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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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In most hospitals, a team of specialists will discuss the treatment that is best for you. This multidisciplinary team| (MDT) will include a surgeon who specialises in bowel cancers, one or more oncologists (doctors who specialise in cancer treatments such as radiotherapy or chemotherapy) and a number of other health professionals.
Together, the MDT will be able to advise you on the best course of action and plan of treatment. They will take into account a number of factors, including your general health, age, the size of the cancer, where it is in the colon, and whether it has begun to spread.
The stage| is very important in determining treatment:
Your doctors will have carried out various tests and investigations to help them plan your treatment. Although they will have a good idea about which treatments you need, they may not be able to tell you exactly until after an operation.
You will be asked to give your permission (consent|) for the hospital staff to give you the treatment. It’s important that you discuss with your doctors the treatments they are recommending and that you understand why a particular type of treatment has been suggested for you.
Often, the cancer can be completely removed with surgery, and for most people it will never come back. People who have stage 1 colon cancer don’t usually need to have any further treatment after their surgery.
People with stage 2 colon cancer are also usually treated with surgery. There may be a risk that the cancer could come back in the future, especially if cancer cells are found in the blood vessels or lymph vessels around the cancer. So, treatment with chemotherapy is sometimes given after surgery to help reduce the risks of the cancer coming back.
In people with stage 3 colon cancer, there is a greater risk that the cancer will come back after surgery, so chemotherapy is usually recommended. Research trials| are trying to find out whether giving drugs known as monocolonal antibodies,| as well as chemotherapy, after surgery can further reduce the chance of the cancer coming back. Other types of treatment that are in the very early stages of research are being tested in clinical trials.
Stage 4 colon cancer means that the cancer has spread from where it started in the bowel. It is also called advanced colon cancer. It can spread into the area around the bowel, such as the abdomen, and this is known as local spread. If the cancer has spread to other parts of the body such as the liver or lungs, this is known as secondary or metastatic cancer.
It’s not usually possible to cure stage 4 colon cancer, but treatment may be able to control it for some time. Treatment may also be used to reduce symptoms and give a good quality of life. However, for some people in this situation, treatment will have little effect upon the cancer and they will have the side effects with little benefit.
The treatment that is most appropriate for you will depend on:
Chemotherapy is the most commonly used treatment for stage 4 colon cancer. It may be given into a vein by injection or drip, or may be taken as tablets or capsules.
Surgery may sometimes be used – to remove a cancer that is blocking the bowel, for example, or sometimes to remove secondary bowel cancers from the liver or lungs.
Radiotherapy | may be used to shrink a cancer that is causing pain. This is known as palliative radiotherapy.
Monoclonal antibodies such as bevacizumab (Avastin®), cetuximab (Erbitux®) and panitumumab (Vectibix®) may be used to control advanced colon cancer for a time.
Many people are frightened at the thought of having cancer treatments, because of the side effects that may occur. Some people ask what will happen if they don’t have any treatment.
Although the treatments can cause side effects, these can often be well controlled with medicines.
Treatment can be given for different reasons and the potential benefits will vary depending upon your particular situation.
If you have early-stage colon cancer (stages 1, 2 and 3) and have been offered treatment that is intended to cure it, it may be easy to decide whether to accept the treatment. Your doctor will talk through your treatment and any other options with you.
However, if a cure is not possible and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead. Making decisions about treatment in these circumstances is always difficult. You may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to, you can still be given supportive (palliative) care, which often involves medicines to control any symptoms.
You can ask for a second opinion if you feel it would be helpful.
For more on planning your treatment, you may find it helpful to read our information on:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.