Treatment for cancers in both the colon and the rectum are different, and the type of treatment received depends on a number of factors including:
- the size and position of the cancer
- whether or not it has spread to other parts of the body
- age and general health
- any personal requirements or concerns
The purpose of surgery for cancer is to remove all or part of the cancerous tumour and neighbouring tissue that may have been invaded by the cancer. Surgery is carried out when it is thought that there is a reasonable chance of removing all the cancer. Sometimes the surgeon cannot tell whether this is possible before the operation.
Very small and early bowel cancer can sometimes be removed during a colonoscopy. However, in most cases surgery is required to remove a section of the bowel.
When a surgical procedure is performed, usually a section of the bowel is removed along with nearby lymph glands. In the vast majority of cases, the bowel can be joined together, and there is no requirement for an artificial opening (stoma) where the faeces, or bowel motion, comes away from the body into a bag or appliance, rather than from the anus as usual.
In some instances, a temporary artificial opening may be necessary, but sometimes it may need to be permanent. If such a stoma is necessary, then a modern reliable appliance is worn which ensures an excellent quality of life for those who required them. Highly qualified nursing staff (stomal therapists) teach and supervise the management of stoma appliances.
While the main treatment for bowel cancer is surgery, chemotherapy and radiotherapy are also used to treat and manage the disease.
Chemotherapy is the treatment of cancer using anti-cancer (or cytotoxic) drugs to kill cancer cells. Because anti-cancer drugs enter the bloodstream and circulate throughout the body, they can kill cancer cells that may have spread to distant parts of the body.
Chemotherapy can be used before or after surgery, and is usually given intravenously (into a vein), or sometimes as tablets. Chemotherapy may be used to use increase the chance of cure, or to shrink the size of the cancer if cure is not possible. When a cancer cannot be cured, chemotherapy can improve survival, reduce symptoms and improve quality of life.
Radiotherapy treats cancer by using radiation (high-energy x-ray or gamma rays) to destroy cancer cells. Treatment is carefully planned to do as little damage or harm as possible to healthy tissue around the cancer. Radiotherapy may be used in addition to surgery to treat rectal cancer; however it is uncommonly used to treat colon cancer.
Radiotherapy can be used before or after surgery, and is often used in conjunction with chemotherapy, but not always. If a tumour is very large or close to vital organs, radiotherapy may be used to shrink the tumour before surgery. Radiotherapy may shrink tumours before surgery and reduce the risk of the cancer returning.
Treatment and ongoing care for bowel cancer involves a number of different doctors, specialists and health professionals. It is important to be treated by specialists that have appropriate training in the management of bowel cancer. Your GP will refer you to these specialists and help coordinate your care.
At Cabrini, our team of bowel specialists hold regular multidisciplinary clinics where they may choose to discuss your case with other medical specialists, ensuring the best possible care and treatment plan.
Remember, every person and every case of bowel cancer is different, so the right treatment plan will differ from person to person. Your GP and bowel cancer specialist will discuss these treatment options with you and determine what is right for you.
Clinical research and trials
Researchers are constantly developing new cancer treatments.
These treatments need to be compared with established cancer treatments to see which is more effective. To do this, doctors need to carry out a clinical trial. This means that a group of patients is selected to receive a new treatment program, while another group receives the currently established treatment. The results of each treatment are then compared.
Clinical trials are only carried out after tests have shown that the new treatment is likely to be beneficial and that there are no serious side effects. Patients enter a clinical trial only if they agree to do so after being fully informed of all the procedures.
Clinical trials are the only scientific way to prove the effectiveness of proposed cancer treatment.