Other types of surgery for colon or rectal cancer

Endoscopic resection

Used for larger benign polyps. Some very early cancers that involve only the inner lining of the bowel may be suitable for endoscopic resection (also called endoscopic mucosal resection or EMR). This involves cutting out the tumour during a colonoscopy. A bowel resection may also still be needed.

Local excision 

People who have very early-stage rectal cancer or are not fit for a major operation may have a local excision. The surgeon puts instruments into the anus to remove the cancer from the lining of the rectum, along with a margin of healthy tissue, without cutting into the abdomen. Methods include:

• transanal excision (TAE)
• transanal endoscopic microsurgery (TEMS)
• transanal minimally invasive surgery (TAMIS).

If there are two cancers 

If there are 2 cancers – In a small number of people, 2 separate cancers may be found in the large bowel at the same time. The cancers may be discovered through tests or during surgery. In this case, there are several options for surgery, including to remove:

• 2 sections of the bowel
• one larger section of the bowel that includes both areas with cancer
• all of the colon and rectum (proctocolectomy) to prevent any chance of another cancer forming.

In some locally advanced cancers, other organs that the bowel cancer is attached to may also be removed along with the bowel containing the cancer. The type of surgery your doctor recommends depends on several factors, including your age, where the tumours are in the bowel, genetic and other risk factors, and your preferences.

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