Bowel (colorectal) cancer

The type of treatment you have will depend on:

• If you have colon or rectal cancer
• The size of the tumour
• Where the cancer is in your body
• If it has spread to your lymph nodes or other parts of your body
• Your general health

A team of healthcare professionals (multidisciplinary team) will recommend a treatment plan specific to you. 

Surgery

• An operation to remove the cancer.
• Surgery is often used to treat cancer in the colon or rectum, especially if the cancer is only in one area (localised).
• Surgery can often cure the cancer if it’s found early. 
•  After your surgery you may have a stoma − an opening on your tummy that lets poo leave your bowel into a bag.
• Read more about surgery for bowel cancer.

Chemoradiation

• This means having chemotherapy and radiotherapy together. 
• It is most often used in treating rectal cancer and only very occasionally in colon cancer. 
• When necessary, chemoradiation is nearly always given before surgery for rectal cancer.

Chemotherapy

• You might have chemotherapy drugs before surgery to shrink the tumour to make it easier to remove and reduce the risk of the cancer coming back.
• Chemotherapy can be given after surgery to reduce the risk of the cancer coming back. 
• It’s also used to treat cancer that has spread. 
• Read more about chemotherapy.

Radiotherapy

• Radiotherapy uses high-energy rays to kill cancer cells and shrink tumours.
• Radiotherapy can be used before or after surgery for rectal cancer to reduce the risk of the cancer coming back.
• It can also help to shrink a cancer before surgery.
• Radiotherapy may also be used to relieve symptoms if the cancer has spread. This is called palliative radiotherapy. 
• Read more about radiotherapy.
   

Targeted therapies 

• Drugs that target particular changes in the DNA of a tumour to stop cancer cells growing or spreading.
• These drugs are often used to control cancer that has spread (metastatic cancer).
• You may have blood tests to look at your genes to see if you are suitable for particular targeted therapies. For example, the RAS gene test will tell your doctors if you are suitable for targeted therapies called cetuximab and panitumumab.
• You may have targeted therapies in combination with other treatments. For example, chemotherapy. 

Immunotherapy

• Drugs that help your immune system to recognise and attack cancer cells.
• In specific cases (depending on a special feature which may be present in your tumour), immunotherapy drugs can be used to treat cancer.
• You might have immunotherapy on its own or with other cancer treatments. 
• Immunotherapy is now being given in both early stage and later stage disease.

The type of side-effects you get will depend on the type of treatment, the dose, the duration and your own general health.

You can read about the different treatments to find out about possible side-effects. Ask your doctor or nurse specialist about possible treatments and tell them if you have any problems after treatment.

We have more information about coping with side-effects and symptoms.

• If the cancer spreads to another part of your body, it is called metastatic or secondary cancer. 
• If bowel cancer spreads, it often spreads to the lung or the liver. 
• Your cancer may be in more than one part of your body when it is first diagnosed. 
• If your cancer has spread it can still be treated. Treatment is usually to try to control the cancer rather than to cure it.
• Often metastatic cancer is treated with chemotherapy or targeted therapies.
• Some people may be suitable for surgery or stereotactic radiotherapy to remove cancer from the liver or the lung, but it depends on the size and position of the cancer and your general health.
• There may also be treatments that you can have as part of a clinical trial.

You can also have treatment to help with any symptoms. You may be referred to the palliative care team, who are experts in managing the symptoms of metastatic cancer.

Read more about metastatic cancer.