The choice of treatment depends mainly on the location of the tumor, whether it is in the colon or rectum, and the stage of colorectal cancer.
Cancer treatment is either local therapy or systemic therapy:
- Local therapy: Surgery and radiation therapy are local therapies. They remove or destroy cancer in or near the colon or rectum. When colorectal cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
- Systemic therapy: Chemotherapy and biological therapy are systemic therapies. The drugs enter the bloodstream and destroy or control cancer throughout the body.
Colon cancer sometimes is treated differently from rectal cancer. Treatment for colon and rectal cancer may involve one or a combination of the following:
An oncologist will walk you through your treatment choices and the expected results. The colorectal cancer specialists at Affiliated Oncologists work with you to develop a personalized treatment plan that meets your needs.Find a Cancer Specialist
Radiation Therapy for Colorectal Cancer
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. It affects cancer cells only in the treated area.
Doctors use different types of radiation therapy to treat cancer. Sometimes people receive two types:
- External radiation: The radiation comes from a machine. The most common type of machine used for radiation therapy is called a linear accelerator. Most patients go to the hospital or clinic for their treatment, generally 5 days a week for several weeks.
- Internal radiation (implant radiation or brachytherapy): This type of radiation therapy is more commonly used for patients with rectal cancer. The radiation comes from radioactive material placed in thin tubes put directly into or near the tumor. The patient stays in the hospital, and the implants generally remain in place for several days. Usually, they are removed before the patient goes home.
- Intraoperative radiation therapy (IORT): In some cases, radiation is given during surgery.
Chemotherapy for Colorectal Cancer Treatment
Chemotherapy uses anticancer drugs to kill cancer cells. Anticancer drugs are usually given through a vein, but some may be given by mouth. You may be treated in an outpatient part of the hospital, at the doctor’s office, or at home. Rarely, a hospital stay may be needed.
The primary chemotherapy regimen for treating colon and rectal cancers is FolFox, a well-established treatment that has proven effective for many patients. It may be used before surgery to shrink the cancer or after surgery to help kill any remaining cancer cells.
Your oncologist will recommend the treatment you’re most likely to respond to based on genetic test results, pathology reports, and overall health. You may also receive chemotherapy in combination with other treatments.
Surgery is often included in the colorectal cancer treatment plan when found in stages 1 or 2. Later stages of colorectal cancer may be treated in other ways without the use of surgery.
- Colonoscopy: A small malignant polyp may be removed from your colon or upper rectum with a colonoscope. Some small tumors in the lower rectum can be removed through your anus without a colonoscope.
- Laparoscopy: Early colon cancer may be removed with the aid of a thin, lighted tube (laparoscope). Three or four tiny cuts are made into your abdomen. The surgeon sees inside your abdomen with the laparoscope. The tumor and part of the healthy colon are removed. Nearby lymph nodes also may be removed. The surgeon checks the rest of your intestine and your liver to see if the cancer has spread.
- Open surgery: The surgeon makes a large cut into your abdomen to remove the tumor and part of the healthy colon or rectum. Some nearby lymph nodes are also removed. The surgeon checks the rest of your intestine and your liver to see if the cancer has spread.
When a section of your colon or rectum is removed, the surgeon can usually reconnect the healthy parts. However, sometimes reconnection is not possible. In this case, the surgeon creates a new path for waste to leave your body. The surgeon makes an opening (stoma) in the wall of the abdomen, connects the upper end of the intestine to the stoma, and closes the other end. The operation to create the stoma is called a colostomy. A flat bag fits over the stoma to collect waste, and a special adhesive holds it in place.
For most people, the stoma is temporary. It is needed only until the colon or rectum heals from surgery. After healing takes place, the surgeon reconnects the parts of the intestine and closes the stoma. Some people, especially those with a tumor in the lower rectum, need a permanent stoma.
Immunotherapy for Colorectal Cancers
Immunotherapy, or biological therapy, uses the immune system to fight cancer. This method of treatment uses materials made by the body or laboratory to simulate a natural substance.
Some people with colorectal cancer that has spread receive a monoclonal antibody, a type of biological therapy. The monoclonal antibodies bind to colorectal cancer cells. They interfere with cancer cell growth and the spread of cancer. People receive monoclonal antibodies through a vein at the doctor’s office, hospital, or clinic. Some people receive chemotherapy at the same time.
A newer cancer treatment drug, immune checkpoint inhibitors, blocks proteins called checkpoints that are made by some types of immune system cells, such as T cells, and some cancer cells. Checkpoints keep the immune system from responding and can often keep T cells from killing cancer cells. Using the inhibitor blocks the proteins to reinforce the body’s ability to fight the cancer cells.
Targeted Therapy for Colorectal Cancer
Targeted therapy for colorectal cancer treatment can be used for recurrent or stage 4 colorectal cancer. This type of treatment focuses on specific genetic mutations, proteins, or the tissue that contributes to the tumor's growth and stops them while allowing healthy cells to continue growing with very little impact.
Testing is recommended for colorectal cancer patients to find the most effective targeted therapy. These tests can identify your tumor's genes, proteins, and other factors that may be contributing to the cancer's growth. One of the following types of targeted therapy may be included in your cancer treatment based on results from testing.
- Anti-angiogenesis therapy. These unique cancer-fighting agents, called angiogenesis inhibitors, block the growth of blood vessels that support tumor growth rather than the growth of tumor cells. Some are monoclonal antibodies that specifically recognize and bind to VEGF (vascular endothelial growth factor), a substance made by cells that stimulate new blood vessel formation. In some cancers, angiogenesis inhibitors appear to be most effective when combined with additional therapies. Because angiogenesis inhibitors work by slowing or stopping tumor growth without killing cancer cells, they are given over a long period.
- Epidermal growth factor reception (EGFR) inhibitors. EGFR is a protein that helps cancer cells grow. Cancerous cells tend to have a lot of this protein on them. By slowing the growth of the protein, the colorectal cancer cells are slower to reproduce.
Clinical Trials Available in South Chicago for Colorectal Cancer
The cancer centers at Affiliated Oncologists proudly participate in clinical research to help identify better treatment options for cancer patients, including colorectal cancer patients. Your colorectal cancer doctor can discuss possible clinical trials available through our clinics.
Find Colon and Rectal Cancer Treatment Near You
The comprehensive approach offered by our colorectal cancer team at Affiliated Oncologists combines the most advanced treatments with education and support services. If you have been newly diagnosed with colorectal cancer, our oncologists specialize in cancer care and are ready to talk to you about your diagnosis and treatment options. Our cancer centers are located throughout South Chicago, including Chicago Ridge, Mokena, Hazel Crest, Palos Heights, and Oak Lawn.