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Colorectal cancer

Treatment options for colorectal cancer

Our colorectal cancer program offers surgery, chemotherapy, immunotherapy and a number of other treatment options. Which would be appropriate for you depends on several factors, including the stage and extent of your disease. Your multidisciplinary team of colorectal cancer experts will answer your questions and recommend treatment options based on your unique diagnosis and needs. Common treatments for colorectal cancer include:

Surgery

Surgery is the most common colorectal cancer treatment. Surgery for colorectal cancer may involve removing tumors, removing the affected section of the colon, reattaching healthy ends of the intestines and removing nearby lymph nodes. In rare cases, the entire colon may need to be removed. Patients may receive chemotherapy and/or radiation therapy before and/or after surgery for colorectal cancer. These adjuvant therapies are intended to target cancer cells that may remain after surgery and may help shrink tumors before they are surgically removed.

Learn more about surgery for colorectal cancer

Immunotherapy

Drugs known as checkpoint inhibitors may be used to treat advanced colorectal cancer that have specific genomic features. The U.S. Food and Drug Administration (FDA) has approved certain checkpoint inhibitors to treat patients with inoperable metastatic tumors with microsatellite instability-high (MSI-H) or mismatch repair deficiency (dMMR) genetic features, regardless of where the tumor is located. MSI-H is often found in colorectal tumors, especially in patients with Lynch syndrome, a genetic condition that elevates the risk of colorectal cancer.

Checkpoint inhibitors work by blocking specific checkpoint receptors, which are immune cells that distinguish good cells from bad ones. Immunotherapy is not recommended for all patients, and responses to the treatment vary. Immunotherapy may also be used in combination with other treatments, such as surgery or chemotherapy.

Chemotherapy

Chemotherapy drugs are designed to destroy cancer cells or impede their ability to grow and reproduce. Chemotherapy may not be necessary for patients with stage I or stage II colorectal cancer, but it is a common treatment option for patients with stage III or stage IV disease. Chemotherapy for colorectal cancer may be given intravenously or in pill form.

Neoadjuvant chemotherapy is given prior to colorectal cancer surgery. An oncologist may recommend a combination of chemotherapy and radiation therapy to help reduce the size of a tumor before surgery. This treatment is more common for rectal cancer.

Adjuvant chemotherapy is given after surgery. This treatment may help destroy colorectal cancer cells that remain after cancer removal surgeries and may help lower the risk of recurrent cancer. Adjuvant chemotherapy may help prevent colorectal cancer from spreading to other parts of the body.

Radiation therapy

Radiation therapy may be an option for colorectal cancer treatment for a number of reasons, including:

  • Radiation therapy delivered before surgery may help shrink tumors so they are easier to remove.
  • Radiation therapy given after surgery may help kill cancer cells that have been left behind.
  • The treatment may be an option for patients who are unable to undergo surgery.
  • Radiation therapy may be used as a palliative treatment, to help shrink tumors that may be causing a blockage in the colon or intestines.
  • Radiation therapy may be given in conjunction with chemotherapy.

Targeted therapy

Monoclonal antibody therapy is a type of targeted therapy used to treat colorectal cancer. Monoclonal antibodies are bio-engineered proteins that may help leverage the body’s natural immune response to recognize, attack and destroy colorectal cancer cells. Monoclonal antibodies may be used alone or in combination with other treatments, such as chemotherapy.