If you’ve been diagnosed with colon cancer, you undoubtedly have many questions, not the least of which is, “What are my treatment options?”
While there are several therapies available to treat colon cancer, your doctor’s recommendation will be based on two key factors: where the cancer is located and to what extent it has spread.
Like any other cancer, colon cancer is defined in stages, with Stage 0 being the earliest stage of cancer and Stage IV being the most advanced. The higher the stage, the more advanced or aggressive treatment may be used. Depending on the stage, your doctor may recommend a combination of treatments, such as surgery with chemotherapy, or radiation.
Treatment Options for Colon Cancer
Surgery is generally the first line of attack for Stages 0 through III, and for Stage IV if the tumor is obstructive or blocking the bowel. Types of surgery include:
- Polypectomy and local excision—early stage removal of the cancer
- Partial colectomy—removal of the cancer with a margin of surrounding healthy tissue and lymph nodes, after which the healthy ends of the colon are reconnected
- Laparoscopic-assisted colectomy—removal of the cancer with a margin of surrounding healthy tissue and lymph nodes through small incisions in the abdomen
- Total colectomy—removal of the entire colon, after which the last part of the small intestine, called the ileum, is then connected to the rectum
- Some surgeries may require a temporary or permanent colostomy: a surgical opening (stoma) through the wall of the abdomen into the colon from which waste material leaves the body and is collected in a colostomy bag.
Radiofrequency ablation uses a special probe with tiny electrodes that kill cancer cells. The probe can either be inserted directly through the skin, which only requires local anesthesia, or through an incision in the abdomen, which is done in a hospital under general anesthesia.
Cryosurgery, also called cryotherapy or cryoablation, uses an instrument to freeze and destroy abnormal tissue.
Radiation therapy uses high-energy X-rays or other types of radiation to kill or shrink cancer cells. External radiation delivers radiation from outside the body toward the cancer, while internal radiation uses a radioactive substance sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer.
Chemotherapy (administered in pill form or by injection or catheter) uses specific drugs to kill the cancer. When taken by mouth or injection, its impact is systemic, which means it affects your entire body. If it’s placed directly into the cerebrospinal fluid, an organ or a body cavity, such as the abdomen (regional chemotherapy), it mainly affects cancer cells in those areas.
If the cancer has spread to the liver, your doctor may use chemoembolization of the hepatic artery. This involves temporarily or permanently blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver so the liver’s arteries can then deliver the chemotherapy directly to the cancer cells.
Targeted Therapy uses medications to target and kill cancer cells while sparing healthy tissue. They are currently used to treat advanced cancers. Targeted therapy is less harmful to healthy tissue, which reduces side effects. It may be used alone or in combination with chemotherapy.
The types of targeted therapies used in the treatment of colon cancer include:
- Monoclonal antibodies (MOAB) that attach to the substances on cancer cells that help them grow, thereby killing the cancer cells, blocking their growth or keeping them from spreading
- Angiogenesis inhibitors that stop the growth of new blood vessels that tumors need to grow
Medications may be used to either prevent or reduce side effects of treatments, or to manage certain side effects once they occur. These include:
- Blood stem cell support medications
- Anti-nausea medications
- Non-steroidal anti-inflammatory drugs (NSAIDs)
Depending on your cancer diagnosis, you may want to think about taking part in a clinical trial—part of the cancer research process to determine if new treatments are safe and effective or better than the standard treatment.
Sarah Cannon — Colon Cancer
Colon Cancer Alliance — Colorectal Cancer Treatment
American Cancer Society — Colorectal Cancer
Cancer.Net — Colorectal Cancer: Treatment Options