Central Maine Healthcare

Where You are the Center

Chemotherapy

Colorectal Cancer

Colorectal cancer is a dangerous disease partly because patients rarely show symptoms before their cancer is too advanced to cure. Fortunately though, if it’s caught early, patients usually go on to full recovery. Central Maine Healthcare wants our entire community over the age of 45 to have colonoscopies so we can help stop this disease.

About Colorectal Cancer

Colorectal cancer refers to cancer that begins in the colon or in the rectum. Colon and rectum cancer are grouped together because they have many features in common, like all cancers, colorectal cancer begins when cells in the body begin to grow out of control.

Prevention

While no cancer can truly be prevented, there are important steps you can take to significantly reduce your risk. It’s likely the best way to do this is getting your colonoscopy as soon as you turn 45. This test allows your gastroenterologist to detect pre-cancerous growths early, before they become cancer. These lifestyle changes are also associated with lower risk of colorectal cancer:

  • Maintaining a healthy weight
  • Increasing your physical activity
  • Reducing alcohol intake
  • Quitting cigarettes if you smoke
  • Increasing the amount of fruits and vegetables in your diet

Detection

Detecting colorectal cancer early is possible through a variety of screening tests. These include visual exams, like a colonoscopy, and stool-based tests, in which a provider checks the stool (feces) for signs of cancer. Stool-based tests are less invasive but must be done more often, usually once a year. A colonoscopy on the other hand is usually needed only once every 10 years.

Treatment

Most polyps do not become cancer, but if you’re diagnosed, rest assured you’re in skilled and caring hands. Our multi-skilled team of gastroenterologists, colorectal surgeon, oncologists, specially trained nurses and support staff will work with you to create a personalized cancer treatment plan.

Extra Support in Your Fight Against Colorectal Cancer

Central Maine Healthcare is devoted to providing the best care for all our cancer patients. In addition to our highly skilled specialists, we offer features designed to give you full support during treatment and recovery. These include navigator nurses specifically dedicated to guiding you to resources that will support you and your family and oncology social workers who offer counseling.

Screening and Diagnosis

We understand no one is eager to get a colonoscopy, but it could save your life! Colorectal cancer is 90% preventable which is why, at Central Maine Healthcare, we’re committed to making the process as easy and convenient as possible so more people will get tested.

What is a Colonoscopy?

A colonoscopy is a test to view the inside of the rectum and colon, all of the large bowel and the lower part of the small intestine. This routine exam is usually done as an outpatient procedure and is administered by a trained gastroenterologist or surgeon using a colonoscope. A colonoscope is a long, thin, flexible tube with tiny camera and light on one end that relays information to a video monitor.

Why Get a Colonoscopy?

A colonoscopy is a safe and effective way to monitor gastrointestinal (GI) health and to check for diseases of the colon. Currently, a colonoscopy is the best defense against colorectal cancer as the most helpful tool in early detection. Colorectal cancer is the second leading cause of cancer deaths in the U.S. and is the third most common cancer in both men and women. Early detection through a colonoscopy could save your life.

Polyps are small growths on the inside wall of the rectum or colon that may become cancerous, removal of these during colonoscopy can actually prevent the polyps from becoming cancer. A colonoscopy is also done to find irregularities in the intestines, or to further look for microscopic evidence of disease through a biopsy taken during the procedure or to treat GI issues.

When Should I Get a Colonoscopy?

The American Cancer Society recommends that people at average risk for colorectal cancer begin regular screening at age 45. If you have a family history of colon cancer, screenings should start earlier. Talk to your provider about when to start regular screenings if you have a family history of colon cancer.

Colorectal Cancer Symptoms

You should also ask your provider about a colonoscopy if you’ve experienced any of the following:

  • Blood present in stool
  • Change in bowel habits
  • Prolonged rectal pain
  • Prolonged stomach pain
  • Inflamed colon as determined by a CT (computerized tomography) scan

Additional Colorectal Cancer Screenings 

Colonoscopy is considered the gold standard in colorectal cancer screening, but we also perform other standard tests to help detect polyps and signs of cancer:

  • Fecal Occult Blood Test: This test, recommended annually, looks for blood in the stool. Polyps bleed more than normal tissue and these tiny amounts of blood can be detected by a test called hemocult.
  • Flexible Sigmoidoscopy: This exam, recommended every five years, evaluates the lower section of the colon and rectum, where most polyps and cancers are located.

Treatment

If you’ve been diagnosed with colorectal cancer, we know how worrisome it can be. But the good news is that colorectal cancer is one of the most treatable cancers. Central Maine Healthcare wants to help you by providing all the compassionate care and support you need to fight this disease.

Treatments We Offer

The type of treatment your provider recommends depends largely on the size and stage of the cancer (early or advanced), as well as your overall health, personal preferences and potential side effects. Our team will work with you to create a plan that you’re completely comfortable with and will focus on keeping you feeling well at every step. Your personal treatment plan may include one or a combination of:

Surgery

Surgery to remove the tumor is the most common treatment for colorectal cancer, especially the early stages. Part of the healthy colon or rectum and nearby lymph nodes may also be removed. If the cancer is small and completely contained within a polyp, your provider may be able to completely remove it during the screening colonoscopy which has less complications and faster recovery, with a minimally invasive laparoscopic procedure, using just a few small incisions in the abdomen.

If the cancer has grown into or through your colon, you may need a procedure called a colectomy, in which the part of your colon that contains the cancer is removed, along with a margin of normal tissue on either side of the cancer.

Many colostomy can be less often, some people may need a temporary or permanent colostomy after surgery. This is a surgical opening through which the colon is connected to the abdominal surface to allow waste to exit the body. This waste is collected in a pouch worn by the patient. Our specially trained ostomy nurses can help learn how to manage the pouch and make any lifestyle adjustments.

Radiation Therapy

Radiation therapy uses high-energy rays (like X-rays) to shrink or kill cancer cells and help prevent recurrence of the disease. The rays can be specifically directed at the part of the body where the cancer is located, and are commonly used to treat colorectal cancer because the tumor tends to recur near where it originally started. It can also be combined with chemotherapy to increase effectiveness.

External-beam radiation therapy is another therapy we use at Central Maine Healthcare to fight colorectal cancer. With this treatment, a machine is used to precisely deliver a high dose of radiation to a small area.

For some people, internal radiation therapy may help get rid of areas that have spread to the liver when surgery is not an option. Brachytherapy is an example of this sort of radiation therapy. It uses radioactive “seeds” placed inside the body to treat the cancer.

Chemotherapy

Chemotherapy is used to kill cancer cells with medicines delivered in varied cycles through either an IV or a pill. It may be used to shrink a tumor before surgery, to kill cancer cells that remain in the body after surgery or radiation or to treat tumors that have developed in other areas of the body. Chemotherapy for colorectal cancer is usually given after surgery if the cancer has spread to lymph nodes, which may reduce the risk of a cancer recurrence. For advanced cancer that is no longer curable, chemo be used to help shrink tumors and relieve symptoms.

Targeted Therapy

Typically used for people with advanced colorectal cancer, targeted drug therapy works to block specific genes and proteins that allow cancer cells to grow, while limiting damage to healthy cells.

Immunotherapy

Some patients with advanced colorectal cancer may benefit from immunotherapy, which uses medicines to help a person’s own immune system find and destroy cancer cells.

Central Maine Healthcare Treats the Whole You

We help you in your battle against cancer by providing extra support along the way. Our nurse navigators, for example, guide all our cancer patients through their treatments and direct them to a variety of supportive resources including:

The Arbor House, a hospitality house near the Central Maine Medical Center campus, provides free accommodations for patients traveling a long distance for medical treatments, and for families visiting loved ones who are hospitalized.

Find a Colorectal Specialist Near You

Breast Cancer

One in eight women will develop breast cancer in her lifetime. But with increased awareness, early detection and innovative new treatments, survival rates continue to rise.

About Breast Cancer

Breast cancer is the uncontrolled growth of abnormal cells within the breast. Breast cancer begins in the breast tissue, which is comprised of glands used for milk production (called lobules) and ducts that connect these lobules to the nipple. The remainder of the breast is made up of fatty, connective and lymphatic tissue.

With the exception of skin cancer, breast cancer is the most commonly diagnosed cancer among women, and the second leading cause of cancer death, second only to lung cancer. Many breast lumps turn out to be non-cancerous, though a malignant lump can mean that the cancer has already spread beyond the breast. That’s why it’s crucial to get regular breast screenings, so your provider can catch and treat any concerns before they become serious.

Prevention

Whether you have a family history of breast cancer or just want to stay on top of your health, Central Maine Healthcare offers the preventive services and support you need for your peace of mind. Start by understanding your personal breast cancer risk factors, and how you can take control right away. If you have a family history of breast cancer, or other factors that may increase your risk, talk to your provider about further ways to prevent the disease.

Detection

If you’re over 40, getting an annual mammogram is your best weapon against breast cancer. Mammography has proven to be the most effective tool for detecting breast cancer early, when it’s most treatable. Central Maine Healthcare offers all-digital mammography, with crystal-clear images that can be magnified to pinpoint any suspicious areas.

Not all breast problems are cancer, but if you’re diagnosed, our breast cancer experts will be by your side. Our dedicated care team—including gynecologic and radiation oncologists, breast surgeons, specially trained nurses, physical therapists and more—work closely to create a personalized cancer treatment plan. Should you need surgery, we offer a full range of breast procedures, including mastectomy, lumpectomy, breast reconstruction and more to help return you to good health. And you have access to leading breast cancer clinical trials, right here at home.

Screening and Diagnosis

One in eight women will develop breast cancer in her lifetime. But with increased awareness, early detection and innovative new treatments, survival rates continue to rise.

Treatment

Not all breast problems are cancer, but if you’re diagnosed, our breast cancer experts will be by your side. Our dedicated care team—including gynecologic and radiation oncologists, breast surgeons, specially trained nurses, physical therapists and more—work closely to create a personalized cancer treatment plan. Should you need surgery, we offer a full range of breast procedures, including mastectomy, lumpectomy, breast reconstruction and more to help return you to good health. And you have access to leading breast cancer clinical trials, right here at home.

The Cancer Care Center includes The Sam and Jennie Bennett Breast Care Center, which is a nationally accredited Breast Center of Excellence, in addition to being accredited by several renowned professional healthcare organizations that supervise the quality of cancer care. That means you can find peace of mind, knowing that you’re getting excellent care, without having to travel far from home.

Treatment of breast cancer depends on many factors, including your overall health and wellness, the stage of the cancer (early or advanced), hormone sensitivity of the tumor and your personal feelings around certain treatments and possible side effects. Our goal is to keep you feeling well throughout treatment without major changes to your usual routine.

Your personal treatment plan may include one or a combination of:

Breast Cancer Surgery

Surgery is the most common treatment for early breast cancer. Depending on the stage of the cancer, there are different types of surgery available:

  • Lumpectomy: Removal of the just tumor and some surrounding tissues.
  • Total mastectomy: Removal of the entire affected breast, but no lymph nodes or muscle.
  • Modified radical mastectomy: Removal of the affected breast as well as any lymph nodes under the arm where the cancer has spread.
  • Radical mastectomy: Removal of the affected breast, lymph nodes and the muscle under the breast.
  • Breast reconstruction: One of our skilled plastic surgeons can restore the breast mounds using your own tissue or from other areas of the body, either at the same time or following a mastectomy.

Chemotherapy

Chemotherapy is used to kill cancer cells with medicines delivered in varied cycles through either an IV or a pill. It may be used to shrink a tumor before surgery, to kill cancer cells that remain in the body after surgery or radiation or to treat tumors that have developed in other areas. Whenever possible, Central Maine Healthcare uses newer medications that help minimize the side effects of chemotherapy.

Radiation Therapy

Radiation therapy uses high-energy rays (like X-rays) to shrink or kill cancer cells and help prevent recurrence of the disease. The rays can be specifically directed at the part of the body where the cancer is located. Treatments are delivered by linear accelerator, where patients lie on a table in a specially designed room.

Hormone Therapy 

Hormone therapy uses medication to block the use of estrogen by the cancer cells, as some types of breast cancer rely on estrogen and/or progesterone to grow. These cells are referred to as “hormone receptor positive” cancer cells. If a tumor is not deemed hormone receptor positive, then hormone therapy is not usually used.

Biological Therapy

Biological therapy works in with the body’s own immune system to help destroy cancer cells or to assist in controlling side effects resulting from other cancer treatments.

Support

Throughout your journey, you’ll find a variety of cancer support services to meet your physical, emotional, spiritual and financial needs. That includes your very own breast cancer nurse navigator to coordinate all of your care, connect you to valuable resources and provide extra comfort and support at every step.

Your Breast Cancer Team

The Cancer Care Center provides a team of support for patients diagnosed with breast cancer. You’ll meet with breast cancer surgeons to discuss the best treatment plans. Our surgeons are one part of your team that also includes radiologists, pathologists, and medical and radiation oncologists. If you choose to have reconstructive surgery following breast surgery, your team will also include CMMC’s plastic surgeons.

All these providers work together, communicating with each other as needed to give you individualized, focused care. Our nurse navigators serve as your advocate and can help you with other parts of the process, like understanding financial and health insurance requirements, the day-to-day impact of treatments, and other needs as they arise.

Bile Duct Cancer

What is Bile Duct Cancer? Your bile ducts are thin tubes that carry bile from the liver, gallbladder, and pancreas into your small intestine to help digest the fats in food. Bile duct cancer happens when cells in the bile ducts divide without stopping and spread into surrounding tissue. Because bile duct cancer occurs deep in the body, it is difficult to detect and there are no screening tests that can find it before it produces symptoms. The good news is that it is very rare, with only 8,000 people per year diagnosed with the disease.

Detection and Diagnosis: Symptoms of bile cancer can include pain in the belly, nausea and vomiting, fever, weakness and dark urine. But experiencing these symptoms does not mean you have the disease – it is quite rare. If you’re concerned about your risk of bile duct cancer, you want a diagnosis or to know the disease has been ruled out quickly. Central Maine Healthcare’s cancer care team is focused on providing fast, accurate testing, along with compassionate care. 

Treatment: Bile duct cancer is usually treated with either surgery or radiation and often with a combination of the two. With surgery, your provider removes as much of the cancer as possible. Sometimes all of it can be removed, curing the cancer. In other cases, the cancer is too advanced, but surgery can be done to remove as much as possible in order to relieve symptoms or treat complications.

The other form of treatment is radiation, which uses high-energy rays or particles to kill cancer cells. This approach allows your provider to try to eliminate cancer that could not be safely removed during surgery. If the cancer can’t be operated on but hasn’t spread to other parts of the body, radiation helps control the disease.

Support: Central Maine Healthcare’s cancer care team includes nurses specially trained for treating cancer patients, nurse navigators who guide patients and their loved ones to a variety of supportive resources, and oncology social workers who help you balance the demands of battling cancer with the rest of your life. Our residential facility, Arbor House, offers patients and families bedrooms, apartments, laundry facilities and a dining room all on the Central Maine Medical Center campus.

Screening for Bile Duct Cancer: Your bile ducts are deep inside your liver and gall bladder so detecting cancer in these areas during a physical exam is very difficult. And so far there are no reliable blood tests or other tests that can help providers discover the disease in its early stages. Usually, bile duct cancer is discovered after tumors have grown large enough to create symptoms. One of the most common is jaundice, a yellowing of the eyes and skin, that’s caused by a blocked duct. Other symptoms of bile duct cancer include:

  • Pain in your belly or sides, which can come from fluid buildup
  • Nausea and vomiting
  • Fever
  • Loss of appetite/weight loss
  • Weakness
  • Itching
  • Light-colored stools
  • Dark urine

It’s important to note that bile duct cancer is quite rare – only about 8,000 people per year are diagnosed with the disease – so if you’re experiencing any of these symptoms, it’s not likely you have bile duct cancer.

Diagnosis of Bile Duct Cancer: Your provider will use a combination of methods to diagnose your condition, including:

  • Physical exam
  • Blood tests – blood is drawn from your body with a needle and examined in a lab
  • Endoscope ERCP spy glass cholangioscopy
  • Ultrasound – a pain-free imaging tool that uses soundwaves
  • CT scan – which uses powerful x-rays to make an image of the inside of your abdomen
  • MRI – image created by high powered magnets that a radiologist uses to detect tumors
  • Endoscopy – endoscope cable with a camera lets your provider see inside your body without surgery or be used to inject dye into bile ducts, which are x-rayed in a test referred to as ERCP (endoscopic retrograde cholangiopancreatography).
  • Laparoscopy – once sedated, your provider inserts a thin tube through an incision with a small video camera so they can see if – and how far – the cancer has spread.

Treating Bile Duct Cancer: Bile duct cancer is usually treated with surgery, radiation or some mix of the two. Your cancer care team will develop a treatment plan based on how advanced the cancer is, whether tests indicate it can be surgically removed, how well your liver is functioning, your age and general health condition, and a host of other factors.

Surgery for Bile Duct Cancer: Because bile duct cancer is difficult to detect, it’s usually only discovered after surgery could cure the cancer. If imaging tests or surgeries indicate the cancer has been caught early, a surgeon may be able to remove all the cancer, plus a margin of healthy tissue around it. This is referred to as curative surgery because it usually cures the cancer.

In most other cases, the cancer is too advanced or is in a spot where surgery to completely remove the cancer would be very risky for the patient. In these situations, your provider may consider palliative surgery, which means the procedure is done to relieve symptoms or treat complications, rather than cure the disease. Both curative and palliative surgeries are major operations that can require long recovery times, so you should be sure you’re well informed about the goals of the surgery, its risks and potential side effects.

Palliative endoscopy is often done to unblock a bile duct which can relieve jaundice or itching that is common with bile duct cancer. While it can help the patient feel better, it is not done to eliminate or cure the cancer. In some cases, a surgeon will rely on the best information available – which may come from imaging tests and/or exploratory surgeries like laparoscopy – to plan a curative surgery but realize when the surgery begins that the cancer is too advanced or widespread to be cured. At this point, they may decide to take palliative measures.

Radiation therapy for bile duct cancer isn’t common and providers disagree about how helpful it is. But your provider may decide in your case that its benefits outweigh its costs, which can include side effects like skin redness and blistering, nausea, vomiting, diarrhea and fatigue. There are two main types of radiation therapy for bile duct cancer:

External beam radiation therapy (EBRT) – uses high-energy rays aimed directly at the tumor to kill cancer cells. EBRT is the most commonly used radiation therapy for bile duct cancer

Brachytherapy – is also known as “internal radiation therapy.” A radiologist places small pellets of radioactive material next to or into the tumor. Since the source of the radiation is so close, it affects the cancer without causing much harm to nearby healthy tissue.

RFA Endoscopic Treatment – CMMC offers these treatments at the Cancer Care Center, which has state-of-the-art radiation therapy services, including EBRT and brachytherapy.

Chemotherapy for Bile Duct Cancer: the use of medical drugs to treat cancer. Also known as medical oncology, it involves giving these drugs in the vein (IV) or taking them by mouth. Since they go directly into the bloodstream, they reach all areas of the body. Like radiation therapy, providers may not agree on whether chemotherapy is helpful for bile duct cancer. Still, your provider may decide it is useful for your case. Chemotherapy may be used in one or a combination of several ways to treat bile duct cancer:

  • To shrink tumors before surgery to make them smaller and easier to remove
  • To lessen the odds that cancer will return after surgery has removed the tumors
  • To help people whose cancer can’t be operated on to live longer
  • To slow the growth of or reduce the size of tumors that are creating painful symptoms by pressing on nerves.

The Cancer Care Center at Central Maine Medical Center offers our cancer patients who need medical oncologists the services of Hematology-Oncology Associates practice, which is committed to offering the most current, individualized, compassionate and convenient care for cancer patients and their families.