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Bowel Cancer Treatment
If you have been diagnosed with bowel (colon) cancer, the size and position of the tumour will influence the course of treatment you are offered. Usually though, the first line of treatment will be surgery, possibly combined with chemotherapy, radiotherapy or biological treatments.
For cancers that are detected at an early stage, treatment can cure bowel cancer and stop it coming back. For more advanced cancers a complete cure isn’t always possible and there’s sometimes a risk that the cancer could recur at a later stage. In advanced cases where the cancer can’t be removed completely by surgery, symptoms can be controlled and the spread of the cancer can be slowed using a combination of treatments.
You will have the opportunity to discuss your particular treatment with a team of specialists that will include your surgeon, a specialist nurse, an oncologist and a radiologist. The treatment they suggest will depend on your general health as well as the stage and spread of the cancer.
If your colon cancer is at an early stage if may be removed using a laparoscopic (keyhole) procedure and you may not need any further treatment. A more advanced cancer may mean that the section of colon affected will have to be removed. Surgery for rectal cancers may not need abdominal incisions. You also may require either a permanent or reversible colostomy or ileostomy.
Side effects of all surgical procedures include bleeding, infection, blood clots and heart/respiratory problems but bowel surgery carries additional specific risks. These include leaking where the resection has not properly healed (in the first few days after surgery), and nerve damage after rectal surgery that (particularly for men) can affect sexual function and urination; constipation and pelvic pain may also occur.
A course of radiotherapy may be given before surgery, or sometimes instead of surgery. Radiotherapy can shrink a cancer so a complete removal is more likely, it can also halt the spread of cancer and, when the cancer is advanced, used as a palliative treatment to control symptoms and slow down the spread.
Rectal cancer can be treated using brachytherapy (with a Papillon radiotherapy machine). This is a contact radiotherapy that is applied directly to the cancer so that the surrounding tissue is not damaged. Usually with this form of radiotherapy fewer treatments are required.
Chemotherapy can be used to treat bowel cancer either before surgery (in combination with radiotherapy), after surgery to reduce the risk of recurrence, or as a palliative treatment to slow the advance of the cancer and control symptoms.
Chemotherapy for bowel cancer usually involves taking a combination of medications that kill cancer cells. They can be taken as a tablet (oral chemotherapy), through a drip in your arm (intravenous chemotherapy), or as a combination of both. Treatment is given in courses of two to three weeks depending on the stage of your cancer. An intravenous chemotherapy session can last from several hours to several days. A course of chemotherapy may be a matter of a few weeks up to 6 months, depending on how well you respond to the treatment. In some cases, it can be given in smaller doses over longer periods of time (maintenance chemotherapy).
Links to further information:
National Institute for Health and Care Excellence (NICE): colorectal cancer guidance
Macmillan Cancer Support: targeted therapies (biological therapies) for colon cancer