Bowel Cancer Treatments

 

If you have received a bowel (colon) cancer diagnosis, the size and position of the tumour will influence the course of treatment you are offered. Usually, 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. The information below tells you a little about the treatments that are available.

Surgery

If your colon cancer is at an early stage if may be removed using a ‘keyhole’ procedure (laparoscopy) and you may not need any further treatment.

Surgery is usually the first stage of treatment but that’s not always the case. Sometime you will have a course of chemo or radiotherapy first to shrink the tumour and improve the chances of surgery successfully removing all the cancer. For more advanced cancers, it may be necessary to remove a whole section of your bowel (called a ‘resection’). The remaining bowel will be re-joined but sometimes a temporary stoma must be created to allow the bowel time to knit together and reduce the chances of infection developing.

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.

Radiotherapy

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 it may be used to control symptoms and slow down the spread (‘palliative’ treatment).

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.

Find out more about papillon radiotherapy

Chemotherapy

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).

Side effects of chemotherapy include fatigue, nausea and vomiting, diarrhoea, mouth ulcers, hair loss and tingling.

Biological Treatments

Newer medicines also known as monoclonal antibodies include cetuximab and panitumumab. They target special proteins found on the surface of some cancer cells. These proteins help the cancer grow, so this targeted treatment can help shrink tumours and improve the effect of chemotherapy. Biological treatments are sometimes used in combination with chemotherapy when the cancer has spread beyond the bowel (metastatic bowel cancer).

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