Colon Cancer Treatment
Depending on how advanced your colon cancer is and a number of other factors, your doctor will determine the proper course of treatment for you. However, it will likely include one or more of the following:
- Eat a healthy diet and take any nutritional supplements your doctor may recommend. Also, if you’re experiencing nausea or diarrhea due to chemotherapy, you may want to avoid spicy, high-fat and high-fiber foods.
- Regular exercise—even just 30 minutes per day—has been shown to reduce the risk of developing colorectal cancer.
- Losing weight can reduce colorectal cancer risk. Obesity—particularly when the weight is in the waist, rather than the hips and thighs—has been found to increase the chances of developing colorectal cancer.
- Stop smoking. Studies show that smokers are 30%-40% more likely to die of colorectal cancer than non-smokers.
- Use alcohol in moderation. Regular use of alcohol among smokers and people with high-fat diets appears to increase the risk of colorectal cancer. If you’re being treated with chemotherapy, you should avoid alcohol completely.
Chemotherapy drugs enter the bloodstream—usually through an IV, but some forms can be given by mouth—and travel through the body to kill cancer cells. Depending on your doctor’s recommendation, chemotherapy can either be given alone at a higher dose, or in combination with radiation therapy at a lower dose.
Your doctor will determine the number of cycles or courses of chemotherapy that is correct for your personalized course of treatment, but usually when patients get chemotherapy alone for colon or rectal cancer, they receive 6-12 cycles. When it is combined with radiation, they may get 2 cycles alone, 2 cycles with the radiation, and then another 4-8 cycles after radiation is done. Your oncologist will determine the proper schedule for you.
Side effects of chemotherapy include nausea and vomiting, fatigue, confusion, decreased blood count, diarrhea and other issues. This is because the chemotherapy may destroy some normal cells while it attacks the cancer cells. There are a number of medications your doctor may recommend to help control these symptoms while you’re undergoing treatment.
During radiation therapy, busts of x-rays are fired from a machine at your cancer cells. Depending on your doctor’s recommendation, radiation therapy may be given in combination with chemotherapy, or—for advanced stages of rectal cancer—your doctor may use heat to damage the tumors and make them more sensitive to radiation, a technique called hyperthermia.
Your radiation oncologist will determine how many treatments you should receive, but patients normally undergo one or two treatments per day with each treatment lasting only a few minutes. The total treatment time may range from 5-8 weeks depending on the total dose your doctor recommends.
As in chemotherapy, the side effects of radiation are caused by damage to healthy cells and tissue, but your oncologist will do everything possible to target the cancer and minimizes damage to normal cells.
If your cancer has not spread beyond the colon or lymph nodes, surgery to remove the tumor is the most common treatment. Depending on your specific case, family history and doctor’s recommendations, the following surgical options may be used:
Prophylactic Colectomy (Removal of Colon)
Patients with a strong family history of cancer, intractable inflammatory bowel disease, familial adenomatous polyposis, or hereditary nonpolyposis colon cancer, may choose to have their colon removed before developing problems. Sometimes, this can be done laparascopically, which usually means smaller incisions and faster recovery.
During this procedure, used when the cancer is found at an early stage, a tube is placed up the rectum into the colon, and the cancerous tumor is removed.
If the cancer is larger, both the tumor and a small amount of surrounding healthy tissue and lymph nodes will need to be removed. In many cases, your surgeon will reconnect the healthy portions of the colon and rectum, possibly avoiding the need for a permanent colostomy.
Partial Resection or Total Colectomy and Colostomy
If your surgeon cannot reconnect the colon, a colostomy will be necessary. A surgical opening will be made through the wall of the abdomen into the colon, through which waste material will leave the body and be collected by a special bag. The colostomy may either be temporary or permanent.
Biological therapy—also known as immunotherapy—uses medications or substances produced by the body to increase your body’s natural defenses against cancer. To date, there have not been significant benefits seen in using immunotherapy to fight colon or rectal cancer, but there are research trials ongoing in several institutions.
The following medications may be recommended or prescribed by your doctor to help prevent or reduce side effects from your cancer treatment, or to manage certain side effects once they occur. This list is meant only to provide some basic information about the medications, and you should always follow your doctor’s instructions.
The following medications are given to help treat nausea and vomiting that occur as a result of chemotherapy, radiation or surgery to treat cancer:
- Prochlorperazine (Compazine)
- Ondansetron (Zofran)
- Granisetron (Kytril)
- Metoclopramide (Octamide, Metoclopramide Intensol, Reglan)
These medications can help reduce inflammation and relieve pain caused by the cancer or fluid buildup caused by treatment:
- Dexamethason (Cortastat, Dalalone, Decadrol, Decadron, Decaject, Dexacorten, Dexamethasone Intensol, Dexasone, Dexone, Hexadrol, Mymethasone, Primethasone, Solurex)
- Prednisone (Cordrol, Deltasone, Liquid Pred, Meticorten, Orasone, Prednicot, Prenisone Intensol, PRed-Pak, Sterapred)
The following medications act on the central nervous system to relieve pain and must be used under close supervision by a doctor due to the risk of mental or physical addiction:
- Hydrocodone (Dilaudid, Hydrostat)
- Methadone (Astramorph PF, Duramorph, Dadian, MS Contin, OMS Concentrate, Oramorph SR, Rescudose, RMS Uniserts, Roxanol)
- Oxycodone and acetaminophen (Percocet)
Blood Stem Cell Support Drugs
During cancer treatment, some of your body’s blood cells may be destroyed along with the cancer cells. So, the following drugs are used to help produce new red or white blood cells, reducing your risk of infection or anemia:
- Filgrastim (Neupogen)
- Epoetin (Epogen, Procrit)
Over-the-Counter Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
These non-prescription medications may be recommended by your doctor to help relieve pain or inflammation caused by your cancer or treatment:
- Ibuprofen (Advil, Bayer Select Ibuprofen, Dolgesic, Excedrin IB, Genpril, Haltran, Ibifon, Ibren, Ibu, Ibuprin, Ibuprohm, Medipren, Midol IB, Motrin, Nuprin, Q-Profen, Rufen, Trendar)
- Naproxen (Aleve, Anaprox, Naprelan, Naprosyn)