Treatment options for rectal and colon cancer include surgery, radiotherapy, chemotherapy and targeted therapy. These may be as part of a clinical trial.
Treatments used for colon and rectal cancer include surgery, chemotherapy, radiotherapy and targeted therapy. Often, a combination of treatments is used. The results of your tests help your doctor plan your treatment.
The treatment you have depends on:
- the stage of the cancer
- the position of the cancer in the bowel
- your general health and preferences.
It is important to talk about treatment options with your doctor. They can explain why they are suggesting a certain treatment plan and how the treatment may affect you.
Surgery to remove the cancer is one of the main treatments. If you have colon cancer, you will usually have the affected part of the colon removed. If you have rectal cancer, the operation usually involves removing part or all of the rectum.
For both colon and rectal cancer, the surgeon will also remove 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 help with symptoms. This may be if the cancer is causing a blockage in the bowel. Surgery can also be used to remove a cancer that has spread to a distant part of the body, such as the liver or lungs.
For colon cancer you may have chemotherapy before surgery. This is called neoadjuvant chemotherapy.
For colon and rectal cancer you may have chemotherapy after surgery to reduce the risk of the cancer coming back. This is called adjuvant chemotherapy.
Bowel cancer sometimes spreads to other parts of the body, such as the liver or lungs. This is called secondary or advanced cancer. If you have secondary cancer, chemotherapy may be the main treatment. It is given to shrink the cancer and to control it for as long as possible. Some people with secondary cancer have chemotherapy to shrink the cancer, before having an operation to remove it.
Chemotherapy may also be used to relieve symptoms if colon cancer has come back after treatment.
If you have rectal cancer, you may have radiotherapy or chemoradiation before surgery. Chemoradiation is when chemotherapy and radiotherapy are used together. Having the treatment before surgery can shrink the cancer, which may mean it can be completely removed with surgery. These treatments help reduce the risk of the cancer coming back in the rectum, or in the tissues close to it.
Radiotherapy is also sometimes used to relieve symptoms of rectal cancer, such as pain or bleeding. This is called palliative radiotherapy.
Other treatments, such as radiofrequency ablation, selective internal radiation therapy (SIRT) and stereotactic ablative radiotherapy (SABR), may also be used to treat secondary bowel cancer. They may relieve symptoms and help to control the cancer for some time.
If you have secondary bowel cancer, your doctor will talk to you about what treatments may be the most helpful.
Targeted therapies are sometimes used to treat bowel cancers (colon or rectal) that have spread to other parts of the body. Targeted therapy drugs target something in or around a cancer cell that is helping it grow and survive. They may be given on their own or with chemotherapy.
Other treatments, such as immunotherapies may also be used to treat bowel cancer that has spread to other parts of the body.
Your doctor may invite you to take part in a clinical trial.
Below is a sample of the sources used in our bowel cancer information. If you would like more information about the sources we use, please contact us at email@example.com
R Glynne-Jones, PJ Nilson, C Aschele et al. ESMO-ESSO-ESTRO Clinical practice guidelines for diagnosis, treatment and follow up for anal cancer. July 2014. European Society of Medical Oncology. Available from www.esmo.org/Guidelines/Gastrointestinal-Cancers/Anal-Cancer (accessed October 2019).
National Institute for Health and Excellence (NICE). Colorectal cancer: diagnosis and management clinical guidelines. Updated December 2014. Available from www.nice.org.uk/guidance/cg131 (accessed October 2019).
Association of Coloproctology of Great Britain & Ireland (ACPGBI). Volume 19. Issue S1. Guidelines for the management of cancer of the colon, rectum and anus. 2017. Available from www.onlinelibrary.wiley.com/toc/14631318/19/S1 (accessed October 2019).
BMJ. Best practice colorectal cancer. Updated 2018. Available from www.bestpractice.bmj.com/topics/en-gb/258 (accessed October 2019).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.
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