Gastrointestinal (GI) Oncology Program

Colon Cancer

Treatment Options

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The Latest Treatments for Colon Cancer

There are three primary treatment options for patients with colon cancer:

surgery
radiation therapy
chemotherapy

A fourth type of treatment, biological therapy, is being tested in clinical trials for colon cancer.

Surgery

Surgery is the most common treatment for all stages of colon cancer. A doctor may remove the cancer using one of the following procedures:

If the cancer is found at a very early stage, the doctor might take out the cancer without cutting into the abdomen. Instead, the doctor will put a tube through the rectum into the colon and cut the tumor out. This is called a local excision. If the cancer is found in a small bulging piece of tissue (called a polyp), the operation is called a polypectomy.
If the cancer is larger, the doctor will take out the cancer and a small amount of healthy tissue around it (bowel or colon resection). The healthy parts of the colon are then sewn together (anastomosis). The doctor will also take out lymph nodes near the intestine and look at them under the microscope to see if they contain cancer.
If the doctor is not able to sew the colon back together, he or she will make an opening (stoma) on the outside of the body to allow waste to pass out of the body. This procedure is called a colostomy. Sometimes a colostomy is only needed until the colon has healed, and then it can be reversed. However, if the doctor has to take out the entire lower colon, the colostomy will be permanent and the patient will need to wear a special bag to collect body wastes. This special bag, which sticks to the skin around the stoma with a special glue, can be thrown away after it is used. The bag does not show under clothing, and most people can take care of these bags themselves.

Side effects of surgery:

The side effects of surgery depend on the location of the tumor and the type of operation, among other factors. Patients are often uncomfortable during the first few days after surgery, but the pain can usually be controlled with medicine. The recovery period after an operation varies from patient to patient.

Radiation Therapy

Radiation therapy is the use of high-energy x-rays to kill cancer cells and shrink tumors. Radiation can come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy). Radiation can be used alone or in addition to surgery and/or chemotherapy.

Side effects of radiation therapy:

The most common side effects of radiation therapy are tiredness, skin reactions (such as a rash or redness) in the treated areas, and loss of appetite. Radiation therapy may also cause a decrease in the number of white blood cells that help protect the body against infection. Most of these side effects can be treated or controlled, and in most cases, they are not permanent.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Most anticancer drugs are injected into a vein (IV) or a muscle; some are given by mouth. Chemotherapy is a systemic treatment, meaning that the drugs flow through the bloodstream to nearly every part of the body to kill cancerous cells. It is generally given in cycles: a treatment period is followed by a recovery period, then another treatment period, and so on. If the cancer has spread to the liver, the patient may be given chemotherapy directly into the artery going to the liver.

If the doctor removes all the cancer that can be seen at the time of the operation, the patient may be given chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy given after an operation to a person who has no visible cancer cells is called adjuvant chemotherapy.

Side effects of chemotherapy:

Chemotherapy drugs generally target rapidly dividing cancer cells. There are other cells in the body that also divide rapidly (including blood cells, cells that line the digestive tract, and cells in hair follicles), and these healthy cells may also be affected by chemotherapy drugs. The resulting side effects include infections, tiredness, temporary hair loss, mouth sores, and other symptoms.

One of the most important side effects of many chemotherapy drugs is lowering of the blood counts. Because chemotherapy can reduce the function of the bone marrow, where most blood cells are produced, it can cause anemia (the patient may have less energy), low platelets (the patient may bruise or bleed easily), or a low white blood cell count (the patient may be more susceptible to infections).

Not all chemotherapy patients develop all of these symptoms, and they usually go away during the recovery period or after treatment stops. Medicines and other treatments are available to control or minimize many of these symptoms.

Biological Therapy

Biological therapy tries to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body’s natural defenses against disease. Biological treatment is sometimes called biological response modifier (BRM) therapy or immunotherapy.

This page was last updated on: March 3, 2008.

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