The most common treatment for colorectal cancer is surgery to remove the tumor. Part of the healthy colon or rectum and nearby lymph nodes will also be removed.
Some patients may be able to undergo laparoscopic colorectal cancer surgery. With this technique, several viewing scopes are passed into the abdomen while a patient is under anesthesia. The incisions are smaller and the recovery time is often shorter than with standard colon surgery.
Radiation therapy is the use of high-energy x-rays to kill cancer cells and is commonly used in treating rectal cancer due to the tendency of this tumor to recur locally. Radiation therapy may be used before surgery to shrink the tumor so that it is easier to remove, or after surgery to destroy any remaining cancer cells.
One recent study found that pre-operative radiation therapy in combination with chemotherapy showed greater benefit compared with the same radiation therapy and chemotherapy given after surgery. The main benefits included a lower rate of the tumor coming back in the area where it started, fewer patients that needed permanent colostomies, and fewer problems with scarring of the bowel in the area where the radiation therapy was administered. Chemotherapy is often given at the same time as radiation therapy to increase the effectiveness of the radiation therapy.
Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. Chemotherapy may be given after surgery to eliminate any remaining cancer cells. In some situations, a doctor will give chemotherapy and radiation therapy before surgery to reduce the size of a rectal tumor and reduce the chance of cancer returning.
Chemotherapy is usually injected directly into a vein, although some chemotherapy can be given as a pill. The most common chemotherapy given for colorectal cancer may cause vomiting, nausea, diarrhea or mouth sores. However, medications to prevent these side effects are available. Because of the way drugs are administered, these side effects are less problematic than they have been in the past for most patients. In addition, patients may be unusually tired, and there is an increased risk of infection.
Some of the first targeted treatments focused on stopping angiogenesis, the process of making new blood vessels. Because tumors need the nutrients found in blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor.
Epidermal Growth Factor Receptor (EGFR) Inhibitors
Researchers have found that the EGFR protein may contribute to the growth of colorectal cancer.