Surgery is the main treatment for colon cancer. However, before treatment starts, a doctor will do a series of tests to find out if the cancer has spread within or beyond the colon. This process is called staging.
Once the stage is determined, you decide on a treatment plan with a team of medical professionals, which may include a surgeon, medical oncologist and radiation oncologist. If the cancer has spread, your doctors may suggest other treatments such as radiation or chemo in addition to surgery.
Surgery is usually the first step in colon cancer treatment. If cancer has not spread to distant sites, surgery may be the only treatment needed.
Types of surgery include:
- Polypectomy. In some cases, if the cancer is very small, only the polyp in which cancer is found is removed. This procedure, called polypectomy, can often be done during a colonoscopy.
- Resection. For a larger tumor, the surgeon performs a resection. The section of colon that contains the tumor is removed as well as a margin of healthy tissue around the tumor. The surgeon then reattaches the healthy ends of the colon. During surgery, the doctor will also take small samples of other tissues, such as lymph nodes, to see if the cancer has spread. Even if the cancer has spread, there is a chance that the surgeon may be able to remove it all.
- Colostomy. If the two ends of the colon cannot be reconnected right away after resection, a colostomy is done. This procedure creates an opening, or stoma, through the abdominal wall to the outside of the body. A bag is attached to the stoma to catch the stool. A colostomy may be temporary, done to give the colon time to heal. It may be closed once the sections of bowel are reconnected. In other cases, the colostomy may be permanent.
Radiation therapy is the use of high-energy x-rays or other types of radiation to destroy cancer cells and to prevent their spread. Radiation may be an option to kill cancer cells that may remain after surgery or to shrink a tumor that is causing a blockage.
Radiation therapy can be delivered in two ways:
- External beam radiation therapy uses a machine to deliver a beam of energy focused from outside the body.
- Internal radiation (or brachytherapy) uses "seeds," a catheter or wires to deliver radiation on or near the tumor site within the body.
Rectal cancer is often treated with radiation before or after surgery to decrease the risk of local recurrence. Radiation with chemotherapy may improve chances for disease-free survival in rectal cancer.
The use of anti-cancer drugs is called chemotherapy, or chemo. Many different combinations of cancer-killing chemicals are used in colorectal cancer. Chemotherapy can be:
- Systemic. Systemic chemotherapy may be taken as a pill or injected into a vein or muscle. It acts throughout the body to kill or stop the growth of cancer cells.
- Regional. In regional chemotherapy, a drug is injected directly into an artery leading to an organ where cancer is located. Colon cancer that has spread to the liver is sometimes treated this way.
- Adjuvant. Adjuvant chemotherapy is the use of chemo drugs following surgery. The goal is to destroy cancer cells that may have been left behind.
A treatment clinical trial is a research study designed to improve current treatment. When the evidence shows that a treatment is better than the standard treatment, the new treatment becomes a standard of care.
One therapy being studied is called targeted therapy. It uses drugs to attack cancer cells without harming healthy cells. Monoclonal antibodies are similar to the proteins that your body produces to fight infection. They can be made in the lab and used to treat certain types of cancer.
If you want to take part in a clinical trial for colorectal cancer, talk to your doctor about studies in your area that are recruiting patients. You may also search for ongoing trials at www.clinicaltrials.gov, an online service of the National Institutes of Health.
Created on 08/24/1999
Updated on 09/22/2010
- American Cancer Society. The cancer experience: colon and rectum cancer. Making treatment decisions.
- National Cancer Institute. Colon cancer treatment: treatment option overview (health professional version).
- National Institute of Diabetes and Digestive and Kidney Diseases. Bowel diversion surgeries: ileostomy, colostomy, ileoanal reservoir and continent ileostomy.
- National Cancer Institute. Colon cancer treatment: treatment option overview (patient version).