infection and a faster recovery with less time spent in hospital.
Minimally invasive bowel surgery is often recommended for early stage cancers and if the surgeon is confident the tumour can be easily removed. This depends on the location of the cancer and its size.
Ask your surgeon if this type of surgery is suitable for you and if it is available at your hospital or treatment centre.

Surgery for colon cancer

The most common type of colon cancer surgery is called a colectomy. There are different types of colectomies depending on where in the bowel the tumour is located.
Before the surgery, the operation and what to expect afterwards will be explained to you. Some people have minimally invasive surgery instead of the procedure described here.
The surgeon will make a cut in the abdomen to remove the part of the colon containing the cancer. The lymph nodes near the colon are also removed. The surgeon joins the two ends of the colon back together.
Sometimes, to allow the area time to heal, the bowel isn’t joined but is brought out onto an opening on the outside of the body. This procedure is called a colostomy and the opening is called a stoma. Another operation to rejoin the bowel can be done a few months later. In some cases, the surgeon will be unable to rejoin the ends of the colon and will connect the large bowel to a permanent stoma. For information about temporary and permanent stomas,
After surgery you will have a scar, usually running from your navel to your pubic area.

Surgery for rectal and anal cancers

If you have rectal or anal cancer, you may have part of the bowel removed, known as a resection. There are different types of resections depending on where in the rectum the cancer is located.

Anterior resection

The surgeon cuts out cancerous tissue in the rectum. You may have one large cut in your abdomen, or if your surgeon uses the minimally invasive technique, you will have small cuts. The type of surgery you have will depend on your situation.
During an anterior resection, the left part of the colon and the upper part of the rectum are removed, together with its blood supply and nearby lymph nodes. The ends of your bowel are rejoined.

Ultra-low anterior resection

If you have an ultra-low anterior resection, the left part of the colon and the entire rectum will be removed. Your surgeon will then perform a coloanal anastomosis. This means that your colon is joined to your anus. In some cases the surgeon may also create an internal pouch (called a colonic J-pouch) using the lining of the large bowel. The J-pouch will be connected to the anus and will work as a rectum. You may have a temporary stoma, which will be reversed once your J-pouch is healed.

Abdominoperineal (AP) resection

An AP resection is a less common type of rectal surgery. In this procedure, the entire rectum and anus are removed. After an AP resection, you will have two wounds: one on your abdomen and one where your anus was removed.
Your doctor will also create a permanent stoma, and waste will be removed through this opening.

Local excision

This type of surgery is usually used for very early stage tumours. The surgeon removes the cancer without cutting into the abdomen. Instead, the surgeon inserts an endoscope, like the one used to take a biopsy, into the rectum and lower colon and cuts the cancer out.
There are several types of local excision. For example, if the surgeon cuts out a cancerous polyp, it is called a polypectomy. If a surgeon cuts out a tumour, it is called a transanal excision.
The type of surgery you have will depend on the location of the cancer. For example, if the cancer is in or near the anal sphincter muscles, a transanal resection is not suitable.

Surgery for advanced cancer

A small number of people will have two separate cancers in their large bowel at the same time. Doctors may find the cancers using diagnostic tests or during surgery.
In this case, there are three options for surgery:

• 1. Remove the two small sections of the bowel.
• 2. Remove one larger section of the bowel, containing both areas with cancer.
• 3. Remove the entire colon and rectum (proctocolectomy) to prevent any chance of another cancer forming.
The type of surgery you have depends on your doctors’ recommendations and what you want.
In some cases, the cancerous part of the large bowel will be attached to another organ, such as the uterus or bladder. This may be caused by inflammation or by the cancer spreading. Your surgeon may remove the attached organ and the large bowel. If you need this type of operation, talk to your surgeon about what to expect. For example, the removal of a woman’s uterus (hysterectomy) causes infertility, so it is important to talk to a doctor or a fertility counsellor before treatment. This person can help you address your feelings and explore your options.
After surgery you will need regular checkups for the rest of your life as the chance of developing another primary cancer is higher than average. For more information about surgery for advanced bowel cancer, call the Cancer Council Helpline on 13 11 20.


Chemotherapy

Chemotherapy is the treatment of cancer with anti-cancer (cytotoxic) drugs. The aim of chemotherapy is to kill cancer cells while doing the least possible damage to healthy cells.
If the cancer is contained inside the bowel, surgery is the only treatment needed and chemotherapy is not used.
Chemotherapy may be used for the following reasons:

• Neoadjuvant therapy – Some people who have surgery have chemotherapy (and/or radiotherapy) beforehand to shrink the tumour and make it easier to remove during surgery.
• Adjuvant chemotherapy – Chemotherapy is often recommended for people if the bowel cancer has spread through the bowel wall or into the lymph nodes but no further.
• Reduce symptoms – If the cancer has spread to other organs, such as the liver or bones, chemotherapy may be used as palliative treatment.
Some people have chemotherapy after surgery. In most cases, you will have 6–8 weeks to recover from surgery, and you will start chemotherapy treatment when your wounds are healed.
Chemotherapy drugs are usually injected into a vein (intravenously) or sometimes given in tablet form. Some people have a small medical appliance called a port-a-cath or catheter placed beneath their skin through which they can receive chemotherapy. You will probably have sessions of chemotherapy over several weeks or months. Your medical team will work out your treatment schedule.
Refer to Cancer Council’s free Understanding Chemotherapy book for more details.


Side effects

The side effects of chemotherapy vary according to the drugs used. Your doctor will talk to you about these side effects and how to manage them.
Some of these side effects include tiredness, nausea, diarrhoea, mouth sores and ulcers, sore hands or feet, and a drop in levels of blood cells.
Most side effects are temporary and there are ways to prevent or reduce them. Tell your doctor or nurse about side effects you experience. They may prescribe medication to manage the side effects, arrange a break in your treatment, or change the kind of treatment you are having.
While having chemotherapy, you will be at a higher risk of getting an infection and bleeding in your bowel or other parts of your body. Tell your doctor if you are fatigued, or if you bruise or bleed easily. If you have a temperature over 38oC, contact your doctor or nurse immediately and go straight to the hospital emergency department.


Radiotherapy

Radiotherapy uses high-energy x-rays or electron beams to kill or damage cancer cells. Radiotherapy may be given before or after surgery for some people with rectal cancer, instead of surgery, or as palliative treatment. 
During treatment, you will lie under a machine that delivers x-ray beams to the treatment area. Each treatment only takes a few minutes once it has started, but setting up the machine and seeing the radiation oncologist during your first treatment session may take a few hours.
Radiotherapy is usually given once a day, Monday to Friday, for about 5–7 weeks. The number of radiotherapy treatments you have will depend on the site and extent of the cancer and your radiation oncologist’s recommendation.

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Treatment for liver cancer

Liver cancer: treatment

Cancer of the liver is a serious cancer. A cancer or tumour of the liver can either start in the liver (called a primary tumour or cancer) or be caused by cancer cells from other parts of the body that have travelled through the bloodstream or lymphatic system and lodged in the liver and started a new tumour (called a secondary tumour or metastasis).
Treatment of either form of liver cancer depends on the type of tumour, the stage it has reached, the general health of the person and their liver, and if there is cancer present in any other part of the body.

Treating primary liver cancer

Primary liver cancer is a relatively rare form of cancer. People with hepatitis B or hepatitis C infection or cirrhosis of the liver are more likely to get primary liver cancer than other people.
The first objective of the doctor treating a primary liver tumour is to ‘stage’ it. This is when the doctor finds out the extent of the cancer: is it just in the liver or has it spread to other parts of the body?
Doctors often use the TNM (tumour, node, metastasis) staging system to stage tumours from I (1) to IV (4), depending on:

• the size of the tumour;
• the degree to which it has invaded nearby blood vessels, lymph nodes and other structures; and
• whether or not the cancer has spread to other areas of the body – ‘distant metastases’.

Higher numbers indicate cancers that are more advanced. For example, a small tumour with no invasion of blood vessels, no spread to the lymph nodes and no distant spread would be stage I; a tumour that has spread to other parts of the body is stage IV.
Treatment of primary liver tumours is usually by one or more of a combination of medical techniques, including the following.

• Surgery. This may consist of cutting out the cancerous part of the liver or full transplantation of another liver to replace the diseased one. Liver transplantation is a difficult procedure and not all people with liver cancer will be suitable for it.
• Cryosurgery or cryotherapy kills the cancer cells by freezing them.
• Chemotherapy uses drugs to kill cancer cells. The medications are usually injected into a vein or artery using a needle. The drugs are taken in the bloodstream to the liver, but can also kill cancer cells in other parts of the body. Sometimes the drugs are put directly into a blood vessel that supplies the liver tumour. Chemotherapy is often used after surgery to kill off any remaining cancer cells in the body.
• Chemembolisation. This medical technique involves blocking the main artery supplying the liver and then inserting the chemotherapy medications between the blockage and the liver. The blood supply then delivers the medications to the liver.
• Radiotherapy uses X-rays or radiolabelled substances to kill the cancer cells. Sometimes the radiation is put into the body with thin plastic tubes to direct it to the exact location of the tumour. The tumour cells can also be targeted by radiation taken directly to them by so-called radiolabelled substances. These radiolabelled substances seek out the liver cells specifically and so deliver the radiation directly to them.
• Ethanol (absolute alcohol) injection directly into the tumour is reportedly quite successful with small tumours.
• Radiofrequency ablation. An electric current of a certain frequency is used to heat and destroy cancer cells. This type of treatment may be used for small, unresectable tumours.
• Targeted treatment. A new medication – sorafenib (brand name Nexavar) has been developed for the treatment of advanced liver cancer. This medication works by interfering with the tumour’s ability to generate new blood vessels.

Treatment of secondary liver cancer

In the case of secondary liver cancer that has spread from other areas, such the colon, surgical removal is sometimes possible if there is only one area of metastasis. However, if there are multiple metastases (secondary tumours) in the liver, surgery may not be effective. In cases of multiple tumour sites in the liver, treatment may include chemotherapy, cryosurgery, radiofrequency ablation or alcohol injections.
Your doctor is the best person to advise you about management options for your particular tumour.

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About Korea Medical VISA

About Korea medical VISA

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Foreign patients and family member

2. Visa Types...
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3. Documents for apply
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For medical reservation, Contact us!
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What is multiple myeloma?

What is multiple myeloma?

Multiple myeloma is a type of cancer affecting plasma cells, which are a mature form of white blood cell found in the bone marrow. Healthy plasma cells are part of the immune system, and fight infections by producing antibodies. In people with multiple myeloma, the plasma cells do not function properly — they grow and divide uncontrollably, and are not able to produce antibodies normally.

What are the symptoms of multiple myeloma?

Some of the characteristic signs and symptoms of the disease include:

• painful bones (most commonly, the spine, ribs and hips are affected);
• bones that fracture easily;
• a tendency to bruise easily;
• being prone to catching infections;
• weight loss; and
• tiredness.

People with multiple myeloma sometimes also have problems with elevated blood calcium levels. This can occur when calcium from bones that are affected by myeloma dissolves into the blood. Symptoms that may suggest a raised blood calcium level include stomach pains, constipation, nausea, excessive thirst and urination, and mental confusion.

How is multiple myeloma diagnosed?

People suspected of having multiple myeloma will usually need to have blood and urine tests, looking for evidence of paraproteins (the abnormal proteins produced by myeloma cells). X-rays or scans of the bones are also performed to determine if there are any areas of bone that have been weakened or eroded by the myeloma cells. A bone marrow biopsy — a test that involves taking a small sample of bone marrow, which is examined under a microscope to look for myeloma cells — is often required.

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Is there a test for breast cancer?

Mammograms — a type of X-ray — are the best way of detecting breast cancer before symptoms develop.

Mammograms are capable of detecting tumours that are too small to be felt. This enables treatment to start sooner than if the tumour was detected when it was larger and able to be felt. The sooner treatment starts the better. Generally, mammograms are recommended for women aged between 50 and 69 every 2 years.

Breast tissue in young women is usually quite dense and mammograms sometimes may not detect lumps. This is why regular mammograms are not usually recommended for women under 40 — along with the fact that breast cancer is rare in younger women.




Korea Medical Tourism Center

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TATTOO ~ risks and precautions

You could be the proud owner of a new tattoo in a matter of hours — but don't let the ease of getting tattoos stop you from making a thoughtful decision about permanent body art. Before you get a tattoo, make sure you know what's involved. Also, be certain that tattooing is the right decision for you. 

How tattoos are done

A tattoo is a permanent mark or design made on your skin with pigments inserted through pricks into the skin's top layer. Typically, the tattoo artist uses a hand-held machine that acts much like a sewing machine, with one or more needles piercing the skin repeatedly. With every puncture, the needles insert tiny ink droplets. The process — which is done without anesthetics — causes a small amount of bleeding and slight to potentially significant pain.

Tattoos breach the skin, which means that skin infections and other complications are possible. Specific risks include:

• Allergic reactions. Tattoo dyes — especially red, green, yellow and blue dyes — can cause allergic skin reactions, such as an itchy rash at the tattoo site. This can occur even years after you get the tattoo.
• Skin infections. A skin infection — which might cause redness, swelling, pain and a pus-like drainage — is possible after tattooing.
• Other skin problems. Sometimes bumps called granulomas form around tattoo ink. Tattooing can also lead to keloids — raised areas caused by an overgrowth of scar tissue.
• Bloodborne diseases. If the equipment used to create your tattoo is contaminated with infected blood, you can contract various bloodborne diseases — including tetanus, hepatitis B and hepatitis C.
• MRI complications. Rarely, tattoos or permanent makeup might cause swelling or burning in the affected areas during magnetic resonance imaging (MRI) exams. In some cases, tattoo pigments can interfere with the quality of the image — such as when a person who has permanent eyeliner has an MRI of the eye.

Medication or other treatment — including possible removal of the tattoo — might be needed if you experience an allergic reaction to the tattoo ink or you develop an infection or other skin problem near a tattoo. 

Make sure you're ready

Before you get a tattoo, ask yourself whether you truly want to invest in permanent body art. If you're unsure or worried that you might regret it someday, give yourself more time to think about it. Don't allow yourself to be pressured into getting a tattoo, and don't get a tattoo if you're under the influence of alcohol or drugs.

If you decide to go ahead with the tattoo, choose the location of the tattoo carefully. Consider whether you want the tattoo to be visible or hidden under clothing. Also remember that weight gain — including pregnancy weight gain — might distort the tattoo or otherwise affect its appearance. 

Insist on safety precautions

To make sure your tattoo will be applied safely, answer these questions:

• Who does the tattooing? Don't attempt to tattoo yourself or allow an untrained friend to do the tattooing. Go to a reputable tattooing studio that employs only properly trained employees. Keep in mind that regulation requirements and licensing standards vary from state to state. Check with your city, county or state health department for information on local licensing and regulations.
• Does the tattoo artist wear gloves? Make sure the tattoo artist washes his or her hands and wears a fresh pair of protective gloves for each procedure.
• Does the tattoo artist use proper equipment? Make sure the tattoo artist removes the needle and tubes from sealed packages before your procedure begins. Any pigments, trays or containers should be unused as well.
• Does the tattoo artist sterilize nondisposable equipment? Make sure the tattoo artist uses a heat sterilization machine (autoclave) to sterilize all nondisposable equipment between customers. Instruments and supplies that can't be sterilized with an autoclave — including drawer handles, tables and sinks — should be disinfected with a commercial disinfectant or bleach solution after each use.

Take good care of your tattoo

How you care for your new tattoo depends on the type and extent of work done. Typically, however, you'll need to:

• Remove the bandage after 24 hours. Apply an antibiotic ointment to the tattooed skin while it's healing.
• Keep the tattooed skin clean. Use plain soap and water and a gentle touch. While showering, avoid direct streams of water on the newly tattooed skin. Pat — don't rub — the area dry.
• Use moisturizer. Apply a mild moisturizer to the tattooed skin several times a day.
• Avoid sun exposure. Keep the tattooed area out of the sun for at least a few weeks.
• Avoid swimming. Stay out of pools, hot tubs, rivers, lakes and other bodies of water while your piercing is healing.
• Choose clothing carefully. Don't wear anything that might stick to the tattoo.
• Allow up to 2 weeks for healing. Don't pick at any scabs, which increases the risk of infection and can damage the design and cause scarring.

If you think your tattoo might be infected or you're concerned that your tattoo isn't healing properly, contact your doctor. If you're interested in tattoo removal, ask your dermatologist about laser surgery or other options for tattoo removal.