Treatment overview for colon cancer
Treatments used for colon cancer include surgery, chemotherapy and targeted therapy. Often, a combination of treatments is used.
Treatment depends on the stage of the cancer and where it is in the colon. It also depends on your general health and personal preferences.
It’s important you have the chance to discuss treatments with your doctor. This will help you understand why a particular plan of treatment has been suggested, and how the treatment may affect you.
Surgery to remove the cancer is one of the main treatments for colon cancer. The operation usually involves removing the affected part of the colon as well as nearby lymph nodes. If the cancer has grown into tissue or organs nearby, the surgeon may remove parts of these too.
Sometimes, surgery is used to relieve symptoms rather than cure the cancer. This may be if the cancer is causing a blockage in the bowel.
Occasionally, surgery may be used to remove cancer that has spread to a distant part of the body, such as the liver or lungs.
Chemotherapy may be given before or after surgery to reduce the risk of the cancer coming back. It can also be used as the main treatment for a cancer that has spread or that can’t be removed by surgery. The aim is to control the cancer for as long as possible.
Chemotherapy may be used to shrink cancer and relieve symptoms if the cancer has come back after treatment, or if it has spread.
Targeted therapies are sometimes used on their own or in combination with chemotherapy to control secondary cancer.
Your cancer specialist may invite you to take part in a clinical trial.
How treatment is planned
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This multidisciplinary team (MDT) will include a:
surgeon who specialises in bowel cancers
medical oncologist (chemotherapy specialist)
clinical oncologist (radiotherapy and chemotherapy specialist)
radiologist (specialist in x-rays and scans)
pathologist (specialist in studying tissue samples to detect diseases)
stoma care nurse.
It may also include other healthcare professionals, such as a gastroenterologist (doctor who specialises in bowel problems), dietitian, physiotherapist, occupational therapist, psychologist or counsellor.
If the cancer has spread to your liver, you may also be referred to an MDT that specialises in surgery for secondary cancer in the liver. In this situation, the two MDTs will work together to plan your treatment.
Talking about your treatment plan
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After the MDT meeting, your cancer specialist or nurse will talk to you about your treatment options.
They will explain the main aims of treatment. These may be to try to cure the cancer, to help you live longer, or to relieve symptoms. They will also tell you the possible short-term and long-term side effects of the treatments.
Deciding on which treatments are right for you is usually a joint decision between you and your cancer team. Cancer specialists have expert knowledge of the treatments that can help, but you know your individual situation and your beliefs and preferences.
Usually, if there is one treatment that has been shown to work best, most people are happy to be guided by their cancer doctor. But there can be times when the choice of treatment will depend on your individual preferences. For example, if having an additional treatment may increase the chance of a cure by a small amount, but at the cost of unpleasant side effects.
If a cure is not possible and the aim of treatment is to control the cancer for some time, it may be more difficult to decide what to do. You may need to discuss this in detail with your doctor. If you choose not to have the treatment, you can still be given supportive (palliative) care to control any symptoms.
When making treatment decision, it’s important to talk things over carefully with your cancer team. It can help to make a list of the questions you want to ask them. You can take this to your next appointment. It’s also helpful to have a relative or close friend with you at appointments. You may choose to keep notes about what has been said.
Before you have any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should be given full information about:
the type and extent of the treatment
its advantages and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it’s not unusual to need repeated explanations. You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You are free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.
Your multidisciplinary team (MDT) uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.