Colon cancer : Treatment

Treatment

Treatment depends partly on the stage of the cancer. In general, treatments may include:

  • Chemotherapy to kill cancer cells
  • Surgery (most often a colectomy) to remove cancer cells
  • Radiation therapy to destroy cancerous tissue

Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous. (See: Colon resection)

There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery. You should discuss this with your oncologist.

Almost all patients with stage III colon cancer should receive chemotherapy after surgery for approximately 6 – 8 months. The chemotherapy drug 5-fluorouracil has been shown to increase the chance of a cure in certain patients.

Chemotherapy is also used to treat patients with stage IV colon cancer to improve symptoms and prolong survival.

  • Irinotecan, oxaliplatin, capecitabine, and 5-fluorouracil are the three most commonly used drugs.
  • Monoclonal antibodies, including cetuximab (Erbitux), panitumumab (Vectibix), and bevacizumab (Avastin) have been used alone or in combination with chemotherapy.

You may receive just one type, or a combination of the drugs.

For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used. This may include:

  • Burning the cancer (ablation)
  • Cutting out the cancer
  • Delivering chemotherapy or radiation directly into the liver
  • Freezing the cancer (cryotherapy)

Although radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer.

Support Groups

For additional resources and information, see colon cancer support groups.

Prognosis (Expectations)

Colon cancer is, in many cases, a treatable disease if caught early.

How well you do depends on many things, including the stage of the cancer. In general, when treated at an early stage, the vast majority of patients survive at least 5 years after their diagnosis. (This is called the 5-year survival rate.) However, the 5-year survival rate drops considerably once the cancer has spread.

If the colon cancer does not come back (recur) within 5 years, it is considered cured. Stage I, II, and III cancers are considered potentially curable. In most cases, stage IV cancer is not curable.

Complications

  • Blockage of the colon
  • Cancer returning in the colon
  • Cancer spreading to other organs or tissues (metastasis)
  • Development of a second primary colorectal cancer

Calling Your Health Care Provider

Call your health care provider if you have:

  • Black, tar-like stools
  • Blood during a bowel movement
  • Change in bowel habits


Review Date : 11/5/2009
Reviewed By : David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital.

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